DEPARTMENT OF HEALTH NATIONAL EPIDEMIOLOGY CENTER

FEBRUARY 2012

Newly Diagnosed HIV Cases in the Philippines

In February 2012, there were 274 new HIV Ab sero-positive individuals confirmed by the STD/AIDS Cooperative Central Laboratory (SACCL) and reported to the HIV and AIDS Registry (Table 1). This was 72% higher compared to the same period last year (n=159 in 2011), and the highest number of cases ever reported in the registry [Figure 1]. Most of the cases (96%) were males. The median age was 28 years (age range:17-57 years). The 20-29 year (59%) age-group had the most number of cases. Forty-six percent (127) of the reported cases were from the National Capital Region (NCR). Reported mode of transmission were sexual contact (235) and needle sharing among injecting drug users (39) [Table 2, page 3]. Males having sex with other Males (87%) were the predominant type of sexual transmission [Figure 2]. Most (98%) of the cases were still asymptomatic at the time of reporting [Figure 3]. AIDS Cases Of the 274 HIV positive cases, six were reported as AIDS cases, all were males. The median age is 36 years (age range: 27-42 years). All cases acquired the infection through sexual contact (1 homosexual, and 5 bisexual). Of the AIDS cases, there was one reported death for this month; a 41-year old male. Overseas Filipino Workers (OFW) Twenty-four of the 274 (9%) reported cases were OFWs [Figure 11, page 4]. There were 22 males and 2 females. The median age was 30 years (age range: 22-57 years). All cases acquired the infection through sexual contact (7 heterosexual, 7 homosexual, and 10 bisexual).
Table 1. Quick Facts
Demographic Data Total Reported Cases Asymptomatic Cases AIDS Cases Males Females Youth 15-24yo Children <15yo Reported Deaths due to AIDS
February 2012 Jan-Feb 2012 Cumulative Data: 19842012

274 268 6 263 11 76 0 1

486 474 12 466 20 133 1 2

8,850 7, 865 985 7,356* 1,483* 2,050 59 345

Philippine HIV and AIDS Registry

*Note: No data available on sex for eleven (11) cases.

Figure 1. Number of New HIV Cases per Month (2010-2012)

300

Number of New Cases

250 200 150 100 50 0 Jan 2010 2011 2012 143 152 212 Feb 130 159 274 Mar 120 172 Apr 154 171 May 153 184 Jun 109 178 Jul 131 204 Aug 108 196 Sep 153 253 Oct 104 200 Nov 112 212 Dec 174 268

Figure 2. Comparison of the Proportion of Types of Sexual Transmission in 2012, 2011 & Cumulative Data (1984-2012)
100%

Proportion of Cases

30
75%

Heterosexual

33 53

Bisexual

2,927

Homosexual

87
50%

2,051 118 72

25%

3,111

0%

F eb r uar y 2 0 12

F eb r uar y 2 0 11

C umulat ive

Figure 3. Number of HIV/AIDS Cases Reported in the Philippines by Year, Jan 1984 to February 2012 (N=8,850)
2500 2250 2000 1750 1500 1250 1000 750 500 250 0
T OT A L A sympt omat i c A I DS Deat h '84 2 0 2 2 '85 10 6 4 4 '86 29 18 11 10 '87 38 25 13 12 '88 32 21 11 9 '89 39 29 10 8 '90 66 48 18 15 '91 85 68 17 13 '92 72 51 21 13 '93 102 64 38 11 '94 118 61 57 19 '95 116 65 51 24 '96 154 104 50 27 '97 117 94 23 10 '98 189 144 45 16 '99 158 80 78 17 '00 123 83 40 9 '01 174 117 57 20 '02 184 140 44 11 '03 193 139 54 11 '04 199 160 39 8 '05 210 171 39 16 '06 309 273 36 18 '07 342 311 31 10 '08 528 506 22 7 '09 835 804 31 1 '10 1591 1564 27 3 '11 2, 349 2, 245 104 *19 '12 486 474 12 2

*Nine initially asymptomatic cases reported in 2011, died due to AIDS that same year.

