Sunday, November 18, 2018

Prescription of Hot Doctors of Pinas: A Primer on Your HIV Testing

By Mark Angello C. Ganon

Celebrating self-care has never been this sizzling! On November 24, 2018, no apple can keep the Hot Doctors of ‘Pinas away as we celebrate the country’s second community-based, multi-site national HIV testing day. Catch them in 15 locations nationwide by signing up here.

Is it your first time to get tested? Don’t worry, the Hot Doctors of ‘Pinas have got you covered. They know it can be downright daunting to try something for the first time, may it be your first vaccine shot, your first visit to the dentist, or your first date.

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Getting yourself tested for HIV for the first time is no exemption to the jitters. Fear of needles and fear of the unknown are the main culprits that give us the cold feet when it comes to getting screened for HIV for the first time. As such, the Hot Doctors of ‘Pinas gives you a prescription of confidence pills for your maiden HIV testing:

1. Courage Pill. Taking charge of one’s sexual health means stepping out of your comfort zone and owning to the challenge that you alone are responsible for your own sexual welfare. If you think you are at risk of a possible HIV infection (e.g. unprotected anal or vaginal sex, or injected drugs and sharing of used needles), then it is high time to get screened for HIV. Our Hot Doctors of ‘Pinas are commending you now for accepting the challenge of getting tested.

2. Knowledge Tablet. Before you head on to the testing site, it’s best to be prepared of the testing process. Knowing how the testing goes will lessen your fear of the unknown. For starters, the HIV test is conducted for free, which means you only need to show up in any of our 15 sites to get tested. Another thing to note is that fasting is not required for your HIV test. Go on and indulge on your favourite comfort food so you will be relaxed throughout the process.

3. Vitamin Trust + Open Mindedness. Our Hot Doctors of ‘Pinas will be with you for the whole-day foray, and so are our able HIV Counselors who will be there to entertain any concerns you may have on your first HIV testing. For the Hot Doctors of ‘Pinas event, Community-Based Screening will be the method used for testing. Once you register, you will be assisted by our able phlebotomy team for the blood test and you will be assisted by our counselors for the results. So if you have any questions on HIV, don’t just google it. You might get more questions rather than answers so you better ask our counselors and volunteers instead.

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4. Booster Shots for Readiness. Getting tested for HIV will entail that you will know your HIV status at the end of the session, which can either be Reactive or Non-Reactive. So to speak, whatever your results may be, the Hot Doctors of ‘Pinas will be with you to help you prepare for the next steps. If your results yielded a Non-Reactive result, that’s great! Your responsibility now is to take care of your sexual welfare through the Triangle of Self-Care (Timely Testing and Treatment, Safe and Satisfying Sex, and Correct and Consistent Use of Condom).

If in case your results turned out Reactive, don’t worry, it’s not the end of the line for you! We will be sending your blood samples for confirmatory and we will start with AntiRetroviral Therapy Treatment (ART) as soon as possible. The ART, in effect, will help lower HIV load in the body, which will eventually lead to an undetectable status. With proper medication and a healthy lifestyle, you can and will continue to live and love, even with HIV.

5. Safe Space Syrup. Whatever your result is, we uphold it with utmost confidentiality. Once you step in our community centers and clinic, consider it as a safe space where judgement is dusted off at the doormat and hope is served for snacks.

Now that you’re ready to get tested, sign up and head on to the nearest testing center and take charge of your sexual health! To register for the Hot Doctors of ‘Pinas, click here.

Saturday, November 17, 2018

LoveYourself Expands with Three New HIV Testing Sites

By Jacob Lazaro and Bet Domingo

YOUR WELCOME: LoveYourself’s newest community is named after the iconic Welcome Rotonda as the gateway to Quezon City from Manila. In photo are the volunteers of LoveYourself together with its partner AIDS Healthcare Foundation (AHF). Aside from AHF, Pilipinas Shell Foundation, Inc. and MACARE Laboratories are the major partners of LoveYourself on this new clinic.

MANDALUYONG CITY – The LoveYourself, Inc., the leading community-led HIV services provider, will be opening its three new HIV testing centers – two in the National Capital Region (NCR) and one in Cebu City.

