DOH-NEC HIV/AIDS Regstiry August 2012

Page 1

AUGUST 2012

DEPARTMENT OF HEALTH NATIONAL EPIDEMIOLOGY CENTER

In August 2012, there were 272 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 39% higher compared to the same period last year (n=196 in 2011) [Figure 1].

Table 1. Quick Facts

Most of the cases (95%) were males. The median age was 28 years (age range: 18-60 years). The 20-29 year (59%) age-group had the most number of cases. Fifty-one percent (138) of the reported cases were from the National Capital Region (NCR).

Demographic Data

August 2012

Jan-Aug 2012

Cumulative 1984—2012

272 252

2,150 2,034

10,514 9,416

Total Reported Cases Asymptomatic Cases AIDS Cases

20

116

1,098

Males

258

2,051

8,941*

Females

14

99

1,562*

Youth 15-24yo

69

597

2,514

Children <15yo Reported Deaths due to AIDS

0 1

4 11

62 353

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

Reported mode of transmission were sexual contact (253) and needle sharing among injecting drug users (19). [Table 2, page 3]. Males having sex with other males (86%) were the predominant type of sexual transmission [Figure 2]. Most (93%) of the cases were still asymptomatic at the time of reporting [Figure 3].

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

350

AIDS Cases Of the 272 HIV positive cases, twenty were reported as AIDS cases, all were males. The median age is 30 years (age range: 21-46 years). All acquired the infection through sexual contact (11 homosexual, 4 heterosexual and 5 bisexual). Of the AIDS cases, there was one reported death for this month; a 41 year old male.

300 250 200 150 100 50 0 Jan

Feb

M ar

A pr

M ay

Jun

Jul

A ug

Sep

Oct

Nov

Dec

2010

143

130

120

154

153

109

131

108

153

104

112

174

2011

152

159

172

171

184

178

204

196

253

200

212

268

2012

212

274

313

233

273

295

278

272

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

Overseas Filipino Workers (OFW)

Heterosexual

100%

Proportion of Cases

Philippine HIV and AIDS Registry

Newly Diagnosed HIV Cases in the Philippines

Twenty-five of the 272 (9%) reported cases were OFWs [Figure 11, page 4]. There were 18 males and 7 females. The median age was 32 years (age range: 22-58 years). All acquired the infection through sexual contact (10 heterosexual, 10 homosexual and 5 bisexual).

36 75%

41

Bisexual Homosexual

3,147

69 67

2,534

50%

148

25%

79

3,956

A ug ust 2 0 11

C umulat ive

0%

A ug ust 2 0 12

Figure 3. Number of HIV/AIDS Cases Reported in the Philippines by Year, Jan 1984 to August 2012 (N=10,514) 2500 2250 2000 1750 1500 1250 1000 750 500 250 0

'84

'85

'86

'87

'88

'89

'90

'91

'92

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

T OT A L

2

10

29

38

32

39

66

85

72

102

118

116

154

117

189

158

123

174

184

193

199

210

309

342

528

835

1591

2, 349

2, 150

A sympt omat i c

0

6

18

25

21

29

48

68

51

64

61

65

104

94

144

80

83

117

140

139

160

171

273

311

505

804

1562

2, 239

2, 034

A I DS

2

4

11

13

11

10

18

17

21

38

57

51

50

23

45

78

40

57

44

54

39

39

36

31

23

31

29

110

116

Deat h

2

4

10

12

9

8

15

13

13

11

19

24

27

10

16

17

8

20

11

11

8

16

18

10

7

1

3

*19

11

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

1


August 2012

Philippine HIV/AIDS Registry

AIDS Cases (1984-2012) Of the 2,150 HIV positive cases in 2012, one hundred sixteen were reported as AIDS cases. Of these, 110 were males and 6 were females. Ages ranged from 7-81 years (median 32 years). Ninety-eight percent (114) acquired the infection through sexual contact (63 homosexual, 31 bisexual and 20 heterosexual), and 2% (2) mother-to-child transmission.

Figure 4. Proportion of Modes of Transmission of AIDS Cases by Year, Jan 1984—August 2012 100%

Proportion of Cases

75%

From 1984 to 2012, there were 1,098 AIDS cases reported. Seventy-six percent (832) were males. Median age is 35 years (age range: 1-81 years). Of the reported AIDS cases, 352 (32%) had already died at the time of reporting. Sexual contact was the most common mode of HIV transmission, accounting for 94% (1,032) of all reported AIDS cases. Almost half (494) of sexual transmission was through heterosexual contact, followed by homosexual contact (389) then bisexual contact (149). Other modes of transmission include: mother-to-child transmission (20), 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.

