HIV/AIDS GLOBAL FACTS (2015)

World Health Organization http://www.who.int/mediacentre/factsheets/fs360/en/

Date Retrieved January 10, 2016
1.

HIV continues to be a major global public health issue, having claimed more than 34 million
lives so far. In 2014, 1.2 [980 0001.6 million] million people died from HIV-related causes

2.

globally.
There were approximately 36.9 [34.341.4] million people living with HIV at the end of 2014

3.

with 2.0 [1.92.2] million people becoming newly infected with HIV in 2014 globally.
Sub-Saharan Africa is the most affected region, with 25.8 [24.028.7] million people living with
HIV in 2014. Also sub-Saharan Africa accounts for almost 70% of the global total of new HIV

4.

infections.
HIV infection is often diagnosed through rapid diagnostic tests (RDTs), which detect the
presence or absence of HIV antibodies. Most often these tests provide same day test results;

5.

essential for same day diagnosis and early treatment and care.
There is no cure for HIV infection. However, effective antiretroviral (ARV) drugs can control the
virus and help prevent transmission so that people with HIV, and those at substantial risk, can

6.

enjoy healthy and productive lives.

It is estimated that currently only 53% of people with HIV know their status. In 2014,
approximately 150 million children and adults in 129 low- and middle-income countries

7.

received HIV testing services.

By mid-2015, 15.8 million people living with HIV were receiving antiretroviral therapy (ART)

8.

globally.
Between 2000 and 2015, new HIV infections have fallen by 35%, AIDS-related deaths have
fallen by 24% with some 7.8 million lives saved as a result of international efforts that led the

9.

global achievement of the HIV targets of the Millennium Development Goals.

Expanding ART to all people living with HIV and expanding prevention choices can help avert

21 million AIDS-related deaths and 28 million new infections by 2030.

10. The Millennium Development Goal of reversing the HIV epidemic was reached ahead of the
2015 deadline - an incredible achievement that testifies to the power of national action and
international solidarity," declared WHO Director-General, Margaret Chan.

PHILIPPINE HIV EPIDEMIC UPDATE (2015)

UNAID and Philippine AIDS Registry DOH http://www.unaids.org.ph/
Date Retrieved: January 10, 2016
1.

The current incidence of HIV/AIDS in the country remains under 0.1% of the total population in
2015 National Rate. However, prevalence rate have exceeded 3.5% among the Key Affected
Populations (KAP) which are the six cities, namely Quezon City, Manila, Caloocan, Cebu, Davao
and Cagayan de Oro.

2.

The Philippines has one of the lowest rates of infection, yet has one of the fastest
growing number of cases worldwide.

3.

The rapid rise in HIV infections nationwide, with ~ 21 new cases reported every day per DOH
records, has made the Philippines one of only a handful of countries at risk of a full-blown AIDS
epidemic if it is unable to address the problem on time.

4.

The Philippines is one of seven countries with growth in number of cases of over 25%, from
2001 to 2009.

5.

Those infected are young with a median age of 27. HIV infection among 15-24 years old
increased more-than ten-fold, from 44 in 2006 to 995 in 2015. The period of initiation to sex
and drug use among key affected populations is as early as from 14 years old.

DAVAO CITY HIV EPIDEMIC UPDATE (2015)

()
HIV SCREENING, DIAGNOSIS AND GUIDELINES
Center for the Disease Control and Prevention http://www.cdc.gov/hiv/testing/index.html
Date Retrieved January 10, 2016
A. TESTS AND GUIDLEINES
There are three types of HIV diagnostic tests: antibody tests, antigen/antibody tests, and nucleic
acid (RNA) tests. Antibody tests detect antibodies, proteins that your body makes against HIV, not HIV
itself. Antigen tests and RNA tests detect HIV directly.
An initial HIV test will either be an antibody test or antigen/antibody test. It may involve sending
blood or oral fluid to a laboratory or obtaining blood or oral fluid for a rapid test. Blood tests can detect
HIV infection sooner after exposure than oral fluid tests because the level of antibody in blood is higher
than it is in oral fluid. Likewise, antigen/antibody and RNA tests detect infection in blood before
antibody tests. No antigen/antibody or RNA tests are available for oral fluid.
Follow-up testing is performed if the initial test result is positive. HIV tests are generally very
accurate, but follow-up testing allows you and your health care provider to be sure the diagnosis is
right. If your initial test is a rapid test and it is positive, you will be directed to get follow-up testing. If
your initial test is a laboratory test and it is positive, the laboratory will usually conduct follow-up
testing on the same blood specimen as the initial test.
Follow-up tests include:
1.
2.
3.

