Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS
Second Reqular Session

HOUSE BILL nyo 8442

Introduced by Representative Michael L. Romero

EXPLANATORY NOTE

HIV/AIDS infection in the Philippines is low but growing. The current incidence of
HIV/AIDS in the country remains under 0.1% of the total population in
2015. The Philippines has one of the lowest rates of infection, yet has one of the
fastest growing number of cases worldwide. The Philippines is one of seven
Countries with growth in number of cases of over 25%, from 2001 to 2015.

Cases are concentrated among men who have sex with men, and secondarily,
among female sex workers. HIV cases among men having sex with men
multiplied over 10 times since 2010, HIV cases are getting younger.

The first case of HIV infection in the Philippines was reported in January 1984,

CURRENT STATUS

Officially. the Philippines is a low-HIV-prevalence country. with less than 0.1
percent of the adult population estimated to be HIV-positive. As of April 2015,
the Department of Health (DOH) AIDS Registry in the Philippines reported 24,936
cumulative cases. In April 2015, 560 new cases were reported showing a 42%
increase compared to the same period in the previous year. In the year 2014, a
total of 6,011 cases of HIV were reported with 91% of the cases being
asymptomatic at the time of reporting while 543 cases were diagnosed as
AIDS. From 2001 to 2015 the number of cases diagnosed per year increased 37
times, from 174 cases diagnosed in 2001 to-,552 for the first 10 months on 2015.


In the years 2010 to 2015, 9|% (22.724) of cases were men with a median age of
28 years, with over half (12.616) in the 25-34 age group. 26% (6.529) of men were
20-24 years of age, an increase from 12% in 2005-2009. Since the year 2000, the
high-prevalence age group has changed from the 30-39 year old age group
being the most affected from years 2000-2004, to the 25-34 age group from
years 2005 to 2009, and to 20-29 age group from years 2010-2015.

The infection rate among men having sex with men has multiplied 10 times from
2010 to 2015. The Department of Health reported in November 2015, that the
fate of prevalence has surpassed 5%, the UN's definition of concentrated
epidemic, in eight citiesnamely: Cebu,Cagayan de Oro, Puerto
Princesa, Davao, Quezon City, Parahaque and Makati, with Cebu reaching
14%.

Between 1984 and 1990. 62% (133 of 216) of cases were female. From 2010 to
2015, females only comprised 5% (1017) of the 20,512 reported cases.

From January 2010 to April 2015, 82% (20.512) of all cases were reported. At the
time of reporting, 93% of these cases were still asymptomatic.

As of April 2015, 9.838 people living with HIV were undergoing Anti-Retroviral
Therapy in 23 treatment hubs.

Overseas Filipino workers account for about 20% of all cases.

MEANS OF TRANSMISSION

Of the 24,936 HIV-positive cases reported from 1984 to 2015, 93% (23,291) were
infected through sexual contact of which 79% (18,023) was through homosexual
and bisexual contact while heterosexual contact comprised the remaining 14%
(3.273). 5% (1,096) of cases was caused by needle sharing among injecting drug
users. 0.3% (73) through mother-to-child transmission, <0.1% (20) through blood
transfusion and needle prick injury <0.1% (3). No data is available for 1.7% (375)
of the cases.

Cumulative data shows 24% (5.268) were infected through heterosexual
contact, 47% (11.023) through homosexual contact, and 30% (7,000) 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%)


GEOGRAPHICAL DISTRIBUTION

From 1984 to 2015, the region with the most number of reported cases
were Metro Manila with 11,081 (44%). Region 4A with 3,230 (13%) cases, Central
Visayas with 2,260 (9%) cases, Region 3 with 2,025 (8%) cases and Region 11 with
1,460 (6%) cases. 3,734 (15%) of cases were distributed around the rest of the
country while 1,146 (5%) had no data on the region.

AT-RISK GROUPS

Most-at-tisk groups include men who have sex with men, with 395 new human
immunodeficiency virus (HIV) infections among within this group from January to
February 2013 alone, 96% up from 2005's 210 reported infections. A
spokesperson of the National Epidemiology Center (NEC) of the Department of
Health says that the sudden and steep increase in the number of new cases
within the MSM community, particularly in the last three years (309 cases in 2006,
nd 342 in 2013), is “tremendously in excess of what is usually expected,”
allowing classification of the situation as an “epidemic”. Of the cumulative total
of 1,097 infected MSMs from 1984 to 2015, 49% were reported in the last three
years (72% asymptomatic); 108 have died when reported, and slightly more
MSMs were reportedly already with AIDS (30%).

Among MSM's, ninety percent of the newly infected are single (up to 35% of past
Cases reported involved overseas Filipino workers or OFWs and/or their spouse),
with the most of the affected people now only 20 to 34 years old (from 45 to 49
years old in the past). The highest number of infections among MSMs is
from Metro Manila. An HIV surveillance study conducted by the University of the
Philippines-Philippine General Hospital showed that out of 406 MSM tested for
HIV from entertainment areas in Metro Manila. HIV prevalence using the rapid
test was 11.8% (95% confidence interval: 8.7- 15.0). Increasing infection rates
were also noted in the cities of Angeles, Cebu, and Davao. | to 3 percent of
MSM's were found to be HIV-positive by sentinel surveillance conducted in Cebu
and Quezon cities in 2001.

