Slowing a virus

Ten years ago on Dec. 3, the world came crashing down on Jebsen Gamido.

Just 19 at the time, Gamido was all set for deployment overseas as a commercial seafarer.

A prerequisite for his job deployment was a medical exam. Feeling completely healthy, Gamido readily underwent what he thought would be a routine test.

When he was handed the results in a sealed envelope, however, he suspected what was coming. This did not diminish the shock of reading the test results: he was positive for HIV, the human immunodeficiency virus.

“You’re young, full of dreams, with a very good job… I felt the world crashing down on me at the time,” Gamido recalled. “It was an emotional moment for me and also for my parents… looking back, it was really tough.”

The infection derailed his overseas deployment, and the next 10 years, he said, were “challenging… it’s more of the stigma, the discrimination… you get to be called things… it limits your chances to be productive.”

But it was a sign of changing times that Gamido realized his dream of working abroad as a seaman only a year after his diagnosis.

This is thanks to the dramatic advances in HIV treatment since Acquired Immune Deficiency Syndrome began claiming many lives, mostly of young people, in the 1980s.

Such treatments are available in the Philippines, with the government even providing them for free to the poor. Yet the country now has the fastest rate of HIV infection not just in the Asia-Pacific region but in the world.

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Gamido looked healthy as he faced “The Chiefs” this week on Cignal TV’s One News. The AIDS-causing virus, he told us, has become “undetectable” in his blood – meaning that HIV is still with him, but at such a low level that he can no longer transmit it.

“Undetectable viral load” is a new category for persons living with HIV/AIDS, according to Dr. Louie Ocampo, country director of the Joint United Nations Program on HIV/AIDS or UNAIDS in the Philippines.

Gamido went through the cocktail of potent drugs to prevent the spread of the virus in his body and keep away AIDS. He must take an antiretroviral maintenance drug daily for the rest of his life, among other medications, but he’s happy with the results.

In 2017, he formed a group called Positibong Marino Philippines, whose main advocacy is to stop discrimination against persons living with HIV/AIDS in the maritime industry.

Ocampo told The Chiefs that overseas Filipino workers – including seamen – are among the sectors at high risk of HIV infection. The highest rate of transmission has been registered among men having sex with men, with 80 percent occurring among people aged 15 to 35.

The youngest case of HIV infection from male-to-male sex in the Philippines, he told me, involved a 13-year-old.

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Why is this happening at a time when people have instant access to a mountain of information on practically any topic, including sex and HIV/AIDS?

Because there’s also a lot of wrong information out there, according to both Ocampo and Gamido. And the internet has also been a great boon to the porn industry, which inspires youthful sexual exploration with disregard for safe sex.

When kids explore cyberspace, they are likelier to go to dating sites than to the UNAIDS website for pointers on preventing HIV/AIDS.

This may be addressed through proper messaging, according to Gamido. Ocampo said “sex-positive messages rather than condemnation” would help.

Gamido admits that at 19, people think they can live forever and HIV/AIDS happens only to others. “You feel invincible,” he told us.

Ocampo said in places where the porn industry is legal and regulated, there is some effort on the part of UNAIDS to reach out to players in promoting safe sex. But UNAIDS works with governments, and such initiatives are unlikely in countries where porn is illegal such as in the Philippines.

A viable approach is what UNAIDS is promoting on the occasion of World AIDS Day 2019, observed on Dec. 3: community participation in preventing the spread of HIV, and in promoting the welfare of those living with the virus.

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Despite laws against discrimination, and which guarantee confidentiality of HIV health records, both Gamido and Ocampo say there is still apprehension about testing positive and suffering from the stigma attached to an affliction that continues to claim lives.

People still worry even about being seen in an HIV testing facility, even if they are genuinely there because the test is a requirement for employment. Ocampo said self-screening could address this problem.

A national condom strategy similar to the one implemented in Thailand, with dramatic results, is also needed, he said.

Access to HIV diagnostic and treatment facilities can use a boost, Ocampo pointed out. There are 140 cities nationwide classified as high-burden for HIV/AIDS, but only a few LGUs have programs specifically targeting the problem, says Ocampo, who cited Quezon City, Manila, Cebu and Mandaue cities as models.

Other LGUs mainly include the HIV/AIDS component in the general public health program, usually alongside the reproductive health or family planning aspect. Gamido, however, said youths typically associate the RH program mainly with managing childbirth and not HIV prevention.

As part of the community-based approach, schools are also encouraged to scale up sex education to include information on HIV/AIDS. Ocampo said sex education should have been introduced following the passage of Republic Act 8504 back in 1998. But he noted that the rollout of the program has been slow, with resistance coming even from some teachers.

Gamido’s group has pushed for basic sex education in maritime schools. His experience is a compelling argument for such lessons.

He is also proof that “undetectable viral load” can be attained and transmission prevented, with the medications now available, including the latest – a pre-exposure prophylaxis pill for HIV-negative persons at risk of infection.

“Get tested. Get treated. Also cooperate, participate. Be part of the community,” Gamido urged the public. “It’s about time. It’s now or never.”