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Thursday, July 5, 2012

Health News: HIV/AIDS in the Philippines






In the Philippines historically has had a relatively low HIV rate, which experts say is particularly surprising given that condom use is discouraged by the powerful Philippines Catholic church. Experts have argued for years over why the Philippines rate is so low, with far less than 1% of the country’s 95 million people believed to have HIV or AIDs, and less than 350 new cases as recently as 2007.

But officials have seen an unexpected surge in cases in the past several years, with a more than five-fold increase between 2007 and 2011, with 2,349 new cases last year. The total number of cases as of April 2012 is 9,396, compared to just 3,061 in 2007. The Philippines is now recording seven new HIV infections a day, versus one a day before 2007, making it one of only seven countries worldwide where HIV infection rates continue to rise rapidly

Government epidemiologists have warned that by 2015, the total number of HIV cases in the Philippines could reach 45,000 from the reported 7,000 cases in 2011.

Risk Profile

ilga.org
Most-at-risk groups include men who have sex with men (MSM), with 395 new human immunodeficiency virus (HIV) infections among within this group from January to September 2008 alone, 96% up from 2005’s 210 reported infections. A spokesperson of the National Epidemiology Center (NEC) of the Department of Health says that the sudden and steep increase in the number of new cases within the MSM community, particularly in the last three years (309 cases in 2006, and 342 in 2007), is “tremendously in excess of what usually expected,” allowing classification of the situation as an “epidemic". Of the cumulative total of 1,097 infected MSMs from 1984 to 2008, 49% were reported in the last three years (72% asymptomatic); 108 have died when reported, and slightly more MSMs were reportedly already with AIDS (28%).

Among MSM's, ninety percent of the newly infected are single (up to 35% of past cases reported involved overseas Filipino workers or OFWs and/or their spouse), with the most of the affected people now only 20 to 34 years old (from 45 to 49 years old in the past). The highest number of infections among MSMs is from Metro Manila, though increasing infection rates were also noted in the cities of Angeles, Cebu, and Davao. 1 to 3 percent of MSM's were found to be HIV-positive by sentinel surveillance conducted in Cebu and Quezon cities in 2001.

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

National Response

Wary of nearby Thailand’s growing epidemic in the late 1980s, 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. However, the Philippines is faced with the challenge of stimulating government leadership action in a low-HIV-prevalence country to advocate for a stronger and sustainable response to AIDS when faced with other competing priorities. One strategy has been to prevent STIs in general, which are highly prevalent in the country.

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.


Source: http://en.wikipedia.org


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