The Philippine Online Chronicles

Last November, the World Health Organization issued a statement that Acquired Immune Deficiency Syndrome (AIDS) has become the leading cause of death for women ages 15-44 around the world. This means that, due largely to having unsafe sex, women of childbearing age are putting themselves at risk of contracting the Human Immunodeficiency Virus (HIV). This also implies that women today may still not yet be in full control of their fertility and reproductive health.

The present scenario

Many are still quick to dismiss HIV as a gay or sex worker disease. And then came the news of HIV cases rising in the call center industry. Call center agents were offended but the news also prompted AKMA-PTM, a call center party list, to come up with an HIV hotline for the 500,000-plus people working for Business Process Outsourcing (BPO) companies in the country. The hotline may prove beneficial but the way this new development was reported irked some people with HIV who are working for better awareness and support for all since people are now thinking that if they are not gay and don’t work for call centers,  they will be immune.

Campaigns to pass the Reproductive Health Bill and have it implemented as well as other awareness drives spearheaded by the DOH and various NGOs are all good and does benefit a lot of people. There is room for improvement, however, in the approach and the ad campaigns. More resources also have to be allocated to provide the necessary facilities for testing and cooperation from different communities will be critical in helping curb the HIV situation in the country.

The need for a different approach

Dr. Patricia Gay, in her speech at the National Conference on Women and HIV/AIDS, encourages people working on HIV/AIDS awareness to look at HIV/AIDS as a sexual and relational issue and not just as a health issue.

Lisa Enriquez, one of the few women with HIV who have come out, was neither a sex worker nor a drug addict. In fact, she got HIV from her Italian husband. This raises the question as to who shall give a face to the many other women who are getting the virus, not because they were particularly promiscuous, but because they were in a relationship they thought was monogamous.

There may be some truth to the news being reported that Filipinos keep having unprotected sex but it does not say how much of these happen casually or how some HIV-carriers may be unwittingly passing the virus on to multiple partners.

Consider the following scenarios and facts:

1. Fubu (F*ck buddy) arrangements, however casual, are still generally based on a level of trust. Some arrangements are even exclusive, if only for a time;
2. A wife is not likely to insist on condom use in a marriage if they’re open to getting pregnant;
3. A girlfriend may not insist on condom use if she is on the pill because she is less likely to be concerned about getting STDs from a man she loves and will only protect herself from an unwanted pregnancy;
4. Because of the perception that it is a gay or druggie disease, men are least likely to consider testing but is most likely to unknowingly spread the virus;
5. People automatically assume their partners are clean especially if they both come from good families, are educated, have jobs, etc;
6. One out of three people with HIV in the country is, or was, an OFW; and
7. Gay guys, with no worries of getting pregnant, are less likely to also insist on condom use.

A woman’s non-use of condoms, whether she is a wife, girlfriend or friend offering benefits, has no bearing on her educational attainment and level of confidence as a person. Her husband may not be the stereotypical philanderer as well. All he needs is just one moment of carelessness, or one adventurous fling with an infected person of the same sex, to bring home to his wife the disease.

OFWs engaging in sexual relationships abroad may also have more to do with loneliness from being away from loved ones for long periods of time rather than immorality.

Thus, awareness campaigns have to start appealing to these emotional and relational aspects of the Filipino’s sexual practices for them to be more effective.

The female perspective

The Department of Health (DOH) pegs the HIV/AIDS situation in the Philippines as an epidemic, with January 2010 registering the highest number of HIV cases. An alarming 50 out of the 143 cases reported last January were HIV transmissions from sharing needles from drug use while 89 of the cases were from sexual contact.  18 out of the cases were female.

Aside from the critical issue of having a body that will not be able to fight opportunistic infections, there are other issues that are particular to women with HIV that need to be addressed, and maybe differently. These include, but are not limited to, the following:

• The biological and physiological makeup of a woman’s reproductive system makes her more likely to get HIV. This fact essentially compromises her when a partner she trusts has unprotected sexual intercourse outside of the relationship;

• The use, availability and affordability of Antiretrovirals (ART) to prevent mother-to-child transmission of HIV and the concurrent fears that though ART may minimize transmission of HIV, exposure to it may also result in congenital anomalies and lifelong malignancies in the babies. This also brings to fore the lack of abortive option for HIV-positive women in the country. There have only been 49 reported cases of mother-to-child transmissions since 1984, however, which may not be enough to warrant such a drastic measure. Add to this the fact that babies born to mothers with HIV only have 1 out of 4 chance of also being HIV-positive, less if the babies are delivered via C-section;

• The use, availability and affordability of ART to prevent transmission of HIV in breast milk. There exists a 30% chance at least of transmitting HIV through breast milk. However, breast milk still offers a myriad of benefits to an infant. For women who are resource-poor and in areas with unpredictable water supply or unfit sanitation, breastfeeding may also be the safest recourse for mothers in ensuring their baby survives;

• The increased heart attack risks due to HIV, with women showing a tripled risk that is probably attributable to a different metabolism;

• The compromised sexual lives as HIV may make women more prone to other infections like UTI and other STDs despite condom use;

• The change of plans affecting marriage and having children in the future;

• The social stigma of being labelled as promiscuous and other sterotypes such as playing the role of primary caregiver while requiring care themselves;

• The aggravated violence on women with HIV, be it continued sexual abuse or physical abuse resulting in the disease being found out. Probable loss of income or inability to contribute to chores may also fuel maltreatment; and

• The children and dependents of HIV-positive women who may have to be raised by others or raised with limited means, as family resources may be affected by long-term health care.

Filipino women who suspect that they may have HIV or have found out for sure through testing may contact Babae Plus, a group primarily aimed at giving a voice to Filipinas with HIV, at Bahay Kanlungan Center (632- 528-4531) or Abot Kamay Center (404-2911) or via e-mail: babaeplus@gmail.com.

A lot is already being done to promote HIV awareness but information drives have to compete with the changing mores of the present time. We have to adjust accordingly. Not doing so may mean that it will be our sons and daughters someday who are stricken with the disease.  Already, the young professionals most at risk of getting HIV are also the ones driving our economy, the implication of which spells disaster for the Filipino nation.

Photos: “Hiv ribbon in SVG format” by Trygve Utstumo, c/o Flickr. Some Rights Reserved / "Gay person" by Mec Arevalo. Some Rights Reserved / “Mother and Child” by Thomas, c/o Flickr. Some Rights Reserved.

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Mec Arevalo is a serial blogger, stay-at-home Mom, breastfeeding peer counselor for L.A.T.C.H. Inc. and volunteer counselor/facilitator for FAD Inc. Aside from being an intentional parent and preparing their family for homeschooling, she does what she can for her advocacies: breastfeeding, children-in-conflict with the law (CICL), HIV/AIDS Awareness and sign language. She relaxes by Plurking and digiscrapping.