HIV cases among injecting drug users rising

Friday, May 20, 2011

TAGAYTAY CITY - There is an epidemic of the human immunodeficiency virus (HIV) among injecting drug users in Cebu City, according to a health official, who also warned of a possible fivefold increase in overall cases of HIV in the Philippines by 2015.

A whopping 53 percent of injecting drug users (IDU) who participated in a survey in Cebu this year were found to have been infected with HIV, the virus that causes Aids or Acquired Immunodeficiency Syndrome, said Dr. Eric Tayag, assistant secretary of the Department of Health (DOH).

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"This confirmed our fears that half of them (IDU in Cebu) are actually infected," he
said during the opening day of the two-day "Media Seminar on Reducing Stig-ma and Discrimination in HIV and Aids" at Estancia Resort Hotel yesterday.

"Unless this is contained, we will have a very precarious situation in Cebu right now," he said.

Mandaue

In Mandaue City, he said, 3.6 percent of IDU are HIV-positive.

This year, though, the DOH received no new reports so far from Central Visayas of an IDU becoming HIV positive.

But instead of being relieved, the DOH official sounded the alarm, saying it's possible that the IDUs were no longer having themselves tested as they were resigned to the fact that "silang lahat, positive na (they are all HIV positive already.) "

He said the local governments in Central Visayas have been implementing strategies to contain the spread of the virus. Yet, he sounded a dire warning, saying the number of HIV cases in the country was increasing amid a shift in the drivers for the increase in cases.

More cases

"It took 20 years before we reached 200 cases a year. Now we're looking at four to five cases every day," Tayag said.

From 1984 to the first quarter of this year, the DOH National Epidemiology Center, of which Tayag is director, recorded 6,498 HIV cases, of which 79 percent were males. But he said estimates of the actual number of HIV cases in the country ranged from 6,000
to 11,000 cumulative cases as of 2008.

A fivefold increase in cases means there could be a cumulative 45,000 cases of people with HIV in the country by 2015.

In 2007, health officials noted a shift in the segment of the population contracting HIV. From 1984-1990, more females than males were living with HIV, as heterosexual contact was the main mode of transmission of the virus then. But in the years that followed, males began to make up a greater proportion of those infected.

Transmission

By 2010, of the four main modes of transmission of HIV, males having sex with males (MSM), heterosexual sex, drug use, and mother-to-child transmission, MSM was already the predominant mode of transmission in 10 of the 16 regions in the country. This year, all regions had MSM as the predominant mode of transmission, Tayag said.

In the first quarter of this year, 214 of the 483 HIV cases reported involved homosexual contact, 159 involved bisexual contact, while only 94 involved heterosexual contact. DOH counts homosexual and bisexual contact as MSM. Two cases in the first quarter involved mother-to-child transmission, while one involved blood products.

The DOH put a conservative estimate of the number of MSMs in the country at 610,019 in 2007, said Dr. Gerard Belimac, program manager of the DOH National Aids/STI Prevention and Control Program. IDUs were estimated to be 14,478 in 2007, he said, while female sex workers numbered 156,108 and male clients of sex workers at 1,423,378. These groups comprise the most at risk population (Marp) for HIV.

Not tested

"Less than 10 percent of the MARP learned their HIV status in 2009," Belimac said.

Since the majority of them have not been tested, many more Filipinos than have been reported could be HIV positive but just don't know it, and, therefore, could also potentially be spreading the virus.

Asked whether the failure of the passage of the reproductive health (RH) bill would stymie efforts to contain the spread of HIV, Tayag said, "Don't put on the RH bill the burden to reverse the trend in HIV." In the same way that the RH bill can't stand alone in addressing poverty, since there are other laws and measures that help address these, he said, the RH bill will just help to unify programs to check HIV.