Annually since 1988, all United Nations member states—including the Philippines—commemorate World AIDS Day on December 1. The initiative, started by the World Health Organization, aims to shed light on the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS), which have claimed the lives of 30 to 41 million people worldwide. This year’s theme is “Know Your Status”.
In the country, discussions surrounding sex are taboo. This comes as no surprise, given that close to 90 percent of Filipinos identify as Christians, according to the Philippine Statistics Authority. Further, this is reflected in the poor state of sex education in Philippine schools, where misinformation and shame abound.
Of the many topics that are glossed over and eventually misconstrued in local sex education classes, HIV comes to mind as being particularly slighted. The abundance of common myths about HIV is further worsened by the social stigma surrounding those who have to live out its harsh realities, especially in light of the current HIV/AIDS epidemic in the Philippines.
What exactly is HIV?
Put simply, HIV is a virus that attacks the human immune system. The virus targets a certain type of white blood cell known as CD4 cells, which help coordinate the body’s defensive response against pathogens—defined as any disease-causing microorganism. As HIV continues destroying CD4 cells, an infected individual’s immune system becomes compromised and can no longer reliably fight off pathogens that enter the body.
As there is currently no cure for HIV, those who acquire it have to bear its consequences for life. Recently, however, there has been progress in the creation of a vaccine for HIV, though it is unknown if it will proceed to clinical trials and subsequent use.
Left untreated, the virus can progress into a stage known as AIDS, indicated by a CD4 cell count being below 200 cells per mm3 of blood. For comparison, a healthy CD4 cell count ranges from 500 to 1,500 cells per mm3 of blood. When the illness progresses into this stage, the immune system is so severely compromised and may lead to the death of the infected individual.
Wiping the fog off the mirror
In an interview with The LaSallian, Denis Cruz, Community Center Coordinator of LoveYourself Uni, dispels some myths about how HIV is transmitted. He elaborates that HIV can only be transmitted through three ways: through transfusion—or direct delivery through a person’s vein—of infected blood and blood products; from mother-to-child, either through conception, childbirth, or breastfeeding; and unprotected penetrative sex.
When asked what falls under ‘penetrative’ sex, Cruz clarifies, “It can be vaginal, oral, or anal. With oral sex, mas mababa yung risk.” He cautions, however, that this lowered risk should not be taken as a free pass to have unprotected oral sex.
(With oral sex, the risks are lower.)
Staying on your guard
The Centers for Disease Control and Prevention recommends that everyone between ages 13 and 64 be tested for HIV at least once. Cruz assures that the test kits at LoveYourself Uni output results with an accuracy rate of 99 percent, but warns, “It really will just depend on the window period.” The said window period, he explains, is the initial three months after penetrative sex, when the virus first becomes detectable.
On what samples they take for HIV testing, the LoveYourself Uni coordinator replies that they “draw a small amount of blood,” though he did not disclose the exact manner of acquiring the blood sample.
All about that PrEP
Given the risks and burdens associated with acquiring HIV, there was a great need for a treatment which could prevent its transmission. In 2012, the United States (US) Food and Drug Administration approved the use and distribution of a treatment comprised of a combination of antiretroviral drugs called pre-exposure prophylaxis (PrEP). These antiretroviral drugs inhibit certain enzymes used by HIV in replicating itself, thus preventing the virus from multiplying in the body and hijacking vital CD4 cells.
What differentiates PrEP from other forms of prophylaxis is that it is taken before exposure to HIV. Cruz puts into perspective what PrEP does, explaining, “Linalagyan niya ng protection ‘yung CD4 [cells] para hindi ma-infect [ng] HIV [ang] CD4 cells. So kahit magkaroon ka ng exposure to the virus, hindi magiging successful ‘yung infection.”
([PrEP] protects CD4 cells from getting infected by the HIV virus. So even if an individual [who takes PrEP] becomes exposed to the virus, he or she will not be successfully infected.)
In the Philippines, PrEP is primarily available in locations such as certain LoveYourself Uni centers, as well as High Precision Diagnostics clinics. On pricing, Cruz mentions that at LoveYourself, PrEP costs P2,000 per bottle of 30 pills, which is enough for a month as PrEP is taken daily. This is much cheaper than in the US, for example, where PrEP can cost up to USD 2,000 or more than P100,000 a month.
Facing overwhelming odds
“We are the country with the fastest-growing HIV epidemic in the world—not only in Asia and the Pacific. [Even] in [last year’s] report, we’re [already] number one in the whole world,” stressed Dr. Louie Ocampo, Country Director for the Joint United Nations Programme on HIV and AIDS Philippines, during a talk conducted in the Manila Doctors Hospital last October 21.
In response to the epidemic, the Department of Health’s (DOH) current and primary goals are to spread awareness by enabling 90 percent of HIV patients to know about their status; to provide antiretroviral therapy (ART) to 90 percent of diagnosed patients; and to ensure that 90 percent of patients undergoing ART are virally suppressed—effectively preventing HIV from proliferating in a patient’s body.
Despite these initiatives helmed by DOH and an increasing amount of support from local government units and non-governmental organizations, the country has yet to yield positive results from the numerous initiatives that have been set in place over the years.
From the cumulative 3,586 cases that had been reported way back in 2008, current numbers have skyrocketed to 69,512 cases in 2019. Fifty five deaths were reported in July alone, majority of whom were males between 25 to 34 years old.
The virus was discovered in 1983 and remains ever so prevalent 36 years since. While Science has prospered in other fields and facets, lingering diseases such as HIV have yet to be remedied through modern means. The mere fact that current medical solutions are only limited to preventing, but not treating, HIV infection is telling of the insurmountable odds that have yet to be conquered by modern human endeavors.
Be that as it may, the absence of a cure is no excuse to abandon and shun individuals who have been afflicted with this disease and bear the social discrimination persisting in a country that continues to be misinformed and blinded by archaic norms.
