JANUARY 2012
DEPARTMENT OF HEALTH NATIONAL EPIDEMIOLOGY CENTER
Newly Diagnosed HIV Cases in the Philippines Table 1. Quick Facts January 2012
Cumulative Data: 1984—2012
Total Reported Cases Asymptomatic Cases
212 208
8,576 7, 601
AIDS Cases Males Females
4 203 9 57
975 7,093* 1,472*
Demographic Data
Most of the cases (96%) were males. The median age was 27 years (age range:7-56 years). The 20-29 year (61%) age-group had the most number of cases. Fifty-eight percent (123) of the reported cases were from the National Capital Region (NCR).
Youth 15-24yo Children <15yo Reported Deaths due to AIDS
1,974 59 342
1 1
*Note: No data available on sex for eleven (11) cases.
Reported mode of transmission were sexual contact (208), needle sharing among injecting drug users (3), and mother-to-child transmission (1) [Table 2, page 3]. Males having sex with other Males (90%) were the predominant type of sexual transmission [Figure 2]. Most (98%) 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
275
AIDS Cases Of the 212 HIV positive cases, four were reported as AIDS cases, all were males. The median age is 34 years (age range: 7-47 years). Three acquired the infection through homosexual contact, and one through motherto-child transmission. Of the AIDS cases, there was one reported death for this month; a seven-year old male.
250 225 200 175 150 125 100 75 50 25 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
Figure 2. Comparison of the Proportion of Types of Sexual Transmission in 2012, 2011 & Cumulative Data (1984-2012) 100%
Proportion of Cases
Philippine HIV and AIDS Registry
In January 2012, there were 212 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=152 in 2011) [Figure 1].
Overseas Filipino Workers (OFW) Thirty-two of the 212 (15%) reported cases were OFWs [Figure 9, page 3]. There were 30 males and 2 females. The median age was 31 years (age range: 19-54 years). All cases acquired the infection through sexual contact (4 heterosexual, 12 homosexual, and 16 bisexual).
Heterosexual
21
28
Bisexual
2,897
80%
82
Homosexual
49
60%
1,964 40%
105
74
Januar y 2 0 12
Januar y 2 0 11
20%
2,993
0%
C umulat ive
Figure 3. Number of HIV/AIDS Cases Reported in the Philippines by Year, Jan 1984 to January 2012 (N=8,576) 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
212
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
506
804
1564
2, 247
208
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
22
31
27
102
4
Deat h
2
4
10
12
9
8
15
13
13
11
19
24
27
10
16
17
9
20
11
11
8
16
18
10
7
1
2
*17
1
*Nine initially asymptomatic cases reported in 2011, died due to AIDS that same year.
1
January 2012
Philippine HIV/AIDS Registry
AIDS Cases (1984-2012) Fig 4. Proportion of Modes of Transmission of AIDS Cases by Year, Jan 1984â&#x20AC;&#x201D;January 2012
From 1984 to 2012, there were 975 AIDS cases reported, 73% (715) were males. Median age was 35 years (range 1-72 years). Of the reported AIDS cases, 342 (35%) had already died at the time of reporting. Sexual contact was the most common mode of HIV transmission, accounting for 93% (910) of all reported AIDS cases.
100%
Proportion of Cases
75%
More than half (474) of sexual transmission was through heterosexual contact, followed by homosexual contact (324) then bisexual contact (112).
50%
25%
0%
Other modes of transmission include: mother-tochild transmission (19), 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.
