DEPARTMENT OF HEALTH NATIONAL EPIDEMIOLOGY CENTER

MARCH 2012

Newly Diagnosed HIV Cases in the Philippines

In March 2012, there were 313 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 82% higher compared to the same period last year (n=172 in 2011), and the highest number of cases ever reported in the registry [Figure 1]. Most of the cases (93%) were males. The median age was 29 years (age range: 2-81 years). The 20-29 year (52%) age-group had the most number of cases. Forty-seven percent (146) of the reported cases were from the National Capital Region (NCR). Reported mode of transmission were sexual contact (280), needle sharing among injecting drug users (31) and mother to child transmission (2). [Table 2, page 3]. Males having sex with other males (83%) were the predominant type of sexual transmission [Figure 2]. Most (95%) of the cases were still asymptomatic at the time of reporting [Figure 3]. AIDS Cases Of the 313 HIV positive cases, seventeen were reported as AIDS cases, 16 males and 1 female. The median age is 31 years (age range: 24-42 years). All cases acquired the infection through sexual contact (7 homosexual, 7 bisexual and 3 heterosexual). Of the AIDS cases, there were three reported death for this month; two were males and one was female, median age was 33 years (age range: 25-42 years). Overseas Filipino Workers (OFW) Thirty-seven of the 313 (12%) reported cases were OFWs [Figure 11, page 4]. There were 31 males and 6 females. The median age was 35 years (age range: 20-56 years). All acquired the infection through sexual contact (17 heterosexual, 13 homosexual, and 7 bisexual).
Table 1. Quick Facts
Demographic Data Total Reported Cases Asymptomatic Cases AIDS Cases Males Females Youth 15-24yo Children <15yo Reported Deaths due to AIDS
March 2012 Jan-March 2012 Cumulative 19842012

313 296 17 290 23 82 2 3

799 769 30 757 42 215 3 5

9,163 8,158 1,005 7,647* 1,505* 2,132 61 348

Philippine HIV and AIDS Registry

*Note: No data available on sex for (11) cases.

Figure 1. Number of New HIV Cases per Month (2010-2012)

350

Number of New Cases

300 250 200 150 100 50 0 Jan 2010 2011 2012 143 152 212 Feb 130 159 274 M ar 120 172 313 A pr 154 171 M ay 153 184 Jun 109 178 Jul 131 204 A ug 108 196 Sep 153 253 Oct 104 200 Nov 112 212 Dec 174 268

Figure 2. Comparison of the Proportion of Types of Sexual Transmission in 2012, 2011 & Cumulative Data (1984-2012)
100%

Heterosexual

Proportion of Cases

48
75%

35

Bisexual

2,974

Homosexual

89
50%

60 2,140

25%

143

71

3,255

0%

M ar ch 2 0 12

M ar ch 2 0 11

C umulat ive

Figure 3. Number of HIV/AIDS Cases Reported in the Philippines by Year, Jan 1984 to March 2012 (N=9,163)
2500 2250 2000 1750 1500 1250 1000 750 500 250 0
'84 TOTAL Asymptomatic AIDS Death 2 0 2 2 '85 10 6 4 4 '86 29 18 11 10 '87 38 25 13 12 '88 32 21 11 9 '89 39 29 10 8 '90 66 48 18 15 '91 85 68 17 13 '92 72 51 21 13 '93 102 64 38 11 '94 118 61 57 19 '95 116 65 51 24 '96 154 104 50 27 '97 117 94 23 10 '98 189 144 45 16 '99 158 80 78 17 '00 123 83 40 9 '01 174 117 57 20 '02 184 140 44 11 '03 193 139 54 11 '04 199 160 39 8 '05 210 171 39 16 '06 309 273 36 18 '07 342 311 31 10 '08 528 506 22 7 '09 835 804 31 1 '10 1591 1564 27 3 '11 2,349 2,243 106 *19 '12 799 769 30 5

*Nine initially asymptomatic cases reported in 2011, died due to AIDS that same year.

Philippine HIV/AIDS Registry

MARCH 2012

AIDS Cases (1984-2012)

Of the 799 HIV positive cases in 2012, thirty were reported as AIDS cases. Of these, 29 were males and 1 was female. Ages ranged from 7-47 years (median 33 years). Ninety-seven percent (29) acquired the infection through sexual contact (12 homosexual, 14 bisexual and 3 heterosexual) and 3% (1) mother-to-child transmission. From 1984 to 2012, there were 1,005 AIDS cases reported. Seventy-four percent (744) were males. Median age is 35 years (age range: 1-72 years). Of the reported AIDS cases, 348 (35%) had already died at the time of reporting. Sexual contact was the most common mode of HIV transmission, accounting for 94% (940) of all reported AIDS cases. More than half (477) of sexual transmission was through heterosexual contact, followed by homosexual contact (335) then bisexual contact (128). Other modes of transmission include: mother-to-child 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.
Figure 4. Proportion of Modes of Transmission of AIDS Cases by Year, Jan 1984March 2012
100%

