You never forget your first time.
Mine happened several years ago. It was 9:30 p.m. on a weeknight, at a nondescript clinic along Shaw Boulevard. The entire appointment lasted an hour, and my anxiety level was high from beginning to end. But it all was worth it, for at 10:30 p.m., I left clutching an envelope with a small piece of paper containing my blood test results.
The words were all capitalized and in bold: NONREACTIVE TO HIV-1 AND HIV-2. In short, negative. The test was quick, sure, but it could've also gone very differently.
That's the direction many Filipinos find themselves in now. According to the April 2017 data released by the Department of Health’s Epidemiology Bureau, there are 42,912 reported Human Immunodeficiency Virus (HIV) cases in the country today. Of that total, 11,740 and 22,039 belong to the 15-24 and 24-34 age brackets respectively.
Breaking this down further, 629 new cases of HIV were reported in April, 37 percent of which came from the National Capital Region while 84 have already progressed to full-blown Acquired Immune Deficiency Syndrome (AIDS). Just a month earlier, the DOH listed 968 new HIV cases, the highest number of cases reported in a month since 1984.
The April report also clearly illustrates two facts: males comprise the bulk of both the cumulative and monthly cases (596 reported for April 2017 and 39,932 since 1984); and sexual contact remains the main mode by which the dreaded virus is transmitted.
If you’re sexually active, have had unprotected sex, and haven't gotten yourself tested yet, keep reading.
The daily scene
The LoveYourself Anglo, a community center along Shaw Blvd. in Mandaluyong City that conducts HIV testing, was brimming with people when we interviewed Ronnievinn Pagtakhan, founder of LoveYourself Project (or simply LoveYourself). According to him, it was surprising sight for a Wednesday afternoon, with clients waiting for blood extraction, treatment, and consultations in designated rooms and areas throughout the whole floor.
According to Pagtakhan, this center processes an estimated 60 to 80 clients per day, including walk-ins. If he adds the number of clients at LoveYourself Uni, its second clinic in Taft Ave. Extension, the total would be around 160. Twelve to 14 percent of this total are reactive/positive, which means that every day, they get 10 to 14 newly diagnosed Persons Living With HIV (PLHIV).
Pagtakhan says 52 percent of Metro Manila’s HIV cases are first diagnosed at both Anglo and Uni, and that they test around 20,000 people each year. For this month alone, LoveYourself has recorded 1,200 reactive clients, already close to the 1,500 it normally sees annually.
'It’s not really who you are that puts you at risk. It’s what you do. It’s not about being gay... it’s not about [gender] orientation. It’s really about how risky your sexual activities are'
Contrary to popular belief, LoveYourself welcomes everyone from all genders and orientations. Its primary target markets may be the youth and men who have sex with men (MSM)—and it’s positioning itself as a male health and wellness center (in contrast to the much bigger number of women’s centers and clinics)—but anyone and everyone can go to Anglo and Uni to get tested/treated.
“Ngayon, in a day, siguro mga 30 to 40 percent na yung hindi MSM,” Pagtakhan observes. “[As for] the reactive rate, kung sa 100 percent of reactive cases, mga 80 percent ang MSM, 20 percent ang straight.” He adds that they also see cases of female reactive clients, who transmitted HIV to their children via pregnancy.
It’s not as complicated as most would think. The process is standard for any LoveYourself site, and is 100-percent free. All client data and results are kept confidential.
-Go to the reception desk to get a number—they will use your date of birth for anonymity.
-Attend a short HIV 101 group class so you’d know (or brush up on) the basics.
-A counselor or life coach trained by LoveYourself will conduct pre-counseling. The counselor will explain to you how HIV testing is done, and what you can expect.
-Go to the laboratory for blood extraction by a medical technologist. Choose between two types of extraction: a finger prick (only for HIV screen and takes only 15 minutes to process), or full extraction (also fully tests for syphilis, tuberculosis, and hepatitis).
-Wait for initial results to be processed by LoveYourself. This takes anywhere from half an hour to an hour. The test kits the center uses have a three-month “window period," which means they will detect infections occurring up to three months before your blood test. At the same time, LoveYourself sends your blood sample to the Research Institute for Tropical Medicine (RITM)’s San Lazaro outpost for secondary screening and validation.
-Go back to the clinic to pick up your results.
-Your counselor will do post-test counseling, regardless of results.
The first three steps would differ if you sign up for LoveYourself Purple, Platinum or Diamond. These three options are made to be discreet, and more accommodating for those who can’t go to the clinics during standard operating hours, plus you get your own HIV 101 class through your counselor.
