Protect your Peace

 

Bayang Pilipinas Ginigiliw

Happy Philippine Independence Day!

Be Grateful!

June is PRIDE month and the KAAMBAG Clinic prepared a strategic program for BEYOND THE RAINBOW: A Deep Dive into Mental Health, Disclosure and the LGBTQIA Journey - the 2nd KAAMBAG Postgraduate Course.

This crucial postgraduate course on PRIDE Month and HIV awareness delved into these important topics, fostering understanding and promoting positive change.

The Department of Health (DOH) has called for a national public health emergency declaration due to a 500% surge in HIV cases in the Philippines. This rapid increase, reaching 57 confirmed cases per day between January and March, is the highest in the Western Pacific Region. The DOH is also urging the public to get tested, emphasizing the importance of free, confidential testing. Additionally, the DOH is recommending various preventive measures, including the use of condoms, lubricants, and pre-exposure prophylaxis (PrEP) to curb the spread of HIV.   95% of all PLHIVs are male with male-to-male sex driving this HIV epidemic.  This statement may or may not trigger stigma and discrimination against the LGBTQIA community, but this is a fact based on the DOH National Epidemiology Bureau HIV/AIDS and ART Registry.

By highlighting the significance of PRIDE Month and HIV awareness, we are setting the stage for a meaningful learning experience.

We will be exploring the current health status, stigma and rights of the LGBTQIA+ community and the challenges they face in their gender-affirming journeys, as well as the access to these communities with strategies for promoting inclusion and prevention, treatment of HIV infection and care and support for people living with HIV (PLHIVs).

IMPORTANCE OF COLLABORATION

This course is a collaborative effort, and we look forward to hearing from the participants, sharing their insights through the comment section of this Facebook LIVE program on several burning questions:

1. How do we celebrate PRIDE MONTH to promote inclusion and genuine acceptance of LGBTQIA+ rights to health, dignity, respect and love?
2. Accepting that male-to-male sex is the key driver of this HIV epidemic is the first step to finding ways to halt HIV transmission.  How do you love the sinner but hate the sin?  How do you be gentle but firm, knowing that while they continue to have sex, you want them to have SAFE SEX.
3. Having new methods of prevention in our armamentarium for HIV treatment hubs and primary HIV care centers like pleasure-based messaging, condoms, lubes, PrEP and self-test kits, how do we implement effectively considering that knowing is not enough?
4. Research shows that although social media and mobile apps facilitate hook ups, Grindr users are more open to HIV prevention measures.  Therefore, HIV program implementers should be where our patients are, and they are online!

The morning session was enlightening about the health status and rights of LGBTQIA+ in the Philippines, self-stigma, pleasure-based messaging and the psychosocial challenges of gender-affirming journeys.  There are gaps in the health system with need to provide access for the LGBTQIA communities.  There should be a paradigm shift in how we approach patients within the spectrum from using fear of HIV transmission as motivation for uptake of preventive measures to pleasure-based messaging, accepting that sexuality is part of health.

The early afternoon session focused more on MEDICAL aspect of managing LGBTQIA and PLHIVs:  Healthcare Needs of LGBTQIA+; Sexual and Social Network Testing as an innovative approach to reaching taboo populations for increased HIV testing, as well as the routine laboratory tests to screen for ARV toxicities and opportunistic infections.

The late afternoon focused more on the pharmacologic innovation of the 3-in-1 pill with dolutegravir-based ARV regimens, the need for ARV adherence and when to offer pre-exposure prophylaxis and post-exposure prophylaxis.  These topics enhanced the health literacy of our PLHIV patients.

 

Philippines HIV Epidemic: A Public Health Emergency Call

HIV/AIDS Surveillance Report for the first quarter of 2025

The Philippines is currently facing a severe public health crisis.  While initial panic-inducing reports were about MPox cases in selected areas in the country, these index cases were found to be among immunocompromised hosts with multiple sex partners.

