A Systematic Review in Literature in Trends and Challenges in HIV Risk and Prevention Research in the Philippines


Authors : Gemelyn S. Hermosura; Zyrene Joy Ethyl Arobio; Shane M. Landicho; Gecelene C. Estorico

Volume/Issue : Volume 9 - 2024, Issue 11 - November

Google Scholar : https://tinyurl.com/yc24jcet

Scribd : https://tinyurl.com/mrdezwtx

DOI : https://doi.org/10.5281/zenodo.14332505

Abstract : The Philippines is experiencing a rapid rise in HIV cases, placing it among the fastest growing HIV epidemics in the Asia-Pacific region. The epidemic disproportionately affects key populations including MSM, transgender women, sex workers, and PWID-men and women who inject drugs. The members of these groups face a number of barriers to accessing HIV prevention and treatment services, including stigma and discrimination as well as inequalities in access to healthcare across geographic regions. The objective of this systematic review is to review the trends, risk factors, barriers, and effectiveness of HIV prevention interventions in the Philippines, focusing specifically on studies published between 2000 and 2024. Utilizing the PRISMA methodology, 21 studies were identified based on relevance to HIV risk and prevention among critical populations. Thus, it shows that there is a worrying upward trend in HIV incidence, especially among PWID, with prevalence peaking at 75% in 2010 in Metro Cebu. Stigma and provider mistrust, as well as significant barriers related to access to healthcare facilities, determined low testing rates and delayed treatment. Promising interventions included rights-based education, community-led HIV care models, and HIVST, each demonstrating positive outcomes in increasing testing and treatment initiation. However, for these programs to achieve long-term effects, they must be scaled up and sustained. The results point to the urgent need for culturally relevant interventions and policy reforms that will combat stigma, ensure comparable access to services for all marginalized groups, bridge prevailing gaps in this research, including regarding young persons and the rural sector, and increase the public health response and imperative inclusive approaches to change the trajectory of the HIV epidemic in the Philippines.

Keywords : Rapid Rise in HIV Cases, Key Populations, MSM (Men Who Have Sex With Men), PWID (People Who Inject Drugs), Stigma and Discrimination, Inequalities in Access to Healthcare.

References :

