For 30 years, from 1984 to present there were a total of 20,424 HIV and AIDS cases reported and it’s constantly increasing. With the changing drivers and trends of the epidemic, it is now the time to go back and assess what we did best and what we missed out.

This year’s theme “The Evidence: A Roundtable Discussion on HIV and AIDS in the Philippines,” will surface and review the current evidence on what is really happening in the country and trace where are we now. There are six themed sessions: Integration of HIV and AIDS in the Education Curriculum, HIV Counseling and Testing, HIV Testing for Minors, Anti-Retroviral (ARV) Treatment in Pregnant Women, ARV Treatment Guidelines, and Human Rights on HIV and AIDS. Distinguished speakers who are experts from the region will elaborate on the best practices that may be effective at the regional level, local program implementers will discuss current policies, coverage extent of reach and challenges, and people living with HIV (PLHIV) will share their personal experiences and advocacy agenda points for consideration.

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We are inviting you to join us on this important event. Let us talk, discuss and look at ways on how to can move forward. Through continued and strengthened solidarity, we will be able to rise above the challenges and remain practical and strategic in approaches to ultimately curb the Philippine HIV epidemic. It is everyone’s concern. None of us can do this alone, but together, we can

Several HIV interest groups recently criticized the DOH for its plans to implement “mandatory” HIV testing while citing provisions in the 1998 AIDS law that does not allow “compulsory” testing.

In the Philippines today, the number of new HIV infections continues to increase month per month and estimates now run to 14 new HIV cases every day. Despite these, the HIV prevalence (new and old infections combined) remains less than 1%. Most of the current infections occur among males who have sex with male who engage in unprotected sex.

Preliminary results from the 2013 Integrated HIV Behavioral and Serologic Surveillance (IHBSS) carried out on 6,305 males who have sex with males offered these findings: 1) 44 for every 1,000 were HIV positive compared to 17 per 1,000 in 2011 2) two-thirds engaged in anal sex while only 37% used condoms in their last anal sex 3) only half accessed the social hygiene clinic for medical services while only 17% were reached thru peer education 4) despite the risks, only 15% were ever tested and only 8% were tested in the past 12 months and knew their results.

In 2013, the United States Preventive Health Services recommended that clinicians screen ALL adolescents and adults ages 15 years-65 years for HIV and younger adolescents or older persons who are at increased risk as well as all pregnant women including those who present in labor. They cited strong evidence that such mandatory screening tests have benefits since screening identifies those who have HIV but otherwise may not feel ill, and if they are infected then they can start with medicines that can make them have better chances of staying healthier and thus delaying AIDS, the final stage of HIV. Individuals who will be offered HIV screening can decline.

Based on the current HIV situation (including future projections) and current strong evidence on benefits of early HIV screening, the Department of Health, mulls mandatory screening by health providers for patients who maybe suspected having HIV infection based on a risk-based assessment. The AIDS law in fact encourages risk based screening. What is mandatory therefore applies to health providers who remain key participants to halt or reverse the HIV epidemic. Mandatory screening maybe extended to pregnant mothers during their prenatal visit to prevent mothers infecting their child.

In the AIDS law, such testing requires informed consent, pre- and post-test counseling, with test results only available to individuals who were tested, bounded by privacy and confidentiality.

What the law prohibits for such HIV testing is when they are used as preconditions to “employment, admission to educational institutions, exercise of freedoms of abode, entry or continues stay in the country, or right to travel, or provision of medical services.” The DOH/Philippine National AIDS Council continues to monitor such discriminatory acts and encourages all concerned to report such acts so that they will be appropriately addressed.

The AIDS law also provides that any person with HIV is obliged to disclose their HIV status and health conditions to their partners while the DOH pursues contact tracing. Contact tracing requires HIV screening and this remains a public health prerogative. Individuals traced from contact tracing will be properly counseled and ethical testing requirements will be observed.

The DOH welcomes criticisms as a means to understand those who have divergent views and to reconcile such different views in a proper venue that allows productive resolution of issues.

Even as DOH mulls such “mandatory” testing, giant steps are necessary to increase public awareness of HIV, concretize a comprehensive plan that is sufficiently financed and end stigmatization and discrimination against HIV.

HIV-related issues are often difficult to take up: sex, sexuality, gender, discrimination, and stigma. With the increasing incidence still largely disregarded, the struggle for awareness and prevention has never been this tough. Cases are shooting up as social media becomes an easy access for sex partners that could lead to risky sexual practices. People fear screening. Government and civil society organizations have scaled up their battles, but at the end of the day, it’s still about numbers that matter. The Philippines is now reporting 12 new cases a day, but any reduction, even in deaths, is nowhere in the data.

Prevention is the best and only thing we can do right now as there is yet no final conclusion to scientific findings of a possible cure. It is not about when and how but it’s about what we do NOW. This is where our role starts, the point where we accept the challenge. This is us. This is me. A counselor. An advocate.

