DEFINITION STAGES OF HIV / AIDS

Human Immunodeficiency Virus (HIV) A.​ Stages of HIV Infection

An infection is caused by HIV, which is a retrovirus that causes immunosuppression. The viral Without treatment, HIV infection typically progresses through three distinct stages, each
infection causes the person to be susceptible to infections that would normally be controlled characterized by varying levels of viral activity, immune compromise, and clinical symptoms.
through immune responses. The term HIV disease is used interchangeably with HIV infection. 1. Acute HIV Infection (Primary Infection or Acute Retroviral Syndrome):
With advances in treatment, HIV is managed as a chronic disease, since people are living This earliest stage typically develops within 2 to 4 weeks after initial HIV infection and lasts
longer. for 1 to 3 weeks, although some symptoms may persist for several months. During this
period, the virus multiplies rapidly and disseminates throughout the body, actively attacking
Acquired Immunodeficiency Syndrome (AIDS) and destroying CD4 cells. The level of HIV in the blood (viral load) is exceptionally high,
A diagnosis of acquired immunodeficiency syndrome (AIDS) is made when an HIV-infected making the individual highly infectious and CD4+ T cell counts fall temporarily but quickly
patient meets criteria established by the CDC. These criteria occur when the immune system return to baseline or near-baseline levels.
becomes severely compromised. As the viral load increases, the absolute number and Signs and Symptoms: Many individuals may not experience any symptoms during
percentage of T cells decrease and the risk of developing opportunistic diseases increase. this stage, or they may present with a non-specific, self-limiting, influenza-like
illness. Common symptoms include fever, headache, a generalized rash, sore throat,
muscle aches (myalgia) and joint pain (arthralgia), swollen lymph glands
STATISTICS
(lymphadenopathy), diarrhea, weight loss, cough, and night sweats. Some may also
According to the World Health Organization (WHO) and United Nations Programme on HIV/AIDS develop painful mouth sores or mucocutaneous ulcerations (oral, anal, penile,
(UNAIDS), an estimated 39.9 million people were living with HIV globally by the end of 2023. In the
same year, approximately 1.3 million individuals acquired HIV, and 630,000 deaths were attributed to esophageal). In more severe cases, acute aseptic meningoencephalitis, aseptic
HIV-related causes. While 30.7 million people were receiving antiretroviral therapy (ART), only 72% meningitis, peripheral neuropathy, facial palsy, or Guillain-Barré syndrome. can
of them achieved viral suppression. q
occur. The median duration of this acute illness is about 20 days, ranging from less
According to the Department of Health’s Epidemiology Bureau HIV/AIDS & ART Registry of the than a week to three months, and it generally resolves spontaneously. Many people,
Philippines (HARP) 2025 First Quarter Surveillance Report, a total of 5,101 newly confirmed HIV
including health care providers, mistake acute HIV symptoms for a bad case of the
cases were recorded in the Philippines from January to March 2025. Since 1984, the country has
recorded 148,831 HIV cases. As of March 2025, 92,712 people living with HIV (PLHIV) were on flu.
ART. However, only 45% of them underwent viral load testing, of which 88% achieved viral 2. Chronic HIV Infection (Asymptomatic HIV Infection or Clinical Latency):
suppression. In Negros Oriental, 125 newly diagnosed HIV cases were reported in the first quarter of This second stage follows the acute phase. During this period, HIV continues to multiply in
2025. The region has a cumulative total of 3,835 confirmed HIV cases since 1984.
the body, but at very low levels. People in this stage may remain asymptomatic for many
years (approximately 8-10 years), hence the term "clinical latency". However, active viral made when an HIV-infected patient meets criteria established by the CDC. A person
replication and gradual immune destruction, characterized by a progressive decline in CD4 with HIV is diagnosed with AIDS if their CD4 cell count drops below 200 cells/mm³
cell counts remaining above 500 cells/µL (normal or only slightly decreased), are still (normal range is 500-1500 cells/mm³) or if they develop one or more specific
occurring throughout this period. With consistent Antiretroviral Therapy (ART), individuals opportunistic infections or cancers that are characteristic of AIDS. The CD4 count is
can remain in this stage for several decades. Without ART, chronic HIV infection typically more than just a numerical value; it is a critical biomarker reflecting the extent of
progresses to AIDS in 10 years or longer, though the rate of progression can vary. Persistent immune damage and guiding clinical decisions, dictating the risk for specific
generalized lymphadenopathy is often present, though patients may not notice it. opportunistic infections and the urgency of initiating or adjusting ART.
Signs and Symptoms: Generally, individuals in this stage experience no specific
DIAGNOSTIC CRITERIA OF AIDS
symptoms or signs of infection.
