Special Report: Ex-inmate leads charge for HIV awareness in Cebu

VENGIE Mendoza did not bat an eye when he said walls have eyes and ears—that in jail, no secret stays hidden.

Mendoza, in a sitdown interview on a Wednesday afternoon, recalled the moment in 2018 when his cellmates discovered his HIV diagnosis (Human Immunodeficiency Virus), something he had only received himself.

He was the first inmate to be diagnosed with HIV or a person living with HIV (PLHIV) in Lapu-Lapu City Jail, a situation that could easily attract attention and stigma among inmates in closer quarters.

SunStar Cebu verified with Jail Officer Junamar Torregue of Lapu-Lapu City Jail that Mendoza is the first diagnosed PLHIV in the jail.

Once deprived of liberty and subjected to discrimination, Mendoza has now transformed into a “visible” PLHIV and a passionate HIV awareness advocate.

PLHIV is a rights-based term for people living with HIV.

“With proper treatment, a PLHIV can thrive and lead normal lives,” he firmly remarked, offering himself as proof that living with HIV does not strip someone of their life or future.

Mendoza, a proud member of the LGBTQ community in Cebu, is just one of the over 164,400 PLHIVs in the country, based on the UNAIDS 2023 Global HIV Data. Some of whom belong to marginalized communities. 

Some key populations who have a higher risk of HIV infection, particularly within marginalized communities, include sex workers, incarcerated individuals, transgender people, men who have sex with men, people who inject drugs (PWIDs), and migrants and refugees.

SunStar Cebu received Mendoza's permission to be identified in the article, along with a signed confidentiality waiver, signed by a notary public.

Mendoza has maintained an undetectable HIV status for six years. An undetectable status is achieved through proper HIV medication, which reduces the virus in the bloodstream to levels so low that it cannot be detected by blood tests.

For the past two years, Mendoza has been working as a case manager—first with the Mandaue City Health Office (under the AIDS Healthcare Foundation) and then with the Lapu-Lapu City Health Office, under the Department of Health.

In this role, he has been dedicated to helping his fellow PLHIVs access essential HIV services and treatment.

‘Imprisoned with a purpose’

For him, in hindsight, being in jail had a purpose, although it took him immense courage and deep introspection to develop the mindset he has today.

Mendoza was arrested in March 2018 for drug use during the time of President Rodrigo Duterte–who ordered the police to kill drug users and pushers in the Philippines.

He was transferred to detention in Lapu-Lapu City Jail the following month.

In June, the jail conducted facility-wide HIV testing; this occurred when the jail had changed wardens, he said.

“Way pugsanay, wa say balibaray (You are not forced to, but you can also not say no),” he said.

After a couple of days, he learned he was positive for HIV.

“It was difficult.” He said he did not know what to do, especially since their movements were very limited in jail.

He started treatment in July.

HIV still a global issue

The World Health Organization (WHO) said on July 22, 2024, that HIV “remains a major global public health issue.

HIV, or the human immunodeficiency virus, is a virus that attacks the body’s immune system, and acquired immunodeficiency syndrome, or AIDS, occurs at the most advanced stage of infection.

While global HIV trends show that new HIV infections and AIDS-related deaths are already declining, the Philippines is still seeing a rapid increase.

Negative attitudes, fear of judgment, limited awareness and education, and unprotected sex are among the factors affecting the rapid increase of HIV cases in the country.

Testing in BJMP

Jail Senior Inspector Jay Ylanan, chief health officer of the Bureau of Jail Management and Penology in Central Visayas (BJMP 7), said that while they conduct testing before admitting inmates to their facilities, it is not mandatory.

“We do the PICT (Provider-initiated counseling and testing), a collaboration with the DOH (Department of Health); once the PDL is tested positive for TB (tuberculosis), he is also tested for HIV because usually those PDLs with HIV also have a great chance of having TB,” he said.

He said inmates regularly undergo HIV testing every three months. If an inmate tests positive for HIV, additional tests are conducted to screen for associated sexually transmitted infections, such as syphilis.