antibody differentiation tests, which distinguishes HIV-1 from HIV-2 antibodies;

HIV-1 nucleic acid tests, which looks for the virus RNA directly;
Western blot and indirect immunofluorescence assay, which detect antibodies.

B. ALGORITHM

(ACE, pki lagay sa Algorithm Please.. Blur ang pic sa ako, thanks )

PHILIPPINE PROVISIONS ON HIV SCREENING, TESTS AND ASSOCIATED ACTS

REPUBLIC ACT NO. 8504 or also known as Philippine AIDS Prevention and Control Act of 1998.
Chan Robles Virtual Library
ARTICLE III (Article Three) - TESTING, SCREENING AND COUNSELLING

Sec. 15. Consent as a requisite for HIV testing. No compulsory HIV testing shall be allowed.
However, the State shall encourage voluntary testing for individuals with a high risk for contracting
HIV: Provided, that written informed consent must first be obtained. Such consent shall be obtained
from the person concerned if he/she is of legal age or from the parents or legal guardian in the case of
a minor or a mentally incapacitated individual. Lawful consent to HIV testing of a donated human body,
organ, tissue, or blood shall be considered as having been given when:
(a) a person volunteers or freely agrees to donate his/her blood, organ, or tissue for
transfusion, transplantation, or research;
(b) a person has executed a legacy in accordance with Sec. 3 of Republic Act No. 7170, also
known as the "Organ Donation Act of 1991";
(c) a donation is executed in accordance with Sec. 4 of Republic Act No. 7170.
Sec. 16. Prohibitions on compulsory HIV testing. Compulsory HIV testing as a precondition to
employment, admission to educational institutions, the exercise of freedom of abode, entry or
continued stay in the country, or the right to travel, the provision of medical service or any other kind
of service, or the continued enjoyment of said undertakings shall be deemed unlawful.
Sec. 17. Exception to the prohibition on compulsory testing. Compulsory HIV testing may be allowed
only in the following instances:
a) When a person is charged with any of the crimes punishable under Articles 264 and 266 as
amended by Republic Act No. 8353, 335 and 338 of Republic Act No. 3815, otherwise known as
the "Revised Penal Code" or under Republic Act No. 7659;
b) When the determination of the HIV status is necessary to resolve the relevant issues under
Executive Order No. 309, otherwise known as the "Family Code of the Philippines"; and
c) When complying with the provisions of Republic Act No. 7170, otherwise known as the
"Organ Donation Act" and Republic Act No. 7719, otherwise known as the "National Blood
Services Act".
Sec. 18. Anonymous HIV testing. The State shall provide a mechanism for anonymous HIV testing
and shall guarantee anonymity and medical confidentiality in the conduct of such tests.
Sec. 19. Accreditation of HIV Testing Centers. All testing centers, hospitals, clinics, and laboratories
offering HIV testing services are mandated to seek accreditation from the Department of Health which
shall set and maintain reasonable accreditation standards.
Sec. 20. Pre-test and post-test counselling. All testing centers, clinics, or laboratories which perform
any HIV test shall be required to provide and conduct free pre-test counselling and post-test
counselling for persons who avail of their HIV/AIDS testing services. However, such counselling
services must be provided only by persons who meet the standards set by the DOH.
Sec. 21. Support for HIV Testing Centers. The Department of Health shall strategically build and
enhance the capabilities for HIV testing of hospitals, clinics, laboratories, and other testing centers
primarily, by ensuring the training of competent personnel who will provide such services in said
testing sites.
ARTICLE V (Article five) - MONITORING
Sec. 27. Monitoring program. A comprehensive HIV/AIDS monitoring program or "AIDSWATCH" shall
be established under the Department of Health to determine and monitor the magnitude and
progression of HIV infection in the Philippines, and for the purpose of evaluating the adequacy and
efficacy of the countermeasures being employed.
Sec. 28. Reporting procedures. All hospitals, clinics, laboratories, and testing centers for HIV/AIDS
shall adopt measures in assuring the reporting and confidentiality of any medical record, personal
data, file, including all data which may be accessed from various data banks or information systems.
The Department of Health through its AIDSWATCH monitoring program shall receive, collate and

