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Discrimination and stigma continue to haunt HIV-AIDS patients, kin
CLAIRE DELFIN, GMANews.TV
MANILA, Philippines - A family woke up to the blaze of fire engulfing their tiny hut in a remote village near OlongapoCity. their neighbors allegedly colluded to torch their house amid fears of getting infected by HIV (human immunodeficiency virus) that one of the members of the family had carried. HIV is the virus that causes AIDS (acquired immune deficiency syndrome).
Nelia Sevidal, executive director of the non-government organization Lunduyan Para sa Pagpapalaganap at Pagtatanggol ng Karapatang Pambata, Inc., says the incident took place years after the enactment of the Philippine AIDS Prevention and Control Act of 1998 (also known as Republic Act No. 8504).
She says the arson episode is a clear manifestation that despite the law that aims to protect the rights of known and suspected HIV-infected persons, discrimination and stigma continue to haunt them and their family. And this is primarily the reason why AIDS prevalence in the Philippines, “though growing, is hidden."
“For the PLHAs (persons living with HIV/AIDS), silence is the only defense against discrimination," says Sevidal.
Deafening silence
What may be worse is the “deafening silence" of Filipino children affected by HIV/AIDS. Sevidal says Filipino parents living with the HIV or AIDS are reluctant to tell their children about their status to protect them from discrimination. Even infected children are not being told about HIV.
The National HIV/AIDS Registry issued by the Department of Health (DOH) lists only known cases of HIV. From January 1984 to October 2008, there were 3,515 HIV-positive cases, with an average of six Filipinos detected every week.
But Sevidal estimates that there could be up to 10,000 HIV cases in the country. And if most of these people have children, it could mean that several thousands of children are affected.
A study conducted by the Lunduyan over six months between 2004 and 2005 showed that affected children gave up their childhood by taking on the role of caregivers and providers.
From an initial list of 190 children, Lunduyan reached 95 of these, mostly aged 6 to 11 years old. Three of these were infected with HIV but had neither received proper treatment nor brought to an institution at the time the research was conducted.
As all these children came from low-income families and lived in depressed areas, they were often left with no option but to take on grown-up roles and carry the emotional and financial burden of keeping the family together.
Such was Nina’s case (not her real name). She was just four years old when her mother was first hospitalized. “When I turned seven, life for me and my parents was a roller coaster ride that never went up!"
Young and innocent, she was already confronted with serious problems from long hospital stays to abandonment from her father, to strained finances, and to quitting school to take care of her ailing mother without even understanding what her illness was.
“I remember one time when she came from the hospital, she brought many small papers with the words HIV and AIDS, I asked her what these were, and she said -- someday, you will understand," Nina was quoted as saying in the study.
After her mother’s death, Nina was taken into the care of an alcoholic uncle before she was finally reunited with her father who already had another family.
Other kids, at a loss for answers, suffer the same, or even worse, fate. Some rebel. Some face forced separation from other siblings.
Lunduyan documented the case of four siblings – Kuya Jun, Ate Rochelle, Reyann and Ben (not their real names) – all under the age of 13 and orphaned by parents who died of HIV-related diseases.
Kuya Jun was the first to leave without telling anyone where he was going. He had not been heard since. Ate Rochelle, the only girl, was taken in by relatives. Reyann and Ben were together, but were living off the streets.
In the 10 Fast Facts on Filipino Children Affected by HIV/AIDS, United Nations Children’s Fund (UNICEF) Philippines mentions that the psychosocial needs of these children are not addressed.
“The children are not given a chance to prepare for the possible impending death of a parent, often remaining in the dark about the disease. Possible support systems like the school, the church, the community are unable to help these children because the silence regarding HIV prevents them from becoming aware of HIV in their community and its impact on the children," the study says.
Lack of information
The stigma is borne because of lack of information.
“When Filipinos are told of HIV, most of them get the vision of a skin-and-bone, ghost-like figure of a person," says Sevidal.
Naturally, given this concept of HIV, none of them would want to get infected. What they don’t know is that HIV does not transmit so easily, and a person with the virus can prolong his life by taking on a more positive lifestyle and taking in antiretroviral drugs, which the government says it provides for free.
