Communicable Diseases: HIV and AIDS

EPIDEMIOLOGY:

HIV/AIDS
Ralph Julius Bawalan

AT A GLANCE
HIV stands for Human Immunodeficiency Virus. It is a retrovirus that causes HIV infection. Its
entrance into the body lowers the immunity (body defense system) or the ability to fight off
disease.

HIV Infection is the successful entry of HIV in the human host, weakening the immune system and
leading to a spectrum of diseases.

AIDS stands for Acquired Immune Deficiency Syndrome. It is a condition characterized by a
combination of signs and symptoms, caused by HIV contracted from another which attacks and
weakens the body’s immune system, making the afflicted individual susceptible to other life
threatening infection.

• The 2010 UNAIDS Report on the Global AIDS Epidemic, reported fewer people are
becoming infected with HIV and fewer people are dying from AIDS globally. However,
seven countries, including the Philippines and Bangladesh, reported that between 2001
and 2009 incidence of new HIV infections has increased by more than 25%.

2010 Global Epidemic Report, UNAIDS

THE PHILIPPINE AIDS SITUATION
• To date, an average of five (5) new HIV cases per day or one (1) in every fi ve (5) hours
are reported in the country, a sharp rise from two (2) cases reported per day at the end of
2009 and one (1) reported case per day in 2007.
• While the national HIV prevalence remains below one (1) percent of the adult
population, HIV prevalence among the most-at-risk populations (MARPs) shows a
pronounced upsurge from 0.08 percent in 2007 to 0.47 percent in 2009.

THE PHILIPPINE SITUATION
• The country and regional consultations that kicked off the commitment to universal
access and identified a number of barriers to expanding HIV programming, which can be
categorized under four broad areas:
• 1. inadequate financing for scaled up AIDS responses (including macro-economic
constraints);
• 2. weak human resource capacity, and health, social, and education systems;
• 3. lack of affordable commodities and low-cost technologies; and,
• 4. human rights, stigma, discrimination, and gender inequality and marginalization of
key populations at higher risk.

COMMON STI

Philippine HIV and AIDS Scenario, 2010

HIV/AIDS IN THE PHILIPPINES
• Several factors put the Philippines in danger of a broader HIV/AIDS epidemic. They include
increasing population mobility within and outside of the Philippine islands; a conservative
culture, adverse to publicly discussing issues of a sexual nature; rising levels of sex work,
casual sex, unsafe sex, and injecting drug use.
• There is also high STI prevalence and poor health-seeking behaviors among at-risk groups;
gender inequality; weak integration of HIV/AIDS responses in local government activities;
shortcomings in prevention campaigns; inadequate social and behavioral research and
monitoring; and the persistence of stigma and discrimination, which results in the relative
invisibility of PLWHA. Lack of knowledge about HIV among the Filipino population is
troubling. Approximately two-thirds of young women lack comprehensive knowledge on HIV
transmission, and 90 percent of the population of reproductive age believe you can contract
HIV by sharing a meal with someone.
• The Philippines has high tuberculosis (TB) incidence, with 131 new cases per 100,000
people in 2005, according to the World Health Organization. HIV infects 0.1 percent of adults
with TB. Although HIV-TB co-infection is low, the high incidence of TB indicates that co-
infections could complicate treatment and care for both diseases in the future.

HUMAN IMMUNODEFICIENCY VIRUS (HIV)
• The result of HIV infection is relentless destruction of the immune system.
• All HIV infected persons are at risk for illness and death from opportunistic infectious and
neoplastic complications as a result of the inevitable manifestations of AIDS
• Retroviruses are unable to replicate outside of living host cells because they contain only
RNA and and do not contain DNA.
• The variant of HIV that is the cause for almost all infections is known as HIV-1.
• A second HIV designated HIV-2 has been isolated. Most cases have appeared in West
Africa. The genetic sequences of HIV-1 and HIV-2 are only partially homologous.
• HIV-2 infection has a longer latent period before the appearance of AIDS, a less
aggressive course of AIDS, and a lower viral load with higher CD4 lymphocyte counts
than HIV-1 infection until late in the course of the disease when clinical AIDS is apparent