evaluate all HIV/AIDS related medical reports. The AIDSWATCH data base shall utilize a coding system
that promotes client anonymity.
Sec. 29. Contact tracing. HIV/AIDS contact tracing and all other related health intelligence activities
may be pursued by the Department of Health: Provided, That these do not run counter to the general
purpose of this Act: Provided, further, That any information gathered shall remain confidential and
classified, and can only be used for statistical and monitoring purposes and not as basis or
qualification for any employment, school attendance, freedom of abode, or travel.
ARTICLE VI (Article 6)- CONFIDENTIALITY
Sec. 30. Medical confidentiality. All health professionals, medical instructors, workers, employers,
recruitment agencies, insurance companies, data encoders, and other custodians of any medical
record, file, data, or test results are directed to strictly observe confidentiality in the handling of all
medical information, particularly the identity and status of persons with HIV.
Sec. 31. Exceptions to the mandate of confidentiality. Medical confidentiality shall not be considered
breached in the following cases:
(a) when complying with reportorial requirements in conjunction with the AIDSWATCH
programs provided in Sec. 27 of this Act;
(b) when informing other health workers directly involved or about to be involved in the
treatment or care of a person with HIV/AIDS: Provided, That such treatment or care carry the
risk of HIV transmission: Provided, further, That such workers shall be obliged to maintain the
shared medical confidentiality;
(c) when responding to a subpoena duces tecum and subpoena ad testificandum issued by a
Court with jurisdiction over a legal proceeding where the main issue is the HIV status of an
individual: Provided, That the confidential medical record shall be properly sealed by its lawful
custodian after being double-checked for accuracy by the head of the office or department,
hand delivered, and personally opened by the judge: Provided, further, That the judicial
proceedings be held in executive session.
Sec. 32. Release of HIV/AIDS test results. All results of HIV/AIDS testing shall be confidential and
shall be released only to the following persons:
(a) the person who submitted himself/herself to such test;
(b) either parent of a minor child who has been tested;
(c) a legal guardian in the case of insane persons or orphans;
(d) a person authorized to receive such results in conjunction with the AIDSWATCH program as
provided in Sec. 27 of this Act;
(e) a justice of the Court of Appeals or the Supreme Court, as provided under subSec. (c) of this
Act and in accordance with the provision of Sec. 16 hereof.
Sec. 33. Penalties for violations of confidentiality. Any violation of medical confidentiality as provided
in Sec.s 30 and 32 of this Act shall suffer the penalty of imprisonment for six (6) months to four (4)
years, without prejudice to administrative sanctions such as fines and suspension or revocation of the
violator's license to practice his/her profession, as well as the cancellation or withdrawal of the license
to operate any business entity and the accreditation of hospitals, laboratories or clinics.
Sec. 34. Disclosure to sexual partners. Any person with HIV is obliged to disclose his/her HIV status
and health condition to his/her spouse or sexual partner at the earliest opportune time.
ARTICLE VII (Article 7) - DISCRIMINATORY ACTS AND POLICIES
Sec. 35. Discrimination in the workplace. Discrimination in any form from pre-employment to postemployment, including hiring, promotion or assignment, based on the actual, perceived or suspected
HIV status of an individual is prohibited. Termination from work on the sole basis of actual, perceived or
suspected HIV status is deemed unlawful.

