Human immunodeficiency virus, or HIV, is a prevailing health issue in the Philippines, with HIV infections on the rise in recent years.
According to the Department of Health, the total number of HIV cases in the country may go up to 215,400 by the end of 2024.
Based on the health agency’s latest data, there were 4,595 individuals who were confirmed HIV-positive from July to September 2024 alone. Of this population, 1,301 (28%) had an advanced HIV infection at the time of diagnosis. An average of 50 HIV cases were also recorded daily in this time period.
Overall, at least 139,662 confirmed HIV cases have been reported to the HIV/AIDS and Antiretroviral Therapy (ART) Registry of the Philippines since the first HIV case was detected in the country in January 1984.
HIV is primarily transmitted through sexual contact, with the DOH noting that sexual contact has continuously been the most common mode of HIV transmission among newly diagnosed patients through the years. From the 139,662 reported cases from January 1984 to September 2024, 134,496 of them acquired HIV through sexual contact.
In other cases, HIV can be spread through needle sharing, mother-and-child transmission, blood transfusions, and needle prick injuries.
Dr. Deano Reyes, an LGBTQ+ health doctor and the medical director of Hara Clinic, a holistic gender and sexual health clinic, spoke to GMA News Online to share his knowledge and insights about HIV and the many ways one can be protected from it.
According to Reyes, anal sex in particular has the highest risk when it comes to HIV transmission.
“The anus [or] the rectum, even though it feels good for sex, is more prone to minor micro-lacerations or injuries, and that creates a portal of entry,” the medical doctor said. “At the end of the day, acquiring HIV is through a portal of entry, meaning the virus needs to have some way to get into your system.”
He explained that since the vagina is specifically designed for sex, it can accommodate the penis and has natural barriers like mucus or lubrication.
“But the anus [or] the rectum can really feel [every] little bit of micro-lacerations. The infected semen or blood can enter through those micro-lacerations. That’s why the risk of HIV is really higher amongst people who participate in anal sex.”
Preventing HIV with condoms
With the rising number of HIV cases in the Philippines, how can we get ourselves protected against the virus?
It all boils down to safe sex. This can be practiced by properly wearing condoms, which Reyes said are 95% effective at preventing HIV and other sexually transmitted infections (STIs).
“Safe sex, a big part of it means being aware of the different illnesses that you can acquire through sex and taking appropriate means to prevent them,” said Reyes.
“Condoms are very useful in the prevention of HIV and other STIs because it’s a physical barrier. May harang. So condoms, when HIV or STIs are carried in semen, there’s a physical barrier that blocks it.”
In the Philippines, most condoms are worn by males, but there are also condoms designed specifically for the opposite sex.
“So male condoms, you slip it on the erect penis. While female condoms, they’re kind of like this hood on top of the [vagina]. So, the physics or design is similar to menstrual cups or something like that,” Reyes explained.
“Foldable sila. Tapos kapag pinasok mo sila tapos binitawan mo, they will place a barrier inside. The material is just the same, and the concept is also the same. It’s just a physical barrier.”
Despite this, female condoms aren’t as commonly used in the Philippines, per Reyes, because “it’s easier to wear a male condom than it is to wear a female condom.”
When used correctly at all times, female condoms are as effective as condoms used by males.
What is Pre-Exposure Prophylaxis (PrEP)?
Despite condoms being proven to be 95% effective in preventing HIV and other STIs, such as gonorrhea, chlamydia, and syphilis, some people still don’t use them.
Reyes believes it’s because condoms reduce the pleasure component of sex.
But times are changing. As modern medicine continues to progress, so do the health interventions that give people more options to protect themselves against HIV.
According to Reyes, one of these alternatives is PrEP, which stands for pre-exposure prophylaxis.
PrEP is a medication that provides up to 99% protection against HIV when taken correctly. Patients regularly take one pill every day, although there is also event-driven PrEP where patients take two pills of PrEP between two and 24 hours before they anticipate having sex.
Although as effective as condoms when it comes to protection against HIV, PrEP doesn’t protect against other STIs and pregnancy, so Reyes still underscored the importance of using condoms in sexual activities.
“You can do PrEP because prep gives you 99% protection from HIV. You can also use condoms. You can actually take both of them together. You can layer your protection. Use [both] condoms and PrEP,” he advised.
What about Post-Exposure Prophylaxis (PEP)?
For people who practice safe sex, a common worry that could arise during intimate moments is if the condom breaks or rips, which increases the chance of contracting HIV.
What should one do if this happens?
“Whenever you have situations where the condom is broken or rips, and you’re worried about HIV, there is this medication called PEP or post-exposure prophylaxis,” Reyes said.