“This move aims to address the growing numbers of HIV infection among the youth and at risk populations,” LoveYourself founder and executive director Ronivin G. Pagtakhan said. In the past 10 years, the proportion of HIV diagnosis in 15-24 age group nearly tripled from 13% in 2008 to 29% in 2018 based on the latest Department of Health data.

Pagtakhan emphasized that it is important to instill into the minds of the youth - like university students – of the ways to prevent HIV, and by having regular testing as a medical routine.

First of the new community centers is LoveYourself Welcome, which opens on the 17th of November (Saturday). It is located at 858 Blumentritt Road cor. Remedios St., Sampaloc, Manila near the iconic Welcome Rotonda. The clinic is open from Tuesdays to Saturdays from 2:00 p.m.- 11:00 p.m.

With LoveYourself Welcome located near the University Belt, it aims to provide a convenient access to HIV screening and other related services for students, youngsters and other demographics in the area.

SERVICE COFFEE: Mark De Castro, a LoveYourself Volunteer, makes a coffee for the visiting clients for their HIV testing and other sexual health concerns. LoveYourself Welcome is inspired by a café that imbibes a safe space for all its stakeholders. The organization envisioned that clients will have the time to relax while waiting for their test results.

The second NCR community center is the Lily by LoveYourself located at the #98 Pineda Building Manalac Ave., Sitio De Asis, Barangay San Martin De Porres Paranaque City, which is just across the Waltermart in Upper Bicutan.

Aside from HIV testing, Lily by LoveYourself, in partnership with Decent Image ofSouth Signal Association (DIOSSA), will also offer hormone replacement therapy and counseling from Wednesdays to Sundays between 12:00 nn-9:00 p.m.

Moreover, LoveYourself White House in Cebu will be operating soon to cater to Cebuanos who seek HIV-related services. This is the first LoveYourself community center outside Metro Manila.

Existing community center of LoveYourself are LoveYourself Anglo (Shaw Blvd., Mandaluyong City), LoveYourself Uni (Taft Ave., Pasay City), and Victoria by LoveYourself (Park Ave., Manila).

These community centers are supported by the AIDS Healthcare Foundation (AHF) and Pilipinas Shell Foundation, Inc. as well as MACARE Laboratories.

LoveYourself is an organization mostly made up of volunteers who take multi-layered action on the HIV epidemic by promoting self-worth and the so-called TSC concept, which means “timely testing and treatment, safe and satisfying sex, and correct and consistent use of condom” as ways to protect one’s self from doing risky behaviors.

Wednesday, November 14, 2018

Hot Doctors of ‘Pinas sizzles this November



By Mark Angello C. Ganon

Hey you! Yes, you! Want to know your HIV status in a quick, costless, and confidential HIV screening process? Come and join the HOT DOCTORS of ‘PINAS in this year’s second wave of the National HIV Testing Day on November 24, 2018. You read that right! We might not have the hot doctor of Instagram, Dr. Mike, but we can’t help but #lovelocal when our own Hot Doctors of Pinas are there to aid us in taking charge of our sexual health. Sign up now!


The Hot Doctors of ‘Pinas event follows the success of This is Me: Brave and Free, the country’s first community-based, multi-site HIV testing event which has catered to more than 700 clients nationwide. This year, LoveYourself has partnered with 10 other Community-Based Organizations (CBOs) manning 15 different testing sites. Yes, that’s 15 different locations to choose from in 14 different cities across the country.