  1. Farr, A. C., & Wilson, D. P. (2010). An HIV epidemic is ready to emerge in the Philippines. Journal of the International AIDS Society, 13, 1-8. https://link.springer.com/article/10.1186/1758-2652-13-16 
  2. UNAIDS. (2022). Philippines: HIV and AIDS   estimates. https://www.unaids.org/en/regionscountries/ countries/philippines
  3. Department of Health [DOH]. (2023). Philippine HIV/AIDS Registry. Retrieved from https://doh.gov.ph/  
  4. World Health Organization [WHO]. (2023). HIV/AIDS data and statistics: Philippines. https://www.who.int/westernpacific/healthtopics/hiv-aids/regional-data
  5. Lopez, S. M. J., Ramiro, V. R., & Roxas, E. (2017). Measuring stigma and discrimination towards people living with HIV among health care workers in a tertiary, government teaching hospital in the Philippines. Acta Medica Philippina, 51(4). https://actamedicaphilippina.upm.edu.ph/ind ex.php/acta/article/view/502
  6. Cáceres, C. F., Konda, K., Segura, E. R., & Lyerla, R. (2008). Epidemiology of male same-sex behaviour and associated sexual health indicators in low-and middle-income countries: 2003–2007 estimates. Sexually transmitted infections, 84(Suppl 1), i49-i56. https://sti.bmj.com/content/84/Suppl_1/i49.s hort
  7. Joint United Nations Programme on HIV/AIDS (UNAIDS). (2017). UNAIDS Data 2017. Available    at: http://www.unaids.org/sites/default/files/me dia_asset/20170720_Data_book_2017_en.pdf  
  8. Oguya, F. O., Kenya, P. R., Ongecha, F., Mureithi, P., Musyoka, H., Muraguri, N., Mundia, B., Angira, C., Shose, M., Basheeb, T. A., Mohamed, A. A., Oyore, J. P., Ochieng, O. G., Dida, G. O., Abdalla, S., & Abdool, R. (2021). Rapid situational assessment of people who inject drugs (PWID) in Nairobi and coastal regions of Kenya: a respondent driven sampling survey. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-11373-9  
  9. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., & McGuinness, L. A. (2021). The PRISMA 2020 statement: an Updated Guideline for Reporting Systematic Reviews. British Medical Journal, 372(71). https://doi.org/10.1136/bmj.n71
  10. Alibudbud, R. (2022). Social and Psychological Factors Influencing HIV Sexual Risk Behaviors among Young Adult Filipino Men Who Have Sex with Men (MSM) in Metro Manila. Sexual Health & Compulsivity, 1–18. https://doi.org/10.1080/26929953.2022.2056555  
  11. Amadora-Nolasco, F., Alburo, R. E., Aguilar, E. J. T., & Trevathan, W. R. (2001). Knowledge, Perception of Risk for HIV, and Condom Use: A Comparison of Registered and Freelance Female Sex Workers in Cebu City, Philippines. AIDS and Behavior, 5(4), 319–330. https://doi.org/10.1023/a:1013182706030  
  12. Amit, J. M. L., Jimenez, S. J. A., Magno, C. J. C. O., Andaya, A. R. Y., & Saniel, O. P. (2015). Knowledge, Attitudes, Sexual Behaviors and Utilization of Health Services among Filipino Men who have Sex with Men (MSM). Acta Medica Philippina, 49(3). https://doi.org/10.47895/amp.v49i3.940  
  13. Bustamante, J., & Plankey, M. W. (2022). Identifying Barriers to HIV Testing Among Men Who Have Sex with Men (MSM) in the Philippines. Georgetown Medical Review, 6(1). https://doi.org/10.52504/001c.36967  
  14. de Lind van Wijngaarden, J. W., Ching, D., Settle, E., van Griensven, F., Cruz, R. C., & Newman, P. A. (2018). “I am not promiscuous enough!”: Exploring the low uptake of HIV testing by gay men and other men who have sex with men in Metro Manila, Philippines. PLOS ONE, 13(7), e0200256. https://doi.org/10.1371/journal.pone.0200256  
  15. De, R. Q., & Operario, D. (2024). Characterizing the “HIV Care Adherence Journey” for Persons With HIV in the Philippines: Conceptual Foundation for Person-Centered Intervention. Journal of the Association of Nurses in AIDS Care, 35(4), 325–338. https://doi.org/10.1097/jnc.0000000000000461  
  16. Estacio, L., Estacio, J. Z., & Alibudbud, R. (2021). Relationship of Psychosocial Factors, HIV, and Sex Work Among Filipino Drug Users. Sexuality Research and Social Policy. https://doi.org/10.1007/s13178-021-00563-0  
  17. Eustaquio, P. C., Docken, S. S., Leyritana, K. T., & Wulandari, L. P. L. (2021). HIV care cascade among cisgender men who have sex with men in a key population-led community center in the Philippines. International Journal of STD                & AIDS, 32(8), 718–728. https://doi.org/10.1177/0956462420987435  
  18. Eustaquio, P. C., Figuracion, R., Izumi, K., Morin, M. J., Samaco, K., Flores, S. M., Brink, A., & Diones, M. L. (2022). Outcomes of a community-led onlinebased HIV self-testing demonstration among cisgender men who have sex with men and transgender women in the Philippines during the COVID-19 pandemic: a retrospective cohort study. BMC  Public Health, 22(1). https://doi.org/10.1186/s12889-022-12705-z  
  19. Freda, E., May, G., Abellanosa‐TacAn, I. P., Alesna, E. T., Leaño, S. A., Ethyl, Y., Akeno Tsuneki, Matsumoto, K., & Kageyama, S. (2011). The early phase of an HIV epidemic in a population exposed previously to HCV in the Philippines. Journal of Medical Virology, 83(6),       941–947. https://doi.org/10.1002/jmv.22070  
  20. Hernandez, L. I., & Imperial, R. H. (2024). View of Men-who-have-Sex-withother-Males (MSM) in the Philippines – Identities, Sexualities and Social Mobilities: A Formative Assessment of HIV and AIDS Vulnerabilities. Upm.edu.ph.  https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/5077/3148  
  21. Montegrico, J., Lee, J.-M., & Alexis, J. (2024). A 13-Year Trend Analysis of HIV Epidemiology in the Philippines (2010 to 2022). Journal of Community Health Nursing,             1–15. https://doi.org/10.1080/07370016.2024.2365146  
  22. Morisky, D. E. (2004). A model HIV/AIDS risk reduction programme in the Philippines: a comprehensive community-based approach through participatory action research. Health Promotion International, 19(1), 69–76. https://doi.org/10.1093/heapro/dah109  
  23. O’Connor, C., Leyritana, K., Calica, K., Gill, R., Doyle, A. M., Lewis, J. J., & Salvaña, E. M. (2021). Risk factors affecting adherence to antiretroviral therapy among HIV patients in Manila, Philippines: a baseline cross-sectional analysis of the Philippines Connect for Life Study. Sexual Health, 18(1), 95. https://doi.org/10.1071/sh20028  
  24. Restar, A. J., Quilantang, Ma. I. N., Surace, A., Ogunbajo, A., Chan, R., Adia, A., Cu-Uvin, S., & Operario, D. (2022). Characterizing Problematic Drug Use Among Transgender Women and Cisgender Men During the Emerging HIV Crisis in the Philippines: Implications for Policy Research. AIDS Education and Prevention, 34(2), 116– 130. https://doi.org/10.1521/aeap.2022.34.2.116  
  25. Restar, A., Surace, A., Adia, A., Goedel, W., Ogunbajo, A., Jin, H., Edeza, A., Hernandez, L., Cu-Uvin, S., & Operario, D. (2022). Characterizing Awareness of Pre-Exposure Prophylaxis for HIV Prevention in Manila and Cebu, Philippines: Web-Based Survey of Filipino Cisgender Men Who Have Sex with Men. Journal of Medical Internet Research, 24(1)e24126.  https://doi.org/10.2196/24126  
  26. Rodenie Arnaiz Olete, Strong, C., Katerina Leyritana, Bourne, A., & NaiYing Monica Ko. (2024). ChemsexPH: The association between chemsex, HIV status and adherence to antiretroviral therapy among men who have sex with men in the Philippines. Journal of the International AIDS Society, 27(7). https://doi.org/10.1002/jia2.26323  
  27. Sison, O. T., Baja, E. S., Bermudez, A. N. C., Quilantang, Ma. I. N., Dalmacion, G. V., Guevara, E. G., Garces-Bacsal, R. M., Hemingway, C., Taegtmeyer, M., Operario, D., & Biello, K. B. (2022). Association of anticipated HIV testing stigma and provider mistrust on preference for HIV self-testing among cisgender men who have sex with men in the Philippines. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-14834-x  
  28. Urada, L. A., Silverman, J. G., Cordisco Tsai, L., & Morisky, D. E. (2014). Underage youth trading sex in the Philippines: trafficking and HIV risk. AIDS Care, 26(12), 1586–1591. https://doi.org/10.1080/09540121.2014.936818  
  29. Urada, L. A., Simmons, J., Wong, B., Tsuyuki, K., Condino-Enrera, G., Hernandez, L. I., Simbulan, N. P., & Raj, A. (2016). A human rights-focused HIV intervention for sex workers in Metro Manila, Philippines: evaluation of effects in a quantitative pilot study. International Journal of Public Health, 61(8), 945– 957. https://doi.org/10.1007/s00038-016-0875-z  
  30. Verdery, A. M., Siripong, N., & Pence, B. W. (2017). Social Network Clustering and the Spread of HIV/AIDS Among Persons Who Inject Drugs in 2 Cities in the Philippines. JAIDS Journal of Acquired Immune Deficiency Syndromes, 76(1), 26–32. https://doi.org/10.1097/qai.0000000000001485  

