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Addressing HIV: Women as the missing link

"It is highly probable that a lot of HIV cases in women are undetected, and therefore, unreported and untreated."

 

HIV infection is a major problem in the Philippines. In fact, it is now considered as an epidemic. Worldwide, the number of new HIV infections are significantly decreasing. The Philippines is one of the few where the reverse is happening. New HIV infections in the country account for more than 85 percent of new cases in the Asia and Pacific. Around 36 new infections are recorded daily, mostly among 15 to 24 year olds.

In July 2019, 1,111 new HIV-positive individuals were reported to the HIV/AIDS and Anti-Retroviral Therapy Registry of the Philippines (HARP). 18 percent (199) of them had clinical manifestations of advanced HIV infection or WHO clinical stage 3 or 4.

The first case of HIV infection recorded in the Philippines was in 1984. Since then up to July 2019, a total of 69, 512 HIV cases have been reported. 38 percent (26,832) of the cases were in Metro Manila, 15 percent (10, 431) were in Region 4A, and 9 percent (6,543) were in Region 3. Thus, 62 percent of all HIV infections are concentrated in three regions in Luzon.

Of those diagnosed as HIV positive, 94 percent (65,162) were males and 6 percent (4,339), females. By age, 51 percent  (35,426) belonged to the 25 to 34 age bracket, and 29 percent (19,820) were aged 15 to 24.

The top modes of transmission are: Among males, male to male sex (85 percent); male to female sex (11 percent), and sharing of infected needles (3 percent). Among females, male to female sex (93 percent) was the top mode of transmission, followed by needle-sharing (3 percent). Interestingly, according to the Philippine National AIDS Council, 68 percent of drug-injecting males had female sex partners, and 25 percent of those involved in MSM had female partners. Mother to infant transmission also happens. To date, 181 children below 10 years old are HIV positive.

When HIV was starting, 62 percent of the 216 cases were among women, mostly sex workers. This was controlled through strict testing of prostituted women. Since 1991, the number of men infected with HIV has since been greater. However, for the same period, the number of diagnosed cases among women tripled. Moreover, the cases among young women aged 15 to 24 years old doubled. 92 percent of HIV-positive females were in their reproductive ages (WRA) when diagnosed.

The reporting of pregnancy status at the time of testing only started in 2011. Since then, a total of 333 pregnant women were diagnosed to be infected. 54 percent (180) of them were aged 15 to 24, and 38 percent belonged to the 25 to 34 age bracket.

Yet, according to the 2017 National Demographic and Health Survey, only 25 percent of WRA have comprehensive knowledge about HIV; 45 percent know where to get tested; and only 5 percent have ever been tested. Of the young women, only 20 percent is reported to have knowledge about HIV.

The lack of knowledge on HIV of women was also revealed in the baseline survey on reproductive health that my group did in Payatas, Quezon City’s poorest barangay. From the survey, 63.3 percent of the respondents said they knew nothing about HIV and AIDS. 68 percent said that they had zero knowledge about existing programs on HIV. 50 percent of the respondents said that one can have HIV infection through the use of public toilets while 20 percent said they did not know. The 46 percent thought that they could get infected through kissing, while 19 percent said they did not know.

What the data are telling us is clear: While men make up the big majority of those infected with HIV, women (including young women) are increasingly getting more vulnerable (again) to the virus. Women are involved in all modes of transmission: More than 60 percent of males who share infected needles have female sex partners, 20 percent of those involved in MSM (males having sex with males) also have female sex partners, male to female sex, and mother to baby transmission. At the end of the day, most males who are at risk of getting infected go back to their families and communities and have sex with their female partners.

It cannot be denied that in order to address HIV and AIDS, interventions involving women are MUST have. However, virtually all HIV and AIDS-related programs only target what the HIV community calls “key populations”—MSM and those who inject drugs. Women, who figure in all modes of transmissions, are invisible. They are NOT targeted by existing interventions.

Because of this invisibility, it is highly probable that a lot of HIV cases in women are undetected, and therefore, unreported and untreated. Who knows how many women have died without even knowing that they had AIDS?

Despite the country’s efforts to curb HIV infections, and the many billions of money poured into HIV programming from the public and international development agencies, the programs remain weak, and the results, wanting. From the target of 80 percent in 2015, only 50 percent of MSMs used condoms, and only 16 percent knew of their status through testing.

Beyond the fact that government entities and schools remain reluctant to aggressively promote consistent and proper use of condom, the cheapest and most effective way to prevent HIV infections, they are forgetting a most vital population—the women. Imagine what women can do to help get a fuller picture of HIV in the country and prevent further infections.

@bethangsioco on Twitter Elizabeth Angsioco on Facebook

Topics: Elizabeth Angsioco , HIV infections , Women , Aids , Philippine National AIDS Council
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