- By Diana G Mendoza
Philippines' HIV epidemic the highest in Asia Pacific
Manila — While its neighbors are seeing huge drops in their HIV infections, the Philippines rocketed high above other countries in Asia Pacific with a record increase in the number of new human immunodeficiency virus (HIV) infections in the last six years.
A 2017 report of the Joint United Nations Programme on HIV/AIDS in mid-July put the Philippines high up with a 141 percent increase in new HIV infections between 2010-2016,
The country's epidemic is fuelled by transmissions among men who have sex with men and transgendered women who have sex with males. The epidemic is also fueled by people who inject drugs, sex workers and the clients of sex workers.
Eamonn Murphy, the new director of the UNAIDS Regional Support Team for Asia Pacific, said the Philippines for many years "has done an excellent job at keeping HIV infections low" while its neighbors such as Thailand and Indonesia were experiencing exponential growth in their AIDS epidemics.
The Philippines also provided a good example of HIV-AIDS legislation when it enacted a law in 1998 to address what it expected would be a looming health and socioeconomic problem in the next decade.
That was an accurate prediction. Currently, the Philippines is opening clinics and intensifying HIV testing and treatment of its other affected populations. It has also vowed to strengthen protective measures such as campaigning for a more widespread condom use. However, few of these programs have been synchronized to respond to the epidemic.
"But the nature of the epidemic has now changed," said Murphy. "Unlike in the past where infections were among sex workers and the government provided services to prevent and treat sexually transmitted infections, now more than 90% of new HIV infections are occurring among MSM and TGW. Condom use and HIV testing is low among both populations."
He said "countries like the Philippines are in many ways a victim of their own past success. Celebrating some success, it took the foot off the pedal," he said in response to emailed questions on the eve of the release of the report.
"The Philippine government needs to retool its HIV program to cater to the growing needs of people who are most at risk and vulnerable to HIV. This has worked before in the Philippines and it can work again." Generally though, he said the Asia Pacific region is lagging behind global trends and a major reason for that is complacency.
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One of the government's immediate solutions was to start enrolling 200 male MSM and TGW in a one-year demonstration research into the feasibility of pre-exposure prophylaxis in the form of the generic capsule Mylan, a once-a-day prevention pill that protects the body from HIV infection. The pill, called Truvada in the U.S. that combines two anti-HIV medicines, has been in use in the US, France, Norway, Australia and Canada and has effectively lessened HIV transmissions.
The Department of Health is also set to implement a "treat all" strategy to put HIV-infected persons on immediate medication or antiretroviral drugs right after they test positive, in order to slow down the progression of the HIV to Acquired Immune Deficiency Syndrome (AIDS) in an infected person, lessening the chances of transmitting the virus to others.
The World Health Organization, which recommended the strategy, said the Philippines is the latest among countries in the region to adopt the policy, following nations in the Pacific islands that are also trying to lessen infections in their populations.
While it is facing the rapid rise of infections, the Philippines also has to contend with a virus mutation, which was discovered by government experts studying the virulence of the AIDS-causing HIV that now changes its molecular structure, signifying the presence of a new strain that progresses fast into AIDS, the terminal phase of HIV infection.