HOW DOES HIV ATTACK THE IMMUNE SYSTEM?
• The human body is protected by the White Blood Cells in the immune system.
• White Blood Cells in the immune system fight disease and germs for your body.
• Strong diseases make the body sick, but the white blood cells usually win in the end.
• HIV is a VERY strong germ that attacks the White Blood Cells themselves, weakening the
body's defenses against diseases and makes the body vulnerable to potentially life-
threatening infections and cancers. HIV then uses human cells to manufacture more of
the virus, eventually killing the host & nearby cells and overwhelms the immune system.
• After a very long struggle lasting years, HIV kills most of the immune system's White
Blood Cells, leaving the body unprotected.
• Many other (secondary) diseases attack (bringing about the condition of AIDS) and
eventually kill the body.

HIV IS TRANSMITTED BY:

• having unprotected sexual intercourse (vaginal, anal or oral), with someone who is HIV
positive. Unprotected, penetrative sex accounts for 80% of total exposures to the disease
worldwide;
• having a transfusion with infected blood;
• sharing syringes and needles with someone who is HIV positive for drugs and tattoos or
other skin
piercing tools such as razor blades and surgical instruments forcircumcision or
scarification.
• mothers to their unborn babies and through breastfeeding.

HIV IS TRANSMITTED THROUGH THE
FOLLOWING BODY FLUIDS:
• Blood
• Semen
• Vaginal/Cervical Fluids
• Breastmilk

HIV IS NOT TRANSMITTED THROUGH:
• Kissing
• Casual contacts or handshakes
• Sharing living quarters, eating or drinking with an infected person
• Mosquitoes and bed bugs.

STAGES OF THE HIV DISEASE
• Stage I: PRIMARY INFECTION
• The patient starts experiencing “flu-like” symptoms
• Stage II: ASYMPTOMATIC ILLNESS
• The patient may remain well for years
• Stage III: SYMPTOMATIC ILLNESS
• The patient experiences “mild” symptoms such as lack of energy, nights sweats, etc
• Some persons with clinical stage 3 have AIDS.
• Stage IV: ADVANCED DISEASES (AIDS)
• The patient experiences opportunistic infections from bacterial, mycobacterial, fungal, protozoal, viral
and malignant sources that can cause any of the following:
• Swollen glands
• Mouth infections
• Brain infections
• Skin diseases
• Lung diseases
• Loss of weight
• All persons with clinical stage 4 have AIDS.

• Exposure
• Seroconversion refers to the development of antibodies to HIV and usually takes place
between 1 and 6 weeks after HIV infection has happened.
• Whether or not HIV infection causes initial symptoms, an HIV-infected person is highly
infectious during this initial period and can transmit the virus to another person. The only
way to determine whether HIV is present in a person's body is by testing for HIV
antibodies or for HIV itself.
• Asymptomatic Stage
• AIDS
• Death

IMMUNOLOGICAL STAGING OF HIV INFECTION

WHEN DOES A PERSON HAVE AIDS?
• The term AIDS applies to the most advanced stages of HIV infection, defined by the
occurrence of any of more than 20 opportunistic infections or HIV-related cancers. In
addition, the CDC defines AIDS on the basis of a CD4 positive T cell count of less than
200 per mm3 of blood.

HIV DETECTION AND TESTING
• HIV can be detected through the following tests:
• Antibody test - an indirect test measures the response of one’s body to the presence of
HIV
• Antigen test - a test that directly measures the virus
• HIV Testing is voluntary, confidential and anonymous, with pre and post-test counseling.
The window period for testing is 6 months from the last exposure with HIV.
• The results of the HIV test must be kept absolutely confidential.
• There is NO vaccine and NO cure for HIV. Anti-retroviral medication (ARVs) may only
slow down the replication of the virus.

WHY TAKE HIV TEST?
• Firstly, if you are HIV positive, you can take necessary steps before symptoms appear to
access treatment, care and support services, thereby potentially prolonging your life for
many years.
• Secondly, if you know you are infected, you can take all the necessary precautions to
prevent the spread of HIV to others.
• Thirdly, your health care provider may recommend it, for example if you are pregnant and
want to protect your unborn child. It may also be recommended by your health care
provider if you are unwell, in order to obtain a more accurate medical assessment.

