DOH scaling up community approach to end HIV epidemic

SUBIC BAY FREEPORT, Philippines – The Department of Health (DOH) and the Research Institute for Tropical Medicine (RITM) are harnessing community participation in the government’s response to the human immunodeficiency virus (HIV) epidemic, as the country attempts to curb the outbreak to meet the Global Sustainable Development Goals (SDGs).

The UNAIDS 2016 Prevention Gap Report indicated a 49% increase in HIV/AIDS prevalence in the country. According to the HIV/AIDS and ART Registry of the Philippines, in May 2016 alone, around 736 people got diagnosed with the virus. (READ: ‘The HIV Generation’: 25 people get infected daily in PH)

The recent statistics also indicated sexual contact as the predominant mode of transmission with 687 cases, followed by injecting drug users with 50 cases, and mother-to-child transmission with two cases.

Dr Rossana Ditangco, head of the Research for Tropical Medicine-AIDS Research Group, said in a media seminar on reporting HIV on Thursday, July 14, that men who are having sex with men (MSM) continue to be the drivers of transmission especially in urban areas. (READ: PH won’t meet MDG target on HIV/AIDS – UNAIDS)

“We must be able to reach 80% of each key affected population and give them access to education, prevention, diagnosis, treatment, and care. The reality, however, is that we only get 40% from each population. To reverse the epidemic, we must reach everyone,” she added.

To address the increasing prevalence of HIV/ AIDS in the country, DOH is launching a two-pronged response to halt and reverse the spread of the infection.

Prevention and mitigating impacts

Through a multi-sectoral approach, DOH hopes to obtain its goal to reduce HIV and sexually-transmitted infections (STI) transmissions among key affected population and mitigate its impact to the individual, family and community level. This includes building a framework of partnership with health facilities, local government units, and non-governmental organizations. (READ: HIV in 6 PH cities may reach ‘uncontrollable’ rates – DOH)

“Reactivating the Local AIDS Councils will help in addressing our Key Affected Population. There will always be a political component, and communities, with their LGU’s, will play a big role in achieving these goals,” added Ditangco.

She also emphasized how multi-disciplinary approach in diagnoses, treatment, and psychosocial support will ensure a continuum of care not only for those who tested positive but also for those who tested negative.

Ditangco it is important to close the gap between those who are not reached by the response, those who get tested and do not get their results, those who tested positive but don’t get treatment, and those who get treatment but are not compliant to their prescribed Antiretroviral Therapy.

DOH puts a premium on using treatment as prevention with antiretroviral therapy (ART), along with the availability of post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) in the country. While PEP and PrEP are only administered in special cases, ART has been proven to stabilize and improve the immune system of people living with HIV (PLHIV), down to a point where the person can be medically stable and symptom free.

“The life expectancy of a PLHIV under ARV is now readily similar to that of a normal person. With proper treatment and care, some even surpass that of those without, not to mention that it could even protect them from non-HIV related illnesses, such as stroke,” Ditangco said.

Scaling up response

While DOH is pushing for similar prevention strategies – such as education, HIV counseling and testing, condom and lubricant use, circumcision, and ARV therapy – the emphasis of their programs will focus more on behavior and value-based education, community based screening and testing campaigns, rapid HIV diagnostic through same-day test result issuance, and early access to treatments.

“We need to break barriers in our approach, so we’re looking at parents and educators for early sex and SOGIE education. HIV prevention and mitigation should go hand in hand with values education, if we are put an end to this epidemic,” Ditangco stressed.

Scaling up also means leveraging the response, not only for the key affected population but also to the general population in the long run.

DOH hopes to empower communities to help end HIV and AIDS by reinforcing preventive behaviors and developing a culture of safe practices from homes to schools. – Rappler.com

Russel Jude Patina is one of Rappler’s Lead Movers in Iloilo City.