AIDs is diagnosed when an individual with HIV develops at least one of the following conditions:
3. Symptomatic HIV Infection (Pre-AIDS): 1.​ CD4+ T Cell count drops below 200 cells/uL
As the chronic infection progresses the CD4+ T cell count drops to 200 to 500 cells/µL and 2.​ One of the following opportunistic infections (OIs):
a.​ Fungal: candidiasis of bronchi, trachea, lungs, or esophagus; Pneumocystis
the viral load increases. Individuals may begin to experience more noticeable, persistent, or jirovecii pneumonia (PCP); disseminated or extrapulmonary coccidioidomycosis;
recurrent symptoms that are not severe enough to be classified as AIDS-defining conditions. disseminated or extrapulmonary histoplasmosis
b.​ Viral: cytomegalovirus (CMV) disease other than liver, spleen, or nodes; CMV
Signs and Symptoms: These can include persistent fever, chronic fatigue, ongoing retinitis (with loss of vision); herpes simplex with chronic ulcer(s) or bronchitis,
swollen lymph glands, persistent diarrhea, unexplained weight loss, recurrent oral pneumonitis, or esophagitis; progressive multifocal leukoencephalopathy (PML);
extrapulmonary cryptococcosis
yeast infections (thrush), Candida organisms rarely cause problems in healthy adults, c.​ Protozoal - toxoplasmosis of the brain, chronic intestinal isosporiasis, chronic
but are more common in HIV-infected people. Outbreaks of shingles (herpes zoster). intestinal cryptosporidiosis
d.​ Bacterial - Mycobacterium tuberculosis (any site); any disseminated or
Recurrent bacterial infections like and vaginal candidal infections; outbreaks of oral extrapulmonary mycobacteria, including Mycobacterium avium complex (MAC)
or genital herpes; and Kaposi sarcoma (KS), which is caused by human herpesvirus or Mycobacterium kansasii; recurrent pneumonia; recurrent Salmonella septicemia
3.​ One of the following opportunistic cancers:
Oral hairy leukoplakia, an Epstein-Barr virus infection that causes painless, white, a.​ Invasive cervical cancer
raised lesions on the lateral aspect of the tongue, is another indicator of disease b.​ Kaposi Sarcoma (KS)
c.​ Burkitt’s Sarcoma
progression. d.​ Immunoblastic lymphoma
4. Acquired Immunodeficiency Syndrome (AIDS): e.​ Primary lymphoma of the brain
4.​ Wasting syndrome. Wasting is defined as a loss of 10% or more of ideal body mass.
AIDS represents the final and most severe stage of HIV infection, marked by profound 5.​ AIDs dementia complex (ADC).
damage to the immune system. At this point, the body's defenses are severely compromised, Viral Load and Transmission: Once HIV progresses to the AIDS stage, individuals typically have a
rendering it incapable of fighting off opportunistic infections, which are also known as high viral load, which significantly increases the ease of HIV transmission to others.
AIDS-defining conditions.
Diagnosis Criteria: A diagnosis of acquired immunodeficiency syndrome (AIDS) is
Survival without Treatment: Without treatment, the prognosis for individuals with AIDS is dire, more frequent and severe with immune suppression.
with typical survival being about 3 years. However, with modern ART, even individuals diagnosed Severe Bacterial Infections: Including invasive pneumococcal infections and Salmonella
with AIDS can achieve viral suppression and immune reconstitution, significantly improving their septicemia.
health and life expectancy. Disseminated Mycobacterial Infections: Refer to the spread of mycobacteria from an initial
site of infection to other parts of the body, often through the bloodstream or lymphatic system
B.​ AIDS-Defining Cancers:
OPPORTUNISTIC INFECTIONS AND AIDS-DEFINING CONDITIONS
Kaposi's Sarcoma: A tumor of the blood vessel walls, often appearing as pink, red,
purple, dark brown, or black lesions on the skin and in the mouth. It can also affect
Opportunistic infections (OIs) are severe illnesses that occur when the immune system is weakened
internal organs, including the lungs and digestive system.
by HIV, allowing pathogens that are normally harmless to cause disease. The risk and severity of OIs
Primary Lymphoma: Cancers that originate in the white blood cells, often
are directly related to the CD4 cell count. These infections are not merely complications; they are
presenting as painless swelling of lymph nodes.
direct manifestations of severe immunodeficiency. Their presence signals the critical need for
effective ART to restore immune function and prevent further morbidity and mortality.
