Philippines faces alarming rise in HIV infections

The waiting room on the third floor of a bustling Manila shopping mall feels like a cozy lounge. Young men and women sit on a plush, light blue sofa next to a table where condoms — plain and chocolate flavor — and lubricants are lined up next to tiny pamphlets with tips to keep hookups fun and safe. 

Dr. Jeremy Jordan Castro, medical officer of the Klinika Eastwood HIV and sexually transmitted infection (STI) testing center, told DW that the focus on wellness rather than illness is deliberate.

"We want to normalize HIV and STI testing as part of regular health care. With advancements in medication and technology, HIV is now manageable like other chronic conditions such as hypertension or diabetes."

Most of the clinic services, which include STI screening as well as medications to prevent HIV before or after potential exposure, are free and are explained by a gender-diverse team trained to provide confidential counseling.

Klinika Eastwood is part of the government's broader efforts to destigmatize sexual health care, encourage HIV testing and treatment and reverse the Philippines' continuous rise in HIV infections, especially among young people.

According to the UNAIDS global report released earlier this month, the country has seen a staggering 543% increase in new infections between 2010 and 2023. While still a low incidence country with a total number of people living with HIV (PLHIV) recorded at 189,900 last year, the Department of Health (DOH) warned that if the current trend continues, the number of PLHIV could reach 448,000 by 2030.

Young people most affected by HIV

Against a general global trend of managing and reducing HIV infections, the Philippines stands as an outlier, grappling instead with an estimated 50 new infections diagnosed a day. Nearly half of new infections in 2024 were among individuals aged 15-24 years, with MSM (men who have sex with men) accounting for 89% of these cases.

"We're seeing infection rates reminiscent of New York or San Francisco during the height of the AIDS crisis in the 1980s," Benedict Bernabe, head of the HIV advocacy and awareness group The Red Whistle, told DW.

Bernabe noted that since 2005, new infections have shifted primarily to men who have sex with men and emphasized the need for government health resources to adapt, focusing on increased testing and targeted interventions for this demographic.

Gibby Gorres of Southeast Asia Against Stigma collective acknowledged that the rise in recorded HIV cases among the youth partly reflects the government's decision to lower the HIV testing age without parental consent to 15. However, he warned against moral panic in the predominantly Catholic country.

"We cannot afford to ignore that young people are sexually active, some perhaps with one or multiple partners. We need to equip them with correct sexual health information and allow them safe access to testing and treatment," said Gorres.

'We want to normalize HIV and STI testing as part of regular health care,' said Dr. Jeremy Jordan Castro, medical officer of the Klinika Eastwood HIV and sexually transmitted infection (STI) testing centerImage: Ana P. Santos/DW

Missed opportunities for early intervention

One in three people living with HIV in the Philippines is diagnosed at a late stage, often after the diagnosis of underlying infections like tuberculosis or pneumonia. In 2023, delayed diagnoses contributed to 1,700 AIDS-related deaths, despite global advancements in treatment such as pre- and post-exposure prophylaxis, which are available for free in state-run clinics.

However, government data shows that only 13% of key populations are aware of pre-exposure prophylaxis, and just 60% know that HIV testing is free.

"The high rate of late diagnoses underscores the urgent need for accessible and timely HIV testing," Lui Ocampo, executive director of UNAIDS Philippines told DW. Currently, it's estimated that nearly 40% of PLHIV in the Philippines are undiagnosed, with misconceptions about HIV and low levels of awareness persisting. Among key populations like transgender women (TGW) and female sex workers (FSW), knowledge about HIV remains alarmingly low, hovering at roughly 30%.

Still a long way to go

Elena Felix has been living with HIV for 30 years. The 66-year-old grandmother recalls her diagnosis in the 1990s, when doctors gave her just ten years to live.

Today, Felix is a staunch advocate for HIV rights and leads the Association of Positive Women Advocates Inc. (APWAI), a support and advocacy group for women living with HIV. She was one of the complainants in a high-profile case against lawyer Larry Gadon who insinuated that former President Benigno Aquino III died of AIDS. Aquino died from a kidney disease in 2021.

Gadon went as far as heckling and threatening PLHIV individuals planning to file a complaint, warning they would be subjected to public humiliation. Earlier this year, the Supreme Court ruled for the disbarment of Gadon. Felix hopes the victory sends a powerful message: HIV status should never be used to shame or discredit anyone.

"If some people think that they can use HIV misinformation to shame and humiliate a former president, it can be very damaging and discouraging especially for young people. We need to change this mindset of victim-blaming that says that if you get HIV, it's a death sentence of your own doing," Felix told DW.

Edited by: Srinivas Mazumdaru