DECEMBER 2012
DEPARTMENT OF HEALTH NATIONAL EPIDEMIOLOGY CENTER
Table 1. Quick Facts
In December 2012, there were 293 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 9% higher compared to the same period last year (n=268 in 2011) [Figure 1].
Dec 2012
Jan-Dec 2012
Cumulative 1984—2012
Total Reported Cases
293
3,338
11,702
Asymptomatic Cases
279
3,152
10,534
Demographic Data
Most of the cases (97%) were males. The median age was 28 years (age range: 18-70 years). The 20-29 year (57%) age-group had the most number of cases. Fifty-two percent (152) of the reported cases were from the National Capital Region (NCR).
AIDS Cases
14
186
1,168
Males
283
3,186
10,076*
Females
10
152
1,615*
Youth 15-24yo
79
897
2,814
Children <15yo Reported Deaths due to AIDS
0 0
4 11
62 353
*Note: No data available on sex for (11) cases.
Reported mode of transmission were sexual contact (288) and needle sharing among injecting drug users (5). [Table 2, page 3]. Males having sex with other males (83%) were the predominant type of sexual transmission [Figure 2]. Most (95%) 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 293 HIV positive cases, fourteen were reported as AIDS cases, 12 males and 2 females. The median age is 31 years (age range: 23-55 years). All acquired the infection through sexual contact (4 homosexual, 4 heterosexual and 6 bisexual). There was no reported death for this month.
300 250 200 150 100 50 0 J an
Feb
M ar
A pr
M ay
J un
J ul
A ug
Sep
Oc t
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
316
295
284
293
Figure 2. Comparison of the Proportion of Types of Sexual Transmission in 2012, 2011 & Cumulative Data (1984-2012)
Overseas Filipino Workers (OFW) Het erosexual
100%
Twelve of the 293 (4%) reported cases were OFWs [Figure 11, page 4]. There were 11 males and 1 female. The median age was 29 years (age range: 23-56 years). All acquired the infection through sexual contact (6 heterosexual, 3 homosexual and 3 bisexual).
Proportion of Cases
Philippine HIV and AIDS Registry
Newly Diagnosed HIV Cases in the Philippines
34
50
Bisexual Homosexual
3,356 75%
87
101
2,874 50%
25%
137
117
4,575
D ec 2 0 12
D ec 2 0 11
C umul at i ve
0%
Figure 3. Number of HIV/AIDS Cases Reported in the Philippines by Year, Jan 1984 to December 2012 (N=11,702) 3500 3250 3000 2750 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
3, 338
A s y mpt 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
3, 152
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
186
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
December 2012
Philippine HIV/AIDS Registry
AIDS Cases (1984-2012) Of the 3,338 HIV positive cases in 2012, one hundred eighty-six were reported as AIDS cases. Of these, 178 were males and 8 were females. Ages ranged from 7-81 years (median 31 years). Ninety-eight percent (183) acquired the infection through sexual contact (102 homosexual, 47 bisexual and 34 heterosexual), 1% (2) mother-to-child transmission, and 1% (1) injecting drug use.
Figure 4. Proportion of Modes of Transmission of AIDS Cases by Year, Jan 1984â&#x20AC;&#x201D;December 2012 100%
Proportion of Cases
75%
From 1984 to 2012, there were 1,168 AIDS cases reported. Seventy-seven percent (900) were males. Median age is 34 years (age range: 1-81 years). Of the reported AIDS cases, 353 (30%) had already died at the time of reporting. Sexual contact was the most common mode of HIV transmission, accounting for 94% (1,101) of all reported AIDS cases. Almost half (508) of sexual transmission was through heterosexual contact, followed by homosexual contact (428) then bisexual contact (165).
50%
25%
0%
Other modes of transmission include: mother-to-child transmission (20), blood transfusion (10), injecting drug use (7), and needle prick injuries (2) [Figure 4]. Two percent (28) of the AIDS cases did not report mode of HIV transmission.