RISK FACTORS/PREDISPOSING FACTORS
Common Opportunistic Infections:
Tuberculosis (TB): Globally, TB is the most common illness and the leading cause of death 1.​ Unprotected Sexual Contact: Engaging in anal or vaginal sex without a condom
among people living with HIV, accounting for nearly a third of HIV-associated deaths. The significantly elevates risk.
high burden of TB among PLHIV highlights the importance of integrated HIV-TB programs, 2.​ Presence of Other Sexually Transmitted Infections (STIs): Having STIs such as syphilis,
especially in endemic areas. herpes, chlamydia, gonorrhea, and bacterial vaginosis increases susceptibility to HIV. STIs
Cryptococcal Meningitis: A severe fungal infection affecting the brain and spinal cord. can cause inflammation and sores in mucous membranes, providing easier entry points for
Prophylaxis is required for patients with a CD4 count less than 100 cells/mm³ and a positive HIV.
serum cryptococcal antigen result. 3.​ Harmful Substance Use: The harmful use of alcohol or drugs, particularly in the context of
Pneumocystis Pneumonia (PCP): A fungal infection that can cause severe lung illness, sexual behavior, can impair judgment and increase risky practices.
historically a common cause of pneumonia in people with HIV. 4.​ Sharing Injection Equipment: Sharing contaminated needles, syringes, or other drug
Candidiasis (Thrush): A very common HIV-related fungal infection that causes thick, white solutions when injecting drugs is a high-risk behavior.
coatings or lesions on the mouth, tongue, esophagus, or vagina. 5.​ Unsafe Medical Practices: Receiving unsafe injections, blood transfusions, or tissue
Histoplasmosis: A fungal infection for which prophylaxis is recommended in endemic areas transplantation, or undergoing medical procedures involving unsterile cutting or piercing, are
if the patient's CD4 count is less than 150 cells/mm³. potential risk factors.
Recurrent Herpes Simplex and Herpes Zoster (Shingles): Viral infections that become 6.​ Mucous Membrane Inflammation: Any inflammation of mucous membranes can facilitate
 HIV transmission. significantly impacts prevention strategies and reduces stigma. But it is important to note that
“undetectable” in laboratory studies of the viral load does not indicate that the virus has been
MODE OF TRANSMISSION
eliminated from the body or that the individual can no longer transmit HIV to others.
HIV is primarily transmitted through the exchange of specific body fluids from an infected individual.
These fluids include blood, breast milk, semen, and vaginal secretions. The most common routes of
transmission are: INCUBATION PERIOD
1.​ Sexual Contact (Semen and Vaginal Secretions): This is the predominant mode globally The incubation period of HIV is the time between initial infection and the development of AIDS.
and in the Philippines, encompassing anal or vaginal sex without a condom.
STAGE APPROXIMATE TIMEFRAME DETAILS
2.​ Blood-borne Exposure: This includes sharing contaminated needles, syringes, or other
HIV Exposure — Acute 2- 4 weeks after infection Flu-like symptoms may appear.
injecting equipment among people who inject drugs, as well as receiving unsafe blood HIV High viral load. Most
transfusions or tissue transplantation. Accidental needle stick injuries also pose a risk, infectious stage.
particularly for healthcare workers. Acute HIV — 2-8 weeks The body starts producing
3.​ Mother-to-Child Transmission (Perinatal/Vertical Transmission): HIV can be transmitted Seroconversion antibodies (detected by
ELISA/Western blot/4th gen
from an infected mother to her child during pregnancy, childbirth (intrapartum), or through tests).
breastfeeding.
HIV — AIDs (if Typically 8-10 years Slow immune deterioration.
untreated) AIDS develops when CD4
It is crucial to emphasize that HIV is not transmitted through ordinary day-to-day contact, such as count <200 cells/mm³ or if an
AIDS-defining illness appears.
kissing, hugging, shaking hands, or sharing personal objects, food, or water. Furthermore,
HIV — AIDs (with May never occur or >20+ years delay Effective ART can maintain
epidemiologic evidence has specifically implicated only blood, semen, vaginal secretions, and
ART) immune function and suppress
possibly breast milk in transmission, with no reported transmission after contact with saliva, tears, viral load indefinitely.
urine, stool, or bronchial secretions.