LoveYourself Purple is for couples who want to get tested and counseled together, and is scheduled only on Sundays. Platinum (which I had signed up for) is for those who want to get tested on specific dates, with limited time slots between 5 p.m. and 9 p.m. Diamond, the most discreet option, would bring a LoveYourself medical technologist and counselor to your home for private testing.
'HIV and other STDs aren’t the sole responsibility of the government. We also need to empower ourselves'
Like LoveYourself Solo or walk-in testing, these services are all free. However, LoveYourself would appreciate donations—for Platinum testing; P550 to P1,000 is recommended to cover equipment and staff costs.
What happens next?
If you’re nonreactive, and as long as you don’t engage in further risky behavior, you’re in the clear. Condoms from here on out, gents.
For clients found to be reactive, LoveYourself acts quickly, and in accordance with its test-and-treat model. Reactive clients are assigned a life coach “[who] serves as a case manager [and] psychosocial support, because we don’t want our treatment to be purely biomedical,” Pagtakhan explains.
Life coaching is vital for people whose lives and routines will change with these results, especially younger clients and those without a existing emotional support system. They are also given discharge instructions to follow until their next appointment and checkup with LoveYourself’s doctors and nurses.
Treatment will be administered immediately, even while waiting for RITM’s test verification. And like HIV testing, LoveYourself offers it for free. Another blood extraction will be done to determine your CD4 level: “For a normal person, [you’d have] a 1,200 cell count," informs Pagtakhan. "Kapag may HIV, 700 cells. Kapag mababa pa roon, urgent case na. Dito sa Pilipinas, 350 cells, doon pa lang nire-require mag-gamot. Kapag 200, AIDS na." Vinn adds LoveYourself follows both government and WHO guidelines for everything it does.
LoveYourself also recommends taking antiretroviral therapy (ART), ASAP, but Pagtakhan clarifies that this is always the client’s choice. “Pagkatapos ng test, no matter how high or low your CD4 count is, we encourage you to start medication. With medication, usually nagiging undetectable na yung viral load after six months.”
The biggest benefit of having an undetectable viral load? Your risk of transmitting HIV to others is much lower.
With LoveYourself’s significant contributions to HIV awareness, testing and treatment, you’d think enough work has already been done. But the organization sees more ways to get people to know their status, practice safe sex, prioritize sexual health, and bridge the gaps unaddressed by existing government initiatives.
One of its latest programs is Project PrEPPY. It focuses on a specific pre-exposure prophylaxis (PrEP) or medication called Truvada that you can take every day for HIV protection. This drug has also been approved for treatment of HIV-1 infections.
Through LoveYourself, the Philippines is the first Southeast Asian country to distribute Truvada. However, the drug “won’t help you from the possibilities or risks from gonorrhea, chlamydia [and other STIs]”, so you must continue using condoms and lubes.
LoveYourself also goes to where its target demographics and audiences are, partnering up with the Victoria Court chain twice a year for free HIV screenings. It does mass testing events as well. And just last year, the organization opened the first HIV testing, treatment, and counseling center catering specifically to transgender people—the Victoria Health and Wellness Center, located in Malate.
It has several quarterly projects in the pipeline. For audience-specific projects, LoveYourself has a different approach: one where harm reduction and sexual health are the focus, and testing/treatment are the supporting components. It is working on programs made specially for online-based sex workers, another to address condom lag among office workers and students (defined by the DOH as the time gap between first sexual encounter and first condom use) and distribute condoms in a safe and non-judgmental space, and another to promote safe and satisfying sex.
Pagtakhan’s goal remains the same: to provide the education and resources for free so that people can empower themselves and know what to do.
“Gusto ko ma-maintain na kung anuman yung services namin, [they are] free,” he says. “Gusto ko libre lahat. Healthcare services aren’t dole outs! It’s a physiological need... And HIV and other STDs aren’t the sole responsibility of the government. Kailangan natin i-empower yung sarili natin.”
Still on the fence about getting tested? Still think you’re not at risk? Still think HIV is only for MSMs? Think again.
“It’s not really who you are that puts you at risk. It’s what you do. It’s not about being gay... it’s not about [gender] orientation. It’s really about how risky your sexual activities are,” Pagtakhan says. “Basta may penetrative sex ka, there’s a risk. Kahit na ano pa yan, kahit oral, there’s always a risk... HIV testing is for everyone. It doesn't choose a gender, it doesn't choose a sexuality. It’s all about what you do.”
Visit www.loveyourself.ph to learn more about LoveYourself’s testing and treatment programs, and/or to schedule your appointment at the Anglo or Uni clinics