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APRIL 2012

DEPARTMENT OF HEALTH NATIONAL EPIDEMIOLOGY CENTER

In April 2012, there were 233 new HIV Ab sero-positive individuals confirmed by the STD/AIDS Cooperative Central Laboratory (SACCL) and reported to the HIV and AIDS Registry (Table 1). This was 36% higher compared to the same period last year (n=171 in 2011) [Figure 1].

Table 1. Quick Facts

Most of the cases (97%) were males. The median age was 27 years (age range: 19-66 years). The 20-29 year (62%) age-group had the most number of cases. Fifty percent (117) of the reported cases were from the National Capital Region (NCR).

Females Youth 15-24yo Children <15yo Reported Deaths due to AIDS

0 1

Demographic Data

April 2012

Jan-April 2012

Cumulative 1984â&#x20AC;&#x201D;2012

233 225

1,032 992

9,396 8,378

Total Reported Cases Asymptomatic Cases AIDS Cases Males

8

40

1,018

225

982

7,872*

8

50

1,513*

74

289

2,206

3 7

61 350

*Note: No data available on sex for (11) cases.

Reported mode of transmission were sexual contact (210) and needle sharing among injecting drug users (23) [Table 2, page 3]. Males having sex with other males (88%) were the predominant type of sexual transmission [Figure 2]. Most (97%) of the cases were still asymptomatic at the time of reporting [Figure 3].

Figure 1. Number of New HIV Cases per Month (2010-2012) Number of New Cases

350

AIDS Cases Of the 233 HIV positive cases, eight were reported as AIDS cases, all were males. The median age is 26 years (age range: 22-66 years). All cases acquired the infection through sexual contact (6 homosexual, 1 bisexual and 1 heterosexual). Of the AIDS cases, there was one reported death for this month; a 22 year old male.

300 250 200 150 100 50 0 Jan

Feb

M ar

A pr

M ay

Jun

Jul

A ug

Sep

Oct

Nov

Dec

2010

143

130

120

154

153

109

131

108

153

104

112

174

2011

152

159

172

171

184

178

204

196

253

200

212

268

2012

212

274

313

233

Figure 2. Comparison of the Proportion of Types of Sexual Transmission in 2012, 2011 & Cumulative Data (1984-2012)

Overseas Filipino Workers (OFW)

Heterosexual

100%

Proportion of Cases

Philippine HIV and AIDS Registry

Newly Diagnosed HIV Cases in the Philippines

Eighteen of the 233 (8%) reported cases were OFWs [Figure 11, page 4]. There were 15 males and 3 females. The median age was 33 years (age range: 23-46 years). All acquired the infection through sexual contact (3 heterosexual, 10 homosexual, and 5 bisexual).

26

23

Bisexual

3,000 75%

71

Homosexual

52 2,211

50%

25%

113

92

A p r il 2 0 12

A p r il 2 0 11

3,368

0%

C umulat ive

Figure 3. Number of HIV/AIDS Cases Reported in the Philippines by Year, Jan 1984 to April 2012 (N=9,396) 2500 2250 2000 1750 1500 1250 1000 750 500 250 0

'84

'85

'86

'87

'88

'89

'90

'91

'92

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

T OT A L

2

10

29

38

32

39

66

85

72

102

118

116

154

117

189

158

123

174

184

193

199

210

309

342

528

835

1591

2, 349

1, 032

A sympt omat i c

0

6

18

25

21

29

48

68

51

64

61

65

104

94

144

80

83

117

140

139

160

171

273

311

506

804

1563

2, 241

992

A I DS

2

4

11

13

11

10

18

17

21

38

57

51

50

23

45

78

40

57

44

54

39

39

36

31

22

31

28

108

40

Deat h

2

4

10

12

9

8

15

13

13

11

19

24

27

10

16

17

9

20

11

11

8

16

18

10

7

1

3

*19

7

*Nine initially asymptomatic cases reported in 2011, died due to AIDS that same year.

1


April 2012

Philippine HIV/AIDS Registry

AIDS Cases (1984-2012) Of the 1,032 HIV positive cases in 2012, forty were reported as AIDS cases. Of these, 39 were males and 1 was female. Ages ranged from 7-81 years (median 32 years). Ninety-eight percent (39) acquired the infection through sexual contact (19 homosexual, 15 bisexual and 5 heterosexual) and 2% (1) mother-to-child transmission.

