HVMADAMBA2018

PHILIPPINES NOW
•  MSM
•  IV drug use
•  gender-based violence
•  teenage pregnancy
•  single mothers
•  new cases of HIV
•  AIDS-related deaths
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Philippines is one of nine countries with

increasing prevalence >25%.
Others are Bangladesh, Guinea-Bissaue, Georgia, Indonesia, Kazakhstan, Kyrgyzstan, Republic of Moldova, and Sri Lanka.

UNAIDS 2016 Estimates

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HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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The age group with the biggest proportion

of cases has become younger!
15-24 year
age group

*25% in
2006-2010

*29% in
2011-2017
HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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HIV among Females

HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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Geographical Distribution

HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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Modes of Transmission

HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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Modes of Transmission

HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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Modes of Transmission

HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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HIV+ Pregnant Patients

HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau
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VSMMC HIV TREATMENT HUB

PLHIV alive on ART 1,395

male 1,116
female 279
PMTCT cases 74
Pedia cases 10
 HIV/AIDS Cases in Cebu City by Year
Cebu City HIV/AIDS Registry 1989-2013 N= 966
Number Asymptomatics Fast and Furious
360 AIDS
320
280
240
200 Hidden and
Low and Slow Growing
160
Prevalence
120
80
40
0 89 90 91 92 93 94 95 96 97 98 99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13
Asymptomatics 3 1 1 1 3 1 4 3 4 3 2 1 2 1 3 2 2 5 7 10 176 141 183 360
AIDS 0 1 0 2 1 1 1 2 4 2 2 3 1 0 4 2 3 2 1 3 1 1 3 5 2

**Age Range = 15-79 yrs. old

39% = 15-24 years old
 HIV/AIDS Cases by Mode of
Transmission
Cebu City HIV/AIDS Registry 1989-2013 N= 966

Sexual Contact vs IDU Sexual Contact

12%

25% 17%

71%
75%

Heterosexual Male, n=28

Sexual Contact, n=240 Heterosexual Female, 41
Injecting Drug Use, n=707 Homosexual/ Bisexual, n=171
HIV Voluntary Counseling and Testing
No. Tested
3000
Positive Negative 17%
2500

2000

1500

1000 20%
26% 22%
500
0.8%
0
2008 2009 2010 2011 2012 2013
Positive 0 1 177 140 188 362
Negative 9 124 496 500 744 2122
Year
 HIV 101
HIV is a virus that attacks the
immune system.
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HIV 101
2. As the viral load increases, the
CD4 lymphocyte count decreases.
 IS HIV THE SAME AS AIDS?
• HIV INFECTION – Successful entry of
the Human Immunodeficiency Virus
inside the body but no signs or
symptoms

• AIDS – Acquired Immune Deficiency

Syndrome; with signs and symptoms;
presence of opportunistic infections
HIV AIDS
 DO YOU THINK YOU CAN GET HIV
THROUGH THE FOLLOWING?

Swimming Pool Mosquito bite Toilet bowl

DO YOU THINK YOU CAN GET HIV
THROUGH THE FOLLOWING?

Kissing Sharing utensils

DO YOU THINK YOU CAN GET HIV
THROUGH THE FOLLOWING?

Shaking hands Hugging

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HIV Modes of Transmission

25-40%
the risk of perinatal acquisition without intervention
 HOW YOU CAN GET HIV
1. INFECTED SEMEN AND VAGINAL FLUID
THROUGH SEXUAL CONTACT WHETHER
VAGINAL, ANAL OR ORAL
 HOW YOU CAN GET HIV
2. INFECTED BLOOD AND BLOOD PRODUCTS

Blood transfusion Organ transplant Sharing of contaminated

needles and syringes
 HOW YOU CAN GET HIV
3. PERINATAL TRANSMISSION OR
“MOTHER-TO-CHILD”

Placental entry During delivery Breastfeeding

PERSONS WITH AIDS
Oral Ulcers (Lu-as)
Zoster (Likos-likos)
Molluscum contagiosum
Genital Warts (Kungo)
Tuberculosis
 Cancer
Kaposi’s sarcoma
• Cancer of the small blood vessels
• Most common cancer in AIDS patients

B cell lymphoma
Cervical Cancer
STD with HIV
STD with HIV
 WHO ARE AT RISK?

Men having sex with men (MSM)

 WHO ARE AT RISK?

Multiple sexual Sexual partners of infected

partners persons / Unprotected
sexual contact
 WHO ARE AT RISK?

Intravenous drug users (while

sharing contaminated
Recipients of
needles & syringes for contaminated blood
injecting drugs used by HIV and/or blood products
infected persons)
 WHO ARE AT RISK?

Body piercings (non-sterile equipment)

 WHO ARE AT RISK?

Body Tattoo
(non-sterile equipment)
WHO ARE AT RISK?

Sharing of
contaminated
personal items
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• Primary prevention of HIV infection

for key populations has to start in
adolescence mainly because
infections now occur at a younger
age.
• On average, the initiation to sex and
drug use is between 14 and 19 years
old.

http://www.unicef.org/philippines/hivaids.html
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HIV in 6 PH cities may reach

'uncontrollable' rates – DOH
Prevalence rate among males who have sex with males

http://www.rappler.com/nation/89412-hiv-6-philippine-cities-uncontrollable-rates
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pregnant women living with HIV

*since 2010 to June 2017
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5%
• Only five per cent of HIV-positive
pregnant women have received
antiretroviral medicines to prevent
mother-to-child transmission.
• Very few of those at-risk have taken an
HIV test, with the number at zero for
those under 18 years.
http://www.unicef.org/philippines/hivaids.html#.V2yW-_l95rQ
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HIV Screening
Preliminary Counselling Dialogue

Key Message:

The fact that you are pregnant is an

evidence of unprotected penetrative
sexual contact which is a mode of
transmission for HIV.

POGS Clinical Practice Recommendations on PMTCT

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Anti-retroviral (ARV) Drugs

Advantages of Option B+

• Earlier treatment for woman’s health and

avoiding risks of stopping and starting
triple ARVs especially in settings of high
fertility
• Simple message to communities

“once ARV started, it is

taken for life.”
POGS Clinical Practice Recommendations on PMTCT
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Primary prevention of HIV among

women of child-bearing age

• A – abstinence
• B – be faithful
• C – check your status
• D – don’t do drugs
• E – educate yourself and
others
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“HIV will end with me!”

What every SUPACA must know
• What is HIV?
• Modes of Transmission of HIV
• Misconceptions regarding
Transmission of HIV
What every SUPACA must know
• How does HIV affect the
immune system?
• Who are at increased risk?
• HIV counselling and testing
• Prevention of Transmission of
HIV Infection (ABCDE)