WHAT IF NEGATIVE RESULT?
• A negative test result means that no HIV antibodies were found in your blood at the time
of testing. If you are negative, make sure you stay that way.

• SAFER SEX
• A – Abstinence
• B – Be faithful
• C – Condom
• D – Do not Inject Drugs
• E - Education

HOW QUICKLY DO PEOPLE INFECTED WITH HIV
DEVELOP AIDS?
• The length of time can vary widely between individuals. The majority of people infected
with HIV, if not treated, develop signs of HIV-related illness within 5-10 years, but the time
between infection with HIV and being diagnosed with AIDS can be 10–15 years.
• Antiretroviral therapy can slow down disease progression to AIDS by decreasing the
infected person’s viral load.

IS IT EVER COMPLETELY SAFE TO HAVE SEX
WITH A HIV-POSITIVE PERSON?
• No, there is always a risk of transmission when having sex with a HIV-positive person.
The risk can be significantly reduced if condoms are properly used every time one has
sex.

ANALYSIS / CLINICAL
• How does HIV treatment – or antiretroviral (ARV) therapy - work in
someone who is HIV positive?
• HIV is a virus that infects cells of the human immune system and destroys or impairs
their function. Infection with this virus results in the progressive deterioration of the
immune system, leading to 'immune deficiency'. Our immune systems are essential
to protect us from developing infections and cancers.
• Combination ARV therapy prevents the HIV virus from multiplying inside a person. If
this growth stops, then the body's immune cells - most notably the CD4 cells - are
able to live longer and provide the body protection from infections.
• The term 'Highly Active Anti-Retroviral Therapy' (HAART) is another term used
to describe a combination of three or more anti-HIV drugs.

CURRENT STATUS OF ARV TREATMENT
• More than 4 million people in low- and middle-income countries were receiving HIV
antiretroviral therapy at the close of 2008.
• Until 2003, the high cost of the medicines, weak or inadequate health care infrastructure
and lack of financing in low- and middle-income countries were problems posted.
• However, enormous progress has been made and the increased political and economic
commitment, stimulated by people living with HIV, civil society and other partners, has
allowed dramatic expansion of access to HIV therapy

EPIDEMIOLOGY: HIV/AIDS
• Demographic
• Economic
• Behavioral/ social
• Modal age
• Racial disposition
• Sex differences
• Health system issues
• Costs
• Trends in case fertility
• Case management / early detection
• Surveillance / Reporting

PREVALENCE
• Officially, the Philippines is a low-HIV-prevalence country, with less than 0.1 percent of the
adult population estimated to be HIV-positive. As of September 2008, the Department of
Health (DOH) AIDS Registry in the Philippines reported 3,456 people living with HIV/AIDS
(PLWHA)- www.plwha.org . UNAIDS estimates that 12,000 Filipinos were HIV-positive by
the end of 2005.

EPIDEMIOLOGY: DEMOGRAPHIC
• Almost two-thirds (63 percent) of HIV seropositive cases were males and ninety percent
were in the 20-49 age group.
• Two percent were less than 10 years old. Majority (85.0%) acquired HIV through sexual
contact, with heterosexual contact being the most common mode of transmission. Two
percent acquired HIV from their mothers.
• Median ages for all the risk groups were in the twenty’s with male respondents (clients of
female sex workers, deep-sea fishermen and the injecting drug users) being older than
the female respondents;
• Most of the respondents were single, except for clients of female sex workers (CFSW)
and deep-sea fishermen (DSF), who were mostly married; · most of the female sex
workers were high school graduates or have reached high school level; MSMs and CFSW
were college graduates; while fifty nine percent of the DSF were elementary graduates.

(2004 STI/HIV/AIDS Surveillance Technical Report)

REGISTERED VS ESTIMATED CASES


NEW CASES PER MONTH

Philippine HIV/AIDS Registry (DOH-NEC Dec 2011)

DECEMBER 2011 RESULTS
• Most of the cases (94%)
were males.
• The median age was 27
years (age range:16-59
years).
• The 20-29 year (62%)
age-group had the most
number of cases.
• Forty-eight percent (128)
of the reported cases
were from the National
Capital Region (NCR).