Sec. 36. Discrimination in schools. No educational institution shall refuse admission or expel,
discipline, segregate, deny participation, benefits or services to a student or prospective student on
the basis of his/her actual, perceived or suspected HIV status.
Sec. 37. Restrictions on travel and habitation. The freedom of abode, lodging and travel of a person
with HIV shall not be abridged. No person shall be quarantined, placed in isolation, or refused lawful
entry into or deported from Philippine territory on account of his/her actual, perceived or suspected
HIV status.
Sec. 38. Inhibition from public service. The right to seek an elective or appointive public office shall
not be denied to a person with HIV.
Sec. 39. Exclusion from credit and insurance services. All credit and loan services, including health,
accident and life insurance shall not be denied to a person on the basis of his/her actual, perceived or
suspected HIV status: Provided, That the person with HIV has not concealed or misrepresented the fact
to the insurance company upon application. Extension and continuation of credit and loan shall
likewise not be denied solely on the basis of said health condition.
Sec. 40. Discrimination in hospitals and health institutions. No person shall be denied health care
service or be charged with a higher fee on account of actual, perceived or suspected HIV status.
Sec. 41. Denial of burial services. A deceased person who had AIDS or who was known, suspected or
perceived to be HIV-positive shall not be denied any kind of decent burial services.
Sec. 42. Penalties for discriminatory acts and policies. All discriminatory acts and policies referred to
in this Act shall be punishable with a penalty of imprisonment for six (6) months to four (4) years and a
fine not exceeding Ten thousand pesos (P10,000.00). In addition, licenses/permits of schools, hospitals
and other institutions found guilty of committing discriminatory acts and policies described in this Act
shall be revoked.

UNRESOLVED ISSUES ON HIV TESTING

1. Current Law [actually] bans the use of HIV testing to discriminate
According to Lee Suy, the newly appointed spokesman of the Department of Health (DOH)
reiterates that the current AIDS law [actually] bans HIV testing to be used as pre-conditions for
employment, admission to educational institutions, exercise of freedoms of abode, entry, or
continuous stay in the country, or right to travel, or provision of medical services.
However, the DOH and the Philippine National AIDS Council (PNAC) are monitoring vigilantly
via HIV testing and urged the reporting of such discriminatory acts so that they could address them
appropriately.
2. DOH wants Mandatory Testing but the Republic Act 8504 clearly states no compulsory
HIV testing shall be allowed. Instead, the State "shall encourage voluntary testing for
individuals with a high risk for contracting HIV.
They [members of the Senate] have not come out with a document that would endorse the
mandatory testing for certain people. Nothing is definite. Theyve only made courtesy calls to [co-]
lawmakers and to understand the process [of amending the AIDS law], Lee Suy told reporters.
DOH wants to revise current AIDS Law, seeks mandatory HIV testing for target groups.
However, this has been opposed by NSAP (the Network to Stop AIDS Philippines), which consists of civil
society groups with the aim to stop the spread of (HIV) in the country, for this could lead to
discrimination against to those who found to be infected with virus.

Everything is only at the exploratory stage. Nothing has been said officially about mandatory
testing [in our Law] that will have the effect of all Filipinos lining up and requiring them to be tested for
HIV. There is no such thing, said Lee Suy.
DOH clarified that proposed mandatory HIV testing is not for all Filipinos. Based on the current
HIV situation (including future projections), and current strong evidence on the benefits of early HIV
screening, the DOH mulls mandatory screening by health providers for patients who maybe suspected
of having HIV infection based on a risk-based assessment, the DOH said.
During the briefing, Lee Suy said among the target populations being considered are patients,
including pregnant mothers, who will be undergoing surgical operations.
Mandatory screening may be extended to pregnant mothers during their prenatal visit to
prevent mothers from infecting their children, the DOH said.
3. Sen. Miriam Defensor Santiagos Criticisms To the Law and Reasons for the Amendment
According to Santiago, Republic Act 8504 or the HIV and Prevention and Control Act enacted in 1998
"was once hailed as a model legislation, but the spread of HIV is outpacing the 13-year-old law.
The following are the statements of the Senator:
"The preventive interventions that it prescribes are no longer fully aligned with
what years of experience and evidence on HIV prevention recommend.
The response to the epidemic has been marked with complacency, lack of
political leadership, and reckless disregard of evidence-informed strategies and
approaches that could prevent the spread of the virus
Every five years, the country adopts an HIV and AIDS Medium-Term Plan, a
national roadmap on HIV and AIDS, but the implementation of this strategic plan is
impeded by recalcitrant government agencies and lack of support from the national
government.
Santiago will push for further amendments to the AIDS Prevention and Control Act to allow minors
aged 15 to 17 years old to give consent to HIV testing and treatment without parental consent
provided that:
1.
2.
3.
4.
5.
6.
7.