Another at-risk group are injecting drug users (IDUs), 1% of whom were found to
be HIV-positive in Cebu City in 2005. A high rate of needle sharing among IDUs in
some areas (77 percent in Cebu City) is of concem. Sex workers, because of
their infrequent condom use. high rates of sexually transmitted infections (STIs).
and other factors. are also considered to be at risk.


The threats and effects that AIDS/HIV brings to the population is a severe cause
for concern. However, the prevalence of virus within the Philippine population
remains low despite an increase in the number of cases. In fact. the Philippines
qualifies as one of the few countries where the growth of AIDS/HIV cases has
approximately increased to 25% from in a span of a couple of years from 2001-
2015.

The rise in the number of cases can be best categorized by specific groups in
the population, First, the age group that is most affected are 15-24 years old.
Young professionals engaging in unprotected sexual intercourse is the main
cause for the contraction and it accounts for one third of the AIDS/HIV-infected
population. Furthermore, the infection within this age group is more prevalent
with homosexual relationships.

This House Bill seeks to foster the recognition of this growing epidemic, socio-
cultural risks and vulnerabilities to HIV/AIDS. To promote and stimulate
government leadership action in a low-HIV-prevalence country, To advocate for
stronger and sustainable response to AIDS when faced with other competing
Priorities.

Thus, the egrly age of this bill is earnestly requested.
/
mci ROMERO Ph.D.


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS
Second Regular Session

6442

HOUSE BILL NO,

Introduced by Representative Michael L. Romero

AN ACT

MANDATING ALL HOSPITALS TO ESTABLISH A HIV/AIDS
TESTING CENTER, TO FOSTER A MORE EFFECTIVE HEALTH
SECURITY SCHEME, TO PROVIDE AN ADDITIONAL
CONTROL AND DETECTION MECHANISM AND FACILITY,
AND FOR OTHER PURPOSES

Be it enacted by the Senate and House of Representatives of the Philippines in

Congress assembled:

SECTION 1. DECLARATION OF POLICY — it is hereby declared a policy of the

state to establish health security standards and mechanisms.

It is also a policy of the state to create facilities that will spearhead and
provide control and detection schemes specifically for those highly contagious,
communicable and deadly diseases, most especially AIDS/HIV.


SECTION 2. PROCEDURE - The republic of the Philippines uses antiretroviral
treatment (ART) to treat people with HIV/AIDS. This treatment involves using
different kinds of drugs such as zidovudine, lamivudine. and nevirapine.

Another method that is being used is lab examination, which will help monitor
the patient's ART or antiretroviral drug level. Since treatment for HIV/AIDS is
based on a case to case level, this will determine how the patient will be
treated.

The antiretroviral drug does not kill the virus that causes the disease. It's
simply a way to help fight infection.

This way, the patient prolongs his/her life even with the disease. With this
being said, patients have to go undergo lab examinations depending on
their respective cases and receive this treatment throughout their
existence. It is a form of therapy that they would have to undergo.

The government will handle most of the costs in association with the disease. As
of April 20th, 2015, the Department of Health (DOH) mentioned that they plan to
buy P180 million worth of ARV or antiretroviral drugs to be used in ART.

SECTION 3. APPROPRIATION

The amount determined by the Department of Health (DOH) for the
implementation of this Act shall be charged under the existing funding of
the Central office of the DOH.

Thereafter such amounts necessary for the successive and continuous
implementation of this Act, including the operational, organizational and
maintenance of reserves shall be automatically appropriated in the
General Appropriations Act (GAA).


SECTION 4, TRANSITORY PROVISION — Existing industries, businesses and
offices affected by the implementation of this Act shall be given six (6)
months transitory period from the effectivity of the IRR or such other period
as may be determined, fo comply with the requirements of this Act.

SECTION 5. IMPLEMENTING RULES AND REGULATIONS — The departments
and agencies charged, to be lead by the Department of Health (DOH)
with carrying out the provisions of this Act shall, shall within sixty (60) days
after the effectivity of this Act, formulate the necessary rules and

regulations for its effective implementation.

SECTION 6. REPEALING CLAUSE — All laws, decrees. executive orders, rules
and regulations, or parts thereof inconsistent with the provisions of this Act
are hereby repealed or modified accordingly.

SECTION 7. SEPARABILITY CLAUSE - If, for any reason, any section or
provision of this Act is held unconstitutional or invalid, the other sections or
provisions hereof shall not be affected thereby.

SECTION 8. EFFECTIVITY CLAUSE — This Act shall take effect after fifteen (15)
days from its publication in the Official Gazette or in at least two (2)
national newspapers of general circulation whichever comes earlier.

Approved,