RA 11166

PHILIPPINE AIDS PREVENTION AND CONTROL ACT OF 1998

Republic Act 8504

Fidel Ramos

Republic Act 8504 signed by?

PHILIPPINE HIV AND AIDS POLICY ACT OF 2018

Republic Act 11166

60% of the reported case (60,000 reported cases from 1984)

2018, HIV infection among the youth

Senator Risa Hontiveros and Representative Kaka Bag-ao of Dinagat Islands.

Republic Act 11166 Lobbied by

Pres. Rodrigo Duterte; December 20, 2018

Republic Act 11166 signed by _____________ on ___________________.

90% of all people living with HIV will know their HIV status (90% diagnosed)

TARGET 1

90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy (90% on HIV treatment)

TARGET 2

90% of all people receiving antiretroviral therapy will have viral suppression (90% suppressed)

TARGET 3

• 95% of people living with HIV knowing their

  HIV status;

• 95% of people who know their status on

  treatment; and

• 95% of people on treatment with

  suppressed viral loads.

95-95-95 for treatment

Reduce the annual number of new HIV infections among adults to 200,000.

Goal by 2030

Luc Montagnier (Pasteur Institute of France) in 1983

= first discovered the virus that causes AIDS ➔ Lymphadenopathy Associated Virus (LAV)

Robert Gallo and his team (US)

renamed LAV to human T lymphotropic virus type Ill (HTLV-III)

in 1986

both the French and the US names were dropped in favor of the new term human immunodeficiencyvirus (HIV).

primate origin

HIV-I and HIV-2 origin

Central Common Chimpanzee (Pantroglodytes troglodytes)

Origin of HIV-I

has been established to be the Sooty Mangabey (Cercocebus atys), an Old World monkey of Guinea Bissau, Gabon, and Cameroon.

Origin ofHIV-2

1930's:

HIV-1 entered the human populations

• Family: Retroviridae

• Genus: Lentivirus

CLASSIFICATION OF THE VIRUS:

•  Family: _______________

• Genus: ________________

HIV-I

more virulent and easily tran smitted, and is the source of the majority of HIV infections through o ut the world; causative agent of AIDS in US and Europe

HIV-2

less easily transmitted and is largely confined to West Africa

• 120 nm in diameter (120 billions of a meter; around 60 times smaller than a red blood cell)

• Roughly spherical

• Single-stranded, positive-sense, enveloped RNA virus

MORPHOLOGICAL CHARACTERISTICS OF THE VIRUSES

HIV-1

two copies of single-stranded RNA enclosed by a conical capsid, which is in turn surrounded by a plasma membrane that is fo nned from part of the host-cell membrane.

HIV-2

morphologically indistinguishable from HIV-1; shares many similarities HIV-1 such as basic gene arrangement.

reverse transcriptase, integrase, and protease.

Other enzymes

• Sexual route

• Mother-to-child route

• Parenteral inoculation

Three Major Routes of Transmission

• Sexual intercourse (vaginal and anal)

• Oral sex (mouth-penis, mouth vagina)

• Heterosexual transmission

Sexual Transmission

• Sharing of infection

• Needle sticks

• Blood transfusion

• Hemophiliatreatment

• Mother to child

• Non-sexual Transmission

• Blood (including menstrual blood)

• Semen

• Vaginal secretions

• Breastmilk

Infectious Body Fluids

• Saliva

• Tears

• Sweat

• Feces

• Urine

Non-Infectious Body Fluids

• Insect bites

• Casual Contact/Sharing dishes or food

• Swimming pools and hot tubs

• Pets

• Contact with saliva, tears, sweat, feces or urine

HIV is NOT transmitted by:

• Immune system

• Central nervous system

2 Major Targets of HIV

• M-Tropic (machrophage tropic)

• T-tropic (T-cell tropic)

Major HIV Strains

AIDS

the disease produced as the effects of HIV infection progress. It is a collection oof signs and symptoms resulting from the specific damage to the immune system caused by infection with the human immunodeficiency virus (HIV).

Primary HIV Infection

STAGE 1

Clinically Asymptomatic Stage

STAGE 2

Symptomatic HIV Infection

STAGE 3

Progression from HIV to AIDS

STAGE 4

There are no standard symptoms of HIV infection or of AIDS.

Clinical Manifestations of AIDS?

• HIV ANTIGEN

• HIV ANTIBODY

• HIV GENES

Tests used in HIV Detection

HIV ANTIGEN

1. ELISA
2. Indirect Immunofluorescent Assay (IFA)

3. Slide Agglutination Test

HIV ANTIBODY

1. ELISA
2. Western Blot Assay

3. Indirect Immunofluorescent Assay (IFA)

4. Slide Agglutination Test
5. Radioimmunoassay (RIA)
6. Radioimmunoprecipitation Assay

HIV GENES

1. In situ Hybdridization

2. Filter Hybridization

3. Southern Blot Hybridization

4. DNA Amplification

• Virus Isolation

• Serology

• Detection of Viral Nucleic Acid or Antigen

Laboratory Diagnosis

Virus Isolation

• IV can be cultured from lymphocytes in peripheral blood.

