Intimate partners now in danger of HIV

BY Danton Remoto
Remote Control
Views and analysis
http://www.abs-cbnnews.com

BALI, INDONESIA – If you think that having an intimate partner will always keep you safe from contracting HIV, better think again.

More women from the Asia-Pacific region – housewives and career women –are contracting HIV from their intimate partners. These women are either married, or have long-term relationships with men who engage in high-risk sexual behavior. These behavior are found in men who have sex with men (MSM), injecting drug users, and clients of female sex workers.

These findings are contained in a new report by UNAIDS, its co-sponsors and civil society partners entitled HIV Transmission in Intimate Partner Relationships in Asia, released at the 9th International Congress on AIDS in Asia and the Pacific, being held in the island resort of Bali until tomorrow.

Men who buy sex are the largest infected population group. Many of them are married – or are about to get married. This puts a significant number of women, often perceived as “low risk” because they only have sex with their husbands or long-term partners, at risk of HIV infection. In the Philippines, data from the AIDS and HIV Registry of the Dept. of Health show that male Overseas Filipino Workers constitute one-third of reported HIV infections every month. Some of them have infected their home-bound wives as well.

The United Nations report estimates that more than 90% of the 1.7 million women living with HIV in Asia got it from their husbands or partners in long-term relationships. By 2008, women constituted 35% of all adult HIV infections in Asia, up from 17% in 1990.

“HIV prevention programs focused on the female sex partners of men with high-risk behaviors still have not found a place in the national HIV plans and priorities of Asian countries,” said Dr. Prasada Rao, Director, UNAIDS Regional Support Team for Asia and the Pacific. “Integration of reproductive health programs with AIDS programs and the delivery of joint services to rural and semi-urban women is the key to reducing HIV transmission among female partners.”

To prevent HIV transmission among intimate partner relationships, the UNAIDS report outlines four recommendations. First, HIV prevention interventions must be scaled up for MSM, injecting drug users, and clients of female sex workers, and should emphasize the importance of protecting their regular female partners.

Second, structural interventions should address the needs of vulnerable women and their male sexual partners. This includes expanding reproductive health programs to include services for male sexual health.

Third, HIV prevention interventions among mobile populations and migrants should be scaled up and include components to protect intimate partners. And last, operational research must be conducted to better understand the dynamics of HIV transmission among intimate partners.

In the Philippines, men who have sex with men (MSM) who practice unsafe sex alternate with OFWs as the groups most vulnerable to contracting HIV. This situation is also found in the rest of Asia, where 90% of MSM in the Asia-Pacific have no access to HIV prevention and care.

If nothing is done about this situation, the spread of HIV in this vulnerable population will escalate sharply in the very near future. Moreover, legal frameworks across the region need a dramatic and urgent overhaul to allow public-health sectors to reach out to MSM. The consequences could very well go beyond MSM to affect the general population.

This warning came at a high level symposium, “Overcoming Legal Barriers to Comprehensive Prevention Among Men who have Sex with Men and Transgender People in Asia and the Pacific” held at the 9th ICAAP. It was co-hosted by the United Nations Development Programme (UNDP) and the Asia Pacific Coalition on Male Sexual Health (APCOM).

“In order to achieve universal access to HIV prevention, treatment, care and support and realize the Millennium Development Goals, we must facilitate an enabling legal environment and human rights based HIV policies and programs for MSM and transgender (TG),” said Jeffrey O’Malley, Global Director of UNDP’s HIV Group, among the speakers at the symposium. “This will mean stepping up our investment in legal and social programs that address stigma and discrimination directed at MSM and TG.”

Professor Vitit Muntharbrhorn of Chulalongkorn University and one of the convenors of the 2006 Yogyakarta Principles of Lesbian, Gay, Bisexual and Transgender (LGBT) Rights said: “One of the challenges for overcoming barriers to prevent HIV is to promote the formulation of humane laws and policies that enable people to participate in addressing the disease in a cooperative manner, rather than driving those living with HIV underground. The latter approach is counterproductive, since it makes the disease more difficult to control. Thus, it is essential to advocate the adoption of laws that do not lead to discrimination and marginalization, and to provide space to respect sexual activities between consenting adults in the private sphere in their diversity.”