Philippine HIV/AIDS Registry

February 2012

AIDS Cases (1984-2012)

Of the 486 HIV positive cases in 2012, twelve were reported as AIDS cases. All were males. Ages ranged from 7-47 years (median 35 years). 92% (11) acquired the infection through sexual contact [homosexual (5), and bisexual contact (6)]. Other modes of transmission include (1) mother-to-child transmission. From 1984 to 2012, there were 985 AIDS cases reported, 74% (725) were males. Median age was 35 years (age range: 1-72 years). Of the reported AIDS cases, 345 (35%) had already died at the time of reporting. Sexual contact was the most common mode of HIV transmission, accounting for 93% (920) of all reported AIDS cases. More than half (474) of sexual transmission was through heterosexual contact, followed by homosexual contact (327) then bisexual contact (119). Other modes of transmission include: mother-to-child transmission (19), blood transfusion (10), injecting drug use (6), and needle prick injuries (2) [Figure 4]. Three percent (28) of the AIDS cases did not report mode of HIV transmission.
Figure 4. Proportion of Modes of Transmission of AIDS Cases by Year, Jan 1984February 2012
100%

75%

Proportion of Cases

50%

25%

0% 1984-2008 Needl e P r i ck B l ood T r ansf usi on M T CT I DU B i sexual Cont act Homosexual Cont act Het er osexual Cont act 2 10 16 4 64 245 442 2009 0 0 1 0 8 16 6 2010 0 0 0 0 7 17 3 2011 0 0 1 2 34 44 23 2012 0 0 1 0 6 5 0

*Note: 28 did not report mode of transmission

Demographic Characteristics (1984-2012)

In 2012, there were a total of 486 cases reported. 96% of the cases reported were males (466). Ages ranged from 7-57 years old (median 28 years). The 20-29 year old age group (60%) had the most number of cases for 2012. For the male age group, the most number of cases were found among the 20-24 years old (25%), 25-29 years old (35%), and 30-34 years old (17%) [Figure 6]. From 1984 to 2012, there were 8,850 HIV Ab sero-positive cases reported (Table 1), of which 7,865 (89%) were asymptomatic and 985 (11%) were AIDS cases. As shown in Figure 6, there is a significant difference in the number of male and female cases reported. Eighty-three percent (7,356) were males. Ages ranged from 1-73 years (median 29 years). The age groups with the most number of cases were: 20-24 years (21%), 25-29 (28%) and 30-34 years (19%) [Figure 6].
Figure 5. Proportion of Sex & Age-Groups in February 2012 & Jan-Feb 2012
100%

Proportion of Cases

75%

50%

25%

0%
February 2012 (M) 50 & older 35-49yo 25-34yo 15-24yo 1-14yo 2 59 129 73 0 February 2012 (F) 0 3 5 3 0 2012 (Male) 5 87 245 128 1 2012 (Female) 1 5 9 5 0

Figure 6. Comparison of the Distribution of Male and Female HIV Cases by Age-Group and Certain Highlighted Years
50 & o lder 45-49yo 40-44yo 35-39yo 30-34yo 25-29yo 20-24yo 1 9yo 5-1

1984-2007

2008

2009

2010

2011

2012

Number of Male Cases

2250 2000 1750 1500 1250 1000 750 500 250 0

<1 5yo
0 250 500 750 1000 1250

Number of Female Cases

1500 1750 2000 2250 <15yo 15-19yo 1 3 5 4 0 33 20-24yo 4 36 28 13 8 191 25-29yo 7 44 21 19 14 225 30-34yo 2 23 34 21 8 202 35-39yo 2 21 15 20 10 154 40-44yo 3 10 9 14 9 90 45-49yo 0 8 7 7 3 35 50 & ol der 1 9 4 5 3 44

<15yo 2012 2011 2010 2009 2008 1984-2007 1 1 1 1 2 27

15-19yo 11 76 50 22 11 15

20-24yo 117 589 405 179 92 157

25-29yo 164 739 455 227 140 374

30-34yo 81 378 256 124 90 414

35-39yo 44 193 128 90 59 364

40-44yo 28 117 81 41 36 279

45-49yo 15 51 42 18 23 185

50 & ol der 5 49 48 29 20 176

2012 2011 2010 2009 2008 1984-2007

0 2 2 1 0 21

*Note: 74 did not report age, 11 did not report sex, 10 did not report age and sex