• Disadvantage: time consuming and laborious and are limited to research studies

Serology

• Enzyme Linked lmmunoSorbent Assay (ELISA)

• Western Blot technique

• Indirect immunoFluorescent Assay (IFA)

Detection of Viral Nucleic Acid or Antigen

CR amplification techniques

• Anti-viral Drugs/Therapy

• Immune Boosting Therapy (vaccines)

• Treatment and Prevention of Specific Opportunistic Infections

Treatment

• Anti-viral Drugs/Therapy

• Highly Active Anti-retroviral Therapy (HAART)

• Triple Drug Therapy

• Monotherapy

• Combination Therapy

• Zidovudine (azidothymidine; AZT)

PHILIPPINE HIV AND AIDS POLICY ACT (ARTICLE 1: THE PHILIPPINE NATIONAL AIDS COUNCIL)

An Act Strengthening the Philippine Comprehensive Policy on Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) Prevention, Treatment, Care, and Support, and, Reconstituting the Philippine National Aids Council (PNAC)

"Philippine Aids Prevention and Control Act of 1998", and Appropriating Funds to all HIV /AIDS National program

Purpose of Repealing the Republic Act No. 8504,

Senate Bill No. 1390 and House Bill No. 6617

PHILIPPINE HIV AND AIDS POLICY ACT

December 20, 2018

PHILIPPINE HIV AND AIDS POLICY ACT was approved on

ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)

Refers to a health condition where these is a deficiency of immune system that stems from infection with the Human Immunodeficiency Virus or HIV, making an individual susceptible to opportunistic infections.

ANTI-RETROVIRAL THERAPY (ART)

Refers to the treatment that stops or suppresses viral replication or replications of a retrovirus like HIV, thereby slowing down the progression of infection.

BULLYING

Refers to any severe or repeated use by one or more persons of a written, verbal or electronic expression, or a physical act of gesture, or any combination thereof, directed at another person that has the effect of actually causing or placing the latter in reasonable fear of physical or emotional harm or damage to one's property; creating a hostile environment for the other person; infringing on the rights of another persons ; or materially and substantially disrupting the processes or orderly operation of an institution or organization.

CIVIL SERVICE ORGANIZATIONS (CSOs)

Refer to groups of nongovernmental and noncommercial individuals or legal entities that are engaged in non-coerced collective action around shared interests, purpose and values.

COMMUNITY–BASED RESEARCH

Refers to study undertaken in community settings, which involve community members in the design and implementation of research projects.

COMPREHENSIVE HEALTH INTERVENTION FOR KEY POPULATION

Refers to evidence-based policies, programs, and approaches that aim to reduce transmission of HIV and its harmful consequences on health, social relations and economic conditions.

COMPULSORY HIV TESTING

Refers to HIV testing imposed upon an individual characterized by lack of consent, use of force or intimidation, the use of testing as a prerequisite for employment or other purposes, and other circumstances when informed choice is absent.

DISCRIMINATION

Refers to unfair or unjust treatment that distinguishes, excludes, restricts, or shows preferences based on any ground such as sex gender, age, sexual orientation, gender identity and expression, economic status, disability, ethnicity, and HIV status, whether actual or perceived, and which has the purpose or effect of nullifying or impairing the recognition, enjoyment or exercise by all persons similarly situated, of all their rights and freedoms.

EVOLVING CAPACITIES OF THE CHILD

Refers to the concept enshrined in Article 5 of the Convention on the Rights of the Child recognizing the developmental changes and the corresponding progress in cognitive abilities and capacity for self-detennination undergone by children as they grow up, thus requiring parents and others charged with the responsibility for the child to provide varying degrees of protection, and to allow their participation in opportunities for autonomous decision-making.

GENDER EXPRESSION

Refers to the way a person communicates gender identity to others through behavior, clothing, hairstyles, communication or speech pattern, or body characteristics.

GENDER IDENTITY

Refers to the personal sense of identity as characterized, among others, by manner of clothing, inclinations, and behavior in relation to masculine or feminine conventions. A person may have a male or female identity with the physiological characteristics of the opposite sex.

HEALTH MAINTENANCE ORGANIZATIONS (HMO)

Refers to juridical entities legally organized to provide or arrange for the provision of pre-agreed or designated health care services to its enrolled members for a fixed pre-paid fee for a specified period of time.

HIGH-RISKBEHAVIOR

Refers to a person's involvement in certain activities that increase the risk of transmitting or acquiring HIV.

HUMAN IMMUNODEFICIENCY VIRUS (HIV)

Refers to the vims, of the type called retrovirus, which infects cells of the human immune system, and destroys or impairs the cells' function. Infection with HIV results in the progressive deterioration of the immune system. Leading to immune deficiency.

HIV COUNSELING

Refers to the interpersonal and dynamic communication process between a client and a trained counselor, who is bound by a code of ethics and practice to resolve personal, social, or psychological problems and difficulties, and whose objective in counseling in the context of an HIV diagnosis is to encourage the client to anxiety and stress, plan for the future (keeping healthy, the context of a negative HIV test result, to encourage the client to explore motivations, options, and skills to stay HIV-negative.