Currently 20 countries in the Asia-Pacific criminalize male-to-male sex, and these laws often lead to abuse and human-rights violations. Even in the absence of criminalization, other legal provisions violate the rights of MSM and TG along with arbitrary and inappropriate enforcement, thus obstructing HIV interventions, advocacy and outreach, and service delivery.

Happily, the Philippines is not one of these countries, since its criminal codes are silent on male-to-male sex. But as one Filipino participant in the international conference said, “But silence does not always mean consent. Sometimes, it can be like the silence of the lambs.”

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3 Pinoys getting HIV every day — UNDP

3 Pinoys getting HIV every day – UNDP
Written by Kristine Servando
http://www.abs-cbnnews.com
http://www.newsbreak.com.ph
Tuesday, 28 July 2009

The Philippines has seen an “alarming” increase in HIV cases in the past year, especially among overseas Filipino workers (OFWs) and men who have sex with men (MSM), according to data by the Dept. of Health, as cited by the United Nations Development Programme (UNDP).

“Last May, the country had 85 reported cases of human immunodeficiency virus (HIV), the highest ever in the country. That’s like 3 people a day, more cases than the A (H1N1) virus,” said Danton Remoto, UNDP Communications officer, at the country’s 1st National Conference on MSM, transgender, and HIV last July 22.

There have been 3,911 HIV cases since 1984, according to Department of Health (DOH) data as of May 2009.

All HIV cases were transmitted through sexual contact, with 36% of cases transmitted through homosexual contact and 89% of cases caused by unprotected sex.

Other “vulnerable groups” are OFWs (making up 22% of total cases last May), out-of-school youth, street children who are sometimes forced into prostitution, and MSM communities (which cross-cultural studies said comprise 10% of the Philippine population).

Although the total HIV cases only consist of less than 1% of the Philippine population – making it a low-prevalence country – Dr. Jessie Fanton of the Philippine National AIDS Council said the numbers are still alarming.

“We will always be low-prevalence because of the high population growth. But if you count warm bodies, it really shows an increase in HIV and AIDS cases,” he said.

Lifestyle causes
HIV patients are also getting younger and younger, with more HIV cases coming from the 20 to 24 age group (29% of total cases this year).

“We have patients as young as 15 to 17. They cannot be said to be uneducated too. So this is alarming,” said Dudz Razon (not his real name), an official from Pinoy Plus Association, a community of persons living with HIV or AIDS (PLWHA).

Fanton, citing a 2007 Integrated HIV Psychological study, said there have been several risk factors that contributed to the rapid spread of HIV in the country.

These include the rise in Internet-usage, which makes it easier to find sexual partners online; the prevalence of drugs and alcohol among MSMs in the past 3 years; and the popularity of anal sex without condoms.

“This is why this is an individual and behavioral issue that needs to be tracked and addressed,” Fanton said.

The 3-day National Conference on MSM, Transgender, and HIV is the first of its kind in Southeast Asia, and aims to combat the rise in HIV cases by linking and training leaders from the MSM and transgender communities, as well as non-government organizations.

More than 50 representatives from gay and rights groups nationwide attended the conference. The project is part of the UNDP’s 3-year HIV Programme, in cooperation with TLF Share and the Health Action and Information Network (HAIN).

‘Double whammy’
Razon, a 40-year-old gay man who has been battling HIV since 1999, said that people like him have to contend with two problems – discrimination for being gay, and discrimination for being a PLWHA.

“We call it a double whammy. Kung baga, MSM ka na, positibo ka pa. Sometimes it’s easier to disclose that you’re HIV positive than to disclose that you are gay,” he said.

“Because on our part, hindi madaling aminin na bading ka at nakuha mo ang HIV through same-sex [intercourse]. Because hindi masyadong pinag-uusapan ang homosexuality sa Philippine culture. There’s a stigma,” he explained.

Razon, who engaged in gay sex only once in his life, said he has been open to his family about his sickness, but is reluctant to open up about his being gay for fear that it would ruin his “good boy” image or that he would face prejudice or violence.

