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Published On: Sat, May 17th, 2014

Philippines DOH clarifies position on ‘mandatory’ HIV testing in response to critics

Several HIV interest groups recently criticized the DOH for its plans to implement “mandatory” HIV testing while citing provisions in the 1998 AIDS law that does not allow “compulsory” testing.

In the Philippines today, the number of new HIV infections continues to increase month per month and estimates now run to 14 new HIV cases every day. Despite these, the HIV prevalence (new and old infections combined) remains less than 1%. Most of the current infections occur among males who have sex with male who engage in unprotected sex.

Public domain photo/ ChristianHeldt via Wikimedia commons

Public domain photo/ ChristianHeldt via Wikimedia commons

Preliminary results from the 2013 Integrated HIV Behavioral and Serologic Surveillance (IHBSS) carried out on 6,305 males who have sex with males offered these findings: 1) 44 for every 1,000 were HIV positive compared to 17 per 1,000 in 2011 2) two-thirds engaged in anal sex while only 37% used condoms in their last anal sex 3) only half accessed the social hygiene clinic for medical services while only 17% were reached thru peer education 4) despite the risks, only 15% were ever tested and only 8% were tested in the past 12 months and knew their results.

In 2013, the United States Preventive Health Services recommended that clinicians screen ALL adolescents and adults ages 15 years-65 years for HIV and younger adolescents or older persons who are at increased risk as well as all pregnant women including those who present in labor. They cited strong evidence that such mandatory screening tests have benefits since screening identifies those who have HIV but otherwise may not feel ill, and if they are infected then they can start with medicines that can make them have better chances of staying healthier and thus delaying AIDS, the final stage of HIV. Individuals who will be offered HIV screening can decline.

Based on the current HIV situation (including future projections) and current strong evidence on benefits of early HIV screening, the Department of Health, mulls mandatory screening by health providers for patients who maybe suspected having HIV infection based on a risk-based assessment. The AIDS law in fact encourages risk based screening. What is mandatory therefore applies to health providers who remain key participants to halt or reverse the HIV epidemic. Mandatory screening maybe extended to pregnant mothers during their prenatal visit to prevent mothers infecting their child.

In the AIDS law, such testing requires informed consent, pre- and post-test counseling, with test results only available to individuals who were tested, bounded by privacy and confidentiality.

What the law prohibits for such HIV testing is when they are used as preconditions to “employment, admission to educational institutions, exercise of freedoms of abode, entry or continues stay in the country, or right to travel, or provision of medical services.” The DOH/Philippine National AIDS Council continues to monitor such discriminatory acts and encourages all concerned to report such acts so that they will be appropriately addressed.

The AIDS law also provides that any person with HIV is obliged to disclose their HIV status and health conditions to their partners while the DOH pursues contact tracing. Contact tracing requires HIV screening and this remains a public health prerogative. Individuals traced from contact tracing will be properly counseled and ethical testing requirements will be observed.

The DOH welcomes criticisms as a means to understand those who have divergent views and to reconcile such different views in a proper venue that allows productive resolution of issues.

Even as DOH mulls such “mandatory” testing, giant steps are necessary to increase public awareness of HIV, concretize a comprehensive plan that is sufficiently financed and end stigmatization and discrimination against HIV. For more infectious disease news and information, visit and “like” the Infectious Disease News Facebook page.

 

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About the Author

- Writer, Co-Founder and Executive Editor of The Global Dispatch. Robert has been covering news in the areas of health, world news and politics for a variety of online news sources. He is also the Editor-in-Chief of the website, Outbreak News Today and hosts the podcast, Outbreak News Interviews on iTunes, Stitcher and Spotify Robert is politically Independent and a born again Christian Follow @bactiman63

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