HIV/AIDS in JordanForearms of Change Center to Enable Community (FOCCEC) is an NGO based in Amman, Jordan, working to help people with HIV/AIDS in Jordan. Through collaborative efforts with several Jordanian health service providers and partners, FOCCEC provides HIV-positive people with access to treatment and care resources. Through a variety of services, FOCCEC aims to support an often underserved and stigmatized community.

HIV/AIDS in Jordan and the MENA Region

With an HIV prevalence rate of 0.1%, the Middle East and North Africa (MENA) region has the fewest HIV cases per capita in the world. In Jordan specifically, this rate is less than 0.1% and the new case count is fairly low. Between the beginning of 2020 and February 2021, Jordan reported 21 new HIV cases. HIV cases do not occur evenly among populations in the MENA region. Sex workers and people who use injectable drugs are at an elevated risk of contracting HIV. However, the total case numbers are low compared to other regions.

While HIV impacts few people living in Jordan, those who are HIV-positive often experience stigma and lack access to proper medical treatment. A survey of Jordanian women found that more than 70% would not want to purchase vegetables from someone with HIV. Instead of receiving medical care, solitary confinement is common among incarcerated individuals with HIV/AIDS in Jordan who are not Jordanian nationals.

Non-citizens may be less likely to seek treatment because of legal concerns. Jordanian healthcare providers are required to report the HIV status of patients to the Jordanian government. The Jordanian government typically deports non-nationals who test positive for HIV. Jordan’s deportation policies impact asylum seekers needing HIV treatment. In early 2020, an HIV-positive Iraqi refugee did not seek treatment because he feared deportation.

FOCCEC Supports HIV-Positive People

FOCCEC works to help people with HIV access testing services and assists in navigating the treatment process. The organization travels outside of Amman to regions of Jordan such as Irbid, Mafraq and Zarqa to increase people’s access to HIV testing services.

Following individuals’ diagnoses, FOCCEC provides treatment and counseling services. It also helps patients with other sexually transmitted diseases. FOCCEC strives to ensure that refugees and non-Jordanians can access HIV treatment services. It also offers monetary support for patients with financial barriers to treatment as a way of making healthcare accessible and affordable.

Preventing HIV Transmission in Jordan

Historically, most cases of HIV/AIDS transmission occurred in other countries. However, local transmission is increasing, particularly among people 20-24 years old. New HIV/AIDS cases are also common in people aged between 30-39, representing 25% of new HIV/AIDS cases in Jordan.

FOCCEC implements programs to improve HIV awareness in Jordan, an initiative that could help reduce local transmission rates. A survey of young adults in Jordan concluded that only 25% of respondents knew that condoms help prevent HIV transmission, suggesting that young Jordanians could benefit from better education on HIV transmission and protection.

FOCCEC is a change-driven organization working to create a world where vulnerable communities in Jordan can access the resources needed to meet their medical and social needs. Through its efforts, the prevalence of HIV/AIDS in Jordan can reduce even further.

Caroline Kuntzman
Photo: Flickr

Children in Pakistan
Pakistan is a mostly Muslim country between Afghanistan and India in South Asia. The country gained independence in 1947 and the government operates as a parliamentary democracy. In recent years, the country has adopted Sunni Islam’s essence, with Northern Pakistan facilitating a sanctuary for various Islamic extremist groups. The life expectancy in the country averages 67 years. In 2015, an Asian Development Bank report determined that 24.3% of Pakistanis live below the poverty line and UNAIDS claimed that 190,000 Pakistani are HIV positive. The organization also stated that the number of deaths from HIV cases has increased by 385% since 2010, with only 12% of patients receiving treatment. Unfortunately, the number of children in Pakistan with HIV has been significant.

Recent HIV Outbreak

Between April and July 2019, medical professionals diagnosed 735 children in Pakistan with HIV. The World Health Organization (WHO) has labeled the epidemic as a Grade Two Emergency. This implies a moderate approach to combating the problem since, according to WHO, Pakistan is one of the lowest spending countries when it comes to funding for health. Pakistan utilizes only 3% of its GDP for healthcare, whereas its neighbor, Afghanistan, allots 10%. Per person, Pakistan spends less than $45 on annual healthcare.