HIV AND AIDS COUNSELOR

Refers to any individual trained by an institution or organization accredited by the Department of Health (DOH ) to provide counseling services on HIV and AIDS with emphasis on behavior modification.

HIV AND AIDS MONITORING

Refers to the documentation and analysis of the number of HIV and AIDS infections and the pattern of its spread.

HIV AND AIDS PREVENTION AND CONTROL

Refers to measures aimed at protecting non-infected persons from contracting HN and minimizing the impact of the condition on persons living with HIV.

HIV-NEGATIVE

Refers to the absence of HIV or HN antibodies upon HIV testing.

HIV-POSITIVE

Refers to the presence of HIV infection as documented by the presence of HIV and HIV antibodies in the sample being tested.

HIV TESTING

Refers to any facility-based, mobile medical procedure, or community-based screening modalities that are conducted to determine the presence or absence of HIV in a person's body.HN testing is confidential, voluntary in nature and must be accompanied by counseling prior to and after the testing, and conducted only with the informed consent of the person.

HIV-RELATED TESTING

Refers to any laboratory testing or procedure done or an individual in relation to a person's HIV condition.

HIV TESTING FACILITY

Refers to any DOH accredited on-site or mobile testing center, hospital, clinic, laboratory, and other facility that has the capacity to conduct voluntary HIV counseling and HIV testing.

HIV TRANSMISSION

Refers to the transfer of HIV from one infected person to an uninfected individual, through unprotected sexual intercourse, blood transfusion, sharing of contaminated intravenous needles, or which may occur during pregnancy, delivery, and breastfeeding.

INFORMED CONSENT

Refers to the voluntary agreement of a person to undergo or be subjected to a procedure based on full information, whether such permission is written or conveyed verbally.

KEY AFFECTED POPULATIONS

Refers to those groups or persons at higher risk of HIV exposure, or affected populations whose behavior make them likely to be exposed to HIV or to transmit the virus.

LABORATORY

Refers to an community-based area or settings, place, where including research studies are being undertaken to develop local evidence for effective HIV response.

MATURE MINOR DOCTRINE

Refers to the legal principle that recognizes the capacity of some minors to consent independently to medical procedures, if they have been assessed by qualified health professionals to understand the nature of procedures and their consequences to make a decision on their own.

MEDICAL CONFIDENTIALITY

Refers to the core duty of medical practice where the information provided by the patient to health practitioner and his/ her health status is kept private and is not divulged to third parties.

OPPORTUNISTIC INFECTIONS

Refer to illnesses caused by various organism, many of which do not cause diseases in persons with healthy immune system.

PARTNER NOTIFICATION

Refers to the process by which the "index client", “source", or "patient" who has a sexually transmitted infection (STI) including HIV, is given support in order to notify and advise the partners that have been exposed to infection.

PERSON LIVING WITH HIV (PLHIV)

Refers to any individual diagnosed to be infected with HIV.

PRE-EXPOSURE PROPHYLAXIS

• Refers to the use of prescription drugs as a strategy for the prevention of HIV infection by people who do not have the HIV and AIDS.

• It is an optional treatment, which may be taken by people who are HIV-negative but who have substantial, higher-than-average risk of contracting an HIV infection.

PRE-TESTING COUNSELING

Refers to the process of providing an individual with information on the biomedical aspects of HIV AIDS, and emotional support to any psychological implications of undergoing HIV testing and the test result itselfbefore the individual is subjected to the test.

POST-TESTING COUNSELING

Refers to the process of providing risk-reduction infonnation and emotional support to a person who submitted to HIV testing at the time the result is released.

PROPHYLACTIC

Refers to any agent or device used to prevent the transmission of an infection.

PROVIDER-INITIATED COUNSELING AND TESTING

Refers to a health care provider initiating HIV testing to a person practicing high-risk behavior or vulnerable to HIV after conducting HIV pre-test counseling. A person may elect to decline or defer testing such that consent is conditional.

REDRESS

Refers to an act of compensation for unfairness, grievance, and reparation.

SAFER SEX PRACTICES

Refers to choices made and behaviors adopted bya person to reduce or minimize the risk of HIV transmission. These may include postponing sexual debut, nonpenetrative sex, correct and consistent use of male or female condoms. And reducing the number of sexual partners.

SEXUALLY TRANSMITTED INFECTIONS

Refers to infections that are spread through the transfer of organisms from one person to another as a result of sexual contact.

SEXUAL ORIENTATION

Refers to the direction of emotional, sexual attraction, or conduct towards people of the same sex (homosexual orientation) or towards people of both sexes (bisexual orientation) or towards people of the opposite sex (heterosexual orientation) or to the absence of sexual attraction (asexual orientation).

SOCIAL PROTECTION

Refers to a set of policies and programs designed to reduce poverty and vulnerability by promoting efficient labor markets, diminishing people's exposure to risks, and enhancing their capacity to protect themselves against hazards, and interruptions on, or loss of income.

STIGMA

Refers to the dynamic devaluation and dehumaniz.ation of an individual in the eyes of others, which may be based on attributes that are arbitrarily defined by others as discreditable or unworthy, and which results in discrimination when acted upon.