XVIII International AIDS Conference

Abstract

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Tracking HIV trends in a low prevalence country signals change in the epidemic (Philippines, 2009)

Presented by Genesis May Samonte (Philippines).

G.M. Samonte1, N. Palaypayon1, E. Telan2, A. Segarra1, E. Tayag1


1National Epidemiology Center, Department of Health, Manila, Philippines, 2SACCL, National HIV Reference Laboratory, Department of Health, San Lazaro Hospital, Manila, Philippines

Background: The Philippines is a low HIV prevalence country with few new cases being either migrant workers or female sex workers (FSW). Until 2007, less than 350 new cases were reported annually to the National HIV Registry. The 2005 and 2007 National Integrated HIV Behavioral and Serologic Surveillance (IHBSS) also showed very low HIV prevalence among the most-at-risk populations (MARP). In 2008, new cases increased to 528. This alerted the Department of Health to determine if the Philippine HIV epidemic was changing.
Methods: IHBSS was done in 23 major cities in the Philippines. Simple random sampling was used for FSW in registered establishments (RFSW), time location sampling for freelance FSW (FFSW) and males having sex with males (MSM), and respondent driven sampling for injecting drug users (IDU). Serologic samples were tested for HIV, syphilis and hepatitis C.
Results: 14,976 respondents participated. Knowledge of HIV prevention increased but risky behaviour remained high. Condom use during last sex was 72% (RFSW), 62% (FFSW), and 22% (MSM, IDU). 14% of MARPs brought a condom. Up to 82% shared needles. Serologic prevalence is shown in Table 1. In one site, HIV positive FFSW and MSM were also IDU.

MARPnHIV (%)Syphilis (%)Hepatitis C (%)
Registered FSW5,3220.130.360.0 (only one site)
Freelance FSW4,1540.392.4120.9 (only one site)
MSM4,5420.992.097.9 (only one site)
IDU9580.212.3035.2
[Prevalence of HIV, Syphilis and Hepatitis C]


Conclusions: The HIV epidemic in the Philippines has changed. The 2009 IHBSS revealed MSM and IDU had the highest risk for HIV infection. The low HIV infection among RFSW may be due to access to strong prevention programs. Results are being used to strengthen programs and redirect national and local response strategies to halt HIV transmission.


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