With the COVID-19 pandemic, many essential health issues have received neglect. In September 2020, Lancet Global Health constructed an investigation around how the pandemic has affected other health crises. In its findings, reports determined that deaths for HIV have increased by 10% since the beginning of the pandemic. The medical system has been under stress due to the pandemic, leading to a decrease in medical support for HIV. During this time, a local reporter named Gulbahar Shaikh, who had been covering a story in Ratodero around this time, decided to have his children tested to be safe. He was reportedly stunned when his daughter, Rida, came back positive for HIV.

Solutions

In November 2019, cases of HIV-positive children in Pakistan started to emerge in Ratodero, a city just north of Larkana. In fact, reports stated that 1,132 children had HIV in Ratodero. As soon as possible, the local government sent experts to respond. During their investigations, it came to light that many of the patients did not have infected parents, which set off a red flag to officials. They later found that many of the infected children saw a doctor named Muzaffar Ghanghro. He was a cheap, in-town physician working primarily with children. Finding this, officials made Ghanghro obtain a test for HIV too. Even when his results came back positive for HIV, he denied the results.

The officials found Ghanghro fully responsible for the increase in outbreaks within children in Ratodero, and police arrested him. He spent about two months in jail but the pediatrician has not received any charges.

In 2019, $6.3 million went into funding investigations for children in Pakistan with HIV, resulting in the shutting down of 300 medical facilities in Ratodero. However, unlicensed private clinics still function on “nearly every block,” and several facilities do not even have a place for physicians to wash their hands.

Save the Children

In 2020, UNAIDS and the United Nations HIV program reported that 2.8 million individuals under 20 were living with HIV. Additionally, over 50% of those individuals were under 10 years old.

An organization fighting for the betterment of children named Save the Children works in Pakistan. Together with the National Health Emergency Preparedness and Response Network, the organization provides reputable health facility managers to implement more humane health responses. The Mothers, Newborn and Child Health Program (MNCH) is an integral part of what Save the Children offers for healthcare. The program provides improved services from households to hospitals to moms and their children. The program’s focus is on the already existing primary healthcare facilities within areas of poverty in Pakistan. The program ensures a healthier emergency and medical experience for children in Pakistan.

Save the Children also has an initiative explicitly targeting individuals with HIV/AIDS. The project consists of providing more support to the physicians practicing in Pakistan. This program provides care to People Living with HIV (PLHIV) through Community and Home-Based Care services. The service actively raises awareness on transmission causes along with referring cases to further investigations. Together with the other efforts, Pakistan hopes to change the trend of rising HIV numbers.

– Libby Keefe
Photo: Flickr

Progress Against HIV/AIDS in ThailandIn the last decade, Thailand has made significant efforts to reduce HIV/AIDS transmission and deaths, resulting in a dramatic decrease in one of the world’s most stigmatized diseases and an effective model for other countries to follow.

HIV — first identified in 1981 — is a viral infection that attacks the human immune system and spreads through bodily fluids. If left untreated, it can cause AIDS, a condition with which most people only survive a few years. There is no cure for HIV/AIDS, but there are treatments such as antiretroviral therapy that can keep the infection from progressing to AIDS.

HIV/AIDS in Thailand

The first case of HIV/AIDS in Thailand was in 1985, and the country continues to have one of the highest rates of the disease in Asia and the Pacific. An estimated 470,000 people are living with HIV/AIDS in Thailand, and 14,000 AIDS-related deaths occurred in the country in 2019.

Like in other countries, the Thai populations most at risk for HIV/AIDS are those living in poverty or otherwise on the margins of society. These circumstances can reduce access to healthcare and testing, which is made worse by the heavy stigmatization of the disease.

Progress in Thailand

However, the Thai government has made substantial progress against the virus after making it one of the country’s prioritized health initiatives. In 2006, Thailand incorporated HIV services into its universal healthcare system, and now testing and treatment are free for anyone who might need them.

Awareness campaigns have also had a large impact on the state of HIV/AIDS in Thailand. The government has partnered with civil society groups to increase public knowledge both about the disease and preventative measures. Another important aspect of these partnerships has been specific efforts to reduce the stigma associated with HIV/AIDS.

Since 2010, the rate of new infections in Thailand has dropped 65%, and AIDS-related deaths have fallen 44%. These improvements have directly resulted from the efforts to increase awareness and improve access to healthcare and testing. Of the Thai population living with HIV, 80% are on antiretroviral treatment, and 78% have suppressed viral loads preventing the infection from progressing to AIDS.

