(Photo from verywellhealth.com)

The province of Palawan registered 89 cases of the human immunodeficiency virus (HIV) from January to August with over a hundred cases probable by the end of 2021, citing the pandemic and trend of hook-up applications.

Ynna Lauron-Doblado, project manager of the Pilipinas Shell Foundation, Inc. (PSFI), stated Wednesday during the commemoration in the city of the importance of World AIDS Day at the Amos Tara Center that Palawan has the highest rate of increase in MIMAROPA, with affected people ranging in age from 15 to 25 years old.

World AIDS Day is widely commemorated every December 1 as an international event devoted to raising awareness of the AIDS epidemic due to the spread of HIV and remembering those who have died of the disease.

PSFI project manager Ynna Lauron-Dobaldo encourages transgender women to use their voices in disseminating information about HIV and screening.

“We’re not yet sure—kasi may apat pa (na buwan), baka sumampa tayo ng 100 kasi 89 na tayo ng August. Baka sumampa pa tayo ng 120, 100 ganyan. Oo, pataas tayo, actually sa buong region ng MIMAROPA, Palawan ang may pinakamataas na rate of increase. Dati mababa tayo, ngayon tumataas siya na medyo mabilis. Ang karamihan na affected nito ay nasa peak of their life, 15 to 25,” she said.

Youth, working and non-working students, men having sex with men, men having sex with women, and mother to a child were among the 89 cases recorded this year.

According to Doblado, Palawan had over 120 cases of HIV in 2020.

They think that the number of cases continues to rise throughout the pandemic because restrictions make it difficult to monitor and gather people who have HIV infection.

“Feeling namin ang (epekto) ni COVID, hindi na namin sila ma-gather in one place. Nahirapan kami, wala kaming avenue to gather them kahit gusto namin sila ipunin, nahirapan kami ipunin sila. Kasi hindi kami pwede mag-congregate,” she said.

“Dati pupunta kami sa isang barangay, magpapa-training kami, two hours. Tapos sino gusto magpa-test, confidential, puwede naman. Ngayon, you cannot do that,” she added.

Candidates of the Puerto Princesa Queen of Queens join the celebration of World AIDS Day on December 1 at the Amos Tara Center.

The PSFI is unable to distribute information at academic institutions where cases may originate due to a lack of face-to-face lectures and sessions.

Lauron explained further that it has been difficult for them to travel to various locations and distribute condoms and lubricants due to mobility limitations.

The trend of hook-up applications is also a factor in the increase of cases, she added.

“Text lang ‘yon, hook up, meet up. Kung sinong malapit then finish na. May mga ganon tayong kaso, once, twice, thrice, iba-ibang tao. Siguro nakarinig siya ng seminar o mga online natin, papa-test dito, positive, bata pa,” she said.

HIV as hidden pandemic
Due to the COVID-19 pandemic, other health concerns and problems are put on hold, which Doblado sees as one of the virus’s drawbacks.

According to Regina Villapa of the City Social Hygiene Clinic of the City Health Office (CHO), 62 of the 89 cases from January to August originated from Puerto Princesa.

She also said that HIV is currently present in around half or 50 percent of the city’s barangays.

Villapa stated that due to the pandemic, the funding allotted for the HIV program’s execution was transferred to the COVID-19 response.

Amos Tara serves as the clinic and consultation area for individuals who would like to know their status.

The local government’s implementation of HIV-related initiatives has also been restricted, making it difficult to reach the Puerto Princesa community of transgender women.

The stigma associated with HIV also continues to stymie their efforts to engage them.

“[Ang] transgender women, mailap sila sa HIV program. Unang-una, stigma, misinformation, kasabay din ng stigma. Although naman dyan ‘yong correct information parang human nature na mas naniniwala sa sabi-sabi—reluctance to seek the truth,” she said.

According to her, the CHO sees the cases as a worrying amount for the city and province’s HIV status.

“Alarming na ‘yan, magkaroon ka nga lang ng few cases, less than 10 sa isang lugar. It is a hidden pandemic siya. Kapag titingnan natin, para siyang iceberg na mas marami ‘yong under kaysa ‘yong nakikita natin,” she said.

PSFI PROTECTS’ initiative
Despite the hurdles in HIV efforts exacerbated by COVID-19, non-governmental organization PSFI continues to contribute to substantial advances in the battle against the disease.

High-risk persons in Palawan may get Pre-exposure Prophylaxis (PrEP) as part of the PSFI PROTECTS (Philippine Response in Optimizing Testing, Empowered Communities, Treatment, and Sustainability) initiative, which is funded through a Global Fund grant.

[L-R] PSFI program manager Ynna Lauron-Doblado, Regina Villapa of the City Social Hygiene Clinic, and Dr. Armie Cleofes of the Ospital ng Palawan cut the ribbon for the pre-exposure prophylaxis (PrEP) to be distributed for initial 35 slots.

There are around 35 places available for the pilot of PrEP distribution from 2021 to 2023.

PrEP is a medicine taken to prevent getting HIV. Research and studies claim it is highly effective for preventing HIV when taken as prescribed by doctors.

“Sabi nga namin, start tayo ng small kasi hindi siya pwede ipamudmod. Meron din ‘yan dapat i-monitor, kailangan ng laboratory, may doctor na magmo-monitor sa kanila. Gusto namin na mamonitor sila bago ipamigay sa iba,” she said.

“Syempre this one is free, baka rin siya dumugin and we don’t want that to happen. Gusto namin na ma-control muna siya, ma-check kung acceptable sa nakararami bago gawin siyang large scale,” Doblado added.

Lauron said that PrEP may be taken in two doses: daily and on an “as-needed basis”. It is strongly advised to continue using a condom in addition to taking PrEP for other sexually transmitted diseases (STDs), and all prospective participants will be screened.

Dr. Armie Cleofas, Medical Officer IV of the Ospital ng Palawan-Red Top Center (ONP-RTC), said PrEP decreases the risk of HIV from intercourse by 99 percent.

“Usually, dapat ang PrEP ay as per prescribed, hindi siya tayo-tayo lang. Hindi siya effective kung hindi siya taken as prescribed,” she said.

The PrEP is the use of antiretroviral drugs prescribed and taken by people who are HIV-negative before being exposed to the virus to prevent becoming infected. It can stop HIV from taking hold and spreading throughout the body, she further stated.

Search for transgender volunteers
Villapa said that they are searching for transgender volunteers to help with the difficulty of engaging their communities. The city’s social hygiene clinic also suggested a trans health package, which was incorporated into the budget for 2022.

RR Morales, a volunteer, and HIV advocate said that cooperation is needed from the public to implement the programs.

“Kung ma-diagnose man o hindi, tutulungan naman—kung mapapansin niyo, holistic approach na ang ibinibigay ng gobyerno o city health office. Kaya wala na reason para hindi i-avail ang services,” he said.

The trans health package includes services such as HIV services and hormone replacement therapy (HRT).