DOH HIV DIAGNOSTIC ALGORITHM

Variables that influence whether infection will be established after an exposure include (1) duration
A.​ rHIVda
and frequency of contact with the organism; (2) volume, virulence, and concentration of the
○​ rHIVda, includes 2 immunoassay tests and 3 RDTs for local validation of sensitivity
organism; and (3) host immune status. The concentration of the virus is an important variable.
and specificity on general and key population in the country.
i.​ The key population includes men who are having sex with men, people in
A pivotal development in HIV prevention is the understanding that people living with HIV who are
prisons and other closed settings, people who inject drugs, sex workers, and
consistently taking antiretroviral therapy (ART) and have achieved an undetectable viral load will not
transgender men and women
transmit HIV to their sexual partners. This concept, known as Undetectable = Untransmittable (U=U),
○​ Selected test kits are as follows:
 i.​ Immunoassay tests
1.​ Sysmex Ag-Ab (CMIA- 4th generation)
a.​ HIV-1 p24 antigen (early marker of infection)
b.​ HIV-1 and HIV-2 antibodies
c.​ 14–20 days after exposure
2.​ Vidas HIV Duo Ultra (ELFA- 4th generation)
a.​ HIV-1 p24 antigen
b.​ HIV-1 and HIV-2 antibodies
c.​ 14–20 days after exposure

ii.​ RDTs
1.​ SD Bioline HIV Ag-Ab cassette The following tests are used in rHIVda Confirmatory Testing for NRL-SLH/SACCL:
a.​ Detects HIV‑1 p24 antigen and antibodies (IgM/IgG/IgA) to ●​ T1-Sysmex HISCL HIV Ag+Ab Assay Kit
HIV‑1 (incl. subtype O) and HIV‑2 ●​ T2- Vidas HIV Duo Ultra or SD HIV-½ 3.0 or Alere Determine HIV ½
2.​ Alere Determine HIV ½ ●​ T3- Geenius HIV ½ Confirmatory Assay Kit
a.​ Detects HIV‑1 p24 antigen alongside HIV‑1 and HIV‑2
antibodies
3.​ Geenius HIV ½ Confirmatory Assay Kit PATHOPHYSIOLOGY
a.​ Used to confirm repeated-reactive results from screening
tests (like SD Bioline or Determine); distinguishes HIV‑1 vs HIV, a single-stranded RNA retrovirus belonging to the Lentivirus genus, initiates its devastating
HIV‑2 infection impact by primarily targeting CD4+ T-lymphocyte helper cells and macrophages and dendritic cells,
which are crucial components of the immune system. The virus gains entry into these host cells
through a high-affinity interaction between its outer envelope glycoprotein and the CD4 molecule on
the cell surface, aided by co-receptors such as CXCR4 for T cells (CXCR4 is involved in the
activation of T cells, particularly CD4+ T cells, by physically associating with the T cell receptor and
transmitting signals) and CCR5 (CCR5 acts as a docking site for HIV-1, alongside the CD4 receptor,
allowing the virus to enter and infect T cells) for monocytes/macrophages.
Once inside, a defining characteristic of HIV's pathophysiology unfolds: its RNA genome is AIDS is clinically defined by a CD4 count falling below 200 cells/mm³ or the manifestation of
reverse-transcribed into proviral DNA (as a retrovirus), which then integrates into the host cell's specific AIDS-defining opportunistic infections or cancers. The risk and severity of these
DNA. This integration makes the infection lifelong, as the viral genetic material becomes a permanent opportunistic infections and AIDS-related cancers are directly proportional to the level of CD4+
part of the host's genome, capable of reactivating and producing new viral particles. This ability to lymphocyte depletion and exposure to potential pathogens.
establish "latent infection" in CD4+ T cells allows the virus to remain "invisible" to CD8+ T cells and
evade immune surveillance, enabling later reactivation and the generation of new virions. This
PHARMACOLOGICAL TREATMENTS
persistent viral reservoir is the primary reason why current antiretroviral therapy (ART) can suppress
viral replication but cannot cure HIV, necessitating lifelong treatment.
The goals of drug therapy in HIV infection are to (1) decrease the viral load, (2) maintain or increase
CD4+ T cell counts, (3) prevent HIV-related symptoms and opportunistic diseases, (4) delay disease
The virus predominantly replicates within activated CD4+ T cells, leading to their progressive
progression, and (5) prevent HIV transmission. HIV cannot be cured, but antiretroviral therapy (ART)
destruction and a continuous decline in their numbers. This depletion of CD4+ T cells is central to the
can delay disease progression by decreasing viral replication. When taken consistently and correctly,
development of immunodeficiency, as these cells are critical orchestrators of both cell-mediated and,
ART can reduce viral loads by 90% to 99%, which makes adherence to treatment regimens extremely
to a lesser extent, humoral immunity.
important.