Thailand is also the first country that has nearly eliminated mother-to-child transmission of HIV/AIDS. Now, less than 2% of children test positive for HIV after being exposed. This has significantly reduced the number of children who are infected and need antiretroviral care.

Future Goals

With all of this progress, the government is in a strong position to continue reducing the prevalence of HIV/AIDS in Thailand. The country still has not met UNAIDS’ 90-90-90 targets where 90% of those HIV positive are aware of their status, 90% are on antiretroviral treatment and 90% have suppressed viral loads. However, Thailand’s efforts remain an important international model of effective policy against HIV/AIDS.

Through its focus on decreasing the number of new infections and improving access to antiretroviral treatment, the prevalence of HIV/AIDS in Thailand has decreased. Along with its prioritization of spreading information and awareness about the disease and its transmission, Thailand has created an effective method for tackling HIV/AIDS.

– Nicole Ronchetti
Photo: Flickr

HIV/AIDS In LiberiaAround 4.9 million people are currently living with HIV in western and central Africa, including a percentage of those living in the small African country of Liberia. With a population of 5.1 million, roughly 1.5% of Liberians aged 15-49 live with HIV/AIDS. While this sounds like a small percentage, this equates to an estimated 47,000 people currently living with HIV/AIDS in Liberia, including 3,600 children.

HIV/AIDS in Liberia

While the percentage of HIV/AIDS in Liberia is lower than in surrounding countries and other regions of Africa, the country still struggles with treatment plans, education on the disease and breaking down stigma that could help prevent further spread. In 2019, UNAIDS released a comprehensive report detailing the spread and effect of HIV/AIDS in the country. The report states that only 33% of those living with HIV are receiving ART treatment. This amounts to 15,000 people currently receiving antiretroviral therapy (ART), a daily medication that reduces HIV in the system. Persons with HIV who do not receive ART treatment are more likely to develop AIDS and spread the virus. Of the 15,000 receiving treatment, 763 are children, which amounts to only 21% of all infected children in the country.

Additionally, only 58% of those living with HIV know their status. Lack of education on HIV testing and little access to testing centers has led to only a little more than half of those infected knowing their status through accurate testing. This lack of education heightens the threat of further spread, putting the health and safety of the entire population at risk. HIV/AIDS is not limited to sexual encounters. It also spreads through shared drug injections and even spreads to infants through breastfeeding. Unfortunately, stigma and discrimination continue to prevent progress.

According to UNAIDS’ 2019 report, roughly 53% of those surveyed in Liberia answered no when asked if they would purchase produce from a vendor who was HIV positive. This kind of stigma and cultivated ignorance around HIV and AIDS further inhibit people from getting tested as they may fear public ridicule. The fear of a positive test prevents the country from creating accurate and beneficial response plans.

Programs and Progress

In 2017, the African Union, in partnership with UNAIDS and others, implemented a series of “catch-up plans” for countries in western and central Africa to combat these issues. These plans included a 90-90-90 goal by 2020, meaning 90% of the people will know their HIV positive status, 90% of HIV positive people will have access to ART treatment and 90% will have viral suppression. The UNAIDS’ full 2020 report for Liberia is not available yet but the 2019 report already showed improvements in the country’s fight to eradicate the disease.

Compared to a 2016 report, the percent of children receiving ART treatment rose from about 17% to 21% in 2019.  Additionally, the percentage of HIV-positive pregnant women receiving ART treatment has increased from 19.3% in 2015 to 90% in 2019. This massive increase helps prevent infants born with HIV and decreases the risk of spread through sexual partnerships. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported the African Union and UNAIDS’ efforts in Liberia and significantly aided in the reduction of HIV-related issues. Therefore, PEPFAR supports health and treatment facilities in four Liberian counties and supported ART treatment for 15,000 HIV-positive persons in 2020.

All these improvements show progress toward the eradication of HIV/AIDS in Liberia. These advancements bring optimism as hope for an HIV/AIDS-free country remains strong.

– Kendall Couture
Photo: Flickr

HIV/AIDS in South Africa
Since the human immunodeficiency virus (HIV) first evolved into the acquired immunodeficiency syndrome (AIDS) in the early 1980s, the virus has rapidly spread to every corner of the globe. It has infected over 65 million people worldwide. With no cure in sight, over 25 million victims have perished at the hands of the virus to date. HIV/AIDS predominantly plagues regions in Africa, Asia and the Pacific. Though cases have dropped since the epidemic heights of the 1990s, this disease continues to afflict 38 million people today and remains a leading cause of death. Here is a summary of HIV/AIDS in South Africa.