1984-2008
2009
2010
2011
Needl e P r i c k
2
0
0
0
2012 0
B l ood T r ans f us i on
10
0
0
0
0
M T CT
16
1
0
1
2
I DU
4
0
0
2
1
B i s exual Cont act
64
8
7
39
47
Homos ex ual Cont act
246
16
19
45
102
Het er os ex ual Cont act
442
6
3
23
34
*Note: 28 did not report mode of transmission
Demographic Characteristics (1984-2012) Figure 5. Proportion of Sex & Age-Groups in Dec 2012 & Jan-Dec 2012 100%
Proportion of Cases
Ninety-five percent of the 3,338 cases were males (3,186). Ages ranged from 2 to 81 years old (median 28 years). The 20-29 year old age group had the most (58%) number of cases for 2012. For the male age group, the most number of cases were found among the 20-24 years old (24%), 25-29 years old (34%), and 30-34 years old (20%) [Figure 6]. From 1984 to 2012, there were 11,702 HIV Ab sero-positive cases reported (Table 1), of which 10,534 (90%) were asymptomatic and 1,168 (10%) were AIDS cases. As shown in Figure 6, there is a significant difference in the number of male and female cases reported. Eighty-six percent (10,076) 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 (29%), and 30-34 years (19%) [Figure 6].
75%
50%
25%
0% Dec 2012 (M )
Dec 2012 (F)
2012 (M al e)
50 & ol der
12
1
71
2012 (Femal e) 12
35-49y o
38
4
531
49
25-34y o
155
4
1, 712
62
15-24y o
78
1
869
28
1-14y o
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 3250
3000
2750
2500
2250
2000
Number of Female Cases
<15yo 1750
1500
1250
1000
750
500
250
0
0
250
500
750
1000
1250
1500
1750
2000
2250
2500
2750
3000
3250
<15y o
15-19y o
20-24yo
25-29y o
30-34y o
35-39y o
40-44yo
45-49y o
50 & ol der
<15y o
15-19y o
20-24y o
25-29yo
30-34y o
35-39yo
40-44y o
45-49y o
50 & ol der
2012
3
95
774
1, 090
622
289
153
89
71
2012
1
8
20
39
23
24
13
12
12
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
0
0
8
14
8
10
9
3
3
1984-2007
21
33
191
225
202
154
90
35
44
2008
2
11
92
140
90
59
36
23
20
1984-2007
27
15
157
374
414
364
279
185
176
*Note: 74 did not report age, 11 did not report sex, 10 did not report age and sex
2
December 2012
Philippine HIV/AIDS Registry
Geographic Distribution % of Cases
I
1%
II
1%
III
10%
IVA
13%
IVB
<1%
V
1%
VI
2%
VII
6%
VIII
1%
IX
1%
X
1%
XI
9%
XII
0
CARAGA
0
ARMM
R OT C 10 %
75%
R eg 3 10 % R eg 4 A 13 %
R eg 11 9%
NCR 52 %
50%
25%
0%
R eg 7 6%
1%
NCR
100%
Figure 7. New HIV Cases by Region, December 2012
1%
CAR
Fig 8. Comparison of Proportion of HIV Cases by Region & Year
In December 2012, bulk of the new HIV cases came from NCR, Region 4A, Region 3, Region 11, and Region 7 [Fig 7]. The three highest reporting regions were NCR, 4A and 3
Proportion of Cases
Region
2012
2007-2011
1984-2012
Reg1
2%
2%
2%
Reg3
7%
6%
9%
13%
12%
13%
Reg6
3%
3%
3%
Reg7
9%
9%
8%
Reg11
7%
7%
6%
51%
54%
51%
8%
7%
8%
Reg4A
*ROTC: Rest of the Country
NCR
52%
ROT C*
Modes of Transmission (1984-2012) Table 2. Reported Mode of HIV Transmission
In 2012, 95% (3,159) were infected through sexual contact, 5% (175) through needle sharing among injecting drug users, and <1% (4) through mother-to-child transmission (Table 2). There were 3,025 males and 134 females infected through sexual transmission. The age range of those infected through sexual transmission was 15-81 years old (median 28 years).
Sexual Contact
Of the 11,702 HIV positive cases reported from 1984 to 2012, 92% (10,805) were infected through sexual contact, 4% (440) 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 3% (375) of the cases.
