How the Philippines can turn the tide on HIV

POINT OF VIEW - Christine Stegling - The Philippine Star

The Philippines has one of the fastest growing HIV epidemics in the world.

Every hour there are three new HIV infections.

Every day there are four AIDS-related deaths.

Every single one of these is avoidable.

Our choices for preventing HIV are no longer limited to abstinence, being faithful or correct and consistent condom use. Thanks to four decades of HIV research and innovation, we have a much bigger toolbox of testing, prevention and treatment options.

We can now diagnose HIV with a painless oral swab or quick pin prick. Self-testing and rapid testing make it far easier for people to learn their status.

We can prevent HIV with a pill. Pre-exposure prophylaxis, PrEP, and post-exposure prophylaxis, PEP, are medicines that stop someone from contracting the virus even if they are exposed.?

And we can even treat HIV so effectively that people can’t pass it on. Last year the World Health Organization confirmed that when a person living with HIV takes their medicines correctly, the level of virus in their blood is undetectable and there is ZERO chance that they can transmit the virus! This concept is called undetectable = untransmittable, or U = U for short.

With today’s tools, people should not be infected at the disturbingly high rates we have seen emerge in the Philippines over the last several years . And those living with HIV should not die due to AIDS-related causes or transmit the virus to others. Instead, they should learn their status as early as possible, get on treatment right away, access support to remain adherent and go on to enjoy healthy, fulfilling lives.

How do we make this vision a reality?

First through political commitment. President Marcos has already declared HIV a national priority, and the country has recently joined the Global HIV Prevention Coalition. This is a consortium of United Nations member-states, UNAIDS co-sponsor agencies, donors, civil society and private sector stakeholders who have come together to strengthen HIV prevention. The Coalition supports countries to deliver the correct mix and scale of prevention services, while holding them accountable for reaching targets.

A key element of this accountability is ensuring that there are adequate domestic investments in prevention. Almost half of the Philippines’ new HIV infections are in youth between ages 15 and 24. This calls for increased financing for programs to address the powder keg combination of low HIV knowledge and early unprotected sex among young people.

The lion’s share of this funding should go to community-led prevention education and HIV service delivery, particularly those focused on young key populations. By “key populations” we mean males who have sex with males, transgender people, people who use drugs, people in prisons and other closed settings and sex workers.

Communities of people living with HIV and of key populations play a key role in ensuring HIV services reach those who need them most. These organizations can raise prevention awareness and increase demand for testing, PrEP and HIV treatment. Many of them can also provide these services themselves while offering the mental, emotional and social support their clients need. The non-judgmental care these organizations offer makes all the difference. Community leadership ensures that HIV programs achieve the highest possible impact. Smart investments in peer- and community-led strategies translate to fewer new infections, higher treatment adherence, lower long-term costs and more saved lives.

There is a third, critical element to winning at HIV prevention: addressing the stigma, profound prejudice and violations that people living with HIV and members of key population communities face. The thorny and tangled issues that increase people’s risks for contracting HIV also keep them away from life-saving services. We cannot succeed in our HIV prevention mission without working to end the stigma and discrimination that push people into the shadows, with all its dangers.

Many stakeholders in the Philippines are doing their part. I would like to highlight a collaborative effort between civil society, journalists and UNAIDS to address misinformation and change the narrative about HIV, people living with HIV and key population communities through news and social media engagement, including the “Visibility is Key” campaign. This mass outreach and sensitization are precisely what are needed to create a social context that supports people in getting the information and care they need.   

Too many people do not think HIV is a “me” problem. It feels more like a “them” problem. But the last 40 years have taught us that if we neglect “them” long enough, HIV winds its way to new groups. Every individual, community and leader can help the Philippines turn the tide from the fastest growing HIV epidemic in Asia and the Pacific to a prevention success!

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Christine Stegling is deputy executive director of UNAIDS.

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