Figure 4. Proportion of Modes of Transmission of AIDS Cases by Year, Jan 1984â&#x20AC;&#x201D;April 2012 100%

Proportion of Cases

75%

From 1984 to 2012, there were 1,018 AIDS cases reported. Seventy-four percent (757) were males. Median age is 35 years (age range: 1-81 years). Of the reported AIDS cases, 350 (34%) had already died at the time of reporting. Sexual contact was the most common mode of HIV transmission, accounting for 94% (953) of all reported AIDS cases. Half (479) of sexual transmission was through heterosexual contact, followed by homosexual contact (343) then bisexual contact (131). Other modes of transmission include: mother-to-child transmission (19), blood transfusion (10), injecting drug use (6), and needle prick injuries (2) [Figure 4]. Three percent (28) of the AIDS cases did not report mode of HIV transmission.

50%

25%

0% 1984-2008

2009

2010

2011

2012

Needl e P r i c k

2

0

0

0

0

B l ood T r ans f us i on

10

0

0

0

0

M T CT

16

1

0

1

1

I DU

4

0

0

2

0

B i s ex ual Cont ac t

64

8

7

37

15

Homos ex ual Cont ac t

245

16

18

45

19

Het er os ex ual Cont ac t

442

6

3

23

5

*Note: 28 did not report mode of transmission

Demographic Characteristics (1984-2012) Figure 5. Proportion of Sex & Age-Groups in April 2012 & Jan-April 2012 100%

Proportion of Cases

In 2012, there were a total of 1,032 cases reported. 95% of the cases reported were males (982). Ages ranged from 2-81 years old (median 28 years). The 20-29 year old age group (58%) had the most number of cases for 2012. For the male age group, the most number of cases were found among the 20-24 years old (26%), 25-29 years old (32%), and 30-34 years old (20%) [Figure 6]. From 1984 to 2012, there were 9,396 HIV Ab sero-positive cases reported (Table 1), of which 8,378 (89%) were asymptomatic and 1,018 (11%) were AIDS cases. As shown in Figure 6, there is a significant difference in the number of male and female cases reported. Eighty-four percent (7,872) were males. Ages ranged from 1-81 years (median 29 years). The age groups with the most number of cases were: 20-24 years (21%), 25-29 (28%), and 30-34 years (19%) [Figure 6].

75%

50%

25%

0% A pr i l 2012 (M )

A pr i l 2012 (F)

2012 (M al e)

50 & ol der

4

0

16

2012 (Femal e) 2

35-49yo

39

1

172

16

25-34yo

109

6

509

25

15-24yo

73

1

282

7

1-14yo

0

0

3

0

Figure 6. Comparison of the Distribution of Male and Female HIV Cases by Age-Group and Certain Highlighted Years 1984-2007

50 & o lder

2008

2009

2010

2011

2012

45-49yo 40-44yo 35-39yo 30-34yo 25-29yo 20-24yo 15-19yo

Number of Male Cases 2500

2250

2000

1750

1500

Number of Female Cases

<15yo 1250

1000

750

500

250

0

0

250

500

750

1000

1250

1500

1750

2000

2250

2500

<15yo

15-19yo

20-24yo

25-29yo

30-34yo

35-39yo

40-44yo

45-49yo

50 & ol der

<15yo

15-19yo

20-24yo

25-29yo

30-34yo

35-39yo

40-44yo

45-49yo

50 & ol der

2012

3

24

258

316

193

90

52

30

16

2012

0

1

6

18

7

8

5

3

2

2011

1

76

589

739

378

193

117

51

49

2011

2

3

36

44

23

21

10

8

9

2010

1

50

405

455

256

128

81

42

48

2010

2

5

28

21

34

15

9

7

4

2009

1

22

179

227

124

90

41

18

29

2009

1

4

13

19

21

20

14

7

5

2008

2

11

92

140

90

59

36

23

20

2008

0

0

8

14

8

10

9

3

3

1984-2007

27

15

157

374

414

364

279

185

176

1984-2007

21

33

191

225

202

154

90

35

44

*Note: 74 did not report age, 11 did not report sex, 10 did not report age and sex