50%

25%

0% 1984-2008

2009

2010

2011

2012

Needl e P r i ck

2

0

0

0

0

B l ood T r ansf usi on

10

0

0

0

0

M T CT

16

1

0

1

2

I DU

4

0

0

2

0

B i sexual Cont act

64

8

7

39

31

Homosexual Cont act

246

16

19

45

63

Het er osexual Cont act

442

6

3

23

20

*Note: 28 did not report mode of transmission

Demographic Characteristics (1984-2012) Figure 5. Proportion of Sex & Age-Groups in August 2012 & Jan-Aug 2012 100%

Proportion of Cases

Ninety-five percent of the 2,150 cases were males (2,051). Ages ranged from 2 to 81 years old (median 28 years). The 20-29 year old age group had the most (59%) number of cases for 2012. For the male age group, the most number of cases were found among the 20-24 years old (26%), 25-29 years old (34%), and 30-34 years old (19%) [Figure 6]. From 1984 to 2012, there were 10,514 HIV Ab sero-positive cases reported (Table 1), of which 9,416 (90%) were asymptomatic and 1,098 (10%) were AIDS cases. As shown in Figure 6, there is a significant difference in the number of male and female cases reported. Eighty-five percent (8,941) were males. Ages ranged from 1-81 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].

75%

50%

25%

0% A ugust 2012 (M )

A ugust 2012 (F)

2012 (M al e)

50 & ol der

9

1

39

2012 (Femal e) 8

35-49yo

39

7

349

30

25-34yo

145

2

1, 080

43

15-24yo

65

4

580

17

1-14yo

0

0

3

1

Figure 6. Comparison of the Distribution of Male and Female HIV Cases by Age-Group and Certain Highlighted Years 1984-2007

50 & o lder

2008

2009

2010

2011

2012

45-49yo 40-44yo 35-39yo 30-34yo 25-29yo 20-24yo 15-19yo

Number of Male Cases 2750

2500

2250

2000

1750

Number of Female Cases

<15yo 1500

1250

1000

750

500

250

0

0

250

500

750

1000

1250

1500

1750

2000

2250

2500

2750

<15y o

15-19y o

20-24y o

25-29y o

30-34y o

35-39y o

40-44y o

45-49y o

50 & ol der

<15y o

15-19y o

20-24y o

25-29y o

30-34y o

35-39y o

40-44y o

45-49y o

50 & ol der

2012

3

51

529

691

389

177

105

67

39

2012

1

4

13

26

17

14

8

8

8

2011

1

76

589

739

378

193

117

51

49

2011

2

3

36

44

23

21

10

8

9

2010

1

50

405

455

256

128

81

42

48

2010

2

5

28

21

34

15

9

7

4

2009

1

22

179

227

124

90

41

18

29

2009

1

4

13

19

21

20

14

7

5

2008

2

11

92

140

90

59

36

23

20

2008

0

0

8

14

8

10

9

3

3

1984-2007

27

15

157

374

414

364

279

185

176

1984-2007

21

33

191

225

202

154

90

35

44

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

2


August 2012

Philippine HIV/AIDS Registry

Geographic Distribution I

3%

II

<1%

III

8%

IVA

12%

IVB

100%

75%

Figure 7. New HIV Cases by Region, August 2012

1%

V

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

In August 2012, bulk of the new HIV cases came from NCR, Region 4A, Region 7, Region 3, and Region 11 [Fig 7]. The three highest reporting regions were NCR, Region 4A, and Region 7.

% of Cases

Proportion of Cases

Region

<1%

VI

3%

VII

10%

VIII

1%

IX

2%

X

1%

R eg 3 8%

R OT C 13 %

R eg 4 A 12 %

50%

25%

0%

XI

R eg 7 10 %

6%

XII

1%

CAR

<1%

CARAGA

2012

2007-2011

1984-2012

Reg1

2%

2%

2%

Reg3

7%

6%

9%

13%

12%

12%

Reg6

3%

3%

3%

Reg7

11%

9%

9%

Reg11

6%

7%

6%

51%

54%

51%

7%

7%

8%

Reg4A

R eg 11 6%

1%

NCR 51%

ARMM

0%

NCR

51%

NCR ROT C*

*ROTC: Rest of the Country

Modes of Transmission (1984-2012) In 2012, 93% (1,991) were infected through sexual contact, 7% (155) through needle sharing among injecting drug users, and <1% (4) through mother-to-child transmission (Table 2). There were 1,902 males and 89 females infected through sexual transmission. The age range of those infected through sexual transmission was 15-81 years old (median 28 years).