DECEMBER 2011 RESULTS
• Reported mode of transmission were sexual
contact (238) and needle sharing among
injecting drug users (30).
• Males having sex with other Males (86%)
were the predominant type of sexual
transmission

• From 1984 to 2011, there were 960 AIDS
cases reported, 73% (700) were males.
Median age was 35 years (range 1-72
years). Of the reported AIDS cases, there
were 341 (36%) deaths.
• Sexual contact was the most common mode
of HIV transmission, accounting for 93%
(896) of all AIDS cases.


NUMBER HIV/AIDS CASES


SEX DIFFERENCES AND AGE GROUP


OCW
• There were 640 (32.0%) HIV Ab seropositive OFWs, of which 38 percent were seamen.
• While reports indicate an increasing number of HIV infection among OFWs over the
years, the data on the proportion of infected OFWs over the total number of cases must
be treated with caution, since this sector is the most commonly tested and therefore
reported, in compliance with the requirement of the OFWs’ host country

(2004 STI/HIV/AIDS Surveillance Technical Report)

NUMBER OF SEXUAL PARTNERS
• The number of sex partners of female sex workers varies from one to 80 per week based
on the BSS conducted from 1997-2003. However, the median was two per week for
RFSW and four per week for FLSW.
• Some MSM reported as many as 55 sex partners per month but the norm was two per
month.
• While almost all men and women have heard about AIDS, only about half know the two
major methods for preventing transmission of HIV (using condoms and limiting sex to one
uninfected partner).

2003 Behavioral Sentinel Surveillance

VISION

HIV/AIDS:
Greater access to holistic response

ECONOMIC: NATIONAL RESPONSE
• the Philippines was quick to recognize its own sociocultural risks and vulnerabilities to HIV/AIDS. Early
responses included the 1992 creation of the Philippine National AIDS Council (PNAC), the country’s highest
HIV/AIDS policymaking body. Members of the Council represent 17 governmental agencies, including local
governments and the two houses of the legislature; seven nongovernmental organizations (NGOs); and an
association of PLWHA.
• The passing of the Philippine AIDS Prevention and Control Act in 1998 was also a landmark in the country’s
fight against HIV/AIDS.
• The PNAC developed the Philippines’ AIDS Medium Term Plan: 2005–2010 (AMTP IV). The AMTP IV serves
as a national road map toward universal access to prevention, treatment, care, and support, outlining
country-specific targets, opportunities, and obstacles along the way, as well as culturally appropriate
strategies to address them. In 2006, the country established a national monitoring and evaluation
system, which was tested in nine sites and is being expanded. Antiretroviral treatment is available free of
charge, but only 10 percent of HIV-infected women and men were receiving it as of 2006, according to
UNAIDS.
• The Government of the Philippines participates in international responses to the HIV/AIDS epidemic. Most
recently, in January 2007, the Philippines hosted the 12th Association of Southeast Asian Nations
Summit, which had a special session on HIV/AIDS.
• The Philippines is a recipient of three grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria
(2004 third round, 2006 fifth round, and 2007 sixth round) to scale up the national response to HIV/AIDS
through the delivery of services and information to at-risk populations and PLWHA.

PHILIPPINE HIV & AIDS REGISTRY
• The Philippine HIV & AIDS Registry is the official record of the total number of laboratory -
confirmed HIV positive individuals, AIDS cases and deaths, and HIV positive blood units
in the Philippines.
• All individuals in the registry are confirmed by the STD/AIDS Cooperative Central
Laboratory (SACCL) at San Lazaro Hospital. While all blood units are confirmed by the
Research Institute for Tropical Medicine (RITM).
• The Registry is a passive surveillance system. Except for HIV confirmation by the NRL, all
other data submitted to the Registry are secondary and cannot be verified (eg individual’s
reported place of residence).

