Text by Henrylito D. Tacio
Photos: WHO
(First of Two Parts)
Experience, so goes a popular saying, is the best teacher.
Jonathan (not his real name) is an example. He can teach well because he has experienced it himself. A noted health advocate from Digos City, he is a person living with human immunodeficiency virus (PLHIV).
HIV is the virus that causes the dreaded disease. While the person remains healthy, he is said to be HIV-infected. But as the disease progresses and symptoms appear, he may develop the late stage of the disease called Acquired Immune Deficiency Syndrome (AIDS).
Most of his friends know that he is a PLHIV as he has revealed his situation to them. “Of course, they are saddened,” Jonathan discloses. “(After hearing my story), they tapped my shoulder and wished that I would surpass all the things that happened to me knowing that I have a positive outlook in life.”
He says he has nothing to hide anymore. As a matter of fact, his colleagues at the Department of Education (DepEd) have known the matter already. “I don’t have anything to be ashamed of,” he says bluntly. “My honesty and being open has paved me for more blessings and favors as they offer prayers for me and so with other PLHIVs.”
A public senior high school teacher, Jonathan teaches accountancy, business, and management strands subjects. He grew up being taken care of by his mother, who’s a single mom.
“I’ve felt the love from my relatives (mostly female-figures),” he admits. “Just like they said, I was a mama’s boy. I used to play with cooking materials, but I never missed playing basketball, too. I even played traditional Filipino games outdoors with my friends in our neighborhood. I think I had a mixed upbringing during my childhood days.”
Now 35, Jonathan had his first sexual encounter with a man when he was still a teenager. After that, he had lots of trysts. More so when he was already in college. He met some of his sexual partners in youth organization meetings (from which he was very active) and even on online chat platforms.
Of course, he had heard about the dreaded disease from newspapers and other forms of information. “My partner and I practiced safe sex when we do anal sex,” he says, “but with oral sex, we don’t use any condoms.”
In 2011, he attended a program in Manila as he was a Posi+ve Youth Ambassador for a non-government organization. Knowing that he was sexually active, his friends cajoled him into undergoing HIV testing. At first, he was adamant, but he finally relented. All laboratory results were negative.
His life completely changed in 2017 when he was finally diagnosed with HIV+. He was admitted to the hospital because his stomach was aching continuously. He felt uneasy and was dehydrated, too. “I was so thin at that time – from my normal weight of 58 kilograms, it dropped suddenly to 46 kilograms,” he says.
The doctor found something was wrong with him. So, he recommended the patient to undergo HIV testing. “After few hours of getting tested, the nurse – who happened to be a former colleague in youth governance – told me the result,” he says.
He accepted the result “without hesitation.” After learning it, “I said to myself and paused for a while and talked to the Lord to heal me and use me to continue my advocacy in making a difference in my community in particular and the whole country in general,” he says.
After getting the result, he immediately told his mother, his friends, and colleagues. Though it wasn’t easy, he had to come out. There is so much stigma and discrimination when it comes to HIV/AIDS, and he wants to do something about it, he says.
“I was admired by my friends and colleagues for coming out as PLHIV,” he says now. “I need to be brave so others can see in me that it is not the end of life yet and that there is still hope.”
The first case of a person infected with HIV was in 1981. The US Center for Disease Control and Prevention (CDC) published a report of five young men with fatal or life-threatening Pneumocystis pneumonia (PCP).
Almost never seen in people with intact immune systems, PCP turns out to be one of the major “opportunistic infections” that kill people with AIDS. Since then, so many things have happened. In 1985, Hollywood actor Rock Hudson died of AIDS – thus giving the disease the much-needed face.
The Geneva-based World Health Organization reported that there were 37.7 million people living with HIV, 1.5 million new HIV infections, and 680,000 AIDS-related deaths in 2020. Around 65% of HIV infections globally were among key populations, including sex workers and their clients, gay men and other men who have sex with men, people who inject drugs and transgender people, and their sexual partners.