The cellular immune response, particularly involving CD8+ T cells, is vital for controlling HIV
The major advantage of using drugs from different classes is that combination therapy can inhibit
replication by lysing infected cells and secreting cytokines that inhibit viral replication. The humoral
viral replication in several different ways, making it more difficult for the virus to recover and
immune system is also impacted, with B cell hyperplasia often leading to lymphadenopathy and
decreasing the likelihood of drug resistance. A major problem with most drugs used in ART is that
hyperglobulinemia. However, the ability to mount effective antibody responses to new antigens (e.g.,
resistance develops rapidly when they are used alone (monotherapy) or taken in inadequate doses. For
vaccines) diminishes as the CD4 count declines. Furthermore, abnormal elevation of immune
that reason, combinations of three or more drugs should be used.
activation, possibly triggered by the absorption of components from bowel bacteria, contributes to
further CD4+ depletion and overall immunosuppression through mechanisms that are still being
Many antiretroviral drugs have dangerous and potentially lethal interactions with other commonly
elucidated.[1]
used drugs, including over-the-counter drugs and herbal therapies. For example, St. John’s wort, an
herb used to alleviate depression, can interfere with ART. Encourage patients to discuss the use of all
Progression to AIDS
over-the-counter and herbal products with their health care providers.
Without effective treatment, the relentless destruction and dysfunction of the immune system by HIV
ultimately lead to the progression to Acquired Immunodeficiency Syndrome (AIDS). At this stage,
the immune system is severely compromised, rendering the body unable to defend itself against
infections and cancers that would typically be harmless to individuals with healthy immune systems.
 CLASS OF ARV MECHANISM OF ACTION GENERIC NAME OF ARV Zidovudine (AZT) +
3TC + DRV + RTV if
Nucleotide/Nucleoside Reverse Insert a piece of DNA into the Tenofovir (TDF) previously on TDF or
Transcriptase Inhibitors (NRTI) developing HIV DNA chain, Lamivudine (3TC) ABC
blocking further devel-opment Abacavir (ABC)
of the chain and leaving the Zidovudine (AZT) Tenofovir (TDF) or
production of the new strand of ABC + 3TC + DRV +
HIV DNA incomplete RTV if previously on
AZT
Non-nucleoside Reverse Inhibit the action of reverse Efavirenz (EFV)
Transcriptase Inhibitors transcriptase Rilpivirine (RPV)
(NNRTI) Nevirapine (NVP)
RECOMMENDED REGIMEN FOR CHILDREN (3 - LESS THAN 10 YEARS OLD)
Protease Inhibitors (PI) Prevent the protease enzyme Lopinavir/ritonavir (LPV/r)
FIRST LINE REGIMEN
from cutting HIV proteins into Darunavir (DRV)
the proper lengths needed to Ritonavir (RTV)
NRTI NNRTI
allow viable virions to
assemble and bud out from the Preferred First Line ABC + 3TC Preferred First Line EFV
cell membrane
Alternative Fist Line AZT or TDF + 3TC Alternative Fist Line NVP

RECOMMENDED REGIMEN FOR ADULTS AND ADOLESCENTS (>10 YEARS OF

AGE) RECOMMENDED REGIMEN FOR INFANTS AND CHILDREN LESS THAN 3 YEARS
OLD
FIRST LINE REGIMEN: 2 NRTI + 1 NNRTI SECOND LINE REGIMEN: 2 NRTI + BOOSTED PI

PREFERRED FIRST LINE NRTI 0-2 WEEKS 2 WEEKS - 3 MONTHS 3-36 MONTHS
TDF + 3TC Preferred Second Line 2 NRTI + LPV/r
ALTERNATIVE FIRST LINE NRTI Preferred AZT+3TC+NVP ABC or AZT + 3TC + ABC or AZT + 3TC +
ABC + 3TC Zidovudine (AZT) +
LPV/r LPV/r
3TC +LPV/r if
previously on TDF or Alternative AZT+3TC+NVP ABC or AZT + 3TC +
ABC LPV/r
FIRST LINE NNRTI EVF TDF or ABC + 3TC +
LPV/r if previously on
AZT MANAGEMENT IN THE COMMUNITY SETTING
The DOH aims to strengthen its testing, treatment, and viral suppression strategies to meet the global
Alternative Second 2 NRTI + DRV + RTV
95-95-95 goals: 95% of people living with HIV (PLHIV) knowing their status, 95% of diagnosed
Line
individuals receiving sustained antiretroviral therapy (ART), and 95% of those on ART achieving
viral suppression. As of early 2025, data indicate that the country is significantly below these
thresholds, with only 55% diagnosed, 66% of those on treatment, and 40% of those achieving viral ●​ Condom and Lubricant Distribution: Free condoms and lubricants are made
suppression. Bridging these gaps is a central priority of the 2025 program. available in health centers, schools, night establishments, and community events.
Distribution is often accompanied by brief counseling to ensure correct and consistent
A.​ Community-Based Prevention and Control Measures use.