ECONOMIC: TREATMENT, CARE AND SUPPORT
• Treatment, care and support (TCS) are also geographically inaccessible as these services
are available only in DOH medical centers (SLH, RITM and other government-retained
hospitals) and the Philippine General Hospital (PGH). The travel time and the additional
transportation costs make it difficult for a number of PLWHAs to access them.
• The quality of laboratory services in some facilities is also deteriorating due to old
equipment, fast turnover of personnel and limited reagents and other supplies.
• Majority of the complaints about insensitive and discriminatory care of PLWHAs were
directed at health service providers themselves.
• Community support systems have been initiated by NGOs and the DSWD, but limited
resources (e.g., trained social workers, limited funds for training and monitoring) impinge
on their capacity to strengthen and expand. There is also no care and support program
focusing on children.
• There is also no assurance that these protocols are adhered to, due to lack of
monitoring.

ECONOMIC: 5TH AIDS MEDIUM TERM PLAN 2011 –
2016 (5TH AMTP)
• The Fifth AIDS Medium Term Plan 2011 – 2016 (5th AMTP) presents strategies and
activities to accelerate the implementation of the national response to avert new infections
and provide treatment, care and support services to those who are already infected.
• With adequate financing and firm political will from its leaders, the Philippines would be
able achieve the expected outcomes of the 5th AMTP which are:
• 1. Persons at risk for, vulnerable to, and living with HIV avoid risky behaviors to
prevent HIV infection
• 2. People living with HIV live longer, more productive lives
• 3. The Country AIDS response is well governed and accountable

BEHAVIOR: CONDOM USE
• In 2010, then Philippine Health Secretary Esperanza Cabral said the Philippine
government had stopped allocating funds for condoms due to church pressure, a move
that Secretary Cabral opposed. Catholic bishops helped build opposition in Congress to
block a reproductive health bill that they said promoted sex education and artificial
contraceptives.

HOW EFFECTIVE ARE CONDOMS IN
PREVENTING HIV?
• Quality-assured male and female condoms are the only
products currently available to protect against STIs,
including HIV.
• However, apart from abstinence, no protective method
is 100% effective, and condom use cannot guarantee
absolute protection against any STI.
• The female condom is only female-controlled
contraceptive barrier method currently on the market.
The female condom is a strong, soft, transparent
polyurethane sheath inserted in the vagina before
sexual intercourse. It entirely lines the vagina and
provides protection against both pregnancy and STIs
including HIV, when used correctly at each act of
intercourse.

2007 EXTERNAL ASSESSMENT OF THE 100%
CONDOM USE PROGRAMME IN SELECTED SITES
IN THE PHILIPPINES (FOUR PILOT SITES + ONE)
• The 100% Condom Use Program in the Philippines was introduced in the late 90’s by the
Department of Health in partnership with the Program for Appropriate Technology in
Health (PATH) as part of the AIDS Surveillance and Education Project (ASEP) of USAID.
• In 2003, 100% CUP was introduced in four sites in Northern Luzon: the cities of
Urdaneta, Dagupan, San Fernando and Laoag with support from WHO Regional and
Country Offices. Prior to expansion of the programme to other sites in the Philippines, an
assessment of the programme was done, which included all the above-mentioned four
sites and one ASEP site (Angeles City).
• Angeles City as an ASEP site was included because of the experiences gained from a site
that has been implementing the program for a longer time and thus, enabling the
measurement of outcomes and
impact.

BEHAVIOR: DOES MALE CIRCUMCISION
PREVENT HIV TRANSMISSION?
• Recent studies suggest that male circumcision can reduce the risk of acquiring HIV
though sex. However, it is not 100% effective and circumcised men can still become
infected. In addition, HIV-positive men who are circumcised can infect their sexual
partners. Male circumcision should not replace other known methods of prevention, but be
always considered as part of a comprehensive of prevention strategy.

BEHAVIOR: MORAL RESPONSE
• The CBCP has continually encouraged a moral response. It said in In the Compassion of
Jesus, A Pastoral Letter on AIDS:
• The “safe-sex” proposal would be tantamount to condoning promiscuity and sexual
permissiveness and to fostering indifference to the moral demand as long as
negative social and pathological consequences can be avoided. We cannot
emphasize enough the necessity of holding on to our moral beliefs regarding
love and human sexuality and faithfully putting them into practice. All these, in
order to prevent the spread of the disease and to provide the foundations for
effective and compassionate pastoral care for those afflicted. Among these moral
beliefs is the beauty, mystery and sacredness of God’s gift of human love. It reflects
the very love of God, faithful, and life-giving. This marvelous gift is also a
tremendous responsibility. For sexual love must be faithful, not promiscuous. It
must be committed, open to life, life-long and not casual. This is why the full sexual
expression of human love is reserved to husband and wife within marriage.
Monogamous fidelity and chastity within marriage–these are ethical demands,
flowing from human love as gift and responsibility for the married.