In Metro Manila, we have LoveYourself Anglo at Mandaluyong, LoveYourself, Inc. at Taguig, HASH - HIV & AIDS Support House, Inc, at Quezon City, LoveYourself Welcome and Pinoy Plus Advocacy, Inc. at Manila City, Victoria by LoveYourself and LoveYourself Uni at Pasay, and, Diossa and LoveYourself, Inc. at Parañaque. For Luzon CBOs outside Metro Manila, we have Juan Posi+ive Movement at Pampanga, Cavite Positive Action Group The JCH Advocacy Inc. and AVES Love and Light at Cavite, and Project H4 at Palawan. For CBOs manning the testing sites at the Visayas and Mindanao areas, we have LoveYourself Whitehouse at Cebu, Kagay-an PLUS - Preserving Life, Uniting Society Inc. at Cagayan de Oro, Mujer-LGBT Organization at Zamboanga, and Olympus Society of Davao at Davao

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With Community-Based Screening (CBS) utilized in all testing sites for the whole-day event, you will be assured a quick and easy screening process. This eliminates the long waiting time of the standard testing, which may last from one to two hours. With the CBS, results are ready in just 15-20 minutes of processing time and will only require a few drops of blood through a finger prick method. It should be noted that with CBS, you will not be given a printed copy of the results. But don’t fret, the third generation kit that will be used is 100% sensitive for non-reactive clients.


For the list of the testing sites and the partner CBOs, please be guided below.

HOT DOCTORS OF ‘PINAS - METRO MANILA SITES

PASAY CITY 
1. CBO      LoveYourself, Inc.
Location    LoveYourself Uni, 2/F LM Building, 2028 Taft Avenue Extension, Pasay City

2. CBO      LoveYourself, Inc.
Location  Victoria by LoveYourself, 2/F Torres Building 2442 Park Ave. Pasay City

TAGUIG CITY
3. CBO       LoveYourself, Inc.
Location 9F Kalayaan Hall, SM Aura Office Tower, Bonifacio Global City

MANDALUYONG CITY
4. CBO       LoveYourself, Inc.
Location     LoveYourself Anglo, Unit 5, 3/F Anglo Building, #715-A Shaw Boulevard, Mandaluyong City

PARAÑAQUE CITY
5. CBO       Diossa and LoveYourself, Inc.
Location     #98 Pineda Building Manalac Ave paranaque across Waltermart Bicutan

QUEZON CITY
Location    TBA

MANILA CITY
7. CBO        Pinoy Plus Advocacy Pilipinas, Inc. and LoveYourself, Inc.
Location    1965 JRB Building Anacleto Street Sta. Cruz , Manila

HOT DOCTORS OF ‘PINAS - LUZON TESTING SITES OUTSIDE METRO MANILA

MABALACAT CITY, PAMPANGA
8. CBO       Juan Posi+ive Movement
Location    104-B Roxas Street, Brgy. Lakandula, Mabalacat, Pampanga

BACOOR CITY, CAVITE
Location    Cavite Positive Action Group The JCH Advocacy Inc., Room 7 and 8 E.M.A Building Km.17 Aguinaldo Highway Bacoor, Cavite

IMUS CITY, CAVITE
10. CBO    AVES Love and Light
Location   Lumina Mall E Cor. Nueno Ave. Imus, Cavite

PUERTO PRINCESA CITY, PALAWAN
11. CBO    Project H4
Location   #41 Abad Santos St., Brgy. Masipag, Puerto Princesa

HOT DOCTORS OF ‘PINAS – VISAYAS TESTING SITES

CEBU CITY
12. CBO    LoveYourself, Inc.
Location   LoveYourself Whitehouse (TBA)

HOT DOCTORS OF ‘PINAS – MINDANAO TESTING SITES

CAGAYAN DE ORO CITY
Location  KPLUS CHAMPION Lounge, Gate 2 & 3, Nuevas Bldg. 8th-21st Street Nazareth, Cagayan de Oro City

ZAMBOANGA CITY
Location  TBA

DAVAO CITY
Location   #36 Loyola St., Bo. Obrero, Poblacion District Davao City

Now that we’ve got all the details covered, mark your calendars and catch our Hot Doctors of ‘Pinas on November 24, 2018 at a testing site near you! To register, click here.

Tuesday, November 06, 2018

Safe Spaces: Bigger and Better for All

By Jacob Lazaro

Safe Spaces is a project of LoveYourself with partner establishments to provide free condoms to anyone who needs them. Launched in 2017, the app-based condom distribution program started with only 20 locations. In less than a year, 30 new establishments have joined the project in efforts to make safer sex more accessible.

