DOH - NEC DEC HIV/AIDS REGISTRY 2012

Page 1

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 1984—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 1984—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 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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