BEHAVIOR: PREVENTION SERVICES
• For MSM, Female Sex Workers and Clients of FSWs
• However, efforts like condom use promotion, harm reduction and provision of social
hygiene services, which are aimed directly at preventing transmission of the virus among
High Risk Groups have produced unclear results, implying inadequacies in both the
quantity and quality of interventions.
• Services from most social hygiene clinics (SHCs) are lacking in quality due to lack of
adequately trained personnel and insufficient logistics like reagents. Also, the location and
layout of many SHCs negate stigma reduction and discourage health-seeking behavior.

HEALTH SYSTEMS ISSUE: HOW CAN MOTHER-
TO-CHILD TRANSMISSION BE PREVENTED?
• Transmission of HIV from an infected mother to her child can occur during
pregnancy, during labour or after delivery through breastfeeding. The risk of mother-to-
child transmission can be reduced by the following:
• 􀂃
Treatment with antiretroviral drugs
• 􀂃
Caesarian section
• 􀂃
Avoiding breastfeeding, but only when replacement feeding is
acceptable, feasible, affordable, sustainable and safe. If not, exclusive breastfeeding
is recommended for the first 6 months.

HEALTH SYSTEMS: WHAT IS PEP?
• Antiretroviral drugs can be prescribed within 72 hours of exposure to potentially
HIVinfected blood or body fluids to prevent HIV sero conversion. This is called “post4
exposure prophylaxis for HIV infection” (HIV-PEP). However HIV-PEP is not 100%
effective, even when started very shortly after exposure, so it is vitally important to try to
take every measure to prevent transmission of HIV in the first place.

HEALTH SYSTEMS: HOW CAN HEALTH-CARE
WORKERS HELP TO PREVENT TRANSMISSION IN
HEALTH-CARE SETTINGS?
• Health-care workers should follow Universal Precautions which are infection-control
guidelines developed to protect health workers and their patients from exposure to
diseases spread by blood and certain body fluids.
• Careful handling and disposal of 'sharps' (items that could cause cuts or puncture
wounds, including needles, hypodermic needles, scalpel and other blades, knives,
infusion sets, saws, broken glass, and nails)
• Hand-washing with soap and water before and after all procedures;
• Use of protective barriers such as gloves, gowns, aprons, masks and goggles when
in direct contact with blood and other body fluids;
• Safe disposal of waste contaminated with blood or body fluids;
• Disinfection of instruments and other contaminated equipment; and
• Proper handling of bedding and clothing stained with blood, diarrhoea or other body
fluids.

MDGOAL 6
• Combat HIV/AIDS, malaria, and other diseases
• Target 9: Halt and reverse the spread of HIV/AIDS by 2015
• Between 1984 and 1992, the reported annual number of confirmed cases
remained below 100. However, in the last seven years, 1993-99, the number of
cases per year had exceeded 100, but remained below 200.
• While the number of confirmed cases of HIV/AIDS is low and the rate of
increase in the number of cases is slow, the potentials for a full-blown epidemic
continue to exist.

HEALTH ISSUE: BLOOD
UNITS SCREENED
• From January to December 2011, 927
blood units were screened reactive for
HIV and referred to RITM for
confirmation. All these HIV reactive blood
units (209) were immediately sent to
RITM and not transfused to anyone.