Our partners are composed of a variety of establishments. From food and beverage to health and wellness, you may just find a safe space in whatever context you find yourself in.

Going to a Safe Space

Kapuwa Bistro + Urban Pub an LGBT themed gastro pub in Quezon City caters a lot of food choices to their customers. Its manager, Julius Borcelo shared how being part of the Safe Spaces project has been a reason for the influx of customers.

"Since we are an LGBT bar, those with the [Safe Spaces] app (Available on Google Play and the App Store) or those who know about us come here just to get free condoms. At first they were laughing because the condoms were just there, but we explained to them that we are in partnership with Safe Spaces to promote safe sex" Borcelo explained.

Safe Spaces helps build a better image for Kapuwa Bistro + Urban Pub for having a sex positive environment. For instance, even if when there are condoms on a customer's table, the employees don't mind it.

In advocating for safe spaces, "safe" doesn't only mean the practice of protected sex, but also provides the feeling of comfort. It also presents that everyone, no matter what kind or amount of sexual activity they engage in won't be afraid of what others would think. In a Safe Space, no one should feel ashamed.

For Employees as well

For some establishments, customers aren't the only people who take advantage of being in a Safe Space.

Rusty [not his real name], a masseur from Hilom Spa Quezon City said that their Safe Spaces supply is also used by his fellow masseurs for their own good, whenever they wanted to get intimate with their partners.


"It's good... We don't need to buy condoms anymore because they're free." Rusty shared.

Touch of Delight, a men only spa in Quezon City has similar experiences. "It's good to practice safe sex. It's good for clients." Andrew [not his real name], a masseur from Touch of Delight shared.

Safe Spaces is there for everyone, and for men only spas like Touch of Delight and Hilom Spa, its presence helps keep their customers and employees safe, because they have access to free protection and information.

Here, There's no Judgement

What makes these places a Safe Space is not just the free condoms, but also the absence of stigma. No stares, no whispers, and no judgement. Just encouragement to stay healthy and safe, because everyone deserves to be.

Andi Ortega, the Safe Spaces coordinator for partner establishments said that she prioritizes establishments that most likely need to share Safe Spaces for its customers, like bars, bath houses, and spas.

These safe spaces were put in sex positive establishments for their open-mindedness as a public place. Moreover, such enterprises where intimate relations may probably start should be hostile towards the concept of protection though use of condoms and lubricant.

If you know of a place that's interested in making safer sex become more accessible to everyone and be part of the Safe Spaces PH community, just send an email to info@safespaces.ph.
_________________________________________________________
Jacob is a front lines kind of man. In my advocacy and passion I've always been vocal and one to take action. As an openly gay man who is also a marvel fanatic I live by the words "Mutant and proud".

Wednesday, October 24, 2018

ART Chronicles: CD4 Count and Viral Load


By: Ronald Bugarin







Every newly diagnosed Person Living with HIV (PLHIV) has to absorb a wealth of information about their journey towards and in treatment.  Among the multitude of terms to remember, most commonly used are “CD4 Count” and “Viral Load” but what do these terms really mean and how important are they to every PLHIV who are on Antiretroviral Therapy (ART)?


CD4 Count

CD4 cells (also known as T-cells, or T helper cells) are white blood cells that fight off infections that enter the body.  Its main function is to send signals upon entry of a virus or bacteria to other types of immune cells, including CD8 cells to fight off the cells infected by bacteria and viruses.


Upon successful HIV transmission in the body, the virus enters the CD4 cells and replicates after which, new copies of the virus will then be released and attaches to other CD4 cells. This ultimately opens the body to possible opportunistic infections due to the continuous decline of the CD4 and CD8 cells.

CD4 count is tested upon HIV diagnosis to check the current state of the immune system. Likewise, CD4 Count serves as indicators of possible risk of opportunistic infections and advanced HIV infection.  It remains as a vital test that can help HealthCare Providers (HCPs) in their decisions for empiric treatment, particularly for PLHIV with advanced HIV infection.

