Innovations for HIV Awareness Campaigns

We keep doing the same things, and expect HIV cases to decrease.  This is the time to introduce innovations to raise HIV awareness, reduce HIV stigma and discrimination and to prevent the transmission of HIV.

Current Situation of the Philippine HIV Epidemic

Statistics from the DOH Epidemiology Bureau indicate that as of September 2018, there were 59,135 total reported cases of HIV in the Philippines since 1984, with 32 new cases per day.  Sexual contact remains to be the predominant (98%) mode of transmission, 85% of whom were males who have sex with males.  Of the 56 newly diagnosed females in September 2018, four were pregnant.  Of the 954 newly diagnosed cases in September 2018, 271 (28%) were young, aged 15-24 years old.

A recent Lancet correspondence article by Gangcuangco in February 2019 recommends six steps to curb the epidemic:
1.  Stigma reduction through education.
2.  Increased HIV awareness among healthcare providers
3.  Availability of pre-exposure prophylaxis
4.  Integrase inhibitors should be used as first-line ART, such as in the combination of tenofovir, lamivudin and dolutegravir (TLD)
5.  Primary care physicians should be empowered to provide HIV care to overcome geographic barriers
6.  Substance abuse should be addressed and mental health be promoted

If we are not insane, then we need to introduce innovative changes to address the Philippine HIV Epidemic.  Inclusive unified efforts to strengthen the collective power of all HIV advocates!

References:

DOH NEC EB HIV/AIDS & ART Registry of the Philippines September 2018 accessed February 13, 2019 on https://www.aidsdatahub.org/sites/default/files/publication/EB_HIV_September_AIDSreg2018.pdf

Gangcuangco, Louie Mar A.  HIV Crisis in the Philippines: Urgent Actions Needed.  The Lancet. Volume 4, Issue 2, PE84, February 1, 2019 accessed February 13, 2019 on https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30265-2/fulltext?fbclid=IwAR13e8EUEtkGoNS2Cp2kvRX22mMiagU_-D-7EZmsB2jrqOCoo6OC9_YLAyM

A Month of Trainings, Seminars and Meetings

I realized that there were so many activities, trainings, seminars and meetings for the month of May that I decided to document these here for future use:

Scarlet May

The month of May is dedicated for awareness of cervical cancer prevention, dubbed as Scarlet May.

May 3, 2017.  To knock out cervical cancer, we decorated our hospital lobby like a boxing ring with round 1 (HPV vaccination), round 2 (cervical cancer screening) and round 3 (cancer treatment), with our medical center chief Dr. Gerardo M. Aquino giving the "opening punch"

May 6, 2017.  Lantern Walk with a Glow at SM Seaside.  Parade from the Pedro Calungsod chapel to the Garden Wing of the SM Seaside, where there was a program with a short lecture followed by singing and zumba dancing.

May 14, 2017.  To make good on our advocacy, we trooped to Lapu-lapu City Health Department where we screened more than 800 women for cervical cancer thru visual inspection with acetic acid (VIA) and directly linked to care with cryotherapy for those VIA-positive.  With 12 women dying of cervical cancer every day, it only takes one minute to save a woman's life from cervical cancer.

Research Activities

May 3, 2017.  Research Training for Consultants.  To address a need to improve research capabilities of our consultants, we conducted a day-long training on basic research methods.

For the whole month of May, we conducted research technical reviews for our residents' research proposals.  Trained consultants review and comment to hel

June 1, 2017.  I was invited to participate in the oral defense of undergraduate students of political science at the UP Cebu College of Arts and Sciences.

June 5, 2017.  Department Resident Interesting Case Contest with guest judges Dr. Ronald Capito, Dr. Mary Girlie Veloso and Dr. Nelson Elle. 