What is HIV/AIDS?

The human immunodeficiency virus (HIV) infiltrates and takes over the cells that protect against infections. As the body’s ability to fight viruses disappears, HIV makes the individual extremely vulnerable to additional infections or diseases. Spread through the transmission of bodily fluids, transmission most commonly occurs during the communal use of drug injection syringes and unprotected sexual activity. When left untreated, HIV can devolve into a lifetime condition called acquired immunodeficiency syndrome (AIDS). No cure exists for HIV or AIDS, but there are preventative measures that an individual can take, as well as treatment, drugs and therapy.

HIV/AIDS in South Africa

In 1982, South Africa was battling the apartheid that had dominated its governance for decades. This landmark transformation created tumultuous political strife that distracted national attention away from the HIV virus that was silently taking root in the gay and impoverished black communities. With drastic changes occurring in the South African government, insufficient measures failed to halt the initial handful of HIV infections from growing by 60% by 1995.

By the time that South African President Nelson Mandela first spoke about the virus, the epidemic had escalated into a public health crisis. South America became the most infected country in the world. Virus deniers and negligent governing officials let the situation further devolve throughout the 1990s and early 2000s. It was not until 2008 and a change in administrations that South Africa treated HIV/AIDS as a public health threat. The new government implemented a plan to distribute medicines and drugs, the largest step South Africa had taken since the virus outbreak 30 years prior.

Currently, efforts to fight HIV/AIDS face infrastructural and monetary difficulties. Public health resources have become sparse as the South African currency lost value. Consequently, HIV/AIDS therapy and antiretroviral treatment declined even while virus rates continue to rise.

In 2019, HIV/AIDS infected an estimated 7.7 million South Africans. That totals 20.4% of the population, with new cases occurring daily. Additionally, more than 72,000 HIV/AIDS-related deaths have occurred in South Africa. Over 70% of South African adults and 41% of minors undergo antiretroviral treatment.

Preventing the Spread

The HIV/AIDS epidemic that continues to plague South Africa may find its match in antiretroviral treatment (ART). This preventative measure is highly popular since the South African government progressed the ART program since the early 2000s. UNAID reported that 70% of South Africans living with HIV/AIDS received ART treatment in 2019, up by 50% since 2010. If an individual tests positive for HIV, they can receive ART to forestall or fully prevent the further devolution of HIV symptoms and the onset of AIDS. South Africans have invested themselves in taking advantage of the free testing. A guaranteed treatment for those testing positive increases the number of South Africans willing to obtain testing.

ART therapy particularly helps mothers with HIV by curbing mother-to-child transmission. This preventative measure has resulted in a strengthening of both mother and child health, and a decrease in birthing mortality and childhood HIV/AIDS infection.

While HIV/AIDS in South Africa remains a massive issue, one can find hope in new and evolving preventative measures. ART treatment offers an avenue to health for many infected individuals. It prevents further spread, curbs symptoms and can make healthy populations resistant to the virus. With South Africa expanding its diagnostic and treatment capabilities, people living with HIV/AIDS may live longer and healthier lives.

– Caroline Largoza
Photo: Flickr

HIV/AIDS in The Dominican Republic
HIV/AIDS in the Dominican Republic is on the agenda of the Pan American Health Organization (PAHO) and HIV/AIDS has been the focus of the Plan of Action for the Prevention and Control of HIV and Sexually Transmitted Infections 2016-2021. The goal of the plan is to end HIV/AIDS in many regions of the Americas, including the Dominican Republic, by 2030.

From 2010 to 2019, HIV cases have reduced to 13 a year and the number of deaths has gone down by 4,000 over the years. Female sex workers are a portion of the population the epidemic affects; they accounted for 37% of new infections in 2019. Less than 30% of individuals do not know they have an infection and about one-third receive a late diagnosis. Over 200,000 were getting antiretroviral treatment in 2019.

HIV Diagnosis Decline

HIV/AIDS in the Dominican Republic has seen an advancement in health through more testing and the option of antiretroviral treatments. The options of PrEP, pre-exposure prophylaxis, and PEP, post-exposure prophylaxis, have contributed to the decline of infections. The COVID-19 pandemic has put a dent in the success of the decline of HIV/AIDS.