In the Philippines, the first case of HIV infection was reported in 1984. Since then, the numbers have gone up. Early this year, the HIV/AIDS and ART Registry of the Philippines (HARP) of the health department said there were 875 confirmed HIV-positive individuals in January 2020.
The National Capital Region topped had the most number of newly reported cases with 285 cases (33%), followed by Region 4A or Calabarzon with 156 cases (18%), and then Central Luzon with 100 cases (11%).
Western Visayas came fourth with 65 cases (7%). Davao and Central Visayas are tied with 50 cases each. All in all, these top regions comprised 81% of the total number of cases in January 2020.
Of the total reported cases, 99% (863) were infected through sexual contact: male-male sex, male-female sex, and sex with males and females. The male-to-male registered the highest number: 592 cases.
Less than one percent (3) of the reported cases each have acquired HIV through sharing of infected needles and through mother-to-child transmission.
What is alarming is that 32% of the new cases involved young people. About 283 of the reported cases were among those 15-24 years old, and 96% (272) were male. Some 69 of these youths were in advance infection with HIV. Ninety-nine percent of the cases were infected through sexual contact.
This phenomenon is not confined to the Philippines alone.
“Majority of people newly diagnosed with HIV are among persons between 25 and 34 years old,” says Dr. Louie Mar Gangcuangco, a Filipino doctor who’s a tropical medicine specialist and senior preventive medicine resident at the Griffin Hospital-Yale School of Public Health in Connecticut, United States. “This is likely driven by the higher risk of sexual behavior within this age group. The accessibility of casual sex through online platforms is also likely contributing to the increased incidence of HIV in this age group.”
During the coronavirus disease 2019 (COVID-19) pandemic, health services were greatly affected. It’s not only those health problems related to heart, mental, and respiratory but even those infectious diseases like tuberculosis (TB) and HIV.
“It is without a doubt that the COVID-19 pandemic has affected HIV work, both in the laboratory and the clinical setting,” admits Dr. Gangcuangco. “In several institutions globally, laboratory work slowed down, with a decreased number of researchers performing experiments and taking turns in the laboratory to ensure social distancing.”
At the time when the pandemic was at its peak, many clinical staff had to focus on caring for COVID-19 patients. “Patients were encouraged to stay home for ‘non-urgent’ concerns, which unfortunately includes delaying HIV testing,” says Dr. Gangcuangco, adding that it was not unique only to HIV testing but also affected other health services such as routine cancer screening.
Davao City was not spared from such a predicament. Dr. Jordana P. Ramiterre, head of the Reproductive Health and Wellness Center, told SunStar Davao that “the restrictions of the COVID-19 pandemic affected their office’s delivery programs and services for the prevention of HIV/AIDS.”
She added that treatment, care, and support to people living with HIV were greatly suffered, especially during the enhanced community quarantine, where people were required to stay at home and movements were restricted.
Meanwhile, Jonathan is very much appreciative that he is still alive despite all the odds he experienced. When asked how he manages his HIV, he replies: “Stay healthy, positive thoughts, adhere to the medicines to suppress the virus, and continue to serve the people and the Lord.”
Even before Jonathan was tested positive, he was already an HIV/AIDS advocate. “It has been my plan to be an advocate to strengthen the program for HIV and AIDS in our community,” he says.
“Now, that I am part of the HIV+ community, it is my dream to organize the PLHIVs. I have committed and found myself into organizing all PLHIVs in my community right now to have a voice in ending stigma and discrimination,” he points out.
He is a teacher, and he has experienced it. “What I have learned from my experiences was being open to my status and having a positive outlook in life is the key to gaining support from the community and slowly ending the stigma and discrimination that every PLHIV face. I said to myself that having this situation and status is a blessing, not a curse,” he says.
Organizations like what Jonathan has organized are very important for PLHIV. “Internal peer support groups are very effective in encouraging every PLHIV to continue with their lives and to stay healthy,” he says. “These groups can help them accept the fact that they are PLHIV with no shame.” (To be concluded)