The Philippines is experiencing a rapid rise in HIV cases, placing it among the fastest growing HIV epidemics in the Asia-Pacific region. The epidemic disproportionately affects key populations including MSM, transgender women, sex workers, and PWID-men and women who inject drugs. The members of these groups face a number of barriers to accessing HIV prevention and treatment services, including stigma and discrimination as well as inequalities in access to healthcare across geographic regions. The objective of this systematic review is to review the trends, risk factors, barriers, and effectiveness of HIV prevention interventions in the Philippines, focusing specifically on studies published between 2000 and 2024. Utilizing the PRISMA methodology, 21 studies were identified based on relevance to HIV risk and prevention among critical populations. Thus, it shows that there is a worrying upward trend in HIV incidence, especially among PWID, with prevalence peaking at 75% in 2010 in Metro Cebu. Stigma and provider mistrust, as well as significant barriers related to access to healthcare facilities, determined low testing rates and delayed treatment. Promising interventions included rights-based education, community-led HIV care models, and HIVST, each demonstrating positive outcomes in increasing testing and treatment initiation. However, for these programs to achieve long-term effects, they must be scaled up and sustained. The results point to the urgent need for culturally relevant interventions and policy reforms that will combat stigma, ensure comparable access to services for all marginalized groups, bridge prevailing gaps in this research, including regarding young persons and the rural sector, and increase the public health response and imperative inclusive approaches to change the trajectory of the HIV epidemic in the Philippines.

Keywords : Rapid Rise in HIV Cases, Key Populations, MSM (Men Who Have Sex With Men), PWID (People Who Inject Drugs), Stigma and Discrimination, Inequalities in Access to Healthcare.

Video Explanation for Published paper

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe