Text by Henrylito D. Tacio
Photos: WHO and Oxfam-Philippines
(Second of Two Parts)
People infected with human immunodeficiency virus (HIV) – the microorganism that causes Acquired Immune Deficiency Syndrome (AIDS) – has many faces in the United States. First, there was Hollywood actor Rock Hudson. The world was shocked when L.A. Laker legend announced that he would retire from basketball because he had AIDS.
In the Philippines, the first person to come out in the open to talk about her ordeal and how she acquired HIV was Maria Dolzura Cortez (who died in 1992). Her life story was serialized in Philippine Daily Inquirer and was made into a movie, Dahil Mahal Kita, starring Vilma Santos (who won acting awards for her sterling performance).
Actually, the first HIV/AIDS case reported in the country was in 1984. Since then, the number of people infected with HIV and who have died of AIDS have increased considerably. Despite all the information campaigns done by the Department of Health, the stigma attached to it still persists.
And despite several laws being passed, discrimination against those with the disease continues.
While undergoing treatment for tuberculosis (TB), 36-year-old “Kevin” came to know that he was positive for human immunodeficiency virus (HIV) when the doctor told him. A call center agent from Cagayan de Oro City, he didn’t reveal his status to his colleagues.
But TB had taken a toll on his health. With frequent stints in the hospital, his colleagues started talking about the root of his health problems. They were speculating that he had HIV. “I felt discriminated against because when I went inside the office one day, I actually heard people whispering, “That’s him! That’s the guy who has HIV!” Kevin recalled.
It was a matter of time that the company’s human resources office came to know the situation. He was called and was asked bluntly whether he had HIV. Kevin felt he had no choice but to disclose his status. He said that immediately following that disclosure, his coworkers started shunning him and refused to speak to him.
That treatment prompted him to quit the job. “I could no longer take it,” he said.
The case of a 26-year-old Elizabeth, another HIV-positive, was even more pitiless. A single mother of a 6-year-old boy, she 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 an 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.
These were just two of the several accounts of workplace discrimination against people infected with HIV compiled by Carlos Conde, the country’s researcher of Human Rights Watch (HRW). The names were changed to protect the privacy of the people interviewed for the report.
“Workers and employees in the Philippines living with HIV who suffer workplace discrimination often do not seek redress,” HRW said in a statement. It added that the government’s response to unlawful firings and harassment is “weak.”
Aside from unlawful firing, workplace discrimination also refers to the refusal to hire and forced resignation of people with HIV. “Some employees may also disregard or actively facilitate workplace harassment of employees who are HIV positive,” the statement said.
In most of the discrimination cases that HRW documented, “employees with HIV did not file formal complaints, most frequently due to fear of being further exposed as HIV positive, which could prevent future employment.”
Even until now, there is still so much to know about HIV/AIDS. “(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 anti-cancer drugs or immune system suppressing drugs given to persons receiving transplant operations.”
Actually, HIV is a relatively weak virus outside the human body. But once it is inside, HIV cannot be obliterated. 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.
HIV 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.
The Geneva-based World Health Organization (WHO), 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,” the United Nations health agency 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 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.”
Being infected with HIV is no longer a death sentence these days. “HIV is not and should not be a death sentence anymore,” points out Dr. Louie Mar Gangcuangco, who has worked as a researcher at the Hawaii Center for AIDS. “If HIV is detected early and if the patient takes antiretrovirals early, the virus can be controlled.”
However, in order to be treated, you need to know if you have HIV. And you will only find out if you undergo HIV testing. “Testing for HIV and other sexually transmitted infections is strongly advised for all people exposed to any of the risk factors,” the WHO said on its website. “This way, people learn of their own infection status and access necessary prevention and treatment services without delay.”
However, all HIV testing services must follow the five principles recommended by WHO: consent (informed), confidentiality, counseling, correct test results, and connection (linkage to care, treatment, and other services).
“Knowing your HIV status is not just a right but also a responsibility. People with HIV can live normal and productive lives as long as they take their medications and follow-up regularly with your doctor. Getting tested is not only for yourself, but also for your loved ones,” says Dr. Gangcuangco.
Like most diseases, HIV can be prevented – as easy as ABC: abstain from sex; be faithful to your partner; condoms must be used during sex (especially to those who have multiple partners); don’t share needles and education about the disease.
Dr. Gangcuango believes that educating the public on safe sex practices, such as the importance of condom use, is key to curbing the HIV epidemic in the country. He suggests several changes in the health care system have to be made.
Aside from having HIV testing accessible to all people, he also includes HIV treatment to be more available to everyone. “This includes training of medical practitioners on the appropriate care of people living with HIV,” he says. “Clinic hours should be expanded to ensure that those who work 8am to 5pm jobs can also access HIV testing and treatment outside of work hours.”
He also talks about pre-exposure prophylaxis. Better known as “PrEP,” it is a daily pill that people can take to prevent HIV. “PrEP is slowly being rolled out in the Philippines and its expansion would be a great addition to our armamentarium against HIV,” he says. “Among those who have HIV infection, ensuring that patients have enough social and clinical support so that they remain adherent to antiretroviral therapy is also very important.”
Right now, there is still no cure for HIV, but thanks to continuing medical advances in medications, HIV can now be seen as a chronic disease. In fact, people infected with HIV can enjoy long careers, get married, and raise families.
“There’s no cure for HIV, but treatment options are much better than they were a few decades ago,” Dr. Gangcuangco says. “Because of medical advancements, many people now live long, active lives with HIV.”