The pandemic is changing the social landscape and interaction of people through social distancing measures. Access to medical personnel has also experienced strain because of rising and new COVID-19 infections. When comparing 2019 to the current pandemic, the diagnosis of HIV has reduced by the thousands in the Dominican Republic. According to PAHO, “Self-testing is a key strategy for reaching the U.N. goal of having 90% of people with HIV know their status.”

PrEP and PEP

PrEP and PEP are two types of antiretroviral treatments that people can use to prevent HIV transmission. Individuals can take the antiretroviral treatment PrEP before HIV infection and it is available through two brands. Meanwhile, one can take PEP after an HIV infection and must take more than one medication. The CDC suggests that individuals consult with a doctor for more information. While both treatments are important, PEP offers more because sexual assault victims can use PEP or those who had a workplace accident. Advisories state that one should take PEP within three days of a dire situation and complete treatment within a month. Both treatments are highly effective with PrEP reducing HIV transmission from sex by 90% and PEP reducing risk by 80%.

HIV Self-Testing Market

The HIV self-testing market looks promising on a global scale especially with  HIV/AIDS in the Dominican Republic. Globally, there is a necessity and high demand for rapid diagnosis of HIV in many regions including Latin America. Self-testing is a better alternative because one can do it privately and it is less risky because it will prevent exposure to the COVID-19 pandemic. The self-testing market will grow more between 2020 and 2025. Self-testing will experience a great impact through government investments in healthcare worldwide. The HIV self-testing kit collects samples through blood, saliva and urine. In HIV testing, blood samples provide the most accurate read. According to MarketWatch, “The self-testing market in Latin America is anticipated to reach a value of 51.24 million USD in the year 2025.”

The COVID-19 pandemic has undoubtedly impacted the fight against HIV/AIDS in the Dominican Republic. However, despite HIV/AIDS’ prevalence, antiretroviral treatments and opportunities to self-test should result in improvements.

– Amanda Ortiz
Photo: Flickr

3 Faith Organizations Helping HIV Orphans in Kenya
The World Bank reported that HIV/AIDS orphaned over 660,000 Kenyan children in 2019. Often having to fend for themselves, 22% of these children frequently experience hunger. Also, many orphans in Kenya exhibit signs of declining health, enroll in school at low rates and live in poverty. In response, several Christian organizations are helping Kenyan orphans receive an education, medical treatment, vocational training and wellness classes. These services allow orphans to thrive on their own once they reach adulthood. Here are three faith organizations helping HIV orphans in Kenya.

Children of God Relief Institute

The Children of God Relief Institute (COGRI) came to fruition in 1992 and works to provide services to impoverished orphans in Kenya who HIV/AIDS affects. COGRI spearheads four main projects to help orphaned Kenyans, providing services ranging from a children’s home to an internationally accredited laboratory focused on HIV/AIDS diagnosis and testing.

In the Lea Toto Project, 377 orphans received antiviral therapy (ART) and 73% of them obtained viral suppression. Only 63% of children in Kenya achieve viral suppression, which means COGRI provides quality care for its patients. Part of COGRI’S high success rate has to do with the surveillance and support patients receive. For example, COGRI monitors each child to make sure they administer their medication correctly and mentorships that orphans established helped develop self-assurance in their road to recovery.

Christian Ministries in Africa

The second faith organization helping HIV orphans in Kenya is Christian Ministries in Africa (CMIA). This ministry emerged in Nairobi in 1985 and strives to protect vulnerable African children. One of its projects, the Grace Children’s Centre, consists of four children’s homes, two of which are for healthy orphans and HIV/AIDS positive orphans.

A second project, the Nakuru GCC Boys Farm Project, offers farming classes to orphan boys. The farming courses serve several purposes, which include growing nutritious food for the boys and teaching them farming techniques. The income from surplus crops helps to fund necessities for CMIA’s Grace Children’s Centre.

Inua Partners in Hope

The Inua Partners in Hope (Inua) program came into existence in 2009 and aims to lift low-income Kenyan children out of poverty. More specifically, the program provides courses that aim to improve all aspects of a child’s life who lost one or more parents to HIV/AIDS.

