ANGELES CITY ? Apple strode in, wearing a blouse printed with Disney cartoon characters. Angel came like she was ready for a volleyball match, while Naomi looked every bit a fashion model bound for the ramp.
?Pusit kami,? Apple said casually before plopping into a chair. Rushing to clear the confusion, she added: ?I mean we?re not squids or octopuses.? As it turned out, ?pusit? is their abridged term for ?positive.? They laughed at their naming game.
?We?re HIV positive,? Apple said, crossing her forefingers in a plus sign. HIV (human immunodeficiency virus) is a virus that attacks the body?s immune system and causes AIDS (acquired immune deficiency syndrome).
Silence lingered. This was their first time to talk to a reporter. They laughed at the thought.
?Are our lives worth a story?? Angel asked.
What they are doing are worth telling.
Apple, 34, Angel, 21, and Naomi, 30, are the first HIV-positive people in Angeles City who have formed themselves into a group. Many others before them ? 73 since 1985 ? dealt with the ailment alone or with their families, a few close friends or with some doctors at the defunct Social Hygiene Clinic in the city.
?Sisters Plus,? the name these three women gave themselves in their coming-out event in a recent AIDS Summit in Angeles, signaled what may be the start of organized actions on the part of HIV-positive persons in the city. Although HIV has scarred their lives and may sooner or later develop into AIDS, they continue trying to find purpose in their lives.
They had stopped selling sexual services when tests confirmed them to be HIV-positive ? Apple in 1994, Angel in 2006 and Naomi in 2007. But they chose to work right on Fields Avenue and Friendship Road, serving also Area, the poor man?s prostitution den, to be near those still active in the flesh trade and help them protect themselves from HIV.
In their reinvented lives, Apple, Angel and Naomi are counselors and peer educators to the commercial sex workers.
For Apple, this is an entirely new approach to the city?s battle against HIV/AIDS. ?In late 2005, I asked Dr. (Teresita) Esguerra (former chief of the Reproductive Health and Wellness Center) to tap me as a peer educator and counselor because HIV/AIDS was about us. We came from the flesh industry. We know the life of a sex worker,? Apple said.
She recruited Angel and Naomi after the two were diagnosed to be ?pusit.? Their hub has been the RHWC where, daily, between 480 and 600 clients come for the routine weekly smear checkup, RHWC chief, Dr. Lucielle Ayuyao, said. ?They come confiding what they notice with their discharge or bodies,? Naomi said of her less than a year work at the RHWC.
Angel has been two years on the job. Spunky and patient, she helps doctors locate women whose tests showed them to be positive for HIV or sexually transmitted diseases. ?Walang katapusang usap (We would have endless conversations),? she said of her encounters with problematic women.
Apple leads the training team that gives seminars on HIV/AIDS. While a janitress at the RHWC, she learned by observing doctors during lectures. In between cleaning duties, she talked to women who looked troubled. Wanting to do more, she took a counseling course with the Pinoy Plus, the first organization of people with HIV/AIDS.
Esguerra?s trust in her steeled her determination to excel in her work. ?I hadn?t answered all the questions during the first seminar I gave and I admitted I didn?t know all. But I tried to improve myself because I knew the lives of other women were at stake,? Apple said.
In idle time during the 8 a.m. to 5 p.m. job, they help in clerical work, Ayuyao said.
Apple said this bouncing back and helping out began with Mercy, an HIV-positive woman. ?Mercy chose not to run away or work again in the bars. She worked here (RHWC) as a janitress then became a counselor. It was through her that I got here. But even as she helped other women, she fought with depression. She died of depression, not from AIDS complications. I took care of her until her death [in 2005]. We cremated her,? Apple said.
?She?s an angel of courage,? she said of her friend who inspired her to continue working with other HIV-positive persons.
Apple, Angel and Naomi said they went into peer education and counseling only after they had accepted their situation. Each went through a difficult process of admission, battling with discrimination within their families, seeking cure, changing lifestyles and, best of all, seizing the courage while rattled by an incurable ailment that they would have to confront all their lives.
They migrated to Angeles from Quezon, Negros Occidental and Surigao del Sur. They finished elementary or high school. All entered the flesh trade in their teens to support their younger relatives or their own children, working in bars that catered to foreigners.
Tough is their newfound work. So it is for the RHWC, Angeles City AIDS Council, nongovernment organizations and the city government.
The industry?s character is one problem. As a ?rest and recreation industry,? it catered mainly to the US military at the nearby Clark Air Base until 1991. Since then, the red light district has lived on both the US military soldiers that come for some 30 or so war exercises yearly, and sex tourism, according to Susan Pineda, executive director of the Ing Makababaying Aksyon (Pro-Women Action).
For another, the figures are unsettling. The city has 180 ?R & R establishments? as of March 2007, or more than double the 78 ?entertainment establishments? that the defunct Social Hygiene Clinic recorded to be the highest in June 1996.
Citing estimates by insiders, Pineda pegged the number of registered sex workers at 12,000. The unregistered ones are more or less that same number.
Ayuyao said that between 6,000 and 7,000 had renewed health licenses as of March to work in entertainment establishments. The number will climb in the next few months, she said.
Monthly consolidated reports by the RHWC showed that 38,312 women and 302 men made ?initial visits? to the center in 2007 for tests to show proof of clean health. The RHWC administered 120,402 smear tests, but the figure did not indicate the number of women who repeated the test.
?Most at risk?
The RHWC?s ?most at risk population? can, in itself, be considered a large group. The number of registered female sex workers starts from a low of 3,509 to a high of 3,738. Men having sex with men number from 957 to 2,871. The clients of female sex workers reach a low of 1,630 to a high of 5,706.
HIV-positive cases have been on the rise. Twenty-three cases were recorded from 1985 to 1993 (the years when the US Naval Medical Research Unit II funded the HIV surveillance program in Angeles); 53 more cases were recorded from 1994 to 2007.
Two more cases were recorded in the first three months of 2008, bringing the total to 78.
STD cases rose five times. The RHWC treated 1,421 cases in 2005, 2,516 cases in 2006 and 6,229 cases in 2007. Most of the afflicted were women; there were only 69 men among the recorded cases.
Conditions encourage women to sell their bodies.
Inquirer sources say the bar fine system, or the sale of sexual services through the bars, is still in practice. From the current rate of P1,350, women get P650 while the mama san (pimp) gets P50 as commission. The rest goes to the bar owner.
Women are drawn to the bar fine system at one point or another. Wages are below the government-set minimum wage of P240 to P260. A dancer is paid P130 nightly and a waitress, P80.
In the recent AIDS summit, regulators dealt with two concerns: How to increase the competency of health providers and regulators to prevent the epidemic rise of HIV/AIDS ?which may lead to the downfall of the tourism industry and the economy of the city.?
Angeles Mayor Francis Nepomuceno has acknowledged the problem.
?We admit having HIV cases and that prostitution may be flourishing. We?re taking decisive actions to protect the people in the red light districts, especially the minors,? he said.
Dr. Cheryl Tuazon, the city health officer, said the city government has allotted P3.9 million, or 10 percent of the gender and development fund this year, for ?strengthening the delivery of health care services of the RHWC.? At least 30 percent of that is appropriated for medicines, she said.