Philippine HIV/AIDS Registry

February 2012

Geographic Distribution
Region I II III IVA IVB V VI VII VIII IX X XI XII CAR CARAGA ARMM NCR % of Cases 3% <1% 5% 12% 1% 1% 2% 15% 0 <1% 2% 10% 1% 1% 1% 0 46%

Proportion of Cases

In February 2012, bulk of the new HIV cases came from NCR, Region 7, Region 4A, Region 11, Region 3, and Region 1 [Fig 7]. The three highest reporting regions were NCR, Region 4A, and Region 7.
Figure 7. New HIV Cases by Region, February 2012
ROTC 12% Reg 11 10% Reg 3 5% Reg 4A 12%

Fig 8. Comparison of Proportion of HIV Cases by Region & Year

100%

75%

50%

25%

0% 2012 Reg1 Reg3 Reg4A Reg6 2% 6% 12% 4% 10% 8% 52% 6% 2007-2011 2% 6% 11% 3% 9% 7% 54% 7% 1984-2012 2% 9% 12% 3% 8% 5% 51% 8%

NCR 46%

Reg 7 15%

Reg7 Reg11 NCR ROT C*

*ROTC: Rest of the Country

Modes of Transmission (1984-2012)

In 2012, 91% (443) were infected through sexual contact, 9% (42) through needle sharing among injecting drug users, and <1% (1) through mother-to-child transmission (Table 2). There were 426 males and 17 females infected through sexual transmission. The age range of those infected through sexual transmission was 17-57 years old (median 27 years). Of the 8,850 HIV positive cases reported from 1984 to 2012, 91% (8,089) were infected through sexual contact, 3% (307) through needle sharing among injecting drug users, 1% (56) through mother-to-child transmission and <1% (20) through blood transfusion and needle prick injury <1% (3) [Table 2]. Other modes of transmission are listed in Table 2. No data is available for 4% (375) of the cases.
Table 2. Reported Mode of HIV Transmission
Mode of Transmission Sexual Contact Feb 2012 n=274 235 Jan-Feb 2012 n=486 443 Cumulative N=8,850 8,089

Heterosexual contact Homosexual contact Bisexual contact

Blood/Blood Products Injecting Drug Use Needle Prick Injury Mother-to-Child No Data Available

30(13%) 118(50%) 87(37%)

0 39 0 0 0

51(12%) 223(50%) 169(38%)

0 42 0 1 0

2,927(36%) 3,111(38%) 2,051(25%)

20 307 3 56 375

Cumulative data shows 36% (2,927) were infected through heterosexual contact, 38% (3,111) through homosexual contact, and 25% (2,051) through bisexual contact. From 2007 there has been a shift in the predominant trend of sexual transmission from heterosexual contact (21%) to males having sex with other males (79%) [Figure 9].
Figure 9. Proportion of Types of Sexual Transmission, Jan 1984Feb 2012
100% 90%

Figure 10. HIV Transmission by Age-Group, 2012 (n=486)

280 260 240

Number of Cases

220 200 180 160 140 120 100 80 60 40

80%

Proportion of Cases

70% 60% 50% 40% 30% 20% 10% 0%

'84 '85 7 2 1 '86 24 0 4 '87 24 4 3 '88 16 2 4 '89 19 2 6 '90 35 4 8 '91 30 4 15 '92 41 5 5 '93 47 2 16 '94 58 3 20 '95 56 8 21 '96 81 7 30 '97 82 7 25 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12

20 0 <7yo 7-14yo 15-17yo 18-24yo 25-34yo 35-49yo 50&ol der

B l ood T r ansf usi on - Femal e M at er nal t o Chi l d I nj ect i ng Dr ug Use - Femal e I nj ect i ng Dr ug Use - M al e Het er osexual Cont act - Femal e Het er osexual Cont act - M al e B i sexual Cont act Homosexual Cont act

