Department of Health | Epidemiology Bureau HIV/AIDS & ART REGISTRY OF THE PHILIPPINES DECEMBER 2018 Average number of people newly diagnosed with HIV per day, selected years 2009 2011 2013 2015 2018 2 7 13 22 32 NEWLY DIAGNOSED HIV CASES In December 2018, there were 877 new HIV confirmed Table 1. Summary of HIV diagnoses and deaths positive individuals reported to the HIV/AIDS & ART Registry Demographic Data Dec 2018 Jan - Dec Jan 2013- Jan 1988- of the Philippines (HARP). Fifteen percent (128) had clinical 2018 Dec 2018 Dec 2018 manifestations of advanced HIV infection (WHO clinical stage Total reported cases 877 11,427 50,357 62,029 3 or 4) at the time of diagnosis [Table 1]. With advanced infectiona 128 2,030 5,933 7,098 Ninety-six percent (846) of the newly diagnosed were male. Male 846 10,828 48,040 58,081b The median age was 28 years old (age range: 15 - 61 years Female 31 599 2,317 3,937b old). Almost half of the cases (48%, 419) were 25-34 years Age Range 15–61 1 mo-73 1 mo-82 1 mo-82c old and 32% (281) were 15-24 years old at the time of testing. Median Age 28 28 28 28 Age groups: <15 y/o 0 30 117 179c More than one-third (37%, 325) were from the National 15-24 y/o 281 3,391 14,728 17,540c Capital Region (NCR). Region 4A (17%, 147 cases), Region 3 (11%, 97), Region 7 (8%, 71), and Region 6 (7%, 66), 25-34 y/o 419 5,756 26,081 31,644c comprise the top five regions with the most number of newly 35-49 y/o 162 1,991 8,291 10,984c diagnosed cases for the month, together accounting for 80% 50 y/o & 15 259 1,140 1,609c of the total [Figure 2]. Pregnant 4 69 280 293 Sexual contact remains the predominant mode of Reported deathsd 71 596 2,645 3,054 transmission (98%, 861). Among this, 88% were males who a WHO clinical stage 3 or 4 b No data on sex for 11 cases have sex with males (MSM). Other mode of transmission c No data on age for 73 cases reported was needle sharing among injecting drug users d Reported deaths due to any cause and not necessarily AIDS related (1%, 10). There were 6 cases that had no data on mode of Fig. 2: Proportion by region of residence among newly diagnosed, transmission. December 2018 Region % Among the newly diagnosed females this month, four were NCR 37% pregnant at the time of diagnosis. One case each from NCR, 4A 17% and Regions 2, 3, and 4A. 3 11% 7 8% Fig. 1: Number of newly diagnosed cases per month, 2016-2018 6 7% 1200 10 3% 11 3% 1000 1 3% 800 9 2% 5 2% 600 12 2% 400 8 1% 200 4B 1% Number of newly diagnosed casesnewlydiagnosed of Number CAR 1% 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2 1% 2016 802 749 734 770 739 838 761 762 762 818 754 749 CARAGA 1% 2017 841 849 968 628 1,098 1,015 854 1,104 938 919 894 993 2018 1,021 871 914 924 950 993 859 1,047 954 1,072 945 877 ARMM <1% Anti-retroviral Treatment (ART) In December 2018, there were 694 patients who were Fig. 3: Number of ART initiation per month, 2016-2018 initiated on ART. The median CD4 of these patients upon 1000 3 enrollment was 234 cells/mm . 900 800 A total of 33,575 people living with HIV (PLHIV) were 700 presently on ART as of December 2018. Most of whom were 600 males (97%). The age of reported cases ranged from 500 5 months to 80 years (median: 31 years old). Ninety-five 400 percent were on first line regimen, 4% were on second line, 300 and 1% were on other line of regimen. Number of PLHIV initiated ART to 200 100 The total figure reflected on this section are the number of HIV positive adult and pediatric patients currently enrolled and accessing Antiretroviral (ARV) medication in 88 treatment hubs 0 and primary HIV care treatment facilities that had reported in the HARP. This report did not Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec include patients who have previously taken ARV but have died, left the country, have been lost to follow-up and/or opted not to take ARV. Lost to follow-up is considered once a person have 2016 461 528 520 520 503 611 539 611 589 566 466 524 failed to visit a treatment facility more than 3 months after the expected date of ARV refill. 