75%

Proportion of Cases

50%

25%

0% 1984-2008 Needl e P r i c k B l ood T r ans f us i on M T CT I DU B i s ex ual Cont ac t Homos ex ual Cont ac t Het er os ex ual Cont ac t 2 10 16 4 64 245 442 2009 0 0 1 0 8 16 6 2010 0 0 0 0 7 17 3 2011 0 0 1 2 35 45 23 2012 0 0 1 0 14 12 3

*Note: 28 did not report mode of transmission

Demographic Characteristics (1984-2012)

In 2012, there were a total of 799 cases reported. 95% of the cases reported were males (757). Ages ranged from 2-81 years old (median 28 years). The 20-29 year old age group (57%) had the most number of cases for 2012. For the male age group, the most number of cases were found among the 20-24 years old (25%), 25-29 years old (32%), and 30-34 years old (21%) [Figure 6]. From 1984 to 2012, there were 9,163 HIV Ab sero-positive cases reported (Table 1), of which 8,158 (89%) were asymptomatic and 1,005 (11%) were AIDS cases. As shown in Figure 6, there is a significant difference in the number of male and female cases reported. Eighty-four percent (7,647) 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 (28%) and 30-34 years (19%) [Figure 6].
Figure 5. Proportion of Sex & Age-Groups in March 2012 & Jan-March 2012
100%

Proportion of Cases

75%

50%

25%

0% M ar ch 2012 (M ) 50 & ol der 35-49yo 25-34yo 15-24yo 1-14yo 7 46 155 80 2 M ar ch 2012 (F) 1 10 10 2 0 2012 (M al e) 12 133 400 209 3 2012 (Femal e) 2 15 19 6 0

Figure 6. Comparison of the Distribution of Male and Female HIV Cases by Age-Group and Certain Highlighted Years
50 & o lder 45-49yo 40-44yo 35-39yo 30-34yo 25-29yo 20-24yo 1 9yo 5-1

1984-2007

2008

2009

2010

2011

2012

Number of Male Cases

2500 2250 2000 1750 1500 1250 1000 750 500 250 0

<1 5yo
0 250 500 750 1000 1250

Number of Female Cases

1500 1750 2000 2250 2500 <15yo 2012 2011 2010 2009 2008 1984-2007 0 2 2 1 0 21 15-19yo 1 3 5 4 0 33 20-24yo 5 36 28 13 8 191 25-29yo 15 44 21 19 14 225 30-34yo 4 23 34 21 8 202 35-39yo 8 21 15 20 10 154 40-44yo 4 10 9 14 9 90 45-49yo 3 8 7 7 3 35 50 & ol der 2 9 4 5 3 44

<15yo 2012 2011 2010 2009 2008 1984-2007 3 1 1 1 2 27

15-19yo 19 76 50 22 11 15

20-24yo 190 589 405 179 92 157

25-29yo 244 739 455 227 140 374

30-34yo 156 378 256 124 90 414

35-39yo 68 193 128 90 59 364

40-44yo 42 117 81 41 36 279

45-49yo 23 51 42 18 23 185

50 & ol der 12 49 48 29 20 176

*Note: 74 did not report age, 11 did not report sex, 10 did not report age and sex

Philippine HIV/AIDS Registry

MARCH 2012

Geographic Distribution
Region I II III IVA IVB V VI VII VIII IX X XI XII CAR CARAGA ARMM NCR % of Cases 2% 0 8% 13% <1% 2% 2% 15% 0 2% 2% 6% 1% <1% 1% 0 47%

Figure 7. New HIV Cases by Region, March 2012

ROTC 11% Reg 11 6% Reg 3 8%

Proportion of Cases

In March 2012, bulk of the new HIV cases came from NCR, Region 7, Region 4A, Region 3, Region 11, and Region 1 [Fig 7]. The three highest reporting regions were NCR, Region 4A, and Region 7.

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

100%

75%

50%

25%

0%

Reg 4A 13%

2012 Reg1 Reg3 Reg4A Reg6 2% 7% 12% 3% 13% 7% 50% 6%

2007-2011 2% 6% 12% 3% 9% 7% 54% 7%

1984-2012 2% 9% 12% 3% 9% 6% 51% 8%

NCR 47%

Reg 7 15%

Reg7 Reg11 NCR

*ROTC: Rest of the Country

ROT C*

Modes of Transmission (1984-2012)

In 2012, 90% (723) were infected through sexual contact, 9% (73) through needle sharing among injecting drug users, and <1% (3) through mother-to-child transmission (Table 2). There were 688 males and 35 females infected through sexual transmission. The age range of those infected through sexual transmission was 17-81 years old (median 28 years). Of the 9,163 HIV positive cases reported from 1984 to 2012, 91% (8,369) were infected through sexual contact, 4% (338) through needle sharing among injecting drug users, 1% (58) through mother-to-child transmission, <1% (20) through blood transfusion and needle prick injury <1% (3) [Table 2]. 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
Mode of Transmission Sexual Contact March 2012 n=313 280 Jan-Mar 2012 n=799 723 Cumulative N=9,163 8,369

