Maternal HIV/AIDS in The Phillipines
By Acelo Worku
HIV continues to be an issue for the developing world as countries and governments struggle to provide equally accessible care and education regarding the disease. While transmission rates in the developing world have ultimately waned in recent years, the Philippines remains a country that is still unable to keep up with the growing number of cases. Between 2010 and 2017, there was a reported 174% increase in cases, the pandemic only serving as an additional hindrance in the management of spread3. As rampant drug use causes many individuals to easily pass the disease along, the downstream transmission creates a growing issue for women and future children. Between 2011 and 2020, the number of HIV positive women who were pregnant has exponentially increased5. Women pay the ultimate price for the actions of men that do not take the proper precautions to protect their partners. Due to the ultimate lack of accessibility to testing, limited safe-sex education, and socially restrictive stigma, women and children in the Phillipines have been sacrificed to the ever-growing HIV epidemic.
Many regions in the Philippines, specifically rural areas, lack effective and consistent testing sites posing a detrimental risk to the health of both mother and child. One of the largest barriers to diagnosis and treatment is the ability to get tested to receive further treatment. Early detection is virtually impossible as women’s prenatal screenings are not making HIV screening mandatory. The Cebu City Health Office, until recently, has made testing optional during prenatal visits 2,4. As of 2020, HIV testing is free-of-charge and encouraged by the government, however, many cases are continuing to go undetected. With many women unable to consistently attend appointments, regardless of whether they tested positive, crucial antiretroviral medication was never administered–essential to hindering mother-child transmission. The perceived low numbers of women affected has prompted minimal literature on the effects of the HIV epidemic on women, leaving little focus from public health response. HIV testing has also been found to be severely affected by socioeconomic status and region4. The geographically disconnected state of the Philippines minimizes the frequency of testing sites. Many testing areas are available in urban centers, likely due to high population concentrations, but leaving rural areas with minimal resources4. Additionally, wealthier residents were found to have a much higher likelihood of getting tested compared to those of lower socioeconomic status2. In wake of the COVID pandemic, HIV testing rates have plummeted by 61% with a continued decline in the use of retroviral therapy1. The continued lack of accessibility, further restricted by the pandemic, emphasizes a need for a call to action.
Safe sex education plays a critical role in the ability of women to take the proper precautions to protect themselves and future generations. HIV transmission dramatically decreases when safe sex methods are incoporated into daily life. One of the many determinants of HIV testing in the Philippines is the education gap for women and children4. Many women are left unsure of what their options are when it comes to various forms of birth control and ways to protect themselves from the spread. The lack of educational campaigns surrounding HIV transmission and the disease progression have caused many women to be unaware of its effects and the positives of early detection. The current educational curriculum surrounding sexual health is limited since having HIV is incredibly stigmatized1. Allowing more opportunities for communities to understand the disease, by integrating it into a culturally-sensitive curriculum, would allow for better awareness and reducing associated stigmas.The little to no knowledge on safe-sex practices and contraceptives was found to be correlated with a lack of HIV testing4. The relationship between testing and education emphasizes the importance of spreading awareness for the betterment of detection and treatment. Education of young women is necessary for limiting the widespread impact of the growing epidemic.
The implications of religion on sex in the social structure of the Philippines has limited the ability for women to control their narrative. The Philippines is both a Catholic and Muslim country, causing there to be a lack in dialogue about pre-marital sex and safe-sex practices. The deeply conservative nature of society allows pregnant women to feel ashamed in getting HIV tested and getting treatment, ultimately harming the lives of themselves and their children1. While the process of testing is extremely divisive and isolating, women are unable to seek out treatment peacefully, as communities bar against them. Due to the already frowned upon pre-marital sex and the stigma associated with STD’s, women are forced into a position where they are unsupported by society. The integrating of sex education into the cirriculum could prove to be beneficial in reducing the societal shame caused by HIV and in turn increase detection to utlimately decrease transmission rates.
The consistent progression of the HIV epidemic in The Philippines has proven to be harmful to the lives of women and their children. With little focus on addressing women during these times of rapid transmission, there is a consistent setback. There is a growing need for effectively addressing women and children through the gaps testing, education, and stigma. The building of a better tomorrow is only possible when change is advocated for and downstream effects can be mitigated.
https://doh.gov.ph/sites/default/files/statistics/EB_HARP_December_AIDSreg2020.pdf
Works Cited
1 Alibudbud, Rowalt. “The Philippine HIV Crisis and the COVID-19 Pandemic: a Worsening Crisis.” Public Health, The Royal Society for Public Health. Published by Elsevier Ltd., Nov. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8443329/.
2 Authors: and Multiple Authors. “Women and Infants in Philippines at Higher Risk of HIV from 'Downstream' Infections.” Pulitzer Center, 15 Feb. 2016, pulitzercenter.org/stories/women-and-infants-philippines-higher-risk-hiv-downstream-infections.
3 Gangcuangco, Louie Mar A. “HIV Crisis in the Philippines: Urgent Actions Needed.” The Lancet Public Health, Elsevier, 6 Feb. 2019, www.sciencedirect.com/science/article/pii/S2468266718302652?via=ihub.
4 Pepito, Veincent Christian F., and Sam Newton. “Determinants of HIV Testing among Filipino Women: Results from the 2013 Philippine National Demographic and Health Survey.” PLOS ONE, Public Library of Science, journals.plos.org/plosone/article?id=10.1371/journal.pone.0232620#sec012.
5 “Welcome to Department of Health Website: Department of Health Website.” Welcome to Department of Health Website | Department of Health Website, doh.gov.ph/.