DOH-NEC November 2012 HIV/AIDS Registry

Page 1

NOVEMBER 2012

DEPARTMENT OF HEALTH NATIONAL EPIDEMIOLOGY CENTER

In November 2012, there were 284 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 34% higher compared to the same period last year (n=212 in 2011) [Figure 1].

Table 1. Quick Facts Nov 2012

Jan-Nov 2012

Cumulative 1984—2012

Total Reported Cases

284

3,045

11,409

Asymptomatic Cases

260

2,873

10,255

Demographic Data

Most of the cases (97%) were males. The median age was 28 years (age range: 17-59 years). The 20-29 year (52%) age-group had the most number of cases. Forty-seven percent (134) of the reported cases were from the National Capital Region (NCR).

AIDS Cases

24

172

1,154

Males

275

2,903

9,793*

Females

9

142

1,605*

Youth 15-24yo

70

818

2,735

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 (282) and needle sharing among injecting drug users (2). [Table 2, page 3]. Males having sex with other males (82%) were the predominant type of sexual transmission [Figure 2]. Most (92%) 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 284 HIV positive cases, twenty-four were reported as AIDS cases, all were males. The median age is 29 years (age range: 20-45 years). Ninety-six percent (23) acquired the infection through sexual contact (15 homosexual, 4 heterosexual and 4 bisexual) and 1 acquired through needle sharing among injecting drug users There was no reported death for this month.

300 250 200 150 100 50 0 J an

Feb

M ar

A pr

M ay

Jun

Jul

A ug

Sep

Oc t

Nov

D ec

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

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

100%

Overseas Filipino Workers (OFW)

Proportion of Cases

Philippine HIV and AIDS Registry

Newly Diagnosed HIV Cases in the Philippines

Thirty-five of the 284 (12%) reported cases were OFWs [Figure 11, page 4]. There were 32 males and 3 females. The median age was 32 years (age range: 21-52 years). All acquired the infection through sexual contact (12 heterosexual, 16 homosexual and 7 bisexual).

31

52

Bisexual

3,306

Homosexual

75%

80

76 2,773

50%

25%

150

105

N o v 2 0 12

N o v 2 0 11

4,438

0%

C umul at ive

Figure 3. Number of HIV/AIDS Cases Reported in the Philippines by Year, Jan 1984 to November 2012 (N=11,409) 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, 045

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, 873

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

172

D eat 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


November 2012

Philippine HIV/AIDS Registry

AIDS Cases (1984-2012) Of the 3,045 HIV positive cases in 2012, one hundred seventy-two were reported as AIDS cases. Of these, 166 were males and 6 were females. Ages ranged from 7-81 years (median 31 years). Ninety-eight percent (169) acquired the infection through sexual contact (98 homosexual, 41 bisexual and 30 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窶年ovember 2012 100%

Proportion of Cases

75%

From 1984 to 2012, there were 1,154 AIDS cases reported. Seventy-seven percent (888) were males. Median age is 34 years (age range: 1-81 years). Of the reported AIDS cases, 353 (31%) had already died at the time of reporting. Sexual contact was the most common mode of HIV transmission, accounting for 94% (1,087) of all reported AIDS cases. Almost half (504) of sexual transmission was through heterosexual contact, followed by homosexual contact (424) then bisexual contact (159).

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

2012

N eedl 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

1

B i sex ual C ont act

64

8

7

39

41

H omosexual C ont ac t

246

16

19

45

98

H et er osex ual Cont act

442

6

3

23

30

*Note: 28 did not report mode of transmission

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

Proportion of Cases

Ninety-five percent of the 3,045 cases were males (2,903). 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 (19%) [Figure 6]. From 1984 to 2012, there were 11,409 HIV Ab sero-positive cases reported (Table 1), of which 10,255 (90%) were asymptomatic and 1,154 (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 (9,793) 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% Nov 2012 (M )

Nov 2012 (F)

2012 ( M al e)

2012 (Femal e)

50 & ol der

6

1

59

11

35-49yo

56

3

493

45

25-34yo

144

4

1, 557

58

15-24yo

69

1

791

27

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 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

<15yo

15- 19y o

20-24yo

25-29yo

30-34y o

35- 39y o

40-44yo

45-49yo

50 & ol der

<15y o

15-19yo

20-24yo

25-29y o

30- 34yo

35-39yo

40-44yo

45- 49y o

50 & ol der

2012

3

85

706

993

564

265

144

84

59

2012

1

8

19

37

21

22

11

12

11

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


November 2012

Philippine HIV/AIDS Registry

Geographic Distribution % of Cases

I

2%

II

1%

III

8%

IVA

17%

IVB

1%

V

0

VI

4%

VII

6%

VIII

1%

IX

0

X

1%

In November 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 Figure 7. New HIV Cases by Region, November 2012 R eg 3 8%