“HIV, when it gets into your system, doesn’t sink its roots into your body right away. It takes some time. So, we have a medicine or intervention that can be given, but it only works up to 72 hours or three days after the encounter.”
In PEP, patients take a medicine every day for 20 days to prevent HIV from taking root in their bodies.
“So, HIV is a virus, meaning it’s not alive. It cannot replicate on its own. It needs to get into your CD4 (white blood) cells and hijack the machinery of your cells to replicate on its own. That’s how it kills the CD4 cells, actually,” Reyes explained.
“What this medicine does is it gives a shield to your cells so that HIV cannot replicate, [it] cannot do what it wants to do.”
PEP is also effective in the event that one forgets to bring condoms and unknowingly engages in sexual contact with someone who has HIV.
Symptoms of HIV
According to Reyes, some people who are in the early stages of HIV might not experience any symptoms at all. Others might experience mild flu-like symptoms, which manifest four to six weeks after acquiring the virus.
“So it’s just like a flu. It is fever, they might feel weak, fatigued, they might have a sore throat, their kidneys and lungs might swell,” he explained.
The National Health Service (NHS) of the United Kingdom also included other symptoms, such as joint pain, muscle pain, and body rash.
Having flu-like symptoms, however, doesn’t automatically mean one has HIV. These symptoms can be caused by other viruses, too, which is why one must really get tested for HIV to be sure.
After this primary stage of infection, which medical professionals call “acute retroviral syndrome,” the symptoms go away and patients will seem to feel well.
“HIV is just dormant and quiet in your body for years. People are really walking around, not really feeling like they have any disease. They don’t know that they have a disease. Their body and HIV will be locked in this battle. HIV and their body will fight for a few years,” said Reyes.
According to him, the dormant or latent period of HIV can last five to eight years before it progresses to AIDS.
“If you don’t take medicine, HIV will inevitably win because your immune system is slowly dying. And if it wins, that’s the final stage of HIV called AIDS.”
At this final stage of HIV infection, Reyes said that one’s immune system is wiped out and the body can no longer fight against infections. A simple cold or cough, for example, can easily progress into pneumonia.
“HIV is the virus, AIDS is the condition that develops if HIV is not treated. And then all those different illnesses that come out when you are already immunocompromised are called opportunistic infections. They take advantage of the fact that you don’t have an immune system and they attack your body,” he explained.
Where should one get tested?
The only way to know if you have HIV is to get tested, and you can have it done in public or private health institutions across the Philippines that provide HIV testing and counseling.
“First, you can contact your local government unit and ask where the nearest social hygiene clinic within your area is. Social hygiene clinics are government-run facilities where they can conduct testing like HIV and also link you to care,” advised Reyes.
Aside from social hygiene clinics, there are also a lot of non-government organizations, such as SHIP, SAIL, and LoveYourself that provide free HIV testing and even medications.
HIV testing is also offered in private healthcare facilities and hospitals, including Hara Clinic.
Treatment and medication
There is no cure for HIV, but there are treatments that help its patients to live a healthy and long life.
If one tests positive for HIV, one can take the HIV medicine called antiretroviral therapy, also known as ART.
“Their job is to interrupt the replication process of HIV so that it doesn’t increase. Pinapatulog lang namin ang virus,” Reyes explained. “So, kung tulog ang virus, andoon lang sila sa katawan mo, but it won’t cause you any harm. They won’t make you progress to AIDS.”
He also said that if properly medicated, HIV patients “can live as long as people who are not infected” and the virus won’t “prevent them from living their life to its full potential.”
“You just have to take medications to control [it], so that it doesn’t cause you further harm. HIV is just like that. You just have to take your maintenance medications to keep you safe and healthy.”
HIV is not a death sentence
As a safe sex advocate, Reyes advised people who are sexually active to get tested regularly for HIV and STIs.
He also urged them to make use of all the ways that can protect them from HIV and STIs.
“There are a lot of things that you can do. You can use condoms. You can use PrEP. There’s such a thing as Doxypep. You can also get vaccinated for HPV. To prevent mental warts and the potential cancers that can happen. You can also get vaccinated for Hepatitis B. So there are ways to protect yourself,” he said.
And as the stigma surrounding HIV continues to persist, Reyes gave encouragement to those living with HIV.
“I know it feels like it might be the end of the world for you. But I want you guys to know that it’s not a death sentence. HIV is just a disease. We can have multiple interventions to make sure that you live a long and fulfilling life,” he said.
“The only important person here is you, and we just have to make sure that you are safe and healthy, and this disease doesn’t define you.”
— CDC, GMA Integrated News
