In the Philippines, people diagnosed with HIV or human immunodeficiency virus has reached 46,985 since 1984. Of this number, almost half are from the National Capital Region (NCR), and 4,412 come from Quezon City, based on a report by the Department of Health (DOH).
To address the threat of the rising HIV epidemic, the Quezon City Government had mobilized a campaign promoting HIV testing, prevention, treatment, and control. HIV can lead to AIDS or acquired immunodeficiency syndrome – the most advanced stage of HIV infection.
In enforcing HIV/AIDS education and awareness, the Quezon City Government organized the HIV Summit on December 6, 2017 at Novotel Manila. This is also part of the LGU’s participation in the World AIDS Awareness Day held every first day of December. The Joint United Nations Program on HIV/AIDS (UNAIDS), DOH, and biopharmaceutical company MSD in the Philippines supported the summit.
Themed, “Partnerships and Synergies: The Service Delivery Network (SDN) for People Living with HIV in Quezon City,” the event shed light on the Quezon City AIDS response journey and highlighted the importance of accessible and interconnected care, treatment, and support services for People Living with HIV (PLHIV) and their families.
Through Quezon City’s SDN approach, coverage and quality of treatment for PLHIV have improved as it facilitated standardized referral between various member organizations. Clients may be efficiently tracked among service providers, and receive continuous care after HIV testing and diagnosis.
“For years, we’ve seen how HIV/AIDS has caused public fear, pain and suffering. This drove us to continuously fight against the epidemic. We are further completing our service delivery network, collaborating with other programs and institutions, innovating, and filling the gaps in response,” explained Quezon City Mayor Herbert Bautista during his keynote message.
Now on its 4th year, Quezon City’s SDN for PLHIV currently covers more than 1,000 cases under the care of their network of service providers. The proactive HIV investments have led to these outcomes: testing has more than doubled reaching 24,000 people in 2016; condom use among males who have sex with males (MSM) almost doubled since the SDN introduction; and between 2014 and 2016, 437 people were enrolled on antiretroviral therapy (ART) which is treatment for HIV infection.
“Despite the progress, many people still don’t receive the continuum of care that they need. Of the people confirmed of living with HIV in the city, only around half actually returned to facilities for new test results, and there is still a huge gap in terms of receiving treatment. Hence it is essential to build on the results we have achieved so far, and expand and intensify prevention and treatment coverage,” explained Dr. Verdades P. Linga, Quezon City Health Officer.
Mayor Bautista, DOH NCR Regional Director Ariel Valencia, Dr. Linga, PLHIV advocate Pinoy Plus, and Positive Action Foundation Philippines (PAFPI) led the launch of the coffee table book which summarized the story of Quezon City’s vision and transformation in its journey against HIV.
To strengthen the awareness campaign, Quezon City Government also turned over the “Reference Material on HIV, AIDS and STI for High School Students” to the Department of Education, QC School Division Office to ensure that all schools in QC include HIV education in their curriculum.
HIV, HPV, and Genital Warts
One of the rising co-infections among PLHIVs that is rarely bought into light is human papilloma virus (HPV) and genital warts. During the summit, a panel discussion on HPV-related diseases in PLHIV was led by Dr. Rontgene Solante, past president of the Philippine Society for Microbiology and Infectious Diseases (PSMID) and a medical specialist at the National Reference Laboratory for HIV/AIDS of San Lazaro Hospital.
“HIV damages the immune system and puts PLHIV at higher risk for HPV infections. Genital warts is a common sexually transmitted disease, and the stigma to discuss it is even more expounded in PLHIV. HPV-induced anogenital lesions are very frequent in men who have sex with men (MSM) who are HIV-positive. Anogenital warts (AGWs) are considered benign lesions caused by low-risk HPV-types, whereas anogenital dysplasias, which are the presence of abnormal cells, are potential cancer precursors associated with high-risk HPV-types” explained Dr. Solante.
“Immunocompromised and HIV-positive patients carry the highest epidemiological burden of HPV infection and comprise a population specifically susceptible to treatment failures and recurrences. In contrast to immunocompetent patients, AGWs of HIV-positive MSM may harbor high-grade dysplasia or even invasive squamous cell carcinoma,” he noted.
Dr. Solante also explained the increased risks of HPV infection in HIV-positive women. “The immune system destroys cancer cells and slows their growth and spread. In women with HIV, a cervical pre-cancer might develop into an invasive cancer faster than it normally would.”
With the local experience presented during the summit, Dr. Solante reinforced the value of immunization, early screening, detection, and treatment. HPV infections are vaccine-preventable diseases, hence, immunization was highly recommended to be taken by HIV-positive men and women. The HPV quadrivalent vaccine, for example, covers HPV types 6, 11, 16, and 18. HPV strains 16 and 18 have been specifically identified as the main cause of cervical cancers globally; strains 6 and 11, meanwhile, are the most common genital warts-causing types.
Inspiring Other Cities
The SDN approach by the Quezon City Government underscored the significant role of multi-stakeholder collaboration in fighting devastating diseases such as HIV infection and AIDS.
“Quezon City is a learning example of having a compelling case of HIV investment and response. The stigma and discrimination against PLHIV are some of the major factors that prevent testing and treatment, and the SDN helps address this by continuously encouraging PLHIV to follow through with the care that they need,” observed Peter Mosende, UNAIDS Executive Director.
“Treatment, care and support, and counseling are vital particularly in reaching out to newly diagnosed clients,” said Owie Franco, President of Pinoy Plus. “Since there is no single agency that can provide all the needs of the clients, it is crucial that a referral system is in place, so that partner agencies can respond according to their needs. We’ve seen the positive results delivered by the Quezon City SDN and hope that similar programs will be in place in more cities across the country.”