As a counselor, I learned to treat every person as an individual with needs and vulnerabilities, not as mere fractions of the statistics. A counselor and the client explore and discover, and act as partners.

It is normal for clients who come to the ASP ICON Clinic for testing and counseling to have apprehensions. They are not alone in this. We let them express their feelings about the process, and help them identify any risks associated with their lifestyle. We aim for their awareness towards a positive and healthy behavior change. We want them to grow and eventually be advocates to other people.

Counseling is a two-way process, with the clients learning from us and us learning from them. We grow and are fulfilled whenever we touch someone’s life. The positive feedback we receive is enough to devote our time more and continue with what we do. The ASP ICON Clinic is blessed with so much support from people and that inspires us more to attain our goal to live in a world where HIV is no longer a disease ignored, feared and disregarded by people.

Counseling also gives us the chance to meet different kinds of individuals of varying perspectives about the disease. It is always about making sure that each client would feel valued and respected regardless of sexual orientation, religion, culture, or social status, and without being judgmental.

From all these, I sure will continue to be a counselor. The pride of being one has been immeasurable. This is not just a job for me but more of a mission and a lifelong advocacy.

Revisiting these words and thinking about their impact today would bring an impression that does not surprise advocates, because they would find out that there has been little progress as much as one would think after more than a decade has passed.

Kirby’s examples of what steps the Australian government has taken to prevent HIV infection during a drug use scare was not what was on everyone’s mind especially after a statement on the moral correctness of protecting their citizens.

He said, “Paradoxically enough, the only way to deal effectively with the problem of the rapid spread of this epidemic in our region is by respecting and protecting the human rights of those who are already exposed to the virus and those most at risk.”

He said that despite political disagreements, political parties recognized that there really was one clear and efficient way to reduce the risk of individuals, especially those who are in sex work, people who inject drugs, males who have sex with other males, and other marginalized persons. It was the “courageous decisions” that have been made by their political leaders to put aside their differences and prioritize these lives that changed the game.

“When we were in the middle of the war on drugs, needle exchange was a very politically risky step to take. But it was taken because the politicians came to the view that saving lives was the ultimate moral test,” he added. He referred to the program wherein people who inject drugs were encouraged to exchange their used needles for new ones when they are about to use drugs anew. He also encouraged the need for a standardized and realistic way of educating the public.

As for the Philippines, where advocates were lobbying for a law (RA 8504) at that time, he said the country’s leaders had “too many words and not enough action” and that they should respond “with more than words”.

RA 8504 or the Philippine AIDS Law was passed a year later in 1998, but it’s disheartening to know that despite Kirby’s reminder to the Philippine government to respond fast, and to adopt the moral correctness of recognizing its moral obligation to protect the rights of its citizens in preventing HIV infection, not much has changed.

There are still many disagreements on what is the ‘morally right’ thing to be done. This at the expense of the lives lost to AIDS and continues to lose at a hastening pace. Would it take another 16 years or more for us to see anything happening in the fight against HIV? We sure hope not.

It’s a matter of prevention versus cure. I’m talking about the constant woes in HIV advocacy caused by people using the Internet as an avenue of baseless accusations and unwarranted disclosure of people’s HIV status.

Early this year, an individual chose an online social network as the platform to indict a student of being HIV-positive and of deliberately infecting other people through a poster of the student’s picture and other identifying features. As expected, with the phenomena brought by these online mediums, the post spread like wildfire through countless re-posts. It drew different comments; a few, of dismay that someone would do this to shame a person, but mostly of confusion and fear that probably, this person might actually be purposely infecting others.

To save a maligned name and disprove the unknown perpetrator, the student took the HIV screening test at a social hygiene clinics and got a non-reactive result.

This has happened before. A blog targeted multiple subscribers of a gay social networking site and branded them HIV-positive as well. This even reached mainstream media and caused quite a blow towards our efforts of dissipating the fear of HIV, which would eventually hamper the public’s opportunities of understanding HIV and AIDS.

In light of a current law penalizing people who malign others, with some using HIV infection at the core of accusations, I think it’s good that there is something to use against persons who put others in a bad light. Given the lack of teeth of RA 8504, or the Philippine AIDS Law, it could help put a stop to the destructive online attacks. But I think we can do more than just chastise.

But then again, why not just aid the campaign on HIV prevention by educating people, strengthening school campaigns and helping the media handle this very sensitive topic? HIV is no longer just a health issue. It is a social issue given the country’s taboo perception on sex and sexual contact, which is currently the most widespread mode of transmission of the virus.

I believe that educating people and removing the stigma is the best preventive measure against hateful remarks online from ever happening again. Not only will it help the country in its goal of lessening HIV prevalence; it will also help persons living with HIV to seek out help without fear of discrimination. Again, as they say, prevention is better than cure.

Disclaimer: The views represented in this article are those of the author and do not necessarily reflect that of AIDS Society of the Philippines, Inc.