Razon said he has also experienced insensitivity from health practitioners themselves, who “react differently when they know a person has HIV.” “Suddenly they wear masks around you and practice universal hygienic measures. So nakakahiya mag-open up sa kanila,” he said.

The Pinoy Plus Association’s peer-to-peer counseling has helped newly diagnosed HIV patients open up about their sickness. The Association, based in Manila, has over 100 active members.

HIV myths
UNDP Country Director Renaud Meyer said there have been cases of violence against gays, lesbians, or transgenders all over Southeast Asia. There are many countries that criminalize homosexuality.

Remoto said discrimination partly allows the sickness to continue, and promotes low self-esteem among persons living with HIV or AIDS.

“There are wrong notions about HIV. People think that if you’re infected it’s because you’re a sex worker, or mahilig ka kasi sa sex, so kasalanan mo iyan. We’re trying to erase that notion,” he said.

Razon shared that many gay PLWHAs are afraid to have sex lest they infect their partner. He said they opt for “careful sexual encounters” like mutual masturbation, watching erotic movies together, or wearing condoms.

“However, this is not purely a gay issue. It is an issue affecting everyone – women, children, and men. It’s more of a question of how the public in general lack access to information and education on HIV and AIDS prevention,” Remoto said.

Poverty also worsens the problem since poor people do not have access to education or healthcare. “If a poor person would choose between a P15 can of sardines or a P15 pack of condoms, which would he or she choose?” he said.

State should invest in AIDS/HIV treatment
Razon said the government should set up clear mechanisms on how to sustain access to HIV treatment without depending heavily on international funding like the Global Fund Project.

He added that the government had supposedly added an “AIDS benefit package” to its health insurance program, but Razon said PLWHAs have yet to feel the benefits.

Global Fund, a private organization, currently provides HIV/ AIDS treatment to select patients through the help of the DOH and Pinoy Plus Association.

“We feel like the government does not feel the magnitude of the HIV problem. It’s time for the government to invest in AIDS [treatment] because trends are changing from low and slow to hidden and growing,” Razon said.

Fanton said the government has been assured of international funding for HIV treatment until 2010.

Antiretroviral drugs keep HIV at bay and stops the weakening of the immune system. Once a person takes HIV or AIDS treatment, he or she must do so every day for the rest of his or her life. Otherwise, they could develop resistance to the drug, allowing opportunistic infections to attack their immune systems, that could be fatal.

DOH National Epidemiology Center statistics reveal that from 1984 to 2009, there have been 318 reported deaths due to AIDS.

No follow-through on laws
The present administration failed to address the HIV problem head-on Remoto said, because it was heavily influenced by the Church’s stand against contraception and family planning.

“In the 1990s, we had a strong HIV/AIDS program under [former Health secretary] Dr. [Juan] Flavier. But it was discontinued. Health centers no longer give out free condoms, and they no longer give out information about HIV or AIDS. So there are no programs, no plans to give information and education,” Remoto said.

Though the Philippines was ahead of its Southeast Asian neighbors when introducing laws like the AIDS Prevention and Control Act of 1998 (Republic Act 8504) or the Reproductive Health Bill, it lagged in terms of passing or implementing these laws.

Anakbayan Rep. Ana Theresia “Risa” Hontiveros-Baraquel, meanwhile, believes the Anti-Discrimination Bill pending in Congress can help curb the spread of HIV.

“[This can help] in terms of accessing the public healthcare system, the bill penalizes any discrimination against lesbians, gays, bisexuals, and transgenders,” she said.

Hontiveros-Baraquel also said there should be government reforms on reproductive health policies, especially in terms of promoting condom use as a socially acceptable practice.

“We think if the government becomes pro-condom, pro-life na iyon dahil makaliligtas sa buhay at kalusugan. Sana maglaan din ng resources din domestically at hindi pagkakaitan ng sapat funds ang local government units para sa HIV or AIDS prevention. They can also change their worldview on sex at hindi na masyado mag-ascribe sa views ng Church,” she said.

Further, many NGO leaders and MSMs who attended the HIV Conference said they did not see any strong presidential candidate for the 2010 polls who had a clear platform on health and addressing the HIV/ AIDS problem. (abs-cbnNEWS.com/Newsbreak)

photos by Kristine Servando