2017 526 600 784 561 683 690 727 846 746 750 658 664 Note: November 2018 data was used for Oriental Mindoro Provincial Hospital & Felipe Abrigo Memorial Hospital due to late submission. 2018 956 778 739 753 757 549 915 944 804 831 685 694 1 HIV/AIDS & ART REGISTRY OF THE PHILIPPINES DECEMBER 2018 HIV/AIDS EPIDEMIC TRENDS IN THE PHILIPPINES (January 1984 - December 2018) The first case of HIV infection in the Philippines was reported in 1984. Since then, there have been 62,029 confirmed HIV cases reported to the HARP. Ninety-four percent (58,081) of which were male and 6% (3,937) were female; there were no data on sex for 11 cases. More than half (31,644 or 51%) were from the 25-34 year age group while 17,540 (28%) were youth 15-24 years old. The median age of diagnosis was 28 years old (age range: 1 month - 82 years); there were no data on age for 73 cases. Eighty-one percent (50,357) of the total diagnosed cases in the Philippines were reported from January 2013 to December 2018. Eleven percent (7,098) of the total ever reported cases had clinical manifestations of advanced infection at the time of reporting (WHO clinical stage 3 & 4) [Table 1]. Fig. 4: Number of HIV cases reported in the Philippines by year, Jan 1984 to Dec 2018 (N=62,029) 12000 10000 8000 6000 Number of HIV Cases NumberHIV of 4000 2000 0 '84 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17 '18 Total Newly diagnosed 2 10 29 38 32 39 66 85 72 102 118 116 154 117 189 158 123 174 183 191 199 210 309 342 528 833 1,583 2,344 3,326 4,804 5,978 7,809 9,238 11,101 11,427 Age and Sex In the early years of the epidemic (1984-1990), 62% (133 compared to the same period of 2013 (229), five years of 216 cases) of those diagnosed were female. On the prior. Ninety-three percent (3,650) of all female cases contrary, from 1991 to present, males comprised 94% were in the reproductive age group (15-49 years old) at (57,998) of the 61,802a diagnosed cases in the Philippines. the time of diagnosis. From January to December 2018, three percent (325) out of 10,828 diagnosed male cases had classified their self- The predominant age group among those diagnosed has identity as female. shifted from 35-49 years old between 2001 to 2005, to 25-34 years old starting from 2006 [Figure 6]. Further, The number of diagnosed HIV infections among females the proportion of HIV positive cases in 15-24 year age has also been increasing [Figure 5]. The number of females group doubled in the past ten years, from 13% in 1999- diagnosed from January to December 2018 (599) was 2008 to 29% in 2009-2018. almost three times the number of diagnosed cases aNo data on sex for 11 cases Fig. 5: Number of females diagnosed per year Fig. 6: Proportion of HIV cases by age group, Jan 1984 to Dec 2018 (N=3,937) Jan 1984 to Dec 2018 Age group 100% 4,000 50+ 3,500 80% 35-49 3,000 2,500 60% 25-34 2,000 1,500 40% 1,000 Number of diagnosed females diagnosed of Number 20% 15-24 500 0 '84 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17 '18 <15 Cumulative 0 7 32 58 76 96 133 161 185 224 275 312 364 406 477 530 568 625 678 738 799 868 958 1,022 1,077 1,181 1,308 1,464 1,620 1,849 2,102 2,427 2,821 3,338 3,937 0% 1991 2011 1997 2017 Diagnosed per year 1987 1992 1993 2012 1995 2013 0 7 25 26 18 20 37 28 24 39 51 37 52 42 71 53 38 57 53 60 61 69 90 64 55 104 127 156 156 229 253 325 394 517 599 2015 1999 1985 1994 1996 2014 2016 1989 1998 2018 1984 1986 1990 2001 2010 2007 1988 2002 2003 2005 2009 2004 2006 2008 2000 Geographic distribution From January 1984 to December 2018, the regions with the The regions with the most number of overseas Filipino most number of reported cases were NCR with 24,418 workers (OFW) reported to HARP were from NCR with (39%) cases, Region 4A with 9,219 (15%) cases, Region 3 2,054 (33%) cases, Region 4A with 1,088 (17%) cases, with 5,703 (9%) cases, Region 7 with 5,586 (9%) cases, and Region 3 with 720 (12%) cases.