High HIV incidence is unacceptable!

'IT offends and angers me that I continue to lose friends today.' This is a quote from Tony Benfield, an HIV activist, in a 2016 Los Angeles Times article about HIV/AIDS and the epidemic in the Philippines. Benfield lost many friends in the 1980s when HIV/AIDS was novel, and the world was ignorant about how it was transmitted. But in 2016, HIV/AIDS was no longer novel. We can't claim ignorance. We know how to fight it. We have the knowledge, we have the tools. So, it should offend and anger us that people are still getting infected, still dying from AIDS. They may not be our friends or even acquaintances but that shouldn't matter. Where other countries have succeeded in bringing down new infections and AIDS-related deaths, the Philippines has gone in the opposite direction. From 'a low-prevalence condition in the 1980s,' Chanelie Tabliga and Chinwebudu Melford write in the paper 'Longitudinal Trends of HIV in the Philippines (1984-2025),' the HIV epidemic has become 'one of the fastest-growing epidemics globally.' It should especially offend and anger us that the Philippines has Southeast Asia's 'highest estimated incidence' among 15-to-19-year-olds, according to recent data from Unicef and reported in the Philippine Daily Inquirer (Aug. 28, 2026). Of course, the higher number of diagnosed HIV cases could also be explained, partly, with higher awareness leading to more people getting themselves tested. While stigma and discrimination remain formidable barriers in HIV/AIDS response, the testing environment is more friendly today than it used to be. I came across an old 'AIDS test' certification from a Cebu City hospital. Yes, AIDS test. AIDS, not HIV. The certification was from 1996 when aliens like me had to secure an 'AIDS clearance certificate' (among other medical clearances) when applying for a permanent visa. The legal basis for the 'AIDS clearance certificate' was Section 29 of the Philippine Immigration Act of 1940 barring certain aliens from entering the country, including 'Persons afflicted with a loathsome or dangerous contagious disease, or epilepsy' (Sec. 29 (a) 2). In the early days, HIV was associated with foreigners, commercial sex workers, and later, drug users who shared needles to inject drugs. In 2007, however, the predominant mode of transmission shifted 'from heterosexual to homosexual contact.' The transmission rate accelerated rapidly (Allen G.P. Ross et al., 2015). Newly diagnosed infections reached an all-time high in 2025. There may, however, be reason for cautious optimism. The most recent official numbers from the Department of Health's Epidemiology Bureau show a significant decline in the average monthly newly diagnosed cases in the first semester of 2026 compared to the same period last year: 1,271 down from 1,666. As mentioned, 2025 saw a record high in newly diagnosed cases — 19,764 or a monthly average of 1,647. So, it is probably too early to be optimistic. On the other hand, the DOH has also noted a decline in the proportion of new cases with advanced HIV disease: 28 percent, or 828 cases, among the newly diagnosed had advanced HIV disease. This rate has been declining — from 37 percent in 2020, to 31–36 percent from 2021–2024, to 29 percent in 2025. Of course, 28 percent is still too high — it tells us that too many either avoid getting tested or didn't know they were infected until they became severely ill. Our relatively sophisticated HIV/AIDS response notwithstanding, it has not reflected in the bottom line. Dalmacito Cordero Jr. (2025) points out that sex education in schools is still inadequate. Risky sexual behavior with many sexual partners and no condoms drives the epidemic. Preaching abstinence or fidelity to one partner is not working. Cordero also points out the proliferation of online dating sites and apps. Casual sex with virtual strangers has never been easier. In the Philippines, the profile of an HIV-infected person is a 15-to-34-year-old male who acquired the virus by having sex with another man. Any significant reduction in infections in this high-risk group would put the Philippines back on track 'to end AIDS as a public health threat by the end of 2030' (UN General Assembly Resolution 80/268, June 23, 2026). But our HIV/AIDS response must be more relevant. Yes, there are other high-risk groups such as transgender women, sex workers and overseas Filipino workers, but more than 90 percent of newly infected are male, a vast majority 15–34 years old, the overwhelming mode of transmission being sexual contact with other men. Messaging, services and other interventions must be designed to reach the younger men. They are already less likely than women to seek preventive medical consultation while more likely to engage in risky sexual behavior. And the men themselves must not wait, must not be passive. While an HIV-positive diagnosis is no longer be — automatically — a death sentence, it still wreaks havoc on the lives of both the infected and their loved ones.