Published in RITM Update Volume 1 Issue 3 (October to December 2014)

He also described himself as “happy-go-lucky” and “careless” – changing partners and engaging in “kiss-and-tells” as often as he could.

That was Marvin, just barely a year ago. After a report in class, his life changed entirely. Marvin, then a 4th year dentistry student, was assigned to do a report on the Human Immunodeficiency Virus or HIV. As he dug deeper into his references, he became more and more alarmed – his newfound knowledge gave explanation to his recurring fevers, rashes, and creamy white patches appearing on his mouth.

A week after his report, he went to the RITM Satellite Clinic in Malate to get tested for HIV. His results were positive.

Rising Cases

Marvin is just one of the 35 million people living with HIV worldwide. HIV, the virus that causes Acquired Immune Deficiency Syndrome (AIDS), destroys the immune system and weakens the body’s ability to fight infections and diseases (UNAIDS, 2011). The cure for HIV has not yet been found, but antiretroviral drugs prevent its progression to AIDS.

In the Philippines, there have been 22,527 recorded HIV cases since the first cases were registered in 1984 (Department of HealthNational Epidemiology Center, 2014).

As years passed, not only the figures have changed, but also the profile of the people infected by the virus. Dr. Rosanna Ditangco, head of the RITM AIDS Research Group (ARG), shared that heterosexual overseas Philippine workers used to comprise most of the HIV cases seen at RITM. In 2006, they started seeing a surge in the number of cases among men who have sex with men (MSMs) who are less than 30 years old.

In the December 2014 Philippine HIV/AIDS Registry, 509 new cases were registered, and nearly half of these new infections (250) were transmitted through male-to-male sexual contact. This group is 19 times more likely to be infected by HIV compared to the general population, according to the World Health Organization (WHO).

Some experts believe that social media, combined with risky behavior and unsafe sex practices, may be one of the factors fueling the alarming rise of HIV infections among the youth, particularly the MSM sector.

Easy Access

A study by the Department of Health (DOH) in 2011 concluded that there is a link between social media and the rise of HIV/AIDS cases among MSM. Of the 180 respondents in the study, more than half (67%) said that they use social media for both dating and sex. Three out of four reported having sex with people they met online.

There are many social networking sites that cater to the MSM community. In these sites, users can upload a personal profile and search for others’ as well. One of the more popular sites is Planetromeo, which Marvin used to frequent for ‘one-night-stands’.

According to the DOH study, it could take about five minutes to over a day to find a sexual partner through social networking sites. The number of sexual partners reported by the respondents attest to the ease of finding partners online – some respondents said they had around 500 sex partners in a year, while the average number of sexual partners found through social networking sites is 82 per year.

“There are indications that MSM who meet online have more opportunities for unsafe sex with multiple partners,” said Dr. Eric Tayag of the DOH in an interview with online-based news platform IRIN/PlusNews Media.

Online Interventions

Since most of the people-at-risk are online, advocates of HIV/AIDS prevention including the RITM-ARG and its partner, The Love Yourself (TLY) Foundation, have now gone online, too. They have been actively harnessing social media to promote HIV awareness and prevention among MSM and other high-risk populations.

“We launch social media-based campaigns and use information and communication technologies. We attract our target population [MSM] by devising tailorfit interventions,” said Vinn Pagtakhan, Executive Director of TLY Foundation. RITM partnered with The Love Yourself Project to reach the MSM commnity. MSM volunteers from TLY are trained by RITM to become peer educators or change agents.

“Change agents are MSMs who can be role models to their clients – they are sexually active but they remain negative. I engaged them because they speak the same language,” said Dr. Ditangco.

Instead of going to physical “hotspots” where MSMs gather, the change agents made the internet their hotspot. They have partnered with social networking sites to reach the MSM community better.

“We found that these sites are also good vehicles to disseminate information. They help us disseminate information via message blasts and advertisements. As an example, we had an event with RITM in November, a special mass testing for men in Quezon City, and it was attended by more than 200 people in that single day. A lot of those who attended found the information through those sites, “said Chris Lagman, Learning and Development Manager of TLY.

Because of these sites, it has become easier for MSM to find TLY if they need to ask questions. TLY has volunteers who conduct online Q&A in these sites. 80% of the questions that they get is about HIV Testing: “’Where can I find a testing center?”, “Is it free?”, “Will other people see me during testing?”, “Who will do the test?”, “Basically, their questions revolve around the usual fears of MSM: to be discovered as MSM or to be seen getting tested,” explained Chris.

Aside from using social networking sites, TLY also uses its website to encourage MSM to get tested. TLY’s website, which has an average 2.5 million hits per year, has an online-based registration for those who need assistance in getting tested. This service accommodates around 100 cases per week.

“We have a group of at least 10 people for this service. We call them the case management team. These case management people are also trained HIV counselors,” said Chris.

Continuum of Care

Aside from encouraging testing, RITM and TLY also aim to reduce the gap between the patients’ diagnosis and treatment. To achieve this, the RITM Satellite Clinic, operated in partnership with TLY, implements a continuum of care model. This ensures that the people who tested positive will be immediately linked to care.

Dr. Ditangco explained that when the two rapid same-day HIV tests are reactive, the change agents immediately conduct counselling to the patients, and transfer them to the RITM hospital for CD4 Testing. The counsellors accompany their clients to RITM hospital or provide them with clear directions on how to find the place. RITM aims to minimize the gap between diagnosis and treatment by ensuring that patients begin with medical treatment immediately.

Marvin is now one of the many change agents at RITM. Through one-one-one counselling, he tries to empower them to lift their self-esteem.

Promising Results

The success of these online interventions and continuum or care is evident on the statistics in Philippines HIV/AIDS Registry.
“If you’ll look at the number of people we tested and number of people who turned out to be positive through our efforts for the whole of Metro Manila, 40% of all newly diagnosed people living with HIV actually came from the efforts of RITM and TLY.

Technology may have contributed to the rise of HIV infection cases, but it has also provided HIV advocates with opportunities to reach the MSM and other at-risk population better.

“I do think that it is successful. I don’t think it alone can solve the issue but I believe it’s a good addition to the portfolio of approaches that the Philippines already has.”, explained Chris.

Technology has changed a lot since the first HIV infection case was found. Strategies for HIV and AIDS prevention must also evolve and keep up with these changes to remain effective and relevant.