Dr. Enrique Tayag, director of the DOH-NationalEpidemiologyCenter, agrees that many Filipinos hold a lot of misconceptions regarding HIV especially with its transmission.
While health experts say HIV is spread through sexual intercourse, mother-to-child infection, and blood transfusion, many Filipinos still believe the virus can be transmitted just by mere touching or talking to an infected individual. Some even think that a mosquito bite can infect someone.
“These are issues that we can address," says Tayag, adding that efforts with the Department of Education have already been undertaken to educate the people about HIV and AIDS.
Sexual behavior
Bong Yap of the AIDS Society of the Philippines, a non-government organization, sees not only misconceptions but ironies in how most Filipinos view HIV.
“While there is a strong stigma against persons living with HIV, there, however, is no conscious effort to get away from being infected from valid sources," says Yap.
He points to the “disturbing results" of the 2002 Young Adolescent Fertility and Sexuality Study, which showed that 23 percent of young Filipinos, aged 15 to 24 years, practice premarital sex. Fifty percent of them know that condom use can reduce the transmission of HIV, but believe they could not contract HIV even without condoms. The same study revealed that 50 percent of sexually active young Filipino males have had multiple partners.
The 2003 National Demographic and Health Survey showed that only one percent of Filipino women aged 20 to 24 years uses condom, and 0.1 percent for those 15 to 19 years old.
“For many young Filipinos, sex is fun without minding its possible consequences," Yap says.
But not only is condom use low among sexually active young Filipinos. Its use among the most at risk population remains below the universal access target. The 2007 Integrated HIV Behavioral and Serologic Surveillance revealed that only 48 percent of female sex workers, 27 percent of injecting drug users, and 49 percent of men having sex with men who have had sex with multiple partners used a condom.
The Remedios AIDS Foundation, Inc. warns that the “ingredients for an explosive epidemic are already here."
In a report posted on its official website says that on top of the low consistent condom use rate among sex workers, there is also a threat from the increasing practice of anal sex and the high prevalence of sexually transmitted diseases.
It says the most recent estimate of chlamydia and gonorrhea infection among the general population is 7.7 percent and 1.7 percent, respectively.
“Reasons for low condom use should be explored, whether they be lack of knowledge or poor attitudes. There is also the presence of societal constraints, such as the resistance of the Catholic Church to condom promotion," the Foundation says.
“It seems, however, that there may be some ground where these conflicting views of the use of condoms can be reconciled; for example, condoms might be promoted for protection rather than for contraception."
Based on the DOH data, transmission through heterosexual contact decreased from 193 in 2006 to 139 in 2007. But, transmission from homosexual (81 to 107) and bisexual (26 to 74) contacts increased.
Overseas workers
The Foundation also places its concern on the rising number of HIV cases among overseas Filipino workers (OFWs). According to DOH record, one of three HIV-positive cases is an overseas worker. Majority of the infected overseas workers are seamen.
In a study conducted among seamen who had worked abroad and returned to the Philippines, 35 percent admitted to having sex abroad, and 36 percent of them had unprotected commercial sex.
The Foundation says that there is no effective surveillance of the OFW population as their infection status is only discovered once they reapply for another work stint abroad. By that time, they could have spread the virus to their partners here in the Philippines.
“The threat that the seamen will serve as the bridge for HIV to the general population is highly likely," the Foundation adds.
The DOH, however, rebuts this claim, saying it is unfair to make general conclusions on or against Filipino seamen.
“It is hard to translate seamen to HIV because unlike sex workers, the alleged sexual promiscuity of seamen abroad has nothing to do with the nature of their occupation. It is a behavioral factor relative to each seaman," Tayag says.
The government has adopted measures to prevent the spread of the virus and reduce its impact. It has strengthened training programs for health service providers, and has procured equipment for social hygiene clinics located in identified risk zones. Mechanisms for monitoring and evaluation are also in place, with certain local government units actively supporting prevention programs.
Moreover, the Philippine Health Insurance Corporation has approved the provision of health benefits for people living with HIV/AIDS.
With the registry widening and surpassing benchmarks, advocates say that indeed, there is no better time to do more than now; otherwise, more and more children will wake up one day wondering what it is to be a child. - GMANews.TV
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