COSTS: RESOURCES
• Resources for HIV/AIDS in the Philippines were mobilized mainly from the following
sources:
• (1) the government’s annual budget allocation through the DOH,
• (2) local public financing and
• (3) external funding from multi-lateral and bilateral agencies.
(WHO, USAIDS, JICA, ILO, UNICEF, UNFPA)

COSTS: TOTAL AIDS SPENDING

National AIDS Spending Assessment, NEDA 2010

COSTS: HIV AND AIDS EXPENDITURE


COSTS: RESOURCES
• With the low performance in achieving Universal Access, the country needs to invest
considerably in prevention and control of HIV, as the estimated financing requirement for
2011 to 2016 is US$ 587.43 million.
• This amount covers human resource capacity building; making affordable commodities
and low cost technologies available and accessible; and outreach, education, referral and
treatment services to key affected populations.

COSTS: FINANCING REQUIREMENT (2011-2016)


COSTS: STD/HIV/AIDS TESTING & TREATMENT
• Agency: DOH / STD AIDS Cooperative Central Laboratory (SACCEL)
Open from: Monday to Friday 8:00am – 3:00pm
Address: Quiricada St. cor Rizal Ave., Sta Cruz, Manila
Tel No.: 732-37-76 to 78 loc. 429, 309-95-28
Services: Pre and Post Test Counseling, HIV/AIDS Testing, STI Testing
Confirmatory test
Consultation fee: P250.00

LIST OF ACCREDITED LABORATORIES FOR HIV
TESTING IN METRO MANILA
LOCATION ACCREDITED LABORATORY

LAS PIÑAS PERPETUAL

PHILIPPINE NATIONAL RED CROSS
OUR LADY OF
MANILA
OSPITAL NG MAYNILA
SAN LASARO HOSPITAL
HOSPITAL OF THE INFANT JESUS
THE FAMILY CLINIC AND HOSPITAL INS.
REMEDIOS AIDS FOUNDATION
POSITIVE ACTION FOUNDATION
ST. CLARE’S

MANDALUYONG THE POLYMEDIC GENERAL HOSPITAL, INC.

MUNTINGLUPA RESEARCH INSTITUTE FOR TROPICAL MEDICINE
MPI-MEDICAL CENTER MUNTINLUPA

PARAÑAQUE MEDICAL CENTER PARAÑAQUE

SOCIAL: INFORMATION EDUCATION AND
COMMUNICATION (IEC)
• Utilizing Behavior Change Communication (BCC) as an overarching framework, these
strategies employed one-on-one risk reduction counseling, community outreach and peer
education complemented with IEC materials, and mass media campaigns.
• Integration of HIV/AIDS into the elementary, secondary and vocational curricula is
continuously being pursued, with teaching modules being revised to be life-skills based.
• The tripartite partnership of the DOLE, employers and labor groups is an effective
strategy in the promotion and adoption of HIV/AIDS programs in the workplace
• Seminars among fisher folks, drivers, men and women in uniform and human resource
groups have also been done.
• Media, legislators, Parents-Teachers Associations and in-school youth were also provided
with STI/HIV/AIDS orientation.
• The current response has been adequate in programmatic scope, but
inadequate in terms of coverage.

SOCIAL: THE RED RIBBON
• The Red Ribbon Foundation was founded in 1993 in memory of Singer and
songwriter Paul Jabara, who conceived of and distributed the first Red Ribbon, and
who died of AIDS.

SOCIAL: BLOW THE WHISTLE
• Blow the RED WHISTLE and STOP the spread of HIV Infection..Be RED - Be Aware -
Be Warned and Blow the RED WHISTLE HARDER!!

• R: READ and EDUCATE - It is critical for everyone to become more educated with the
basic facts and fundalmentals about HIV transmissions and associated risk behaviors.
After 30 years of its first outbreak isn't it time to finally get it right? Be part of our
empowerment solution!

• E: ERADICATE - RED WHISTLE is a local organization that initiate to eradicate the
further progression and stigmas of HIV by resurrecting the level of HIV Awareness back
to the forefront of every media channel available. For more than a decade we have
downplayed the epidemic and missed the mark on a generation that are "At Risk" of
being plagued today.

• D: DEFEND and ADVOCATE - Before we can stop any epidemic, we first have to
recognize the magnitude of the disease. HIV is still a threat across the United States
and among our youth. Although there are treatments assisting them to live longer lives
than ever before, HIV is still a significant health issue and a real threat to our youths.
Surprised? Learn the facts and hear our voices.

