Differentiated Service Delivery for YKP

Knowledge = YOUTH-LED LEADERSHIP

Attitudes = REMOVAL OF STRUCTURAL BARRIERS, DIFFERENTIATED SSRVICE DELIVERY, STIGMA REDUCTION, YOUTH-FRIENDLY SERVICES, SAFE SPACES

Practices = DIGITAL INTEGRATION

95% of all people living with HIV are aware of their status = increase HIV case finding through expanded opt-out facility-based HIV screening, community mobile testing, index testing, social and sexual network testing, self-testing

Youth groups are enablers to HIV awareness campaign. 

Nothing about us without us!

95% of all diagnosed PLHIVs are on ART = intensive case management with multi-disciplinary team approach with case manager, social worker and nurse through personal healthcare team chat groups, SMS and calls, Facebook page and website, with monthly support group meetings

95% of all PLHIVs on ART are virally suppressed = enhanced ARV adherence counseling with HACT pharmacists during each dispensing, social workers following up interruption in treatment and nurses linking to care those lost to follow up.

Hence, we develop Differentiated Service Delivery for Young Key Population!

HOW DO WE REACH THE YOUNG KEY POPULATION TO STOP THE SPREAD OF HIV IN THE COUNTRY?

National Public Health Emergency.  In 2025, DOH Secretary Ted Herbosa called for declaring HIV a national public health emergency pointing to the 500% increase in reported cases over a 10-year period. Secretary Herbosa is quoted saying “Pag sinabing Public Health Emergency, hindi ibig sabihin lockdown. Ang ibig sabihin nun, yung mga resources ng gobyerno ay mas magagamit. Mas maraming ahensiya ang marerecruit at masasama.” (When we say a public health emergency, it doesn’t mean a lockdown. It means that the government’s resources will be utilized, more agencies and recruits will work together.)  HIV is no longer considered a death sentence, thanks to advances in treatment. Early testing remains the critical first step.  HIV counseling is the gateway to treatment, care, support and prevention.  The next question is how to effectively increase HIV case finding considering the stigma against HIV testing.

HIV Treatment Facilities.  A total of 338 facilities nationwide have been officially designated, comprising of 192 treatment hubs and 146 primary HIV care facilities, by virtue of DOH Department Circular No. 2026-0065: Updated Directory of DOH-Designated Human Immunodeficiency Virus (HIV) Treatment Hubs and Primary HIV Care Facilities in the Philippines as of December 31, 2025. The infrastructure

Philippines HIV Statistics.  The Department of Health - Epidemiology Bureau released the 2025 Quarter 4 HIV/AIDS & ART Surveillance of the Philippines (HASP) report. The latest Philippine HIV estimates show that by the end of 2025, there  would have been 252,800 estimated People Living with HIV (PLHIV) in the country. As of December 2025, 153,207 (61% of the estimated) PLHIV have been diagnosed or laboratory-confirmed. Further, 100,671 (66% of the diagnosed) PLHIV are currently on life-saving Antiretroviral Therapy (ART), of which 58,887 (59%) PLHIV have been tested for viral load (VL) in the past 12 months. 

Young key affected population.  Of 4,277 newly reported cases for the 4th quarter 2025, 94% were males, 1,361 (32%) were 15–24 years old, 1,929 (45%) were 25–34 years old.  The trend by age group is that diagnosed cases are getting younger as predominant age group shifted to 25-34 years old starting 2006, and the proportion of cases among 15-24 years old has reached 30% as of 2025.  Rapid changes in sexual norms and behaviors, and increased mobility may have created a “risk situation” for the spread of HIV. Concerns are raised about the appropriateness and the scope of government and non-governmental approaches to the exploding HIV and STD epidemics.  Reaching young key affected populations (YKPs) including young men who have sex with men, transgender youth, young people who inject drugs and young sex workers, requires moving beyond traditional clinic-based models.

HOW DO WE REACH THE YOUNG KEY POPULATION TO STOP THE SPREAD OF HIV? Global strategy emphasizes youth-led leadership, digital integration and the removal of structural barriers.