Jan-Dec 2012 n=3,338
Dec 2012 n=293
Mode of Transmission
Cumulative N=11,702
288
3,159
10,805
Heterosexual contact
50(17%)
480(15%)
3,356(31%)
Homosexual contact
137(48%)
1,687(53%)
4,575(42%)
Bisexual contact
101(35%)
992(31%)
2,874(27%)
Blood/Blood Products
0
0
20
Injecting Drug Use
5
175
440
Needle Prick Injury
0
0
3
Mother-to-Child
0
4
59
No Data Available
0
0
375
Cumulative data shows 31% (3,356) were infected through heterosexual contact, 42% (4,575) through homosexual contact, and 27% (2,874) 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=3,338)
Figure 9. Proportion of Types of Sexual Transmission, Jan 1984â&#x20AC;&#x201D;December 2012
1800 1700
100%
1600 1500
90%
Number of Cases
1400
Proportion of Cases
80% 70% 60% 50%
1300 1200 1100 1000 900 800 700 600 500 400 300 200
40%
100 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
Heterosexual
1
7
24
24
16
19
35
30
41
47
58
56
81
82
138
114
93
128
129
129
123
131
193
139
160
216
274
388
480
Bisexual
0
2
0
4
2
2
4
4
5
2
3
8
7
7
9
10
8
5
8
14
12
14
26
74
127
252
467
806
992
Homosexual
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
1036 1,687
<7yo
7-14y o
15-17y o
18-24yo
25-34yo
35-49y o
B l ood T r ans f us i on - Femal e
-
-
-
-
-
-
50&ol der -
M at er nal t o Chi l d
1
3
-
-
-
-
-
I nj ec t i ng Dr ug Us e - Femal e
-
-
1
3
9
4
-
I nj ec t i ng Dr ug Us e - M al e
-
-
2
55
53
45
3
Het er os ex ual Cont ac t - Femal e
-
-
-
24
53
45
12
Het er os ex ual Cont ac t - M al e
-
-
-
35
191
92
28
B i s ex ual Cont act
-
-
2
277
550
149
14
Homos ex ual Cont ac t
-
-
7
491
918
245
26
3
December 2012
Philippine HIV/AIDS Registry
Overseas Filipino Workers (OFW) In 2012, there were 342 HIV positive OFWs, comprising 10% of cases reported for the year [Figure 11]. Of these, 301 (88%) were males and 41 (12%) were females. All were infected through sexual contact. There were 2,130 HIV positive OFWs since 1984, comprising 18% of all reported cases [Figure 11]. Seventy-eight percent (1,671) were males. Ages ranged from 18 to 69 years (median 34 years). Sexual contact (97%) was the predominant mode of transmission (Table 3). Eighty-six percent (1,831) were asymptomatic while 14% (299) were AIDS cases. Table 3. Mode of HIV Transmission Among OFWs
Sexual Transmission
Dec 2012 Jan-Dec 2012 n=12 n=342
Cumulative N=2,130
12
342
2,068
Heterosexual contact
6(50%)
108(32%)
1,206(58%)
Homosexual contact
3(25%)
136(40%)
491(24%)
Bisexual contact
3(25%)
98(29%)
371(18%)
Blood/Blood Products
0
0
10
Injecting Drug Use
0
0
1
Needle Prick Injury
0
0
3
No Data Available
0
0
48
Number of Cases
Mode of Transmission
Figure 11. Number of OFWs Compared to Non-OFWs by Year (1984-2012) 3200 3000 2800 2600 2400 2200 2000 1800 1600 1400 1200 1000 800 600 400 200 0 OFW Non - OFW % of OFW
Blood Units Confirmed for HIV As of December 2012, 242 blood units were confirmed positive for HIV by RITM. There is no available data yet on the total number of blood units donated. 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 they underwent voluntary counseling and testing as individuals.
2012
2011
January
17
11
February
18
15
March
'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
342
1
8
23
34
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 2 9 9 3
50% 20%
29
35
0%
8%
2 8 % 13 %
56
78
58
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 %
34
Month January
2,087 2,169 2,278
21
20
May
21
10
March
June
9
32
April
2,498
May
2,633
June
2,761
July
2,914
August
3,026
July
22
22
August
25
18
September
13
18
October
14
22
November
22
17
September
26
18 November
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
2012
14
October
National HIV/AIDS & STI Strategic Information and Surveillance Unit
10 %
Table 5. Number of PLHIV on ART
April
Total
12 %
As of September 2012, there are 3,115* People Living with HIV presently on Anti-Retroviral Therapy (ART). Data for Oct-Dec 2012 is not yet available.
February
December
11%
PLHIV on Anti-Retroviral Therapy
Table 4. Number of Confirmed HIV Positive Blood Units Month
'8 4
242
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
December
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
3,115 Data not yet available Data not yet available Data not yet available
* 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 individualâ&#x20AC;&#x2122;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