SOCIAL: TRAINING
• Capability building efforts had been strengthened over the years as the necessity for
prevention efforts became increasingly felt
• For service providers that also include the HIV/AIDS Core Teams (HACTs), training on
comprehensive and syndromic STI management had been conducted.
• For the labor sector, there is Occupational Safety and Health Training (AIDS 101) for key
regional implementers that include DOLE and TUCP trainers.
• There were also efforts to promote HIV/AIDS prevention among specific occupational
groups considered exposed to higher levels of risks (e.g., tattoo artists and embalmers).
• Initial efforts targeting men and women in uniform were pioneered in 1999 and again in
2002, building the capacities on HIV/AIDS prevention among enlisted personnel in the
Armed Forces of the Philippines (AFP) and Philippine National Police (PNP).

REPUBLIC ACT 8504:
THE PHILIPPINE AIDS PREVENTION AND
CONTROL ACT OF 1998
• Article I: Education and Information - Section 6: HIV/AIDS Education in the Workplace

All government and private employees shall be provided with standardized basic information and instruction on HIV and AIDS. H IV / AIDS education
shall be integrated into orientation, training, continuing education, HR dev’t programs, etc

• In collaboration with the DOH, DOLE shall oversee the anti-HIV/AIDS campaign in all private companies.

• Article III: Testing, Screening and Counseling:

Section 16: Prohibition on Compulsory HIV Testing

Section 18: Anonymous HIV Testing

• Section 19: Accreditation of HIV Testing Centers

• Section 20: Pre-test and Post-test Counselling

• Article VI: Confidentiality

• Section 30: Medical Confidentiality
All health professionals, medical instructors, workers, employers, recruitment agencies, insurance companies, data encoders, and other custodians
of any medical records, file, data or test results to observe strict confidentiality particularly the identity and status of p ersons with HIV

Release of HIV/AIDS Test Results will only be allowed to the following parties:

• Section 34: Disclosure to Sexual Partners
Any person with HIV is obliged to disclose his/her HIV status and health condition to his/her spouse or
sexual partner at the earliest opportune time.

• Article VII: Discriminatory Acts and Policies - Section 35: Workplace Discrimination

SURVEILANCE / REPORTING
• Of the 268 HIV positive cases reported in December 2011, nine were classified as AIDS.
Seventy-one percent of the cases received information on HIV prevention, services
available for HIV cases, implications of an HIV positive result from screening and
confirmation. Their sources of information were one-on-one counseling, group
counseling, pre-departure orientation seminar (PDOS), pamphlets, videos, internet and
seminars.
• Philippine National AIDS Council
• Problem: For example, the establishment of an HIV/AIDS program in the workplace is not
enforced due to inadequate number of personnel in the DOLE.

SURVEILLANCE/ REPORTING
• The DOH shall be mainly responsible for providing technical assistance to LGUs in
establishing their surveillance systems, which the latter shall be responsible for operating
and maintaining.
• Surveillance data will follow the routine flow from the LGU and hospitals to the DOH -
Center for Health Development (CHD) and DOH-national level. The DOH shall be
responsible for disseminating reports to all concerned.
• In research, the Phil National AIDS Council shall review and update the research agenda
for the next six years which shall serve as a guide in the review and approval of research
studies to be undertaken.
• The local level stakeholders are encouraged to undertake their own researches on
concerns applicable to their area.

FURTHER READING
• 2010 Global Report on HIV.
• 2010 Philippine UNGASS Report
• AIDS Medium Term Plan. 4 th Operational Plan 2009 – 2010.
• Philippine HIV and AIDS Registry, December 2011. Department of Health -National
Epidemiology Center, p 3
• Health Sector Response to HIV/AIDS Prevention and Control The Philippines Country
Report 2008
• Costed AIDS Medium Term Plan 2011-2016 (AMTP5)
• National AIDS Spending Assessment (NASA), 2007-2009, NEDA p 8
• Universal Access to Treatment, care, and Support. Philippine Country Report
• Costing Guidelines for HIV/AIDS Intervention Strategies. Geneva: UNAIDS, 2004.

Communicable Diseases: HIV and AIDS

In this document