Generation gap.  The "generation gap," a term popularized in the 1960s, describes the disconnect between different generations, particularly as they reach adulthood.  Baby Boomers (1946–1964) often value loyalty, stability, and traditional work structures.  Generation X (1965–1980) generally value independence, self-reliance, and balance.  Millennials (1981–1996) known for being tech-savvy, valuing flexibility, and open-mindedness.  Generation Z (1997–2012) often characterized as digitally native, socially conscious, and valuing diversity.  Miscommunication between older (face-to-face) and younger (digital/text) generations can cause tension in workplaces and families. Active efforts to understand different perspectives, fostering open communication, and showing respect for differing views.  This may be a challenge for a Gen X-er like me to reach out and connect with Gen Z and Gen Alpha adolescents.

YOUTH-LED LEADERSHIP.  Considering the challenges of the generation gap, peers are often the most trusted sources of information because they share lived experiences and reduce the fear of judgement. Young people should be "active agents of change" such that trained peer educators can navigate "hard-to-reach" spaces, provide psychosocial support and help peers navigate the healthcare system.

T1.  How do we empower young people to become active agents of change to advocate for sexual health needs and STI/HIV prevention?

DIGITAL INTEGRATION.  Knowing that young people are on social media these days point to social media as a powerful tool to reaching  YKPs who are made "invisible" due to stigma in physical spaces.  An innovative NIH-funded study reduced new HIV cases by 70% in rural populations by pairing digital tools with tailored HIV services delivered by community health workers and clinicians.  This strategy of leveraging existing healthcare infrastructure with available HIV prevention and treatment options could become a model for reducing HIV incidence in other settings.

The intervention had three components:

First, trained community health workers employed by the government visited each home to offer adults HIV testing. The workers referred adults who tested HIV-positive to their local health center for HIV treatment and referred adults who tested HIV-negative but said they were at risk for the virus to HIV prevention products and services. 

Second, healthcare providers at local health centers were trained to deliver personalized HIV prevention and care in a manner that was sensitive and responsive to the choices and preferences of their clients. 

Finally, enhanced use of a ministry of health-compatible app on handheld devices linked health workers in the communities with clinicians, medical records and services in health centers, facilitating follow-up with clients and community-based delivery of prevention medications. 

T2.  How can we utilize social media to offer prevention and treatment options to reduce HIV incidence?

REMOVAL OF STRUCTURAL BARRIERS.  If we hope for different results, we need to change our approach from traditional clinic-based services to "youth friendly" health services.  To increase uptake, differentiated service delivery must be provided considering the evolving capacities of youth - offering flexible hours, confidential testing and non-judgemental staff.  Integrating care and bundling HIV testing with other services such as STI management, mental health support and gender-affirming care like for expanded opt-out facility-based HIV screening -  makes to de-stigmatize and normalize HIV testing.  Setting up a one-stop shop for harm reduction, prevention interventions and peer support address time and effort costs of accessing health care.

T3.  What sustainable service innovations can we suggest to remove structural barriers and increase uptake of HIV testing?

 

Join us tonight at 9PM MLA time for our #HealthXPH tweetchat on Blue Sky at https://bsky.app as we discuss how we can reach the young key population to stop the spread of HIV in the country.  Log on to your Blue Sky account then search #HealthXPH and follow the prompts of the moderator.  Don't forget to type in #HealthXPH with your messages so they can be viewed by other people joining the tweetchat.

Migraine Headache

I've been having this migraine headache since Tuesday and today is Sunday.  I asked my neurologist if I should be worried, and she reassured me that it sounded still like migraine.

Linus warned that I might have brain cancer and if that's the case, I'd rather have a stroke.  Fast and sudden.  I don't like it to be like #BasyangPH where the wind speed was slow (not as destructive as #OdettePH) but still carrying with it volumes of rainfall that reeks havoc and destruction through flooding.  The one thing I fear in life is PAIN, but that is what I deal with everyday.

Pain serves a purpose in life.  

Expectation vs Reality

When caricatures are less threatening than real people, caricatures tend to make people seem cute and friendly with wide eyed smiling faces.

