Text by Henrylito D. Tacio
Photo from gloveclinic.com
A single mother of a 6-year-old boy, 26-year-old Elizabeth worked as a cashier at a café in Manila. When she learned about her status, she was totally devastated. “I cried all the time, every time I’m reminded of what happened,” she said, adding that she cried even more “because of the discrimination I’m going through.”
Two years after she was diagnosed of having HIV, Elizabeth started to suffer from double vision and frequent headaches. Her doctor, who could not determine whether she was suffering from an opportunistic infection, suggested that she undergo magnetic resonance imaging (MRI) on her eyes.
Because the doctor recommended rest, she needed to file a leave of absence from her company. “I told our human resources about my status so I can have a valid excuse for my leave, which was going to take a long time because the doctor wanted me to rest,” she said.
She was fired as a result. “My supervisor said she understood me and would like to help,” she said. The supervisor then referred Elizabeth to the manager of a manpower company that supplies workers for restaurants. The manager told her: “Since there may be people who won’t understand what happened to you, I need to pull you out of the coffee shop.”
The manager then asked Elizabeth to fill out forms, one of which turned out to be a resignation letter from the employment agency, not just the coffee shop. “I asked why and he told me it’s because I was exposed to food,” she said. “He was very good at convincing me to resign for my own good, that resigning would reduce my stress, things like that. But it was painful. I know what he was asking me to do was wrong. It felt wrong.”
At the manager’s urging, she signed the resignation letter.
Elizabeth’s case — from the collection of Human Rights Watch — is one of the many sob stories of people who are infected with human immunodeficiency virus (HIV), the microorganism that may result later on to acquired immune deficiency syndrome (AIDS).
Although being HIV-infected is no longer a death sentence, the disease is still one of the most dreaded and favorite subject matter of gossip. In addition, the stigma and discrimination attached to it is very prevalent.
Despite the fact the Philippines is still under threat by coronavirus disease 2019 (COVID-19), the pandemic doesn’t stop HIV/AIDS from proliferating among those who engage in “risky sexual behaviors.” Among those who are doing such acts are gays, bisexuals, men who have sex with men (MSMs), and others who participate in unprotective sex and with multiple partners.
In General Santos City, for instance, Shine Soccskargen, Inc. is very much worried over the surge of HIV/AIDS confirmed cases in the city. The infections, said Cris Lopera, could become a major problem for the city if not immediately given proper attention by concerned agencies.
Lopera is the executive director of gender rights and reproductive health of Shine Soccskargen, a health advocacy group. He was the source of information for a news report circulated by the Philippine News Agency.
Quoting a report from the City Health Office’s (CHO) HIV/AIDS Core Team, he said the confirmed cases in General Santos City have already increased to 112 as of the end of September. In comparison, there were only 44 cases detected last year.
Lopera urged stakeholders, including the city government, to “take another look at the situation and not just focus on the COVID-19 pandemic.” As he puts it: “We should not wait for the cases to increase to 100 every month before we act on the problem.”
Speaking of the COVID-19 pandemic, those who are HIV-positive are classified under the A3 priority group in the government’s vaccination program. But for their safety, they need to have medical clearance before they can be vaccinated, as required by the health department.
Despite limited data, available information suggests current WHO (World Health Organization) recommended COVID-19 vaccines – AstraZeneca/Oxford, Johnson, and Johnson, Moderna, Pfizer/BioTech, Sinopharm, and Sinovac – are safe for people living with HIV.
During the start of the COVID-19, doctors see a similar type of stigma among those infected. In the past, people would fear and shun people who were HIV-positive; the same is true for those with COVID-19.
“Some medical frontliners who had been working in the COVID-19 wards found themselves similarly ostracized by the people around them, even by many landlords refusing to shelter them,” wrote one scribe.
“HIV and COVID-19 are considered as similar outbreaks that have captured the attention of the public dramatically. It’s the dread of infection that causes this fear, even with the presence of the HIV Law and better policies,” the scribe added.
HIV was first reported in 1981 in the United States. “(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.
Dr. Hubley says HIV 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 anti-cancer drugs or immune system suppressing drugs given to persons receiving transplant operations.”
In the Philippines, the first case of HIV infection was reported in January 1984. As of January 2021, about 29 Filipinos are infected with HIV each day, according to the HIV/AIDS and Art Registry (HARP) of the Department of Health (DOH).
There were 890 reported cases, of which 172 (19%) had clinical manifestations of advanced HIV infection at the time of testing. Ninety-six percent (852) of the reported cases were male. Of the total male cases, 24 (3%0 reported their self-identity as female (transgender women) at the time of testing.
At the time of diagnosis, more than half of the cases (53%, 468) were 25-34 years old, 25% (220) were 15-24 years old, 20% (179) were 35-49 years old, 2% (21) were 50 years and older, and less than one percent (2) were less than 15 years old. The median age was 28 years old (range: 3-70 years old).
Actually, HIV is a relatively weak virus outside the human body. But once it is inside, HIV cannot be killed. The virus is spread through the exchange of body fluids with a 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 breastfeeding.
According to HARP, almost all (97%, 859) of the total reported cases in January 2021 were infected through sexual contact. There were six cases that had acquired HIV through sharing of infected needles, and one child had been infected through mother-to-child transmission.
Among the newly reported cases whom had acquired HIV through sexual contact, most (89%, 765) were males who had sex with males and followed by male-female sex (11%, 94).
According to the United Nations 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 immunodeficient. 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 United Nations Health agency pointed out.
AIDS is the most advanced stage of HIV infection. “This can take from 2 to 5 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.”
A person with HIV will never know he is positive of the virus unless he or she undergoes an HIV test. “Having an HIV test is the only way to know for sure whether you have HIV,” said the website, www.aidsmap.com. “If you have HIV, it’s very important that it’s diagnosed. This will give you the best chance of getting the treatment and care you need to stay well.”
Currently, there is no cure known for HIV, but the virus can be controlled with proper medications called antiretrovirals. “With healthy lifestyle and if antiretrovirals are taken every day, people with HIV can have an ‘undetectable’ virus in their blood,” says Dr. Louie Mar Gangcuangco, who has worked as a researcher at the Hawaii Center for AIDS.
By “undetectable,” he means that the virus is still in the body but in very low amounts that it cannot be detected by the machine.
According to the boyish-looking physician, HIV is not and should not be treated as a death sentence anymore. “If HIV is detected early and if the patient takes antiretrovirals early,” he says, “the virus can be controlled. There is still no cure for HIV but the bad effects of the virus can be prevented if medications are taken early.”
His final words: “I urge everyone who has had unprotected sex to please have an HIV test in your nearest HIV treatment hub/social hygiene clinic. People with HIV need to get tested to prevent damage to their immune system that can cause infections such as pneumonia, tuberculosis, diarrhea that can lead to death.
A total of 48,314 people living with HIV were presently on anti-retroviral therapy (ART) as of January 2021. Most (96%, 46,483) were males. The age of reported cases ranged from 1 to 82 years (median: 32 years old). Ninety-five percent were on the line regimen, 4% were on the second line, and 1% were on the other line of regimen.
ART is recommended for everyone who has HIV. ART can’t cure HIV, but HIV medicines help people living with HIV live longer, healthier lives. In addition, ART also reduced the risk of HIV transmission.
Despite this, people living with HIV are still struggling to find jobs.
“It’s difficult to find a job these days with my condition because I have to disclose my status so I can have a schedule that is good for my health, that fits my medical condition,” admits Jomar, an engineer who’s HIV-positive. “But if I disclose my condition, chances are I won’t get hired.”