2


April 2012

Philippine HIV/AIDS Registry

Geographic Distribution I

2%

II

<1%

III

5%

IVA

15%

IVB

1%

V

1%

VI

3%

VII

16%

VIII

1%

IX

<1%

X

0

XI

4%

XII

0

CAR

R eg 4 A 15%

50%

25%

0%

R eg 7 16 % NCR 50 %

0

NCR

75%

R eg 3 5%

R OT C 10 %

1%

ARMM

100%

Figure 7. New HIV Cases by Region, April 2012

<1%

CARAGA

Fig 8. Comparison of Proportion of HIV Cases by Region & Year

In April 2012, bulk of the new HIV cases came from NCR, Region 7, Region 4A, Region 3, and Region 11 [Fig 7]. The three highest reporting regions were NCR, Region 4A, and Region 7.

% of Cases

Proportion of Cases

Region

2007-2011

1984-2012

2%

2%

2%

Reg3

6%

6%

9%

13%

12%

12%

Reg6

3%

3%

3%

Reg7

13%

9%

9%

7%

7%

6%

50%

54%

51%

6%

7%

7%

Reg4A

R eg 11 4%

50%

2012 Reg1

Reg11 NCR ROT C*

*ROTC: Rest of the Country

Modes of Transmission (1984-2012) In 2012, 90% (933) were infected through sexual contact, 9% (96) through needle sharing among injecting drug users, and <1% (3) through mother-to-child transmission (Table 2). There were 892 males and 41 females infected through sexual transmission. The age range of those infected through sexual transmission was 17-81 years old (median 28 years).

Table 2. Reported Mode of HIV Transmission Mode of Transmission

April 2012 n=233

Sexual Contact

Of the 9,396 HIV positive cases reported from 1984 to 2012, 91% (8,579) were infected through sexual contact, 4% (361) through needle sharing among injecting drug users, 1% (58) through mother-to-child transmission, <1% (20) through blood transfusion and needle prick injury <1% (3) [Table 2]. Other modes of transmission are listed in Table 2. No data is available for 4% (375) of the cases.

Jan-Apr 2012 n=1,032

Cumulative N=9,396

210

933

8,579

Heterosexual contact

26(12%)

124(13%)

3,000(35%)

Homosexual contact

113(54%)

480(51%)

3,368(39%)

Bisexual contact

71(34%)

329(35%)

2,211(26%)

Blood/Blood Products

0

0

20

Injecting Drug Use

23

96

361

Needle Prick Injury

0

0

3

Mother-to-Child

0

3

58

No Data Available

0

0

375

Cumulative data shows 35% (3,000) were infected through heterosexual contact, 39% (3,368) through homosexual contact, and 26% (2,211) through bisexual contact. From 2007 there has been a shift in the predominant trend of sexual transmission from heterosexual contact (21%) to males having sex with other males (79%) [Figure 9]. Figure 10. HIV Transmission by Age-Group, 2012 (n=1,032)

Figure 9. Proportion of Types of Sexual Transmission, Jan 1984â&#x20AC;&#x201D;April 2012