Table 2. Reported Mode of HIV Transmission August 2012 n=272

Mode of Transmission Sexual Contact

Of the 10,514 HIV positive cases reported from 1984 to 2012, 92% (9,637) were infected through sexual contact, 4% (420) through needle sharing among injecting drug users, 1% (59) through mother-to-child transmission, <1% (20) through blood transfusion and needle prick injury <1% (3) [Table 2]. No data is available for 4% (375) of the cases.

Jan-August 2012 n=2,150

Cumulative N=10,514

253

1,991

9,637

Heterosexual contact

36(14%)

271(14%)

3,147(33%)

Homosexual contact

148(58%)

1,068(54%)

3,956(41%)

Bisexual contact

69(27%)

652(33%)

2,534(26%)

Blood/Blood Products

0

0

20

Injecting Drug Use

19

155

420

Needle Prick Injury

0

0

3

Mother-to-Child

0

4

59

No Data Available

0

0

375

Cumulative data shows 33% (3,147) were infected through heterosexual contact, 41% (3,956) through homosexual contact, and 26% (2,534) through bisexual contact. From 2007 there has been a shift in the predominant trend of sexual transmission from heterosexual contact (20%) to males having sex with other males (80%) [Figure 9]. Figure 10. HIV Transmission by Age-Group, 2012 (n=2,150)

Figure 9. Proportion of Types of Sexual Transmission, Jan 1984—August 2012

1200 1125

100%

1050 975

Number of Cases

90%

Proportion of Cases

80% 70% 60% 50%

900 825 750 675 600 525 450 375 300 225

40%

150 75 0

30% 20% 10% 0% '84

'85

'86

'87

'88

'89

'90

'91

'92

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

Het er os ex ual

1

7

24

24

16

19

35

30

41

47

58

56

81

82

138 114 93

B i s ex ual

0

2

0

4

2

2

4

4

5

2

3

8

7

7

9

10

8

5

8

14

12

14

26

74

Homos ex ual

0

1

4

3

4

6

8

15

5

16

20

21

30

25

36

30

17

32

46

40

27

47

81

107 215 336 680 10361, 06

128 129 129 123 131 193 139 160 216 274 388 271 127 252 467 806 652

<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

1

3

-

-

-

-

-

I nj ect i ng Dr ug Use - Femal e

-

-

-

2

6

1

-

I nj ect i ng Dr ug Use - M al e

-

-

2

51

48

43

2

Het er osexual Cont act - Femal e

-

-

-

15

37

29

8

Het er osexual Cont act - M al e

-

-

-

19

96

55

12

B i sexual Cont act

-

-

1

172

367

105

7

Homosexual Cont act

-

-

3

332

570

146

17

3


August 2012

Philippine HIV/AIDS Registry

Overseas Filipino Workers (OFW) In 2012, there were 222 HIV positive OFWs, comprising 10% of cases reported for the year [Figure 11]. Of these, 191 (86%) were males and 31 (14%) were females. All were infected through sexual contact. There were 2,010 HIV positive OFWs since 1984, comprising 19% of all reported cases [Figure 11]. Seventy-eight percent (1,561) 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 (1,712) were asymptomatic while 15% (298) were AIDS cases. Table 3. Mode of HIV Transmission Among OFWs

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

August 2012 n=25

Jan-August 2012 n=222

Cumulative N=2,010

25

222

1,948

Heterosexual contact

10(40%)

66(30%)

1,164(60%)

Homosexual contact

10(40%)

89(40%)

444(23%)

Bisexual contact

5(20%)

67(30%)

340(17%)

