HIV Treatment Hubs

It is always nice to see fellow advocates of PLHIVs and 

With luminary Dr Elfleda Hernandez guiding us.

Integrated Women's Health Screening

It's the last few days of National Women's Month and a few days ago, I was at a "Bongga Ka Dai" women's empowerment activity where OBGYNs were called on to provide breast examination screening for breast cancer, cervical cancer screening with VIA and HIV screening.  I was asked on the spot to speak to convince the women to get screened, to avail of the free services we were offering.

Mainly, I told them that we cannot give what we do not have, so we need self care first before addressing the needs of others.  Free services are offered, considering doctors came out of the hospital and clinics just to serve - that should be reason enough to avail of integrated women's health screening.

I searched Gemini for Integrated Women's Health Screening and this is what it came up with.  Gemini said:

Integrated reproductive health screening for women has shifted toward a more holistic, "one-stop-shop" model in 2026. This approach moves away from siloed tests, instead combining reproductive, metabolic, and preventive screenings into a single clinical pathway.

The World Health Organization and local health departments now prioritize the integration of HIV/STI services with general reproductive health.

• Cervical Cancer (Updated 2026): For women aged 30–65, primary hrHPV testing every 5 years is the preferred standard. A major 2026 update now includes self-collection kits as a validated and recommended option for average-risk women.

• Breast Health: Annual clinical breast exams starting at age 20, with mammograms typically recommended every 1–2 years starting at age 40–50 (or earlier based on risk).

• Infectious Disease Integration: Screening for HIV, Syphilis, and Hepatitis B is increasingly bundled with prenatal care and routine family planning visits to reduce stigma and improve uptake.

• Metabolic & Hormonal: Integrated packages now frequently include Fasting Blood Sugar (FBS), Lipid Profiles, and Thyroid (TSH) testing, particularly for women experiencing irregular cycles or signs of PCOS.

The 2026 National Women's Month theme in the Philippines is "WE for Gender Equality and Inclusive Society" featuring the sub-theme "Lead Like the Babaylans, Filipinas!" Join us tonight as we discuss details on integrated women's health screening in commemoration of National Women's Month (March 2026):

T1. The "One-Stop-Shop" Model: What are the primary clinical and administrative barriers to providing cervical cancer screening, HIV testing, and maternal health services in a single visit?

T2. Inclusivity in Screening: How do current integrated screening protocols address the needs of marginalized groups, including transgender men, non-binary individuals, and sex workers?

T3. The Impact of Education: How can we evolve "Health Literacy" campaigns to move beyond just awareness and actually trigger the behavioral change needed for a woman to book her first screening?

Deflection Bias

Here is response to the questions posted by Doc Remo on the #HealthXPH chat:

T1. When do system constraints appropriately guide our decisions—and when do they begin shaping how we justify them?

T2. How often do we revisit decisions initially attributed to “limitations” and re-examine our clinical reasoning?

T3. In a constrained system, what does accountable decision-making actually look like in practice?

Biorisk Management Office

Good morning, everyone!

It is a privilege to welcome you all to this essential training on Biosafety and Biosecurity.

​Today marks a significant milestone for our institution. As we expand our capabilities in research and diagnostics, we also inherit the profound responsibility of managing biological risks with precision and care.  I would like to personally thank each and every one of you for taking up the challenge and being part of history in the making - the first ever Institutional Biosafety and Biosecurity Committer in Visayas and Mindanao!

​Before we dive into the technicalities, I would like to extend our deepest gratitude to our colleagues from the Research Institute for Tropical Medicine (RITM).  Thank you for responding so graciously to our invitation. Your expertise is the gold standard in this country, and having your guidance as we move toward establishing our Institutional Biosafety and Biosecurity Committee (IBBC) is invaluable. We don't just want to "comply"; we want to build a culture of safety that protects our staff, our community, and the environment.

​Why This Matters

​In the world of biological sciences, the line between discovery and danger can be thin. The establishment of an IBBC is not just a bureaucratic requirement; it is our "safety net."

• ​Biosafety ensures we protect ourselves from the agents we work with.
• ​Biosecurity ensures we protect the agents from those who might misuse them.

​Our Goals for This Training

1. ​Foundational Knowledge: Understanding the different Biosafety Levels (BSL) and the specific protocols required for each
2. ​Risk Assessment: Learning how to identify potential hazards before they become incidents.
3. ​Governance: Defining the roles and responsibilities of our upcoming IBBC to ensure oversight is consistent and rigorous.

​"Safety is not a gadget but a state of mind." – Eleanor Everet






 

​Let us approach today’s session with an open mind and a proactive spirit. We are here to learn from the best so that we can become the best stewards of biological safety in our region.

​Thank you, and let’s have a productive training session and I hope we have some fun while we're at it!

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.