In response to the growing HIV epidemic in the Philippines, the Department of Health (DOH) ●​ Pre-Exposure Prophylaxis (PrEP): PrEP is offered for free to individuals at
continues to implement an integrated set of prevention and control strategies grounded in the substantial risk of HIV through DOH-accredited facilities and partner NGOs such as
principles of public health equity, accessibility, and community empowerment. These the Family Planning Organization of the Philippines (FPOP) and LoveYourself Inc.
strategies aim to curb new infections, expand treatment coverage, and build resilient systems While barangay health centers do not always dispense PrEP directly, they act as referral
of care, especially within vulnerable and hard-to-reach populations. gateways where clients can be screened and linked to PrEP providers.
●​ Tailored Messaging: Customized educational materials are developed to reflect the
1.​ Health Promotion and Literacy Campaigns lived realities of key populations. Youth-centric approaches include social media
Recognizing the foundational role of education in behavior change, the DOH has influencers, digital story-telling, and peer discussions, while messages for MSM and
intensified its health promotion efforts through evidence-informed Social and TGW focus on safe practices, health-seeking behavior, and legal protections.
Behavior Change Communication (SBCC). Several national campaigns are
implemented in partnership with local health offices, civil society organizations, and
the education sector. These include:
3.​ Community-Based HIV Testing and ART Initiation
1.​ Health is Life Campaign: Anchored on the DOH Health Promotion Framework, this
campaign highlights Priority Area 6: Practice Safe Sex and promotes age-appropriate, Expanding HIV testing beyond hospitals and clinics has proven crucial in reaching people
culturally sensitive messages encouraging informed decisions about sexual and unaware of their status. The DOH supports a variety of community-based testing modalities:
reproductive health. It employs community-level education sessions, social media
content, and school-based activities to reach both general and high-risk populations.​ ●​ Barangay-Level Screening Initiatives: Many barangay health centers across the
country, particularly in urban and high-prevalence areas, offer free HIV testing and
2.​ KonsulTayo Campaign: This campaign supports access to primary care services, counseling as part of their public health services. Local Health Units (LHUs) coordinate
including HIV counseling and testing, by raising awareness about service availability, with Barangay Health Workers (BHWs) to organize community-based screening days or
benefits, and entitlements under the Universal Health Care (UHC) Law. It also builds integrate testing into other routine services such as maternal care, STI treatment, or
trust in health workers and motivates individuals to seek preventive services earlier.​ family planning. Some barangays also partner with NGOs to offer door-to-door or
house-based testing, especially for adolescents and at-risk adults. In cities like
3.​ Undetectable = Untransmittable (U=U) Campaign​ Dumaguete, barangay health centers and the CIty Health Office offer free, confidential
This evidence-based messaging initiative educates people that individuals living with HIV testing and counseling, often integrated with STI screening. Peer educators assist
HIV who maintain an undetectable viral load cannot sexually transmit the virus to with referrals and follow-up.
others. The campaign uses digital platforms, outdoor advertisements, peer education, ●​ Mobile Testing Units and Pop-Up Clinics: DOH and civil society partners deploy
and grassroots outreach to promote U=U among both PLHIV and the general public. It mobile HIV testing vans in universities, markets, night establishments, and high-traffic
also aims to reduce internalized stigma and boost treatment adherence.​ areas. These pop-up clinics provide free rapid HIV tests, usually accompanied by pre-
and post-test counseling.
2.​ Primary Prevention Strategies ●​ Peer-Led Social and Sexual Network Testing: In hard-to-reach or stigmatized
populations (e.g., MSM, TGW, sex workers), peer educators and trained volunteers
The DOH promotes a combination prevention model to reduce the risk of HIV transmission, conduct outreach and offer free, discreet HIV testing through their social or sexual
combining biomedical, behavioral, and structural approaches. These strategies are delivered networks. These “index-driven” strategies have proven successful in building trust and
free of charge at the barangay level through Local Government Units (LGUs), Barangay increasing testing rates. Peers often accompany clients through the process and assist in
Health Centers (BHCs), and community-based organizations. linkage to care if the result is reactive.
 ●​ HIV Self-Testing (HIVST): Since its formal integration into the DOH strategy in 2022, ●​ Adolescent-Friendly Health Services (AFHS) ensure that clinics are welcoming,
HIV self-testing kits are now distributed for free by partner NGOs (e.g., LoveYourself, nonjudgmental, and tailored to the developmental needs of young people.
FPOP, Red Whistle) through barangay outreach, clinics, and discreet online ordering
platforms. These kits allow individuals to test themselves privately at home. Follow-up METHODS OF PREVENTION
pathways are established via text hotlines, chat support, or referral slips, ensuring that
reactive results are linked to confirmatory testing and care.
