Living POSITIVE

Dr. Joven Cuanang : “As healthcare workers, we have to be very aware of the rising incidence of HIV/AIDS.”

MANILA, Philippines - The day Wanggo Gallaga learned that he was HIV positive, he was in disbelief and did not know what to do.  The son of acclaimed film director Peque Gallaga, Wanggo, now 36 years old, confesses to living a very liberal life: sex, drugs and rock and roll.

But still he did not expect he would actually get infected with HIV. In 2008, he decided to take the HIV test after bouts with fever and unexplained illnesses since 2007.  It would change his life forever.

Yet, he refused to let the virus win and take over his life. Gallaga, a writer, went on with his life and decided to come out and tell the whole world his story. Since 2009, he has been giving interviews to raise awareness on the issue and for others to learn from his experience. He wanted to tell others that it could happen to anyone. But he also wanted to tell others that it could be prevented. 

However, six years since he first started talking about HIV, his words seem to have fallen on deaf ears.

 “I’ve been talking about this for years but the numbers are still growing,” Gallaga tells STARweek in between sighs of frustration.

He traces the growing incidence of HIV in the Philippines to the severe lack of awareness among the people on what HIV is and how it is transmitted.

“Until now, people ask me, ‘Can I kiss someone with HIV?’”Gallaga says.

 According to the Department of Health (DOH), in May 2015, there were 748 new HIV Ab sero-positive individuals, a growth of 51 percent compared to the 495 individuals recorded in the same period last year.

This marks the highest number of cases reported since 1984. Most or 95 percent of the cases were still asymptomatic at the time of reporting.

This compares to the April 2015 numbers when there were only 560 new HIV Ab sero-positive individuals, 42 percent higher compared to the same period last year, which counted 393 individuals. Most or 94 percent of the case were also still asymptomatic at the time of reporting.

In terms of gender, 96 percent were male. The median age was 28 years, but ages ranged from 16 to 69. More than half or 55 percent belong to the 25 to 34 year age group, while 28 percent were youth aged 15 to 24 years, according to the DOH.

By region, the National Capital Region reported the most number of cases with 273 or 37 percent of total cases.

Reported modes of transmission were sexual contact and needle sharing among drug users. Eighty-six percent of the sexually transmitted cases were among males who have sex with males.

Indeed, the statistics are stark and telling and are sending jitters throughout the medical community.

To date, since the first case of HIV infection in the Philippines was reported in 1984 until May 2015, there are now 25,684 HIV Ab zero-positive cases reported to the HIV/AIDS and ART Registry of the Philippines.

In an interview with STARweek, Dr. Joven Cuanang, a neurologist and chairman of the board of St. Luke’s College of Medicine, said the medical community feels the urgent need to raise the public’s awareness on the issue because of the growing incidence of HIV in the Philippines. “It’s already an epidemic,” he says.

Gallaga agrees. “It’s definitely an epidemic already.”

Cuanang himself has noticed an increase in neurological diseases related to HIV.

In St. Luke’s Quezon City, the top three neurologic complications of HIV are CNS infections, malignancies and lymphomas.

Other HIV-related complications on the rise include dementia, viral infections and neuropathies.

In one of the regular meetings of consultants at St. Luke’s dubbed as the grand rounds, Cuanang told a crowd of mostly healthcare workers that the community has to be very aware of the problem.

“As healthcare workers, especially that we are an academic medical center, we have to be very aware of the rising incidence of HIV/AIDS among us because this is already present in our community,” he says.

Cuanang says that St. Luke’s alone is seeing a high incidence of HIV infections.

Data from the hospital showed that last year, there were 70 cases in the hospital. For this year, there are already 41 cases as of end-June.

“Everyone talks about MERS-CoV and everything, but I think if you take a look at the newspapers, and even the way our Department of Health is taking this particular illness, they’re not really serious about it. And that really troubles me because in the hospital, we already see a big incidence of people coming in with AIDS and are dying, and this is afflicting our young people,” Cuanang says.

However, he stresses that the problem of HIV-AIDs is preventable by good health education.

“So I think it is very important that we, as an academic community, should force ourselves to come up with some action plan,” he says.

Cuanang believes that health workers must be involved in research.

“We want to influence those statistics, and not just the encounter where your engagement with the patient is one on one. You become familiar with the patient, but in the academic medical center, that’s not the way we should do it. We have to be involved in research, in terms of education, which is the whole basis of our existence as a medical center,” he says.