The
The
The
The
The
The
The

minor is living independently;

minor is pregnant;
minor is already a parent or has suffered a miscarriage;
minor has no contact with parents of guardians;
minor has clinical condition that suggests infection with HIV;
knowledge of HIV status is in the best interest of the minor; or
minor is part of the key populations as determined by the Philippine National AIDS Council

(PNAC)
4. The World Health Organizations Stand on Mandatory Testing.
The WHO GLobal Programme on AIDS recommends that people should not be tested for HIV
without their free consent. Apart from being a violation of human rights, mandatory HIV testing does
not make public health sense:
1. Unlike for other infectious disease, there is at present no way to cure people with HIV, make
them uninfectious to others, or vaccinate those who come into contact with them.
2. Isolating people with HIV makes no sense, as they are not "contagious" and uninfected
people have other ways to protect themselves from infection.

3.Even if you can force someone to take an HIV test, you can't coerce safer sexual behavior. On
the contrary, helpful behavior change is far more likely to occur when testing is voluntary and
test results are kept confidential.
4. Mandatory screening of the whole population is extremely costly, logistically unwieldy, and
cannot possibly identify everyone who is infected.
5. Mandatory testing of groups such as couples planning to marry and pregnant women does
not protect the public health, and may even endanger it - e.g. by dissuading pregnant women
from seeking medical care.
6. Mandatory testing of people thought to be at high risk of having HIV endangers the public
health. The threat of testing drives them away from the kind of support they need if they are to
stay uninfected and not infect others, e.g. syringe exchange programmes for drug users.
7. Overall, the "benefits" of mandatory testing are largely illusory, and its side effects are
positively dangerous. There is nothing to be gained for the public health - and much to be lost by making HIV tests compulsory instead of voluntary and confidential.

4. New CDC Guidelines for HIV Screening Raise Ethical Issues.

The Centers for Disease Control and Prevention (CDC) has announced
significant

changes

in

its

recommendations

for

HIV

screening.

The

agencys

new

recommendations differ from prior policies and established practices in several important
ways.
These differences include the following:
1.
HIV screening is to be a normal part of medical practice for adult (under age 65) and
adolescent (over age 12) patients in all health care settings unless the prevalence of HIV
infection is documented to be less than 0.1 percent in a particular providers patient
2.

population.
Informed consent prior to testing is not required. Instead, the health care professional need
only notify the patient that an HIV test will be performed unless the patient declines. The
CDC concludes that [g]eneral informed consent for medical care should be considered
sufficient . . . for HIV testing, and no separate written consent for the test should be

3.

required.
HIV testing should be done without requiring pre-test or concurrent counseling. Prevention
counseling is strongly encouraged as part of an HIV screening program only in settings,
such as STD clinics, where risk behaviors are regularly assessed.

Ethical issues implicated in the CDCs new guidelines arise at two points. First, the ethical
foundation for routine screening programs requires an assessment of several factors that
identify and balance anticipated benefits and costs. Second, the implementation of routine
screening raises ethical issues for health care providers. Certain assumptions about the
implementation of a screening program may be essential to the balance of benefits and
burdens; and if these assumptions fail, the ethical justification for the program is weakened.
Routine

screening

for

HIV

has

been

controversial

because

of

anticipated

negative

consequences related to cost and effectiveness, as well as to confidentiality, privacy, and

discriminatory treatment of persons who are HIV-positive. The ethical framework used to

examine routine screening program includes an analysis of factors that relate to whether the
programs benefits outweigh its anticipated negative consequences.
Beyond purely operational issues, however, routine HIV screening as recommended by the
CDC triggers certain ethical obligations on the part of providers. Among these are obligations
relating to voluntariness, continuing care, and confidentiality and privacy.