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.