550

100%

500 450

Number of Cases

90%

Proportion of Cases

80% 70% 60% 50%

400 350 300 250 200 150 100

40%

50 0

30% 20% 10% 0% '84

'85

'86

'87

'88

'89

'90

'91

'92

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

Het er osexual

1

7

24

24

16

19

35

30

41

47

58

56

81

82

138 114 93

B i sexual

0

2

0

4

2

2

4

4

5

2

3

8

7

7

9

10

8

5

8

14

12

14

26

74

Homosexual

0

1

4

3

4

6

8

15

5

16

20

21

30

25

36

30

17

32

46

40

27

47

81

107 215 336 680 1036 480

128 129 129 123 131 193 139 160 216 274 388 124 127 252 467 806 329

<7yo

7-14yo

15-17yo

18-24yo

25-34yo

35-49yo

50&ol der

B l ood T r ansf usi on - Femal e

-

-

-

-

-

-

-

M at er nal t o Chi l d

1

2

-

-

-

-

-

I nj ect i ng Dr ug Use - Femal e

-

-

-

2

6

1

-

I nj ect i ng Dr ug Use - M al e

-

-

2

28

31

25

1

Het er osexual Cont act - Femal e

-

-

-

5

19

15

2

Het er osexual Cont act - M al e

-

-

-

6

44

26

7

B i sexual Cont act

-

-

-

90

187

51

1

Homosexual Cont act

-

-

1

155

247

70

7

3


April 2012

Philippine HIV/AIDS Registry

Overseas Filipino Workers (OFW) In 2012, there were 109 HIV positive OFWs, comprising 11% of cases reported for the year [Figure 11]. Of these, 96 (88%) were males and 13 (12%) were females. All were infected through sexual contact. There were 1,897 HIV positive OFWs since 1984, comprising 20% of all reported cases [Figure 11]. Seventy-seven percent (1,466) were males. Ages ranged from 18 to 69 years (median 35 years). Sexual contact (97%) was the predominant mode of transmission (Table 3). Eighty-five percent (1,613) were asymptomatic while 15% (284) were AIDS cases. Table 3. Mode of HIV Transmission Among OFWs

Figure 11. Number of OFWs Compared to Non-OFWs by Year (1984-2012) 2200

Apr 2012 n=18

Jan-Apr 2012 n=109

Cumulative N=1,897

18

109

1,835

Heterosexual contact

3(17%)

29(27%)

1,127(61%)

Homosexual contact

10(56%)

42(38%)

397(22%)

Bisexual contact

5(28%)

38(35%)

311(17%)

Blood/Blood Products

0

0

10

Injecting Drug Use

0

0

1

Needle Prick Injury

0

0

3

No Data Available

0

0

48

Sexual Transmission

2000

Number of Cases

Mode of Transmission

1800 1600 1400 1200 1000 800 600 400 200 0 OFW Non-OFW % of OFW

Blood Units Confirmed for HIV As of March 2012, 69 blood units were confirmed positive for HIV by RITM. Data for April is not yet available. There is no available data yet on the total number of blood units donated. These are confirmed positive blood units, not blood donors. One donor can donate more than one blood unit. HIV positive blood donors may not be in the HIV & AIDS Registry unless they underwent voluntary counseling and testing as individuals.

2012

2011

January

17

11

February

18

15

March

34

14

April

'85

'86

'87

'88

'89

'90

'91

'92

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

1

2

0

3

9

5

10

7

14

29

31

24

35

27

51

67

60

79

96

93

86

92

130 106 122 164 174 271 109

1

8

29

35

23

34

56

78

58

73

87

92

119 90

138

91

63

95

88

100 113 118 179 236 406 671 1417 2078 923

50% 20% 0%

'08

'09

'10

'11

'12

8% 28% 13% 15% 8% 19% 28% 26% 21% 23% 23% 27% 42% 49% 45% 52% 48% 43% 44% 42% 31% 23% 20% 11% 12% 11%

Data not yet available

20

As of March 2012, there are 2,278* People Living with HIV presently on Anti-Retroviral Therapy (ART). Data for April is not yet available. Table 5. Number of PLHIV on ART Month

2,087

February

2,169

March

10

June

32

July

22

August

18

September

10

October

22

November

17

October

December

18

November

209

December

69

2012

January

May

Total

'07

PLHIV on Anti-Retroviral Therapy

Table 4. Number of Confirmed HIV Positive Blood Units Month

'84

April May June July August

2,278 Data not yet available

Treatment Hubs in the Philippines 1. Baguio General Hospital and Medical Center 2. Ilocos Training and Regional Medical Center 3. Cagayan Valley Medical Center 4. Jose B. Lingad Medical Center 5. San Lazaro Hospital 6. Philippine General Hospital 7. Research Institute for Tropical Medicine 8. Makati Medical Center 9. The Medical City 10. Bicol Regional Training and Teaching Hospital 11. Western Visayas Medical Center 12. Corazon Locsin Montelibano Memorial Regional Hospital 13. Vicente Sotto Memorial Medical Center 14. Gov. Celestino Gallares Memorial Hospital 15. Zamboanga City Medical Center 16. Southern Philippines Medical Center

September * This is not a cumulative number. It does not include those who already have died, left the country, or decided to stop taking ART.

4


DOH - NEC April 2012 HIV/AIDS Registry