●​ Rapid ART (Antiretroviral Therapy) Initiation: In line with WHO guidelines, the 1.​ Decreasing Risks Related to Sexual Intercourse
DOH advocates for same-day ART initiation where feasible. Trained staff guide new
clients through medication literacy, side-effect management, and psychosocial support. a.​ ABC Approach: Abstinence, Be faithful, Condom use
Pregnant women who test reactive through routine barangay prenatal screening are b.​ Consistent use of condoms (male/female)
immediately enrolled in the HIV care continuum to prevent mother-to-child
transmission). This includes prompt initiation of antiretroviral therapy (ART) to suppress 2.​ Decreasing Risks Related to Drug Use
maternal viral load and protect the fetus, along with counseling and psychosocial support 3.​ Decreasing Risks of Perinatal Transmission
to promote adherence, mental well-being, and safe delivery. After birth, the infant
receives prophylactic treatment (e.g., Nevirapine) to further reduce the risk of perinatal a.​ Mother-to-child transmission prevention (PMTCT)
transmission, followed by early infant diagnosis (EID) using HIV PCR testing at six 4.​ Decreasing Risks at Work
weeks of age. Regarding feeding, if the mother is adherent to ART and virally
suppressed, exclusive breastfeeding is recommended for the first six months, followed by a.​ Safe needle programs (harm reduction)
complementary feeding while continuing breastfeeding up to 12–24 months. However, if 5.​ HIV Testing
the mother is not on ART or her viral load is not suppressed—and if formula feeding is
acceptable, feasible, affordable, sustainable, and safe (AFASS)—exclusive formula a.​ HIV testing and counseling (VCT)
feeding from birth is advised. Continuous follow-up by pediatricians, midwives, and 6.​ Antiretroviral therapy (ART) for PLHIV
HIV-trained healthcare providers ensures effective monitoring, support, and care
throughout the postnatal period. 7.​ Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP)
4.​ Mental Health Integration 8.​ Education and stigma reduction
Acknowledging the psychological toll of HIV, particularly among adolescents, LGBTQIA+
individuals, and newly diagnosed patients, the program incorporates:
PHILIPPINE GOVERNMENT PROGRAMS IN CONTROLLING THE SPREAD
●​ On-site Psychosocial Services in select treatment hubs and testing centers.
●​ Mental Health Screening as part of routine HIV care.
●​ Referral Systems to psychiatrists, social workers, or community counselors for those 1.​ RA 11166 (HIV and AIDS Policy Act of 2018):
exhibiting signs of depression, anxiety, or substance use. a.​ Goals and Objectives: This landmark legislation aims to promote prevention,
5.​ Targeted Youth-Focused Interventions
treatment, care, and support for people living with HIV (PLHIV) and key affected
Youth aged 15–34 account for over 80% of new HIV diagnoses. To address this:
populations. It also seeks to institute stronger protective mechanisms against
●​ Comprehensive Sexuality Education (CSE) is implemented in public schools, HIV-related stigma and discrimination, and ensure equitable access of Filipinos to
following the DepEd’s revised health curriculum in partnership with DOH and NGOs.
quality healthcare.
●​ Youth Peer Educator Programs build capacity among young leaders to conduct peer
counseling, host school-based seminars, and facilitate safe space discussions. b.​ Strategies: The Act promotes a multi-sectoral approach to HIV and AIDS prevention,
treatment, care, and support, ensuring access to services while protecting patients
 from discrimination. It also encourages local governments and national government diagnosed on ART, and 85% on ART virally suppressed).
agencies to invest and allocate funds for HIV programs. b.​ Strategies: Strategies include prevention, testing, treatment, and adherence;
2.​ DOH HIV & AIDS SURVEILLANCE OF THE PHILIPPINES (HASP) addressing social/legal barriers; and improving strategic information and program
a.​ Goals and Objectives: This surveillance serves as a cornerstone for informing management. Service delivery aims to maximize options (e.g., inclusion of PrEP and
policies and providing strategic information crucial for advocacy, planning, HIV self-testing), increase points of access (e.g., online testing options), diversify
monitoring, and evaluation of the national HIV response. It facilitates the efficient access points (e.g., strengthen community-run services), and improve quality of
allocation of resources for evidence-based interventions by providing robust service delivery (e.g., enhance case management).
epidemiological data on HIV trends, especially among key and vulnerable 4.​ Love Yourself Clinics, Project Red Ribbon, and partnerships with LGUs for community
populations. testing.
b.​ Strategies: Tracks nationwide HIV and AIDS cases through passive a.​ Goals and Objectives: These initiatives aim to increase HIV testing rates and ensure
(laboratory-based) and active (behavioral and serologic) surveillance systems. accessible, youth-friendly, and stigma-free responses. They reflect a growing
Collects and analyzes data from the HIV/AIDS & ART Registry of the Philippines openness among individuals and key populations to get tested and seek HIV-related
(HARP). Monitors the HIV care cascade (testing, linkage to care, ART initiation, services. The DOH advises concerned individuals to take the free and confidential
viral suppression). Generates monthly, quarterly, and annual epidemiological reports HIV test offered by the government.
