Text and Photos By Anthony Lopez – Animator, National Council for Children and Young People on HIV (NCCYP-HIV)
Tagaytay City – The Cavite Provincial STI, HIV and AIDS Council conducted a program implementation review on the existing programs and services that address the issue of HIV in the province. This was held on December 17-18, 2012. The attendees were from different member agencies: the Department of Education, the Provincial Information Office, the City and Municipal Health Offices, the Barangay Health Workers Federation, the Philippine National Police, the Cavite Association of Sanitary Inspectors, the Coalition of Cavite Christian Churches, the Cavite Provincial Tourism Office and the Provincial Population Commission.
One of the main objectives of the activity was to present each agency’s accomplishments in the realization of local response to HIV progression. It also sought to build a more cohesive network of offices to work on the probable recommendations, programs and policies towards handling the HIV epidemic. To further rationalize the objectives of the meeting, Dr. Hilda Bucu of the Provincial Health Office revealed that from January to October 2012, the total number of new HIV cases in the province was 216.
To describe that situation as alarming would have been a real understatement. Since 1986 until December of 2011, the total number of reported HIV cases in the province was 220. Only four more cases and the province would have broken its own record of HIV cases in just a span of 10 months.
The morning session showcased the City of San Pablo in Laguna as one of the models of best practices among HIV programs. Following this, an introduction to the National Council for Children and Young People on HIV was presented by yours truly. The NCCYP-HIV was explained as a mechanism created by children and young people with the help of the Council for the Welfare of Children and Lunduyan Foundation to monitor and evaluate existing HIV related programs in the country.
In the afternoon, the Regional Epidemiology and Surveillance Unit represented by Kenneth Divinagracia revealed the current HIV situation in the province of Cavite. According to his report, the cities of Imus, Bacoor, Dasmarinas, Cavite and Tagaytay were the most at-risk areas in the province. The highest number of cases came from the 20-29 year-old age group, with homosexual and bisexual contact having the highest percentage when it came to modes of transmission. Ninety-six percent of all HIV cases in Cavite involved men.
Another thing that was discussed was the combined efficiency and proficiency of health workers in addressing the needs of people who have been exposed to, infected by and/or affected by HIV. The report showed that only 43% of all hospitals and laboratories in Cavite had HIV and AIDS Core Teams (HACT), and 100% of them were still untrained.
The HACT is multi-disciplinary group of health workers with different functions for matters related to the diagnosis, management and care of people living with HIV, and the prevention and control of HIV infection in hospitals.
In Cavite, 54% of all hospitals and laboratories offered Voluntary Counseling and Testing (VCT). However, 93% of the counselors were untrained.
According to Republic Act 8504, counselors for HIV testing should be trained to meet the standards prescribed by the Department of Health. The responsibilities of counselors are to discuss, with the persons being tested, the implications of knowing their HIV status and to facilitate in the coping stage afterwards. Advocates and health workers have long fought stigma and discrimination against people living with and affected by HIV.
Contrary to the efforts that many have exerted, it was also revealed that in the province, 99% out of 106 hospitals and laboratories lacked basic HIV and AIDS orientations. This is very alarming, since health workers should be the primary source of information and care for people living with HIV.
The questions now are: How can these hospitals and laboratories provide adequate, proper and non-discriminating health care if they do not have the basic knowledge for doing so? How can we ensure that proper counseling will be conducted if practitioners are not well equipped with even basic information? Professionally, their capabilities are neither disputed nor doubted by anyone. The concern is with regard to the special needs of people living with HIV. For instance, confidentiality must be observed in handling these cases. These and more are what the council and its partner organizations need to address.
The next presentation was from the representative of the Philippine National AIDS Council, led by Dr. Avelino. Their presentation focused on the programs and strategies that have been implemented or have changed throughout the years. This included the creation of the AIDS Medium Term Plan and the AIDS Law. An underlying issue that also arose was the overlapping of certain legislation regarding proper HIV responses.
Responses, Challenges and the Call to Participate
Dr. Zerrudo, President of the Cavite STI, HIV and AIDS Council, acknowledged that not all members are ready to implement their own HIV response. She said this in an interview during the event. She also added that another reason for the Program Implementation Review was for them to see all the accomplishments of the members. This was so that they could look for solutions and recommendations for the areas for improvement of each member agency and organization. Unfortunately, barely half of all members were represented that day due to reasons beyond their control.
The council presently conducts awareness campaigns within the council members, with the expectation that these agencies would disseminate the information to their own respective communities and areas of jurisdiction.
Present during the review was Board Member Irene Bencito of the 7th District of Cavite. According to her, coming up with good legislation to support HIV programs was one kind of help that the provincial board and herself would be able to do. Bencito also cited that since a number of HIV cases in the province come from OFWs, they have created a migration center which gives basic HIV information for people who are planning to go outside of the country, even those not necessarily from Cavite.
Since Cavite is a place where people, especially OFWs, are able to find budget-friendly housing options, many decide to move there. This being said, another important point that we need to remember is not all HIV cases come from the place where it is reported. A person may be diagnosed in Manila to have HIV, for example, but they may be residing permanently in a province in the Visayas. The council intends to clarify this situation since the risk of the province of Cavite being stigmatized and discriminated against because of the number of HIV cases is very high.
Values education and working with families is one of the strategies that the provincial government is eyeing to address the needs of the youth. They recognize, though, that this is not enough, which is why they are open to work with different youth organizations to further strengthen their HIV response for the youth.
Some other challenges that the provincial government recognized was found “in the process of inculcating the importance of why we are doing this,” as Bencito said. The council decided it has to find a way to make citizens realize why they need HIV information, and understand the gravity of the situation in the province. “It is important that we lead and let the people participate with our example. In that way we can track the problematic areas, the cause and we can prevent such things from happening,” Bencito added.
The provincial government’s call to the public is to be aware and be part of the HIV program. Bencito said: “Leaders, children, the youth, men and women of the community can help a lot if we really come up with the goal of eradicating the disease in the province.”
Dr. Avelino from the Philippine National AIDS Council, on the other hand, wants to send a three-tiered message to the public. He says: “First, WE NEED TO TALK ABOUT HIV: it’s only when we talk about HIV that we come to deal with the issue. Second, BE RESPONSIBLE: we need more accountability with our actions. Lastly, LET’S GET INVOLVED.”
The two-day implementation review ended with a planning workshop, with the goal of creating a framework of programs to be implemented for the following year.