Heterosexual contact Homosexual contact Bisexual contact

Blood/Blood Products Injecting Drug Use Needle Prick Injury Mother-to-Child No Data Available

48(17%) 143(51%) 89(32%)

0 31 0 2 0

98(14%) 367(51%) 258(36%)

0 73 0 3 0

2,974(36%) 3,255(39%) 2,140(26%)

20 338 3 58 375

Cumulative data shows 36% (2,974) were infected through heterosexual contact, 39% (3,255) through homosexual contact, and 26% (2,140) through bisexual contact. From 2007 there has been a shift in the predominant trend of sexual transmission from heterosexual contact (21%) to males having sex with other males (79%) [Figure 9].
Figure 9. Proportion of Types of Sexual Transmission, Jan 1984March 2012
100%

Figure 10. HIV Transmission by Age-Group, 2012 (n=799)

450 400

Number of Cases

90% 80%

350 300 250 200 150 100 50 0

Proportion of Cases

70% 60% 50% 40% 30% 20% 10% 0%

<7yo Blood Transfusion - Female Maternal to Child Injecting Drug Use - Female Injecting Drug Use - Male
'84 '85 1 0 0 7 2 1 '86 '87 '88 24 0 4 24 4 3 16 2 4 '89 '90 '91 19 2 6 35 4 8 30 4 15 '92 '93 '94 41 5 5 47 2 16 58 3 20 '95 '96 '97 56 8 21 81 7 30 82 7 25 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12

7-14yo 2 -

15-17yo 2 1

18-24yo 2 19 4 5 70 112

25-34yo 4 22 15 32 150 196

35-49yo 1 23 14 20 37 53

50&older 2 6 1 5

1 -

Heterosexual Contact - Female Heterosexual Contact - Male Bisexual Contact Homosexual Contact

Heterosexual Bisexual Homosexual

138 114 93 128 129 129 123 131 193 139 160 216 274 388 98 9 36 10 30 8 17 5 32 8 46 14 40 12 27 14 47 26 74 127 252 467 806 258

81 107 215 336 680 1036 367

Philippine HIV/AIDS Registry

MARCH 2012

Overseas Filipino Workers (OFW)

In 2012, there were 91 HIV positive OFWs, comprising 11% of cases reported for the year [Figure 11]. Of these, 81 (89%) were males and 10 (11%) were females. All were infected through sexual contact. There were 1,879 HIV positive OFWs since 1984, comprising 21% of all reported cases [Figure 11]. Seventy-seven percent (1,451) 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 (1,596) were asymptomatic while 15% (283) were AIDS cases.
Table 3. Mode of HIV Transmission Among OFWs
Mode of Transmission Sexual Transmission Mar 2012 Jan-Mar 2012 n=37 n=91 37 91 Cumulative N=1,879 1,817
2200 2000 1800 1600 1400 1200 1000 800 600 400 200 0
OFW Non-OFW % of OFW '84 1 1 '85 2 8 '86 0 29 '87 3 35 '88 9 23 '89 5 34 '90 10 56 '91 7 78 '92 14 58 '93 29 73 '94 31 87 '95 24 92 '96 35 '97 27 '98 51 138 '99 67 91 '00 60 63 '01 79 95 '02 96 88 '03 93 '04 86 '05 92 '06 '07 '08 '09 '10 '11 '12

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

Heterosexual contact Homosexual contact Bisexual contact

Blood/Blood Products Injecting Drug Use Needle Prick Injury No Data Available

17(46%) 13(35%) 7(19%)

0 0 0 0

26(29%) 32(35%) 33(36%)

0 0 0 0

1,124(62%) 387(21%) 306(17%)

10 1 3 48

Number of Cases

130 106 122 164 174 271 91

119 90

100 113 118 179 236 406 671 1417 2078 708

50% 20% 0%

8% 28% 13% 15% 8% 19% 28% 26% 21% 23% 23% 27% 42% 49% 45% 52% 48% 43% 44% 42% 31% 23% 20% 11% 12% 11%

Blood Units Confirmed for HIV

In March 2012, 34 blood units were confirmed positive for HIV by RITM. This was 143% higher compared to the same period last year (Table 4). 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 they underwent voluntary counseling and testing as individuals.
Table 4. Number of Confirmed HIV Positive Blood Units Month January February March April May June July August September October November December Total 69 2012 17 18 34 2011 11 15 14 20 10 32 22 18 10 22 17 18 209

PLHIV on Anti-Retroviral Therapy

As of January 2012, there are 2,087* People Living with HIV presently on Anti-Retroviral Therapy (ART). Data for March is not yet available.
Table 5. Number of PLHIV on ART Month January February March April May June July August September October November 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.
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

2012 2,087
Data not yet available Data not yet available