to guide public health action. Supports the development of strategic frameworks and b.​ Strategies: Strengthening community-run services and diversifying access points for
national plans (e.g., AIDS Medium-Term Plans). Enhances surveillance inclusivity testing are key strategies. The DOH has also made HIV confirmatory testing faster
by focusing on key populations, such as MSM, TGW, PWID, and sex workers. and more accessible with 168 rapid HIV diagnostic algorithm (rHIVda) laboratories
operational nationwide.
3.​ National AIDS/STI Prevention and Control Program (NASPCP) 5.​ Thrive Dumaguete
a.​ Goals and Objectives: By 2022, reverse the trend of the HIV epidemic by reducing a.​ Goals and Objectives: This initiative aims to deliver holistic, stigma-free, and
estimated annual new HIV infections to less than 7,000 cases. Increase condom use accessible HIV and TB care through hospital-based and community-supported
among Men who have Sex with Men (MSM) and Transgender Women (TGW) to services. It supports early detection, treatment continuity, and family-centered care
70%, increase Pre-Exposure Prophylaxis (PrEP) coverage to 7% of MSM, increase for people living with HIV (PLHIV) in Negros Oriental. Thrive Dumaguete
HIV diagnosis to 95%, increase ART coverage to 95%, sustain viral suppression encourages individuals to seek early testing and offers continuous medical and
among PLHIV on ART at 90%, increase safe injecting practices among People Who psychosocial support.
Inject Drugs (PWID) to 80%, and reduce barriers to accessing HIV prevention, b.​ Strategies: Integration of HIV and TB services within the provincial hospital
testing, and treatment services. PNAC’s 7th AIDS Medium Term Plan (AMTP) streamlines care under one roof. Partnerships with national medical centers ensure
2023-2028) is to achieve 85-85-85 by 2028 (85% of PLHIV diagnosed, 85% of those clinical quality. Outreach efforts and education programs are also used to combat
 stigma and increase community-based testing and awareness. [Link]
6.​ Provision of Free ARVs through DOH and PhilHealth-accredited facilities
ilippines_v1.pdf
a.​ Goals and Objectives: The primary objective is to ensure equitable access of
British Society for Immunology. (n.d.). Human Immunodeficiency Virus (HIV).
Filipinos to quality healthcare and to accelerate the delivery of medical services to
individuals living with HIV. This provision aims to support PLHIV members in [Link]
seeking appropriate management and encourage other PhilHealth members to sign up
uman-immunodeficiency-virus-hiv
for regular testing.
Centers for Disease Control and Prevention. (n.d.). HIV prevention.
b.​ Strategies: PhilHealth offers an enhanced Outpatient HIV Treatment (OHAT)
Package, providing an annual benefit of ₱58,500, which covers antiretroviral therapy [Link]
(ART) for all individuals with confirmed positive HIV test results, regardless of their
Centers for Disease Control. (n.d.). Recommendations for prevention of HIV transmission in
clinical or immunological status. This package is accessible through any of the 234
health-care settings. [Link]
PhilHealth-accredited DOH-designated HIV Treatment facilities nationwide.
7.​ School-based HIV education campaigns and STI integration in RH programs Department of Health (Philippines). (2018). Revised policies and guidelines on the use of
a.​ Goals and Objectives: These campaigns aim to strengthen HIV/AIDS awareness and
antiretroviral therapy (Administrative Order No. 2018-0024). Legaldex.
education, emphasizing prevention, testing, and treatment. Specifically, they seek to
[Link]
develop HIV and AIDS champions among the youth by educating them on local
policy development, strengthening their capacity to lead youth-led HIV awareness y
and prevention campaigns, and ensuring the integration of HIV and AIDS into local
Department of Foreign Affairs (Philippines). (n.d.). PH shares its strategies to address HIV/AIDS
youth development plans. The DOH also advises the practice of combination
with the United Nations.
prevention methods, including condom use and pre-exposure prophylaxis.
b.​ Strategies: This includes aggressive information campaigns with media support. [Link]
Youth leaders, such as Sangguniang Kabataan (SK) officials, are being trained to
trategies-to-address-hiv-aids-with-the-united-nations
facilitate discussions and integrate HIV/AIDS response into local youth development
Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2014). Medical-Surgical Nursing -
plans, fostering youth-led awareness and prevention campaigns.
Single-Volume text and elsevier Adaptive learning package. Elsevier.
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