R OT C 14 %

R eg 4 A 17%

Fig 8. Comparison of Proportion of HIV Cases by Region & Year 100%

75%

Proportion of Cases

Region

50%

25%

0%

XI

R eg 7 6%

8%

XII

2012

2007-2011

1984-2012

R eg1

2%

2%

2%

R eg3

7%

6%

9%

13%

12%

12%

R eg6

3%

3%

3%

R eg7

9%

9%

9%

R eg11

7%

7%

6%

51%

54%

51%

8%

7%

8%

2%

CAR

1%

CARAGA

2%

ARMM

NCR 4 7%

0

NCR

R eg4A

R eg 11 8%

*ROTC: Rest of the Country

N CR

47%

R OT C*

Modes of Transmission (1984-2012) In 2012, 94% (2,871) were infected through sexual contact, 6% (170) through needle sharing among injecting drug users, and <1% (4) through mother-to-child transmission (Table 2). There were 2,747 males and 124 females infected through sexual transmission. The age range of those infected through sexual transmission was 15-81 years old (median 28 years). Of the 11,409 HIV positive cases reported from 1984 to 2012, 92% (10,517) were infected through sexual contact, 4% (435) 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.

Table 2. Reported Mode of HIV Transmission Nov 2012 n=284

Mode of Transmission Sexual Contact

Jan-Nov 2012 n=3,045

Cumulative N=11,409

282

2,871

10,517

Heterosexual contact

52(18%)

430(15%)

3,306(31%)

Homosexual contact

150(53%)

1,550(54%)

4,438(42%)

Bisexual contact

80(28%)

891(31%)

2,773(26%)

Blood/Blood Products

0

0

20

Injecting Drug Use

2

170

435

Needle Prick Injury

0

0

3

Mother-to-Child

0

4

59

No Data Available

0

0

375

Cumulative data shows 31% (3,306) were infected through heterosexual contact, 42% (4,438) through homosexual contact, and 26% (2,773) 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=3,045)

Figure 9. Proportion of Types of Sexual Transmission, Jan 1984窶年ovember 2012 100%

Number of Cases

90%

Proportion of Cases

80% 70% 60% 50% 40% 30% 20% 10% 0% '84

'85 '86

'87 '88

'89 '90

'91 '92

'93 '94

'95 '96

'97 '98

'99 '00

82 138 114 93

'01 '02

'03 '04

'05 '06

'07 '08

'09 '10

'11 '12

H eterosexual

1

7

24

24

16

19

35

30

41

47

58

56

81

Bisexual

0

2

0

4

2

2

4

4

5

2

3

8

7

7

9

10

8

128 129 129 123 131 193 139 160 216 274 388 430 5

8

14

12

14

26

74 127 252 467 806 891

H omosexual

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 10361550

1650 1575 1500 1425 1350 1275 1200 1125 1050 975 900 825 750 675 600 525 450 375 300 225 150 75 0 <7yo

7- 14y o

15-17y o

18-24yo

25-34y o

35-49yo

50&ol der

B l ood T r ans f us i on - Femal e

-

-

-

-

-

-

-

M at er nal t o C hi l d

1

3

-

-

-

-

-

I nj ect i ng Dr ug U se - Femal e

-

-

1

3

9

4

-

I nj ect i ng Dr ug U se - M al e

-

-

2

55

51

43

2

Het er osexual C ont act - Femal e

-

-

-

23

49

41

11

Het er osexual C ont act - M al e

-

-

-

28

168

87

23

B i s exual Cont ac t

-

-

2

243

498

137

11

Homos exual Cont ac t

-

-

7

454

840

226

23

3


November 2012

Philippine HIV/AIDS Registry

Overseas Filipino Workers (OFW) In 2012, there were 330 HIV positive OFWs, comprising 11% of cases reported for the year [Figure 11]. Of these, 290 (88%) were males and 40 (12%) were females. All were infected through sexual contact. There were 2,118 HIV positive OFWs since 1984, comprising 19% of all reported cases [Figure 11]. Seventy-eight percent (1,660) 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 (1,819) were asymptomatic while 14% (299) were AIDS cases. Table 3. Mode of HIV Transmission Among OFWs

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

Jan-Nov 2012 n=330

Cumulative N=2,118

35

330

2,056

Heterosexual contact

12(34%)

102(31%)

1,200(58%)

Homosexual contact

16(46%)

133(40%)

488(24%)

Bisexual contact

7(20%)

95(29%)

368(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

Sexual Transmission

3000 2800 2600 2400 2200 2000 1800 1600 1400 1200 1000 800 600 400 200 0

Number of Cases

Nov 2012 n=35

Mode of Transmission

OFW Non - OFW % of OFW

Blood Units Confirmed for HIV As of November 2012, 216 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 t hey 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

3 30

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

2 36

4 0 6 6 7 1 14 17 2 0 7 8 2 7 15

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 %

5 0% 20 %

2 8 % 13 %

12 %

11%

34

As of September 2012, there are 3,115* People Living with HIV presently on Anti-Retroviral Therapy (ART). Data for July and August is not yet available. Table 5. Number of PLHIV on ART 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

June

2,761

July

2,914

August

3,026

July

22

22

August

25

18

September

13

18

October

14

22

November

22

17

December

18

September October November

Total

11%

PLHIV on Anti-Retroviral Therapy

Table 4. Number of Confirmed HIV Positive Blood Units Month

'8 4

216

217

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

* This is not a cumulative number. It does not include those who already have died, left the country, or decided to stop taking ART.

December

National HIV/AIDS & STI Strategic Information and Surveillance Unit 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

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

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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