One solution, he believes, is to help prevent the spread of the virus.

“I am now proposing or thinking aloud that we probably have to have things like what Dr. Esperanza Cabral was talking about before. You know she was talking about condoms at that time and the church killed her. You know what I’m saying? We’re talking about treatment of AIDS, which costs a lot of money…Prevention is still the important thing to do,” Cuanang says.

 In 2010, Cabral, the former health secretary, was widely criticized by the Catholic Church for distributing condoms and trying to keep the deadly HIV/AIDS cases from escalating.

In response, she said she was distributing condoms to prevent the spread of the virus and not as a family planning program.

“What’s the kind of strategy that we should adopt? You know these can become bigger and bigger. We become a sounding board for ideas and change. This is what we mean by an academic medical center. I’m thinking now of getting some congressmen to take a look at the present laws. There are many doctors who are in Congress. What are they doing about this?” Cuanang says.

It’s not only the medical community that is getting jittery over the situation.

Artists themselves, some of whom are HIV positive, are getting alarmed over the situation in the country.

Ballet Philippines, for instance, is coming up with Body Positive+ as its season opener, which is a show about health and promoting a positive body image.

“When we started realizing that HIV was spreading at such an alarming rate, yet it was barely being talked about, we decided to dedicate our show to this cause,” Margie Moran-Floirendo, Ballet Philippines president, tells STARweek.

She says that Body Positive+ is a mixed bill featuring the iconic Black Swan and White Swan pas de deux, as well as Requiem for a Cygnet, a contemporary work inspired by Swan Lake’s four little swans.

“Along with other landmark pieces, these works showcase our dancers’ innate athleticism, thus promoting a positive body image. We delve into the rising prevalence of HIV in the Philippines with works such as Enrico Labayen’s award-winning Cloth.”

Labayen is a multi-awarded choreographer based in San Francisco, who is HIV positive. 

Body Positive+ will be shown at the CCP Little Theater on Sept. 12, 13, and 19.

Moran hopes that with the show, Ballet Philippines would be able to convey the message that anyone can be vulnerable to HIV, but there are precautions and preventive measures that can be taken, such as practicing safe sex.

The collective ignorance and lack of awareness, she says, is part of the reason why HIV is spreading so alarmingly.

“Many performing artists here and abroad have passed away due to HIV/AIDS, but these losses have also served to inspire the creation of many new theatrical works. We’re proud to be joining this conversation through dance,” she says.

Ballet Philippines is also partnering with various sectors to bring attention to the issue.

“The more people who speak up about it, the more we will learn about and understand the situation we are all in. In line with this, we are partnering with the Department of Health for a lecture series that we will bring to various high schools, colleges and call centers around the metro,” Moran says.

Gallaga agrees that the key to addressing the situation is to raise awareness of the public.

“We have to make people aware at an early age. HIV and sex education should be taught at an early age and constantly. We can’t leave it to the parents because kids don’t want to talk about that to their parents. But if you do it as a medical lesson, then it takes away some of the stigma and the awkwardness,” Gallaga says.

He believes the government is very reactionary and doesn’t want to take a stronger stand on the issue because it does not want controversy.

“Based on the statistics, there are 22 people per hour on average that are getting infected with HIV here in the Philippines, but never once did the President mention it in his State of the Nation Address. And the number is growing steadily,” he says.

The Department of Health, for its part, does not consider the situation an epidemic.

“No, it’s not yet an epidemic,” Dr. Lyndon Lee Suy, DOH spokesman, tells STARweek.

However, he stresses that it is a priority issue for the health department. He points out that the numbers are growing because people are getting themselves tested because they are now more aware of the problem.

The DOH, he says, continues to raise awareness on the situation by going around the country to lecture to different communities.

For Gallaga, however, the key really is to make HIV awareness part of the curriculum in primary education so that awareness starts early on.

Life goes on for Gallaga. He refuses to let the virus win. A freelance writer, he has recently finished a play about the millennial generation and continues to contribute to magazines and other online publications.

He will publish his first e-book soon, mostly his poems and other musings.

And yes, he continues to live and love but never without a condom now.

“Some people tell me, they don’t like the feeling of using a condom,” Gallaga says.

But for someone who has learned his lesson the hard way, he refuses to be anyone’s reason to be infected with HIV.

“I tell them, ‘okay, you don’t like the feeling of using a condom but believe me, you won’t like the feeling of HIV either’,” Gallaga says.

 

 

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