1 -

1 1

1 9 4 3 40 74

2 12 7 18 101 114

17 5 11 28 31

1 2 3

Het er osexual B i sexual Homosexual

1 0 0

138 114 93 9 36 10 30 8 17

128 129 129 123 131 193 139 160 216 274 388 50 5 32 8 46 14 40 12 27 14 47 26 81 74 127 252 467 806 169

107 215 336 680 1036 224

Philippine HIV/AIDS Registry

February 2012

Overseas Filipino Workers (OFW)

In 2012, there were 56 HIV positive OFWs, comprising 12% of cases reported for the year [Figure 11]. Of these, 52 (93%) were males and 4 (7%) were females; all infected through sexual contact. There were 1,850 HIV positive OFWs since 1984, comprising 21% of all reported cases [Figure 11]. Seventy-seven percent (1,427) were males. Ages ranged from 18 to 69 years (median 35 years). Sexual contact (97%) was the predominant mode of transmission (Table 3). Eighty-five percent (1,570) were asymptomatic while 15% (280) were AIDS cases.
Table 3. Mode of HIV Transmission Among OFWs
Mode of Transmission Sexual Transmission Feb 2012 n=24 24 Jan-Feb 2012 n=56 56 Cumulative N=1,850 1,788
2200 2000 1800 1600 1400 1200 1000 800 600 400 200 0
OFW Non-OFW % of OFW '84 1 1 '85 2 8 '86 0 29 '87 3 35 '88 9 23 '89 5 34 '90 10 56 '91 7 78 '92 14 58 '93 29 73 '94 31 87 '95 24 92 '96 35 '97 27 '98 51 138 '99 67 91 '00 60 63 '01 79 95 '02 96 88 '03 94 99 '04 88 '05 94 '06 '07 '08 '09 '10 '11 '12

Figure 11. Number of OFWs Compared to Non-OFWs by Year (1984-2012)

Heterosexual contact Homosexual contact Bisexual contact

Blood/Blood Products Injecting Drug Use Needle Prick Injury No Data Available

7(29%) 7(29%) 10(42%)

0 0 0 0

11(20%) 19(34%) 26(46%)

0 0 0 0

1,114(62%) 375(21%) 299(17%)

10 1 3 48

Number of Cases

130 106 122 164 175 271 56

119 90

111 116 179 236 406 671 1416 2078 430

50% 20% 0%

8% 28% 13% 15% 8% 19% 28% 26% 21% 23% 23% 27% 42% 49% 45% 52% 49% 44% 45% 42% 31% 23% 20% 11% 12% 12%

Blood Units Confirmed for HIV

In February 2012, 18 blood units were confirmed positive for HIV by RITM. This was 20% higher compared to the same period last year (Table 4). There is no available data yet on the total number of blood units donated. These are confirmed positive blood units, not blood donors. One donor can donate more than one blood unit. HIV positive blood donors may not be in the HIV & AIDS Registry unless they underwent voluntary counseling and testing as individuals.
Table 4. Number of Confirmed HIV Positive Blood Units Month January February March April May June July August September October November December Total 35 2012 17 18 2011 11 15 14 20 10 32 22 18 10 22 17 18 209

PLHIV on Anti-Retroviral Therapy

As of January 2012, there are 2,087* People Living with HIV presently on Anti-Retroviral Therapy (ART). Data for February is not yet available.
Table 5. Number of PLHIV on ART Month January February March April May June July August September October November December
* This is not a cumulative number. It does not include those who already have died, left the country, or decided to stop taking ART.
Treatment Hubs in the Philippines 1. Baguio General Hospital and Medical Center 2. Ilocos Training and Regional Medical Center 3. Cagayan Valley Medical Center 4. Jose B. Lingad Medical Center 5. San Lazaro Hospital 6. Philippine General Hospital 7. Research Institute for Tropical Medicine 8. Makati Medical Center 9. The Medical City 10. Bicol Regional Training and Teaching Hospital 11. Western Visayas Medical Center 12. Corazon Locsin Montelibano Memorial Regional Hospital 13. Vicente Sotto Memorial Medical Center 14. Gov. Celestino Gallares Memorial Hospital 15. Zamboanga City Medical Center 16. Southern Philippines Medical Center

2012 2,087
Data not yet available