HIV: From death sentence to lifetime treatment

Part Two

‘Raising awareness is a key part of tackling the Philippines HIV epidemic, now the fastest-growing in the world.”—Carlos H. Conde, of the Human Right Watch.

About 1,098 people are carrying human immunodeficiency virus (HIV) in May this year, according to a report released by the HIV and AIDS Registry of the Philippines of the Department of Health.

“This is the highest recorded cases ever since 1984,” the report said, adding that there are now 29 Filipinos infected with HIV each day.  In 2015 the Geneva-based World Health Organization (WHO) pictured the Philippines as “having the fastest growing HIV epidemic in the world.”

From January to May, a total of 4,388 cases have been recorded, including 516 Acquired Immune Deficiency Syndrome (AIDS) cases and 187 deaths.  In May alone, 15 people reportedly died of complications brought by AIDS.

At least five regions had the most number of reported new cases.  Davao region had the least, with 60 cases, while the National Capital Region (NCR) had the most—404 cases.  The other three were Calabarzon, 155 cases; Central Luzon, 108 cases; and Central Visayas, 98 cases.

The first case of HIV infection in the Philippines was reported in January 1984.  In July 2000 three agencies—the Health Action Information Network, the National Economic and Development Authority and the United Nations Development Program—came up with a publication entitled “A Matter of Time: HIV/AIDS Development in the Philippines.”

According to the book, with only 13,000 infected Filipinos, the status of HIV/AIDS in the country was described as “low and slow”.  Most of these infected, at that time, believed that AIDS is a foreigners’ disease. “It’s not a Filipino disease,” one of those infected said.  “I thought that since I had no foreign partners, just Filipinos, it’s impossible for me to get infected.”

Filipinos in the far-flung areas, likewise, believed HIV/AIDS was common only in Metro Manila.  “They said there’s no AIDS here in Davao, only in Manila,” commented a teenager who’s HIV-positive.

In 2015 Davao City was listed by the health department as one of five cities outside of Metro Manila with “high prevalence” of HIV/AIDS. The other four were the cities of Angeles, Bacolod, Cagayan de Oro and Zamboanga.

Sixteen cities and municipalities in NCR were listed as “high risk areas”.  Also included were Bulacan (particularly San Jose del Monte), Antipolo, Cainta, Bacoor, Imus, Dasmariñas and Laguna (specifically Santa Rosa).

When the first official report of the disease was published in 1982, no one knew it would become the most devastating epidemic in human history. “HIV continues to be a major global public health issue, having claimed more than 35 million lives so far,” the WHO reported.

According to the UN health agency, HIV targets the immune system and weakens people’s defense against infections and some types of cancer.  “As the virus destroys and impairs the function of immune cells, infected individuals gradually become immuno deficient.  Immune function is typically measured by CD4 cell count,” the WHO explained.

Immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off, the WHO pointed out.

AIDS is the most advanced stage of HIV infection.  “This can take from two to five years to develop, depending on the individual,” the WHO said.  It defines AIDS as “the development of certain cancers, infections, or other severe clinical manifestations”.

“[AIDS] is a syndrome because there are a range of different symptoms, which are not always found in each case,” explains Dr. John Hubley, author of The AIDS Handbook: A guide to the understanding of AIDS and HIV. “It is acquired because AIDS is an infectious disease caused by a virus, which is spread from person to person through a variety of routes.  This makes it different from immune deficiency from other causes such, as treatment with anticancer drugs or immune-system suppressing drugs given to persons receiving transplant operations.”

HIV is spread through the exchange of body fluids with high viral load, like cerebral fluid, amniotic fluid, blood, semen, cervical and vaginal secretions and breast milk.  The virus is transmitted by sexual intercourse (vaginal, penile, anal and, in some instances, oral), blood and blood products (through transfusion) and shared needles.

A woman infected with HIV may spread the virus to her child during pregnancy, during birth or shortly after birth and through breast-feeding.

In the May report of new HIV cases, 558 were infected through homosexual contact, 360 through bisexual contact, 150 by heterosexual contact and 27 by injecting drugs.  At least three infants were infected by their mothers.

The health department said that most HIV cases were transmitted through sexual contact.  That was how 84 overseas Filipino workers got the virus.  In addition, about 86 percent of those infected through sexual contact were men having sex with men.  It is also the most common form of transmission in Davao City, according to Alma Mondragon, the Mindanao executive director of Alliance Against AIDS in Mindanao.

“A single sexual encounter can be sufficient to transmit HIV,” Hubley wrote.  “Although the risk from an individual sexual act may be low, the more times a person has sex, the greater the likelihood that transmission will take place. Women appear to be more at risk than men from heterosexual sex.  The transmission of HIV from man to woman is believed to take place more easily than from woman to man.”

“The great majority of reason how it is acquired, however, is really through unprotected sex and drug use,” said Dr. Jordana P. Ramiterre, chief of the Reproductive Health and Wellness Center of the Davao City Health Office.  “We again say that it is not who you are but [that] you do which poses you the risk of having AIDS.”

Dr. Willie T. Ong, an internist-cardiologist and author of several health books, said there are four stages of HIV/AIDS.  In Stage 1, known as primary infection, the person experiences “flu-like” symptoms and will test positive for HIV.  In Stage 2 (called asymptomatic illness), the person is HIV-positive and, yet, doesn’t have any symptoms of the disease (lasts around three to 10 years).

As the immune system weakens because of HIV, the person now develops symptoms, such as fever, fatigue, night sweats and weight loss.  This is Stage 3 or symptomatic illness. It goes to Stage 4 or advanced disease when “the disease takes a turn for the worse and the person develops so-called opportunistic infections from bacteria, viruses and fungi”.

The question is: how will you know that you are an HIV carrier?  It can only be answered by testing for HIV.  “The HIV test works by detecting antibodies produced by a person after exposure to the virus,” Ong explained.  “A common problem here is when to do the HIV test.  If a person has become infected with the HIV virus, how long is the lag time before the person test positive?”

According to studies, most persons will develop a positive HIV test within  two to eight  weeks after exposure.  “Around 97 percent will develop these antibodies within three months of exposure,” Ong said.  “A few rare cases [less than 3 percent] will take six months to become positive.  Because of this, experts recommend that a person gets an HIV test at six weeks and at three months after exposure.  It is optional to take another test at 6 months after exposure.”

(To be concluded)