Inua’s three-step program focuses on hope, life skills training and entrepreneurship. Throughout, Inua accentuates its “8 Dimensions of Wellness” for its young students:

  • Emotional: Feel comfortable discussing their sentiments with others and confront adversity in their lives.
  • Physical: Learn to become healthier with nutritious food and adequate exercise.
  • Social: Help form and sustain connections with others around them.
  • Occupational: Teach how to make a difference in the workplace and society.
  • Spiritual: Discover how to achieve tranquility and comfort.
  • Intellectual: Demonstrate how to continue learning in their everyday lives and to use their problem-solving skills.
  • Environmental: Learn to look after the environment and others around them.
  • Financial: Educate how to budget money and to become financially independent.

Inua’s program offers a variety of vocational training to older children, including hairdressing, mechanics, agribusiness, hospitality, welding and masonry. Orphans take their new skills and build businesses in their village to make a living. Additionally, these adolescents hire other struggling orphans to work in their business and teach them their newfound skills.

Looking Ahead

These three ministries are great examples of faith organizations helping HIV orphans in Kenya. Although the Kenyan government proactively attempts to combat the HIV/AIDS epidemic, faith-based organizations stepped up to address the affected youth who struggle to make ends meet and require medical interventions. With adequate medical treatment and education, orphans in Kenya are learning how to take control of their lives and not let HIV/AIDS weigh them down.

– Samantha Rodriguez-Silva
Photo: Flickr

 Preventing HIV in KenyaA new, injectable antiretroviral drug, cabotegravir (CAB LA), may have significant potential for preventing HIV among sub-Saharan African women. In November 2020, the World Health Organization (WHO) reported trial results of the HIV Prevention Trials Network Study (HPTN 084), testing the use and effectiveness of CAB LA in preventing HIV among more than 3,200 HIV-negative, sexually active women across east and southern Africa. This drug could significantly lower prevalence rates and help in preventing HIV in Kenya, which has one of the largest HIV/AIDS epidemics in the world.

Cabotegravir or CAB LA

CAB LA, a long-acting pre-exposure prophylaxis (PrEP) regimen, requires an injection only every eight weeks and has been shown to be 89% more effective in preventing HIV than taking a daily oral antiretroviral PrEP, a generic pill currently marketed as Truvada.

Kenya’s HIV Epidemic

The first case of HIV in Kenya appeared in 1984. By 1990, HIV was one of the leading causes of illness in the country. At its highest point, more than three million Kenyans lived with AIDS. Since then, the government of Kenya decreased the prevalence of HIV from its 10.5% peak in 1996 to 5.6% in 2012. By 2019, the prevalence rate was 4.5% in adults aged 15-49. However, certain vulnerable populations within Kenya are more at risk of getting HIV, such as women. Males have an estimated prevalence rate of 4.5% while the rate for females is 5.2%. Among youth aged between 15 and 24 years old, boys have a prevalence rate of 1.34% compared to girls at 2.61%.

The only option for preventing HIV in Kenya is a daily PrEP pill called Truvada. The government of Kenya first approved oral PrEP for country-wide distribution in 2015, and since 2017, has scaled up the distribution throughout Kenya. However, of the 1.5 million Kenyans living with HIV, only 26,098 (1.7%) are currently on PrEP.

Though 72% of the population had been tested for HIV, only 70% had been tested more than once. Frequent testing, at least once a year if sexually active or at least every six months if part of a particularly vulnerable population, is vital to giving care and treatment for at-risk groups.

The Potential of CAB LA for Preventing HIV in Kenya

  1. The HPTN study reported that CAB LA is nine times more effective in preventing HIV in Kenya than the Truvada pill, the current form of PrEP. The PrEP pill is only effective if taken daily and is not a standalone prevention method for other STIs or unplanned pregnancies. The new drug also does not require other forms of protection, such as condoms.
  2. This drug gives vulnerable populations more HIV options for preventing HIV in Kenya. Vulnerable populations include sex workers, men who have sex with men, people who inject drugs, youth and women. These vulnerable populations face stigma, which affects their ability to access PrEP pills. Because the injection is needed only once every two months, the increased discretion and ease of the infrequent injection may increase its use and thus increase the protection of those who need it.
  3. Discretion in use of the drug may be able to reach more women specifically. In combination with the stigma attached to HIV, women in Kenya face discrimination in terms of access to education, employment and healthcare. As a result, men often dominate sexual relationships, with women not always able to practice safer sex, even when they know they should. For example, in 2014, 35% of adult women (aged 15-49) who were or had been married had experienced spousal violence and 14% had experienced sexual violence. Women in Kenya find it especially difficult to take a daily pill, which significantly reduces the effectiveness of the medicine. Only 68% of Kenyan women have access to antiretroviral pills.

