CASES of HIV/AIDS decreased by 25 percent in 2010 worldwide, but the Philippines was an exception, according to a report released by the Joint United Nations Programme on HIV and AIDS (UNAIDS).
“The number of HIV infections and AIDS cases in the country continues to rise, and not lessen,” said Merceditas Apilado, UNAIDS social mobilization adviser, in an interview with the Philippine Daily Inquirer.
The Philippine HIV and AIDS Registry reported that 92 percent of the HIV/AIDS cases from 1984 to 2012 were primarily due to sexual interaction. Only four percent was caused by needle sharing among illegal drug users, while cases of mother-to-child virus transmission registered less than one percent.
According to Enrique Tayag, director of the National Epidemiology Center (NEC) of the Department of Health (DOH), HIV is an infection primarily caused by sexual activity.
“One should understand that HIV is a sexually transmitted infection,” Tayag told the Varsitarian. “Sexual exposure has different risks. Anal sex will pose greater risk than vaginal sex.”
Tayag said there were cases were HIV was transmitted through blood transfusion, prompting the government to implement strict screening procedures.
“Before a person can donate blood, he will have to undergo an interviewed physical examination and a blood test to assess his eligibility to donate blood,” Tayag said.
Bernardo Cuevas, chairman of the Clinical Epidemiology Department of the Faculty of Medicine and Surgery, said unnatural sexual acts increase the risk of acquiring HIV.
“The occurrence of transmission is more in perverse sexual acts,” he said.
Cuevas confirmed that HIV can be transferred through body secretions.
“There has to be a break or opening in order for the virus to enter the body. Kissing does not facilitate the transfer of the virus,” he said. “However, the act itself can cause a scratch which can become an entry point for the virus.”
HIV is a retrovirus that leads to AIDS, a collective term for diseases that impair the function of the immune system to protect the body from foreign entities. It can be transmitted through sexual intercourse, needle-sharing, and childbirth.
A retrovirus is a type of virus that needs host cells to support its replication. In the case of HIVs, the CD4+ T cells, or the T helper cells which are primarily responsible in instigating the body’s reaction to infections, serve as the host.
The transfer of the virus happens when HIV attaches to the CD4+ T cells which allow the virus to make copies of itself.
HIV then kills the CD4+ T cells and the decline in the latter’s number leads to the weakening of the immune system, which causes a person to be more vulnerable to life-threatening and rare kinds of diseases.
‘Modern day leprosy’
A research by the Philippine Population Association considered technology as a catalyst of the inflation of HIV/AIDS cases in the country, as it “frequently mediated the face-to-face mode of initiating and sustaining frequency of communication.”
“The Internet was used for finding and meeting potential dates. Commonly used platforms were chat rooms, social networking site, and dating sites,” the study states. “It provides a rapid mode for facilitating the spread of AIDS virus for this particular group of people in the Metropolitan area.”
Tayag also considered technology as a probable cause of HIV inflation in the country.
“Before, a person is usually limited to just one sexual partner, but the rise of the Internet allowed the user to visit websites where he can freely choose and get a partner,” he said.
Discrimination also makes it harder to prevent the disease from spreading.
“AIDS is the modern day leprosy. People don’t want to be tested because of the stigma. There is this fatalistic notion—they’d rather not know,” said Edu Razon of Pinoy Plus, an organization of individuals infected by HIV and AIDS.
A research conducted by the Population Council showed that in Southeast Asia, the concept of being guilty about having the disease contributed to the rise of HIV/AIDS cases.
The Population Council also discovered that discriminations are experienced by people infected with HIV and AIDS in the workplace.
“[Such] discriminatory practices as pre-employment screening, denial of employment to individuals who test positive, termination of employment of people living with HIV/AIDS (PHA), and stigmatization of PHA who are open about their HIV status have been reported from developed and developing countries,” Population Council’s study states.
The decline in morality, which was evident in the latest report of NEC, also triggered the increase in HIV cases. Data from the DOH showed that 95 percent of the reported cases this year are males.
The NEC report showed that HIV transfer is most prevalent in homosexual intercourse. From 1984 to May 2012, 40 percent of the cases of HIV transmission through sexual intercourse were due to homosexual contact, mostly male having intercourse with another male, while 26 percent was due to bisexual contact. Young people, aged 15 to 24 years old, took more than 20 percent of the reported cases since 1984.
The early cases of AIDS were first observed in the United States, with drug users and gay men as initial patients.
Government strategies
One of the main strategies of DOH to prevent the increase of HIV/AIDS cases is to encourage the people to use condoms when having sexual intercourse.
“The use of condom does not eliminate the risk, but it does reduce [the] risk,” Tayag said.
However, Cuevas doubted the efficiency of condoms in reducing the chance of acquiring the disease.
“This disease is highly concentrated on homosexuals,” he said. “Condom addresses heterosexual sex, so its effectiveness is not targeting the majority of the patients.”
The Philippine Health Insurance Corporation guarantees 30,000 pesos worth of antiretroviral (ARV) therapy for every person infected with HIV.
ARV drugs are medications for the treatment of infections caused by HIV.
“Peer Outreach Program” is also conducted by DOH to target the key population in HIV transmission.
“We consider female sex workers, people who inject drugs, and males having sex with other males as the key population,” Tayag said. “In this program, we get a representative from the same population to educate and help the patients deal with the disease.”
Meanwhile, a study conducted by Steve Cole and Jerome Zack of the University of California, Los Angeles (UCLA) showed that stress allows fast spread of the HIV virus within a person’s body.
Zack explained that when a person becomes stressed, the body releases norepinephrine, a stress hormone that affects the amygdala, a part of the brain that controls response and attention, which inadvertently permits the replication of the HIV.
“Norepinephrine enables HIV to enter the immune cell more easily and to reproduce more readily. So more virus gets in and comes out, resulting in a 10-fold increase in the amount of virus produced,” he said.
The research also proved that stress cancels the effect of ARV.
Recently, a pill called Truvada was approved by the Food and Drug Administration (FDA) of the United States to be taken as a preventive regimen against HIV infection.
“Truvada for PrEP is being approved with a Risk Evaluation and Mitigation Strategy (REMS) to minimize the risk to uninfected individuals of acquiring HIV infection and to reduce the risk of development of resistant HIV-1 variants,” according to a press announcement released by FDA on July 16.
