The Research Institute for Tropical Medicine (RITM), through its AIDS Research Group (ARG), conducted a three-day HIV Clinical Care Training among healthcare workers of the Armed Forces of the Philippines (AFP) from June 21-23, 2023 at the Philippine Army General Hospital, Taguig City.
A total of forty-three (43) health service personnel, including doctors, nurses, and medical technologists from the Philippine Army General Hospital, Philippine Navy Manila Naval Hospital, Philippine Air Force General Hospital, National Reference Laboratory – San Lazaro Hospital/STD AIDS Cooperative Central Laboratory (NRL-SLH/SACCL), and Victoriano Luna (V.Luna) General Hospital, attended and participated in the training.
Clinical Research Division (CRD) OIC-Chief Dr. Rossana Ditangco, led the RITM team. On the first day, Dr. Natasha Julienne M. Delgado, Medical Officer III of the Medical Department, discussed the different clinical conditions associated with the HIV disease, such as sexually transmitted infections (STIs), pulmonary tuberculosis, hepatitis B and hepatitis C, and COVID-19. Dr. Ditangco and Dr. Delgado also delivered discussions on appropriate treatment and prevention such pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
On the second day, Dr. Delgado discussed the psychosocial consequences and issues related to HIV such as non-communicable diseases (NCDs) and Mental Health. This was followed by Dr. Ditangco’s discussions on immunopathogenesis and virologic, immunologic, and clinical course of HIV infection. She also discussed the principles and strategies on the holistic management of patients with HIV.
An in-depth discussion on HIV basic counselling and adherence counselling was facilitated by Mr. Roldan S. Bucal, RN, Nurse III of the HIV/AIDS Core Team and ARG Clinic Manager of the Medical Department. On the last day of the training, the participants were able to focus on the natural history of HIV, its clinical management, pediatric HIV, principles of antiretroviral therapy (ART), and antiretrovirals (ARVs) in the Philippines.
HIV remains as a global public health issue, with ongoing transmission in all countries globally. In 2021, the World Health Organization (WHO) reported 38.4 million people living with HIV, 650,000 people died from HIV-related causes, and 1.5 million people acquired HIV. In the Philippines, the Department of Health (DOH) recorded 4,819 HIV cases, including 141 deaths for the first three months of 2023. Based on the HIV/AIDS Registry of the Philippines Report, in March 2023 alone, 2,078 new HIV cases were recorded with 57 deaths. The report also identified sexual contact as the most common mode of HIV transmission with 2,025 cases. Out of the 2,025 cases, 1,478 accounted for male-to-male sex, 343 for sex with male and female, and 204 for male-to-female sex.
The DOH also projected that by 2030, HIV cases will reach 364,000, with nearly half of the new infections aged 15 to 24 years old. It is also reported that the HIV epidemic in the country is concentrated among key and vulnerable populations, including men having sex with males, transgender women, female sex workers, people who inject drugs, young key population, as well as women and children. Although testing and treatment is available in the country, stigma and discrimination prevents people with HIV to seek consult, get tested, and get treated for HIV infection.
In 2021, the US Military HIV Research Program (MHRP) along with the Armed Forces Research Institute for Medical Sciences (AFRIMS) and the Department of Defense’s HIV/AIDS Prevention Program’s (DOD-DHAPP), received funding from the United States Agency for International Development’s (USAID) DOD’s President’s Emergency Plan for AIDS Relief (DOD-PEPFAR) to develop a military-military partnership in the Philippines. Through a security cooperation partnership between the US DOD and the AFP, various activities, such as policy assessment, lab strengthening, clinical training, and diagnostic capabilities to improve HIV prevention, testing, treatment, and surveillance, make up the program. These activities were coordinated through the Joint United States Military Assistance Group (JUSMAG)-Philippines.
The three-day training on HIV clinical care among AFP healthcare workers is one of the activities of the DOD PEPFAR Philippines Program targeted to enhance prevention and case finding and to strengthen care and treatment through capacity-building of its healthcare workers on HIV clinical care. At present, the V. Luna Medical Center is the dedicated hospital for the AFP, with the provision of treatment and care for most of the HIV-positive people and PLHIVs being referred to V. Luna. After the training, the AFP healthcare workers are expected to lead the primary care treatment and implementation of prevention programs on HIV within their respective health facilities and/or military treatment facilities (MTFs), including the establishment of their own HIV and AIDS Core Team (HACT) and/or establishment of OPD clinic for HIV.
Dr. Maribel Develos, Technical Director of the DOD PEPFAR Philippines Program, presented to the group the AFP HIV Program Roadmap to 2030. She highlighted the two (2) main components of the program – enhanced prevention and case finding; and strengthened care and treatment. Dr. Develos called for the participation and commitment of the healthcare workers of the AFP in reaching the goals of the HIV Program. Through mutual cooperation and joint effort between DOD PEPFAR and the AFP, the program aims to reach the following targets – 2-3 trained staff deployed to all 49 MTFs; establishment of HIV treatment hub and rapid HIV diagnostic algorithm (rHIVda) certification of MTFs with existing capabilities; and inclusion of STI and HIV prevention, stigma and discrimination reduction in the training curriculum of all military trainings. By 2030, the program aims to reach 9 to 10 military camps and 28,500 military personnel per year.
An AFP-wide campaign launch on the AFP HIV Program is set to take place on July 20, 2023 with the campaign hashtag of #EveryBuddyLabanSaHIV.