This week, DOH Secretary Ted Herbosa sounded off the alarms that the HIV epidemic is even more problematic than mounting fears about MPox due to the more than 500% increase in HIV case findings from 2010 to 2025, based on the DOH National Epidemiology Bureau HIV/AIDS Surveillance Report for the first quarter of 2025.  This prompted the DOH to call for the declaration of a national public health emergency to mobilize resources and intensify intervention efforts. 

Here are the key findings:

1. Dramatic increase:  From January to March 2025, the Epidemiology Bureau recorded 5,101 newly diagnosed HIV cases with 57 new cases detected per day.  Compared to 2010 statistics, this represents 564% increase, making the Philippines the country with the fastest-growing HIV epidemic in the Western Pacific region. 

https://web.facebook.com/DOHgovPH

2.  Youth Most Affected:  Although half (74,081, 50%) of cases were 25-34 years old and 44,187 (30%) were among the youth aged 15-24 years old, the increase is most pronounced among the 15-24 years old age group with some reports indicating a 500% rise in cases.  The youngest reported was a 12 year old from Palawan.

https://bit.ly/HASP2025Q1

3.  Predominant Mode of Transmission:  Although there are people who inject drugs in Central Visayas who get HIV, sexual contact remains the primary mode of HIV transmission, with a significant shift towards male-to-male sexual contact since 2007.

https://bit.ly/HASP2025Q1

4.  Total Cases:  As of March 2025, the cumulative number of reported HIV cases in the Philippines since 1984 is 139,610 (55% of the estimated) PLHIVs who have been diagnosed or laboratory-confirmed, and are currently living or not reported to have died. Further, 92,712 (66% of the diagnosed) PLHIV are currently on life-saving Antiretroviral Therapy (ART), of which, 41,786 (45%) PLHIV have been tested for viral load (VL) in the past 12 months. Among those tested for VL, 36,630 (88%) were virally suppressed.  The latest Philippine HIV estimates show that by the end of 2025, there will be 252,800 estimated People Living with HIV (PLHIV) in the country.  If left untreated, by 2030 there will be an estimated 400,000 PLHIVs who will need anti-retroviral drugs provided by government funding.

https://bit.ly/HASP2025Q1

5.  Advanced HIV Disease at Diagnosis: Reporting of Advanced HIV Disease (AHD)17 cases only started in 2011. Among the total reported cases, 41,550 (29%) were diagnosed with AHD, 8% higher compared to the same quarter of the preceding year.  Advanced HIV Disease at the time of diagnosis indicates delayed testing and treatment.

https://bit.ly/HASP2025Q1

6.  Funding Challenges:  On January 20, 2025, the Trump administration issued an Executive Order freezing all foreign assistance funds for 90 days, citing the need to align programs with the administration's foreign policy priorities.  On January 24, 2025, the U.S. Department of State sent a cable to all U.S. Embassies ordering the immediate suspension of all foreign assistance.  This "Stop Work Order" halted funding for programs including the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) with significant impacts on HIV prevention, treatment, care and support.  

Join us tonight on #HealthXPH at 9PM on BlueSky to discuss this public health emergency call:

T1.  What do you think are the causes and contributing factors to escalating the HIV epidemic in the Philippines?

T2.  With a national public health emergency declaration for HIV, what government response would you recommend to address this crisis?

T3.  What is the role of social media for a comprehensive and multi-pronged approach to halting HIV transmission?

Dare to Risk

Dare to be different.

Dare to try.

Dare to be bold.

9 Life Lessons

 Life Lessons from a Comedian

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Basics of Menstrual Health

I gave a lecture on the Basics of Menstrual Health for the Philippine Society of Public Health Physicians and the AIDS Healthcare Foundation, in celebration of the 2025 Menstrual Hygiene Day on Mau 28, 2025.

Someone told me that we should be giving this lecture to adolescent girls in schools to teach them about sex and how to prevent STIs and HIV.  I think that is really a good idea, but it should be more of a program and a partnership with DepEd and schools rather than just projects and spur of the moment invites.