1984-2008
2009
2010
2011
2012
Needle Prick
2
0
0
0
0
Blood Transfusion
10
0
0
0
0
MTCT
16
1
0
1
1
IDU
4
0
0
2
0
Bisexual Contact
64
8
7
33
0
Homosexual Contact
245
16
17
43
3
Heterosexual Contact
442
6
3
23
0
*Note: 28 did not report mode of transmission
Demographic Characteristics (1984-2012) From 1984 to 2012, there were 8,576 HIV Ab sero-positive cases reported (Table 1), of which 7,601 (89%) were asymptomatic and 975 (11%) were AIDS cases. As shown in Figure 5, there is a significant difference in the number of male and female cases reported. Eighty-three percent (7,093) were males. Ages ranged from 1-73 years (median 29 years). The age groups with the most number of cases were: 20-24 years (20%), 25-29 (27%) and 30-34 years (19%) [Figure 5]. Figure 5. 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
Number of Female Cases
<15yo 0
2250
2000
<15yo
1750
15-19yo
1500
20-24yo
1250
25-29yo
1000
30-34yo
750
35-39yo
500
40-44yo
250
45-49yo
250
500
750
1000
1250
1500
1750
2000
2250
0
50 & older
<15yo
15-19yo
20-24yo
25-29yo
30-34yo
35-39yo
40-44yo
45-49yo
50 & older
2012
1
3
52
73
43
14
6
8
3
2012
0
1
1
4
0
0
2
0
1
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
January 2012
Philippine HIV/AIDS Registry
Geographic Distribution In January 2012, bulk of the new HIV cases came from NCR, Region 4A, Region 3, Region 11, Region 6, and Region 7 [Figure 6]. The three highest reporting regions were NCR, Region 4A, and Region 3.
Figure 7. Comparison of Proportion of HIV Cases by Region in January 2012, 2007-2011, & Cumulative Data (1984-2012) 100%
75%
Reg1 1%
Reg12 1%
Proportion of Cases
Figure 6. Proportion of New HIV Cases by Region, January 2012 Reg2
Reg11 7% Reg3 8%
50%
25%
0%
Reg4A 12% NCR 58%
Reg5
Reg6 6% Reg7 CAR 4% 1%
January 2012
2007-2011
1984-2012
Reg1
1%
2%
2%
Reg3
8%
6%
9%
Reg4A
12%
12%
12%
Reg6
6%
3%
3%
Reg7
4%
9%
8%
Reg11
7%
7%
5%
NCR
58%
54%
51%
ROTC*
3%
9%
9%
*Rest of the Country
Modes of Transmission (1984-2012) In 2012, 98% (208) were infected through sexual contact, 1% (3) through needle sharing among injecting drug users, and <1% (1) through mother-to-child transmission (Table 2). There were 199 males and 9 females infected through sexual transmission. The age range of those infected through sexual transmission was 18-56 years old (median 27 years). Of the 8,576 with HIV from 1984 to 2012, 92% (7,854) were infected through sexual contact, 3% (268) through needle sharing among injecting drug users, 1% (56) through mother-to-child transmission and <1% (20) through blood transfusion. Other modes of transmission are listed in Table 2. No data is available for 4% (375) of the cases.
Table 2. Reported Mode of HIV Transmission Jan 2012 n=212
Mode of Transmission Sexual Contact
Cumulative N=8,576
208
7,854
Heterosexual contact
21(10%)
2,897(37%)
Homosexual contact
105(50%)
2,993(38%)
Bisexual contact
82(39%)
1,964(25%)
Blood/Blood Products
0
20
Injecting Drug Use
3
268
Needle Prick Injury
0
3
Mother-to-Child
1
56
No Data Available
0
375
Cumulative data shows 37% (2,897) were infected through heterosexual contact, 38% (2,993) through homosexual contact, and 25% (1,964) through bisexual contact. From 2007 there has been a shift in the predominant trend of sexual transmission from heterosexual contact (22%) to males having sex with other males (78%) [Figure 9]. Fig 9. HIV Transmission by Age-Group, 2012 (n=212)
Figure 8. Proportion of Types of Sexual Transmission, Jan 1984â&#x20AC;&#x201D;Jan 2012
140
90%
120
Number of Cases
100%
Proportion of Cases
80% 70% 60% 50%
100