First Place: Dr. Maria Floribeth Daraman/Helen Amorin - Basal cell carcinoma of the vulva

Second Place: Dr. Diorelle Malaque/Helen Amorin - A Rare Case of Ovarian Gonadoblastoma

Third Place: Dr. Kristina Plaza/Marilou Viray - A Case of Papillary Serous Cystadenofibroma

Fourth Place: Dr. Justine Galdo/Kristina Dosdos - Intramural pregnancy

Fifth Place: Dr. Genevieve Vista/Helen Madamba - Aspergilloma in Pregnancy

Maternal Death Reviews

May 4, 2017.  POGS Quarterly Morbidity and Mortality Conference and Continuing Medical Education on Asthma in Pregnancy

May 10-11, 2017.  Cebu City Health Department Maternal Death Review at Montebello Villa Hotel

May 19, 2017.  Department of Health Regional Office VII Maternal Death Surveillance Response  at Crowne Regency Guadalupe, Cebu City

May 24, 2017.  The Department of Obstetrics and Gynecology conducts its own monthly Morbidity and Mortality Conference, inviting our friendly consultants and residents from the Department of Internal Medicine to help us with the verbal autopsy of our maternal mortalities.

Advocacy Lectures on HIV/AIDS

May 17, 2017.  Department of Health Regional Office VII Technical Updates on HIV/AIDS and Prevention of Mother to Child Transmission of HIV in Bohol

May 20, 2017.  The Cebu Velez General Hospital conducted a lactation management education training (LMET) and I talked about the issue of prevention of mother to child transmission of HIV in relation to breastfeeding.  Some issues that still need to be addressed is the safety of wet nursing when the donor mother is not tested for HIV.

May 31, 2017.  The VSMMC HACT conducted an HIV Awareness Seminar for VSMMC hospital staff, and I shared about prevention of mother to child transmission of HIV.  My main message that "HIV will end with me" opines the ABCDE to prevent HIV transmission: 

A - abstinence 

B - be faithful 

C - check your HIV status

D - don't do drugs 

E - educate yourself and others about HIV

...and here a bit more of a month worth of a peek into my life as a trainor, mentor, advocate...

Community-Based Recovery Program for Drug Dependents

I attended a youth forum in our community one day.  The attendees were asked to list down the relevant issues of children and youth in society today.  Different sharing of perspectives and disclosure of personal experiences narrowed the issues to violence and drug dependency leading to sexual abuse resulting to teenage pregnancy and HIV/AIDS.

I come from Cebu, an island in the middle of the Philippine archipelago.  Cebu faces the challenge of dual epidemics of drug abuse and HIV/AIDS.  Based on a recent surveillance study, Cebu City has one of the highest concentrated epidemics of HIV in the Philippines and the main mode of transmission is via intravenous drug use.  This gives us an idea of the burden of the drug problem in our communities.  

Over 7,000 suspected drug users and drug dealers have surrendered in Cebu province since President Rodrigo Duterte was elected on May 9.  President Duterte expressed that Cebu has the highest number of drug dependency rates in the Philippines. With the current war on drugs, thousands have voluntarily surrendered to the government for rehabilitation.  Existing rehabilitation centers can no longer accommodate patients who wish to avail treatment services in public facilities.  Hence, the government turns to the private sector, the civil society organizations and the barangays to create community-based drug rehabilitation and recovery programs which consider intensive phase, relapse prevention and skills training for alternative economic opportunities.

Drug rehabilitation is a complex program that many do not understand. Patients need to be treated holistically.  Healthcare providers can determine which patients would qualify for a community-based rehabilitation program.  With community support, healthcare providers can manage and follow up patients and de-load the need to institutionalize.  There would be a combination of psychological counselling, pharmacotherapy, family development, skills training, and increased advocacy campaigns to improve awareness on drug rehabilitation.  We therefore ask the question: what can we do in our own personal capacity to help rehabilitate and reintegrate these drug dependents into our community?

On June 2017, the Central Visayas Consortium for Health Research and Development will be having its innovation conference and one of the plenary lectures will be on community-based recovery programs, and we’d like to call for collaborators on researches that need to be done on this topic to find solutions to this multi-faceted emerging health issue.  We hope that we can discuss this topic academically to find solutions to this very relevant problem.

T1.  In your view, what is the impact of drug dependence on your community’s health?

T2. What would be the components of a successful community-based drug recovery program?

T3.  What is the role of social media in solving drug dependency problems?