Gov’t urged to strengthen policies on HIV stigma

Roberto Ruiz shown from the HIV advocacy video played during the AIDS Candlelight Memorial last May at the San Lazaro Hospital —photo by Diana Mendoza

(Last of two parts)

MANILA, Philippines — The Philippines has the highest rate of transmission of the human immunodeficiency virus (HIV) in the Asia-Pacific, with an average 55 people diagnosed with the virus daily, according to the Department of Health (DOH).

The country even has the fastest-growing HIV epidemic in the region, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS).

READ: Man living with HIV for decades recalls struggle with stigma

Its deputy executive director, Christine Stegling, who visited the Philippines last month, described the numbers regarding the Philippines as “disturbingly high,” with almost half the country’s new infections among the youth between ages 15 and 24.

“Every hour, there are three new HIV infections in the Philippines. Every day, there are four AIDS-related deaths. Every single one of these is avoidable,” Stegling said.

She cited President Ferdinand Marcos Jr.’s commitment to declaring HIV a national priority and the country’s inclusion in the Global HIV Prevention Coalition of UNAIDS, through which UN member states and other stakeholders are provided prevention services while being held accountable for reaching their targets.

But for these efforts to succeed, she urged the government to invest in HIV prevention through increased financing for programs “to address the low HIV knowledge and early unprotected sex among young people” and “key populations” including MSMs (men who have sex with men), transgenders, drug users, inmates and sex workers.

Stegling also asked the government to expand HIV services, strengthen community-led prevention, develop a sustainability plan and address stigma and discrimination.

New messaging

On May 6, the DOH released a circular adopting the “U=U” guide to help reduce HIV transmission and remove the stigma associated with the illness.

The new messaging, which stands for “Undetectable equals Untransmissible,” aims to promote the finding that persons living with HIV (PLHIV) who achieve and maintain a viral load—the amount of HIV in the blood—at undetectable levels could no longer transmit HIV to others and are at low risk of transmitting the virus to their children.

“This provides guidance on the powerful evidence for U=U messaging and the opportunities to destigmatize HIV and promote viral suppression,” stated the DOH circular, which also cited an advisory last year by the World Health Organization (WHO).

The WHO had adopted scientific findings from the 2023 International Conference on HIV Science and 244 studies published in “The Lancet” medical journal.

The DOH circular encouraged the active promotion of U=U among health facilities and workers.

Dr. Loyd Brendan Norella, program manager of the Philippine Response in Optimizing Testing, Empowered Communities, Treatment and Sustainability (Protects), described the U=U campaign as a powerful tool to help discourage stigma and change mindsets.

Protects is a grant recipient of the Global Fund, the world’s largest funder of HIV, tuberculosis, and malaria programs.

“With other new developments, the U=U campaign will hopefully lead to a more enlightened approach to more people undergoing HIV testing, better adherence to treatment and health care and better mindsets,” he said.

Other “tools” that people may avail themselves of include self-testing and rapid testing, pre-exposure prophylaxis—a pill taken to prevent getting HIV from sexual contact and injecting drug use—and post-exposure prophylaxis, which prevents contracting the virus even when one is exposed.

‘Changing our language’

Norella said it is important to “flip the narrative” by creating spaces for people to tell their stories and claim their rights.

It is just as crucial to help people stay away from internalized or self-stigma that manifests in self-loathing and self-blaming. “Feeling unlovable makes people to not seek medical assistance and to not adhere to medication for those under treatment,” he said.

Professor Yvonne Gilleece, chair of the British HIV Association, called on journalists, policymakers, and academics to “use compassionate words that can build dignity. Be kind, be inclusive.”

“We’re still a long way to remove the stigmatizing situations and incidents, but I would like to encourage changing our language,” she said in an online forum on the importance of language in HIV response, held in the run-up to the 25th International AIDS Conference in Munich this week.