80
60
40
40%
20
30%
0
20% 10% 0%
'84 '85
'86 '87
'88 '89 '90
Heterosexual
1
7
24
24
16
19
35
Bisexual
0
2
0
4
2
2
Homosexual
0
1
4
3
4
6
'91 '92 '93 47
'94 '95 58
56
'96 '97 '98 81
'99 '00 '01
'02 '03
'04 '05 '06
'07 '08 '09
'10 '11
'12
30
41
82 138 114 93 128 129 129 123 131 193 139 160 216 274 388 21
4
4
5
2
3
8
7
7
9
10
8
5
8
14
12
14
26
74 127 252 467 806 82
8
15
5
16
20
21
30
25
36
30
17
32
46
40
27
47
81
107 215 336 680 1036 105
<7yo
7-14yo
15-17yo
18-24yo
25-34yo
35-49yo
50&older
Blood Transfusion - Female
-
-
-
-
-
-
-
Maternal to Child
-
1
-
-
-
-
-
Injecting Drug Use - Female
-
-
-
-
-
-
-
Injecting Drug Use - Male
-
-
-
-
2
1
-
Heterosexual Contact - Female
-
-
-
2
4
2
1
Heterosexual Contact - Male
-
-
-
-
8
3
1
Bisexual Contact
-
-
-
20
52
10
-
Homosexual Contact
-
-
-
35
54
14
2
3
January 2012
Philippine HIV/AIDS Registry
Overseas Filipino Workers (OFW) In 2012, there were 32 HIV positive OFWs, comprising 15% of cases reported for the year [Figure 10]. Of these, 30 (94%) were males and 2 (6%) were females; all infected through sexual contact. There were 1,826 HIV positive OFWs since 1984, comprising 21% of all reported cases [Figure 10]. Seventy-seven percent (1,405) 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 (1,547) were asymptomatic while 15% (279) were AIDS cases. Table 3. Mode of HIV Transmission Among OFWs
Figure 10. Number of OFWs Compared to Non-OFWs by Year (1984-2012)
Cumulative N=1,826
32
1,764
Heterosexual contact
4(12%)
1,107(63%)
Homosexual contact
12(38%)
368(21%)
Bisexual contact
16(50%)
289(16%)
Mode of Transmission Sexual Transmission
Blood/Blood Products
0
10
Injecting Drug Use
0
1
Needle Prick Injury
0
3
No Data Available
0
48
2200 2000
Number of Cases
Jan 2012 n=32
1800 1600 1400 1200 1000 800 600 400 200 0
'84
'85
'86
'87
'88
'89
'90
'91
'92
'93
'94
'95
'96
'97
'98
'99
'00
'01
'02
'03
'04
'05
'06
OFW
1
2
0
3
9
5
10
7
14
29
31
24
35
27
51
67
60
79
96
94
88
94
130 106 122 164 175 271
Non-OFW
1
8
29
35
23
34
56
78
58
73
87
92
119
90
138 91
63
95
88
99
111 116 179 236 406 671 1416 2078 180
% of OFW
Blood Units Confirmed for HIV Table 4. Number of Confirmed HIV Positive Blood Units
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.
Monthly Report
2012
2011
17
11
February
15
March
14
April
20
May
10
June
32
July
22
August
18
September
10
October
22
November
17
December
18
Total for the year (Jan only)
National HIV/AIDS & STI Strategic Information and Surveillance Unit
'08
'09
'10
'11
'12 32
8% 28% 13% 15% 8% 19% 28% 26% 21% 23% 23% 27% 42% 49% 45% 52% 49% 44% 45% 42% 31% 23% 20% 11% 12% 15%
PLHIV on Anti-Retroviral Therapy
In January 2012, 17 blood units were confirmed positive for HIV by RITM. This was 55% higher compared to the same period last year (Table 4). There is no available data yet on the total number of blood units donated.
January
50% 20% 0%
'07
As of January 2012, there are 2,087 People Living with HIV presently on Anti-Retroviral Therapy (ART). Table 5. Number of PLHIV on ART Month January
2012 2,087*
February March April May June July August September October November
17
209
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
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).
National Epidemiology Center, Department of Health, Bldg. 19, San Lazaro Compound, Sta. Cruz, Manila 1003 Philippines
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.
Tel: +632 651-7800 local 2926, 2952 Fax: +632 495-0513 Email: HIVepicenter@gmail.com Website: http://www.doh.gov.ph
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