Are young Pinoy gays the new face of AIDS in RP?

It started with a cough that never went away. Then came a sore that never seemed to heal. After days of fervent worrying, Paul (not his real name) decided not to see his regular doctor anymore. He proceeded to have an HIV test.

The 23-year-old call center agent had heard stories about a colleague who always got sick and never seemed to get better. “He contracted the flu one month, then pneumonia several weeks later. It was unusual," Paul said. Upon the advice of a doctor, the office mate went to a clinic and had his blood screened for the Human Immunodeficiency Virus (HIV). A week later, the bad news came: he tested positive for the virus. When Paul found out about his colleague, he knew he needed to be tested immediately. After all, he was the perfect fit for the profile of high-risk individuals for HIV and Acquired Immunodeficiency Syndrome (AIDS): a young gay man who has multiple partners and has had unprotected, penetrative sex with other men. Gay rights advocates and AIDS awareness groups have confirmed that young gay men are beginning to represent the new face of HIV/AIDS in the country, with recent figures showing an increasing trend in homosexual transmission. Since 2007, two-thirds of HIV infections recorded in the country were found among men with homosexual or bisexual relations, according to statistics from the Department of Health (DOH). This is significantly higher than the overall figure of 43 per cent for homosexual and bisexual transmission since the first HIV case was reported 25 years ago, official data shows. In the same period, 90 per cent of the cases were sexually transmitted infections, with intravenous drug use accounting for the rest. In 2009, however, all the new cases so far came from sexual contact, majority among young men. From January to October this year, 86 per cent of the 629 new cases who tested positive for HIV were males. In October alone, 80 new HIV-positive cases were recorded, mostly men aged 25-34 years old who had sex with other males. “It's impossible not to touch on homosexual concerns when relating to HIV/AIDS programs," said Malu Marin, executive director of the AIDS advocacy group ACHIEVE. “But we approach HIV/AIDS programs in the country holistically," she said. With new cases of HIV infections rising by one-third this year, the Philippines is one of the countries where a “hidden and growing epidemic" is imminent, the United Nations warned on the occasion of World AIDS Day on Dec. 1. The increasing trend worries Renaud Meyer, UN Development Program country director for the Philippines, who says the government is unlikely to achieve the Millennium Development Goals of stopping the spread of HIV by 2015. “Instead of reversing and halting it, we see increasing cases," Meyer told GMANews.TV. “It is important to promote voluntary testing especially among vulnerable and high risk group because when more people get tested, we’ll have a better knowledge on the real situation in the Philippines," Renaud added. Overall, the DOH has recorded 4, 218 HIV-positive Filipinos from 1984 up to October 2009. A total of 828 Filipinos developed AIDS, and 318 have since died including one this year, according to official records. Back to the closet Medical professionals concede that the figures do not reflect the real picture of HIV/AIDS in the country, as there could be many more under-reported cases among individuals who are either scared to take the test or lack awareness about the disease. Cebu Rep. Nerissa Corazon Soon-Ruiz, chair of the House committee on the Millennium Development Goals, said there are an estimated 11,000 undocumented and unreported HIV and AIDS cases in the country. A doctor by profession, Ruiz said a bill needs to be passed to amend the existing Philippine AIDS Prevention and Control Act of 1998 to increase the current level of awareness among Filipinos about the problem. The envisioned legislation will also propose appropriate measure to support HIV and AIDS carriers and their families by improving support systems for them. Dr. Olive Dizon, a medical specialist at HIV/AIDS wing of San Lazaro hospital, the country’s center for infectious and communicable diseases, said Filipinos need to be re-educated about taking HIV tests. “The stigma is still there," Dizon told GMANews.TV. “But if they won’t get tested they have no other way to find out." The present law provides free counseling behind closed doors for those who want to take the test. “It is important to have the same doctor for the pre-test and post-test screenings to foster confidence with the patient and also trust," Dr. Dizon said. Doctors can never reveal their