Blood/Blood Products

0

0

10

Injecting Drug Use

0

0

1

Needle Prick Injury

0

0

3

No Data Available

0

0

48

Sexual Transmission

2200 2000 1800

Number of Cases

Mode of Transmission

1600 1400 1200 1000 800 600 400 200 0 OFW Non - OFW % of OFW

'8 4

'8 5

'8 6

'8 7

'8 8

'8 9

'9 0

'9 1

'9 2

'9 3

'9 4

'9 5

'9 6

'9 7

'9 8

'9 9

'0 0

'0 1

'0 2

'0 3

'0 4

'0 5

'0 6

'0 7

'0 8

'0 9

'10

'11

'12

1

2

0

3

9

5

10

7

14

29

31

24

35

27

51

67

60

79

96

93

86

92

13 0

10 6

12 2

16 4

17 4

271

222

1

8

29

35

23

34

56

78

58

73

87

92

119

90

13 8

91

63

95

88

10 0

113

118

17 9

236

4 0 6 6 7 1 14 17 2 0 7 8 19 2 8

0%

8%

15 %

8%

19 % 2 8 % 2 6 % 2 1% 2 3 % 2 3 % 2 7 % 4 2 % 4 9 % 4 5 % 5 2 % 4 8 % 4 3 % 4 4 % 4 2 % 3 1% 2 3 % 2 0 %

50% 20%

2 8 % 13 %

11%

12 %

10 %

Blood Units Confirmed for HIV

PLHIV on Anti-Retroviral Therapy

As of August 2012, 167 blood units were confirmed positive for HIV by RITM. There is no available data yet on the total number of blood units donated.

As of June 2012, there are 2,761* People Living with HIV presently on Anti-Retroviral Therapy (ART). Data for July and August is not yet available.

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 t hey unde rwe nt voluntary counseling and testing as individuals.

Table 4. Number of Confirmed HIV Positive Blood Units 2012

2011

January

Month

17

11

February

18

15

March

National Epidemiology Center, Department of Health, Bldg. 19, San Lazaro Compound, Sta. Cruz, Manila 1003 Philippines Tel: +632 651-7800 local 2926, 2952 Fax: +632 495-0513 Email: HIVepicenter@gmail.com Website: http://www.doh.gov.ph

Month

2012

14

January

2,087 2,169

April

21

20

February

May

21

10

March

2,278

June

9

32

April

2,498

May

2,633

July

22

22

August

25

18

September

18

October

22

November

17

December

18

Total

National HIV/AIDS & STI Strategic Information and Surveillance Unit

34

Table 5. Number of PLHIV on ART

167

217

Philippine HIV & AIDS Registry Report Editorial Team: Patricia Isabel T. Gayya, RN, MSPH HIV Surveillance Assistant, HIV Unit Krizelle Anne G. Ronquillo, RSW Asst. HIV Surveillance Officer, HIV Unit Noel S. Palaypayon, RN, MGM-ESP HIV Surveillance Officer, HIV Unit Genesis May J. Samonte, MD, PHSAE Epidemiologist, HIV Unit Agnes B. Segarra, MD, PHSAE Chief, SRAE, NEC Enrique A. Tayag, MD, PHSAE,FPSMID,CESO III Director IV, NEC

June

2,761

July

Data not yet available Data not yet available

August

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

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.

Philippine HIV & AIDS Registry The Philippine HIV & AIDS Registry is the official record of the total number of laboratory-confirmed HIV positive individuals, AIDS cases and deaths, and HIV positive blood units in the Philippines. All individuals in the registry are confirmed by the STD/AIDS Cooperative Central Laboratory (SACCL) at San Lazaro Hospital. While all blood units are confirmed by the Research Institute for Tropical Medicine (RITM). Both are National Reference Laboratories (NRL) of the Department of Health (DOH). Mandatory HIV testing is unlawful in the Philippines (RA 8504). The process of reporting to the Registry is as follows: All blood samples from accredited HIV testing facilities that are screened HIV reactive are sent to SACCL (individuals) or RITM (blood units) for confirmation. Confirmed HIV positive individuals and blood units are reported to the DOH-National Epidemiology Center (NEC), and are recorded in the Registry. The Registry is a passive surveillance system. Except for HIV confirmation by the NRL, all other data submitted to the Registry are secondary and cannot be verified. An example would be an individual’s reported place of residence. The Registry is unable to determine if this reported address is where the person got infected, or where the person lived after being infected, or where the person is presently living, or whether the address is valid. This limitation has major implications to data interpretation. Thus, readers are cautioned to carefully weigh the data and consider other sources of information prior to arriving at conclusions.

4


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