 

Opening Remarks for HIV Symposium for International Condom Day

 

Maayong hapon mga ka-AMBAG ug mga ka-TEACHCebu!

Distinguished guests, colleagues, and fellow advocates.

Welcome to today’s HIV symposium!

Ania ka karon for another educational discourse on the essentials of HIV diagnosis, treatment, care, support and prevention as we celebrate International Condom Day.  Along with abstinence, fidelity and pre-exposure prophylaxis, correct and consistent condom use is still one of our effective armamentarium against the spread of HIV.  Since 1990, condoms have averted an estimated 117 million new HIV infections.  Yet, as we lean into 2026, we face a paradox:  as our medical toolkit expands with PrEP and advanced ART, our reliance on the most cost-effective, dual-protection tool we have is wavering.

Ang pagsaulog sa International Condom Day (nga gihimo matag Pebrero 13, usa ka adlaw before Valentine’s Day) importante kayo isip pahinumdom sa pagmatngon sa sexual health.

Ania ang mga rason nganong angay kini saulogon:

1.  STI/HIV Prevention.  Proteksyon batok sa mga sexually transmitted infections.  Ang paggamot og condom mao ang usa sa labing epektibo nga laagi aron malikayan ang pagkatap sa HIV ug uban pang sexually transmitted infections.

2.  Prevention of unplanned pregnancy.  Paglikay sa dili planadong pagmabdos.  Importante kini alang sa family planning ug pagseguro nga andam ang magtiayo kon magkaanak.

3.  Safe Sex.  Responsableng paghigugma.  Isip “adlaw sa mga kasing-kasing” ang International Condom Day nagpahinumdom nga ang tinuod nga paghigugma naglakip sa pagprotektar sa kaugalingon ug sa partner.

4. Breaking Stigma.  Edukasyon sa pag break sa stigms.  Ang pagsaulog niini makatabang sa pag-edukar sa publiko ug pagwagtang sa kaulaw o stigma sa pagpalit ug paggamit og condom.

5.  Accessibility.  Sayon ug dali ra makuha ang condom.  Nay libre nga condom sa mga health centers, city social hygiene clinics ug sa mga HIV treatment hubs.  Ang mga condom dali ra makuha ug barato, naghimo niini nga sayon nga pamaagi sa pag-atiman sa panglawas.

 

Our goal today is RETHINK, REBUILD and RISE.  We must rethink our distribution strategies, rebuild the momentum for barrier protection, and rise above the stigma that still surrounds sexual health.  Let this symposium be the catalyst for a year where protection is not just available, but accessible to every individual, regardless of their zip code or status.

Our theme is "Strengthening Facility-Based HIV Case Finding and Integrated STI and Hepatitis Management" as the Vicente Sotto Memorial Medical Center KAAMBAG Clinic celebrates International Condom Day with our fellow advocates, patients and stakeholders. We have prepared a good program for you with our expert resource persons.  

Dr Noreen Matig-a talks about Screening and Management of STIs to “Stay Safe, Stay Informed: Essential Facts on STI Testing and Care”

Dr Mitzi Inting will lecture on Hepatitis B, Hepatitis C and Syphilis “The Invisible Trio: Why Safer is always SEXY"

Dr Lui Balbuena of the DOH will talk about the Epidemiology of HIV/AIDS "The CEBU HIV Profile:  From Concentrated Epidemic to Community Awareness"

Dr Jamaica dela Cruz discusses Increased HIV Case Finding “The Default Choice:  How Expanded Opt-Out Screening Increases Case Detection and Reduces Stigma"

Awareness is Key

Control is FREE

CEBU will #StopHIV

AI and the Mental Healthcare Worker

 

This beautiful night sky over Cebu City is my view for tonight as we discuss about the use of AI in mental health over #HealthXPH on Blue Sky.

Stephanie Miaco shared her write up on AI and the [Mental] Healthcare Worker where she explores the use of AI bots and therapy replacement options.  It is about Artificial Intelligence and replacing human empathy.

Focused Effort

One drawback of wearing many hats is that it becomes difficult to focus.  There are a lot of evidence that shows focused effort makes for more success than multi-tasking.