patients’ identities, even to their fellow doctors. Sometimes, Dr. Dizon said she had to tell patients to calm down before taking the test, explaining to them that not all opportunistic infections like TB or herpes are linked to HIV. “These infections could attack the body when the immune system is down. When a person is stressed or depressed, his immune system is down. Sometimes, it’s just that." Often, the stigma is borne out of lack of proper information. Nelia Sevidal, executive director of the non-government organization Lunduyan Para sa Pagpapalaganap at Pagtatanggol ng Karapatang Pambata, Inc., said Filipinos have a twisted image of what persons living with HIV/AIDS (PLHAs) look like. “When Filipinos are told of HIV, most of them get the vision of a skin-and-bone, ghost-like figure of a person," Sevidal told GMANews.TV. In many cases, however, this is a false picture. With regular check-up and medication with antiretroviral drugs, PLHAs can look like any healthy individual, she says. But fear of ostracism from their family and communities make PLHAs, or sometimes even those just thinking of taking an HIV test, adopt a culture of silence. “For the PLHAs, silence is the only defense against discrimination," says Sevidal. In a 2007 study, the Johns Hopkins Bloomberg School of Public Health in Maryland found out that people living in countries where infections are widespread may have fewer preconceptions about HIV patients. According to their survey, there is much greater stigma against HIV/AIDS patients in countries such as Thailand, which is ranked 17th worldwide, than Zimbabwe, which has the fourth highest rate of HIV infection in the world, with approximately one-fourth of all adults infected.. “The findings imply that when people have more accepting attitudes toward HIV/AIDS, they are more likely themselves to get tested and seek treatment, as well as to be supportive of friends and family with the illness," read an article on the Johns Hopskins newsletter. Don’t be afraid of a little test Mandatory HIV tests are unlawful in the Philippines. Only Filipino workers bound for the Middle East often get tested as a requirement for employment, along with young urban professionals like Paul who, concerned about their health, can afford to shell out between 300 and 1,500 pesos for the screening. “Every time I cough, or have some sores on my legs or get herpes in my mouth, I wonder if I have it," said Paul. Six months ago, he finished treatment for tuberculosis, which he thought he might have contracted from the overcrowded MRT train on his way to work. But after a few months, he had to see a doctor again -- this time, for a wound on his leg that took a long time to heal. When he told a friend about taking an HIV test, he was told he should never be seen at a clinic testing for HIV; by merely appearing in one, he would be announcing to the world that he is gay and he is guilty of contracting the disease. Ignoring his friend’s advice, Paul decided to take an HIV test at the STD/AIDS Cooperative Central Laboratory (SACCL) at the San Lazaro Hospital in Manila. Established by the Japanese government in 1996, the SACCL is a modern HIV testing center that boasts of up-to-date laboratory facilities. It is designated as the National Reference Laboratory for HIV/AIDS, Hepatitis and other Sexually Transmitted Diseases in the country. Although the SACCL had one-way mirrors, Paul was still wary of the curious stares he got outside the office. He also felt uneasy about the required pre-test screening. “The first question was the toughest, ‘Do you have sex with other men?’" Paul confessed. “I was afraid that if I said ‘Yes’ the doctor would look at me differently. It took a while before the word was dragged out of my mouth. At that point, I felt it’s not okay to be gay." The counseling session took 30 minutes. Both patient and doctor filled out a questionnaire and a recommendation note was given to the SACCL for the test. The test consisted of taking a blood serum from the patient. Paul had the option not to use his own name to protect his identity. After a week, the test results came out: “Non-reactive." Paul made sure he read it correctly. “I was relieved. That was such great news," he said. His doctor advised him to take another HIV test six months later, as sometimes, HIV antibodies may take time to manifest in the blood. Paul took the test in October, and he said he will take the second test in May. Until then, he vows to remain celibate. - YA/GMANews.TV If you want to undergo HIV testing, visit the STD/AIDS Cooperative Central Laboratory at the San Lazaro Hospital, Quiricada St., Sta. Cruz, Manila. Tel No: 732-3776 to 78 Local 207