Though not yet approved by the U.S. Food and Drug Administration (FDA), the developer of the drug, ViiV Healthcare, expects cabotegravir to be ready for the market by early 2021.

– Charlotte Ehlers
Photo: Flickr

hiv epidemic in the philippinesThe HIV epidemic in the Philippines is the fastest-growing in the Asia and Pacific region. According to UNAIDS data, HIV prevalence in the Philippines increased by 207% from 2010 to 2019. AIDS-related deaths rose by 338% in the same period. In 2019, an estimated 97,000 people were living with HIV in the Philippines. Of those, 73% knew their status and 44% were receiving antiretroviral treatment.

Although these statistics indicate some progress, the Philippines still falls far below the 90-90-90 target set by UNAIDS. Aimed at ending the HIV epidemic by 2020, the program wanted to ensure that 90% of people living with HIV would know their HIV status. It also strove to give 90% of people with a diagnosed HIV antiretroviral therapy and induce viral suppression in 90% of those receiving treatment. Unfortunately, the world is not on track to meet these goals, and new targets are being developed for 2025.

Populations Most Affected

The prevalence rate of HIV in the Philippines among adults ages 15 to 49 was 0.2% in 2019. This national rate, however, masks alarmingly high prevalence rates among specific populations. The groups most affected by the HIV epidemic in the Philippines often face social stigma, isolation and legally sanctioned discrimination. These populations include people who inject drugs (PWID), men who have sex with men (MSM), sex workers and transgender people. However, new technologies, programs and initiatives are working to lessen the burden of disease and stigma on these populations.

People Who Inject Drugs

According to UNAIDS, the HIV prevalence rate among people who inject drugs in the Philippines is 29%. Among PWID, only 26.9% have been tested and are aware of their status. Key factors fueling the HIV epidemic in the Philippines among PWID include hostile public opinion and brutal law enforcement. These constitute major barriers to HIV testing and awareness. While official statistics released in 2018 revealed that over 4,500 drug users were victims of extrajudicial killings, civil society estimated the true toll to be as high as 20,000.

Progress in HIV testing is crucial to reduce HIV prevalence among PWID, who struggle to access services due to their criminalized status. Various alternative testing methods, such as rapid finger-prick testing, can reduce barriers to testing for PWID. In particular, self-testing kits, which allow people to test in private, have attracted a large proportion of first-time testers in Thailand and have achieved impressive success in China.

Men Who Have Sex With Men

The HIV prevalence rate among men who have sex with men is 5%, the second-highest among key affected populations. MSM who fear social stigma and discrimination often do not participate in HIV prevention programs. As a result, the participation rate for these programs is 14.6%, and the majority of MSM lack awareness about HIV. Condom use in this population is also low at 40.1%. However, condom distribution and sex education programs would benefit MSM, many of whom reported not using condoms because they were “not available.” Fighting the HIV epidemic in the Philippines means tailoring help to MSM.

Sex Workers

Female sex workers in the Asia and Pacific region are 29 times more likely to be living with HIV than other adult women of reproductive age. The HIV prevalence rate among sex workers in the Philippines is now 0.6%. This group has the highest rates among affected populations for coverage in prevention programs and condom use, which are 71.8% and 85.3%, respectively. Many important national HIV prevention programs raise awareness about HIV and encourage condom use among sex workers. These programs include the 100% Condom Use Program, the HIV Counseling and Testing Service, and programs led by the Philippine National AIDS Council.

Transgender People

Transgender people are one of the populations most affected by the HIV epidemic in the Philippines, with a prevalence rate of 3.9%. However, there is little information or research about the effects of HIV on the transgender community in the Philippines. A key problem is the lack of transgender visibility due to social exclusion and widespread stigma. This challenges efforts to obtain health data and develop targeted programs to support transgender individuals. To raise awareness about gender identities and transgender acceptance, sexual health education and gender studies programs must be more inclusive. This would help reduce the stigma and barriers to healthcare for transgender people in the Philippines and engage them in HIV prevention and treatment programs.

