Beyond Viral Suppression: Enhancing Quality of Life for HIV Patients in the Philippines

Series: Sciencious Medical Writing Conference

Human immunodeficiency virus, commonly known as HIV, is notorious for its belligerent aggression towards the human immune system. Once infected with HIV, the immune system is significantly weaker and is more susceptible to various illnesses making resilience from sickness arduous. This article will cover human immunodeficiency virus and its correlation to cancer. Furthermore, it will discuss the state of HIV—stigma, healthcare, and monitoring—in the Philippines and the possible initiatives to help enhance the quality of life for HIV patients. 

Human immunodeficiency virus 

The human immunodeficiency virus (HIV) perpetrates the weakening of a human’s immune system as it attacks white blood cells, specifically, the CD4 cells. The transmission of HIV occurs due to the exchange of bodily fluids with an HIV-positive individual. This may be through the exchange of saliva, semen, or through cross-contamination of injection drug equipment. In the early stages of contracting the virus, the HIV-positive individual may experience fever, headache, rash, or sore throat. Eventually, when the virus progresses, symptoms such as swollen lymph nodes, weight loss, and diarrhea will manifest. 

Complexity of HIV. The absence of a cure for HIV is due to its obscurity and its behavior of integrating into several cell types of the host genome. Since these HIV-infected cells typically go to hiding in the lymph nodes, liver, or spleen, these cells are now called latent cells which are regulated by the antiretroviral treatment to avoid the worsening of HIV manifestations. 

Antiretroviral Treatment (ART). Antiretroviral treatment is the common treatment for HIV regulation. Although it cannot eradicate HIV in an individual’s body, it helps with the overall progression of the virus. Introduced in the mid-1990s, highly active antiretroviral therapy (HAART) was discovered to lessen the occurrence of cancer— specifically Kaposi sarcoma and non-Hodgkin lymphoma. HAART reduces the amount of HIV circulating in the body through the blood vessels which leaves room for partial recovery of the immune system. 

Correlation Between HIV and Cancer

As the human immunodeficiency virus continues to weaken the ability of the body to fight against diseases, it makes the individual more susceptible to all kinds of sickness—including cancer. It is noteworthy to know that an HIV patient undergoing ART is still more vulnerable to contracting illness compared to an HIV-negative individual. 

Epstein-Barr virus (EBV). Although EBV is commonly dormant among people, HIV increases its chances of developing into a non-Hodgkin and Hodgkin lymphoma. Once EBV progresses, individuals with HIV are more susceptible to cancers such as immunoblastic lymphoma, nasopharyngeal cancer, and gastric cancer. 

Kaposi sarcoma-associated herpesvirus (KSHV). An individual exposed to KSHV may develop Kaposi’s sarcoma and lymphoma. This disease yields cancer cells in the gastrointestinal tract of a person. Despite the disease being common in men, Kaposi’s sarcoma is usually transmitted through saliva rather than semen. With the help of ART, the disease is mostly prevented among HIV-positive individuals, only having 6 cases per million people. 

HIV in the Philippines 

In the span of 11 years (2012-2023), the rate of daily HIV-related deaths in the Philippines experienced an increase of 411%. Furthermore, in January 2023, 110 736 cases of HIV were reported in the country 86 of these were aged 19 and below. It was also determined that populations most at risk of HIV in the Philippines are: men having sex with men, persons who inject drugs, transgender populations, and people who exchange or get trafficked for sex. 

The stigma surrounding HIV. Currently, 81% of Filipinos experience stigma. Much of this stigma takes form through societal and workplace discrimination and being the topic of gossip by peers. More pressing issues are the non-consensual disclosure of health information of an HIV-positive individual common in professional workspaces. Furthermore, this also results in self-stigma where the individual manifests feelings of guilt, shame, isolation, and not wanting to be a parent. 

Access to HIV services. In January 2023, it was reported that the Philippines possessed 180 HIV-care facilities where ART is exclusively found in these treatment hubs. This poses a great problem for accessibility as ART was not made available in commercial pharmacies making it inaccessible for HIV patients in rural areas of the country. Furthermore, the lack of accessible facilities makes for a weak monitoring system of HIV patients in the Philippines.

Increasing HIV Treatment Hubs in the Philippines 

As of the latest report of the HIV/AIDS Registry of the Philippines, 86 young individuals have been diagnosed with HIV. While this is a small amount compared to the country’s population, it cannot be denied that the lack of HIV care facilities masks the real number of HIV-positive youth and individuals in the Philippines. The integration of HIV care centers and materials in school clinics will help alleviate the problem. Despite concerns that this will promote sex amongst the youth, it will more importantly inform them of safe sexual intercourse and the consequences of unsafe sex. Ultimately, the exposure to HIV care centers at a young age may increase the level of empathy of Filipinos towards HIV-positive individuals which may cultivate a safe and supportive space that will contribute to the eradication of the stigma that surrounds HIV.

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