A total of 192 PDLs among the nine facilities managed by BJMP 7 are PLHIVs.

Of the number, the majority are in the Cebu City Jail Annex (a facility that caters to PDL with special medical needs), at the Mandaue City Jail, and at the Talisay City Jail.

Ylanan said these are also their three biggest facilities.

The majority of PLHIVs in jail in the region are PWIDs, said Ylanan.

“The majority, or about 98 percent, are undetectable because we do viral load testing every six months as part of our monitoring,” he added.

Stigma and discrimination

Inside the jail, Mendoza said he got used to hearing some inmates suggest he deserved to be placed in “bartolina” (solitary confinement) to prevent him from infecting others, as if isolation was a normal response.

However, there is no scientific or medical basis for isolating people living with HIV (PLHIV) under ordinary circumstances.

According to UNAIDS, HIV can only be transmitted through specific means: penetrative sex, blood transfusion, sharing of contaminated needles in healthcare settings or drug injection, and from mother to infant during pregnancy, childbirth, and breastfeeding.

Lack of knowledge of how HIV is transmitted and fear of contracting the disease often leads to PLHIV stigma. According to UNAIDS, stigma “often serves as a precursor to discrimination, which creates an environment where negative attitudes and beliefs about HIV and the communities linked to it are widespread and dangerously tolerated.”

Faced with stigma from the inmates, it was a BJMP nurse who helped Mendoza realize that a positive HIV diagnosis wasn't the end for him.

“I never questioned God with ‘why me?’ because I knew the choices I had made," he said, hesitantly revealing that he had engaged in sex work at a young age.

He believes he acquired HIV through unprotected penetrative sex, noting that having unprotected sex with multiple sexual partners heightens the risk of contracting HIV.

In 2017, Mendoza developed shingles, a viral infection that causes a painful rash. Although he did not undergo testing at the time, he received treatment for it. Shingles is more common among individuals with weakened immune systems, including those living with HIV.

“Nigawas jud siya. Nag tubig-tubig siya (in my chest). (It really broke out, and there was fluid in my chest)," he recalled.

“Usahay ang Ginoo dili siguro siya mo allow sa atoang plans… like kung wala ko nagpa-test (in jail), basig patay na ko ron, diba,” he added.

(Sometimes, I think God doesn’t allow our plans to unfold as we intend. If I hadn’t been tested in jail, I might not be here today.)

Mendoza had access to HIV medicines inside the jail.

He also participated in programs such as the Therapeutic Community and Modality Program, livelihood production, and the Alternative Learning System.

Mendoza was released on probation in 2021.

Outside the jail, he is leading a different lifestyle with a new set of friends.

Although he generally feels at peace with his health now, he said there are days when doubt and negativity creep in. Yet, his sense of purpose keeps him going every day.

“I really asked God what my purpose in life is…For others, it may seem like a curse, but for me, it’s a gift that I need to discover. God gave this to me, and while it's not just about HIV, I sometimes forget how life-changing it has been and how I fought for myself."

HIV case manager

As an HIV case manager, Mendoza’s biggest challenge is convincing newly diagnosed individuals to seek treatment, particularly those without a steady income.

To support them, Mendoza connects these individuals with non-governmental organizations and sometimes government agencies to help them access care and livelihood assistance.

“When I do counseling, I disclose my status, that we are the same. I’ve been a PLHIV for six years, but I did not come to a point where I acquired opportunistic infection. It's because I had early treatment,” he added.

Mendoza also highlighted the importance of establishing a support group network to assist PLHIVs within the community.

He said some discontinue treatment or are lost to follow-up because they are too busy. Most PLHIVs who work have an 8–5 schedule, and by the time they finish work, the clinic is already closed.

He said a support group could help maintain contact with these clients.

Some digital interventions, such as the use of text messages, mobile apps, or websites to deliver reminders, guidance and support, can also help provide information about medication adherence, strategies, and even pre-exposure prophylaxis (PrEP), a medicine taken to prevent getting HIV.

(First of two parts)

(Tomorrow: Overcrowded jails strain HIV care) (WBS)