The Effect of COVID-19

Lockdowns in the Philippines due to COVID-19 have blocked access to essential services for HIV patients, including treatment and testing. Eamonn Murphy, UNAIDS regional director for Asia and the Pacific, stressed that the Philippines needs to do more to convince those in high-risk populations to seek out HIV-related services.

Continued attention to these key affected populations is necessary to reduce HIV prevalence rates and make progress toward HIV eradication. In this way, focused programs can work toward lessening the severity of the HIV epidemic in the Philippines.

– Alice Nguyen
Photo: Flickr

HIV in the PhilippinesThe Philippines is designated as a quickly growing epicenter of the HIV epidemic. Before the COVID-19 outbreak, HIV in the Philippines was surging, largely due to their poor healthcare system. There is fear that the COVID-19 pandemic may exacerbate such difficulties due to restricted public transportation, the establishment of checkpoints and consequently, the inaccessibility of treatment.

While the COVID outbreak has many downsides, it may provide an opportunity to improve HIV services in the Philippines. Advocacy groups, community-based organizations and volunteers are now uniting to foster innovative solutions for the HIV epidemic.

The Philippines’ Department of Health Adopts Telemedicine

Travel and physical distancing restrictions have disrupted the supply and distribution of antiretroviral drugs; these drugs are essential for Filipino people living with HIV (PLHIV). Therefore, the Philippines’ Department of Health (DOH) recommends HIV facilities adopt an online courier service. This would ensure access to treatment while minimizing the risk of patient and staff exposure to COVID-19. This method allows PLHIV to choose their preferred medicine pick-up location and time through a mobile application.

The DOH’s plan for app-based medication distribution is key to enhancing the quality of HIV treatment and counseling. This app also improves HIV healthcare for the post-COVID world. However, this is not the only way Filipinos are improving HIV healthcare. Officials are working to give community-based organizations opportunities to participate in the DOH’s endeavors. These efforts are a favorable step towards the efficient mitigation of HIV in the Philippines.

Community-Based Organizations Revamping the Philippines’ HIV Healthcare Services

Network Plus Philippines, Pinoy Plus Advocacy Pilipinas, Red Whistle and TLF Share Collective are coordinating to implement a new guideline issued by the Philippines’ DOH. The guideline guarantees that PLHIV will receive their medicine through courier services, focusing on PLHIV in rural communities. Examples of contributions from community-based organizations are listed below:

  1. Red Whistle: Red Whistle mobilized 40 volunteers to collect antiretroviral refills from treatment facilities and deliver them across the country. It has worked with local authorities to avoid disclosure of confidential clientele information and partnered with MapBeks, an online mapping community, to create the #OplanARVayanihan: a map showing the nearest antiretroviral drug centers and delivery options.
  2. TLF Share Collective: TLF Share Collective has helped to deliver antiretroviral therapy to Filipinos. It has developed a tool to monitor medication delivery by community volunteers and created FAQ-cards for patients.
  3. Pinoy Plus Advocacy Pilipinas: PPAP has established a PLHIV Response Center where people with HIV can ask for information about accessible treatment hubs and advice on antiretroviral therapy.

International Assistance

In addition to the community-based organizations’ efforts to eliminate HIV in the Philippines, the international community has also provided guidance through programming and financing.

For example, UNAIDS has coordinated with The United Nations Development Programme to advise the Philippines’ Government on how to manage their HIV problem in the context of COVID. The UN’s creation of an analytical survey has revealed valuable information on the issues affecting PLHIV. These issues range from concerning factors like the feeble safeguarding of human rights to a lack of access to mental health and social protection services.

Similarly, USAID, The U.S. Agency for International Development, is collaborating with the Filipino government to assist them in establishing universal health care. Together, they are addressing legislative and institutional obstacles within their health financing system. The USAID’s services include prevention programming and case identification to strengthen epidemic control; funding streams from the Department of Health and local health budgets that align with UHC Law Provisions; and estimates for total future domestic investment requirements.

While COVID-19 presented a scope of challenges for HIV treatment and care services, it also propelled community-based organizations, the Filipino Government and international institutions to cooperate and execute innovative policies. The Philippines’ healthcare system will continue to combat HIV and become a robust system devoid of the defects that COVID-19 highlighted.

Joy Arkeh
Photo: Flickr