Below is a table showing the normal range of CD4 Count as well as PLHIV CD4 Count in cubic millimeter (mm3):

CD4  COUNT
IMMUNE SYSTEM STATUS
Between 500 to 1,500 cells/mm3
Normal CD4 range, immune system is healthy
Below 500 cells/mm3
Possibly immune compromised if PLHIV
Below 350 cells/mm3
Advanced immune compromised if PLHIV, with possible opportunistic infections

Since 2013, the World Health Organization (WHO) guidelines in administering ART to PLHIV has set the threshold to below 500 cells/mm3  for the start of ART, giving priority to those with advanced HIV infection or with a CD4 Count of below 350 cells/mm3.  But in 2015, two large randomized controlled trials on the efficacy of ART at varying CD4 Count levels showed that starting ART, regardless of CD4 Count, has showed significant decline in the progression of the infection. Thus, WHO updated their guidelines in September 2015 to strongly recommend that all PLHIV should start with ART regardless of their CD4 Count and stop monitoring the CD4 Count of PLHIV who are already stable in their ART.

CD4 Count are measured prior to start of ART.  Upon ART initiation, CD4 count monitoring could be done every 3 to 6 months or upon ART failure.

Viral Load

Viral load (VL) is the amount of HIV present in your blood. The higher the viral load, the quicker a person’s immune system will be damaged, increasing their risk of opportunistic infections. Also, viral load provides an early and more accurate indication of ART failure and the need for a change in ART combination, which also reduces the risk of drug resistance (HIV becoming resistant to the ART’s efficacy) among PLHIV.

Viral load of PLHIV should be monitored routinely at 6 and 12 months interval from initial HIV diagnosis and then every 12 months thereafter to ensure the stability of the ART and detect treatment failure earlier and more accurately.  Monitoring PLHIV who are linked to care is important to ensure successful treatment, to identify adherence problems and to determine whether ART regimens should be changed.


ART failure occurs when the viral load of a PLHIV exceeds 1000 copies/mL based on two consecutive viral load measurements within a 3-month interval.  Adherence support and counselling are needed following the first viral load test to prevent drug resistance.

An Undetectable viral load (less than 34 copies/mL) is the ultimate indication of ART’s effectiveness and is a goal that many PLHIV strive for. This is also crucial with the recent pronouncement of UNAIDS that PLHIV who adhere to their ART and have undetectable status can no longer transmit HIV. This means that ART adherence can be a way to stop the spread of HIV.


CD4 Count versus Viral Load

Upon start of treatment, ART suppresses the further replication of CD4 cells infected with HIV. Upon viral suppression, the immune system then has a chance to recover naturally and ultimately fight off any opportunistic infections attacking the body.

The graph below shows the correlation of CD4 cells and viral load before and after ART initiation.  If a PLHIV does not start with ART upon diagnosis, the CD4 count decreases while the viral load continues to increase.  Likewise, when ART has been initiated, CD4 count slowly increases while the viral load decreases. Hence, CD4 count has an inverse correlation with viral load.

Image Retreived from: https://commons.wikimedia.org/wiki/File:Hiv-timecourse_copy.svg
Recent studies suggest that in situations where viral load testing is routinely available and individuals are virally suppressed (Undetectable), long-term CD4 Count monitoring adds little value and stopping CD4 Count for monitoring purposes will have major cost savings.

Below are the various CD4 Count and Viral Load Testing cost in selected hospitals / treatment centers:

Laboratory Clinic / Hospital
CD4
Viral Load
The Medical City I-REACT (Individual Rate)
1,715.00
13,900.00
The Medical City I-REACT (Group Rate)

6,230.00
Makati Medical Center
5,135.00
8,835.00
St Luke’s Medical Center (Global City)
2,575.20
8,689.60
St Luke’s Medical Center (Quezon City)
6,885.00
10,655.00
LoveYourSelf Anglo***
1,500.00
7,500.00
San Lazaro Hospital
2,000.00
5,000.00
National Kidney Transplant Institute
4,600.00
4,900.00
*** Please take note that LoveYourself offers its Viral Load and CD4 tests to clients enrolled in our treatment program for FREE. The prices in the table are cost assumptions for those services should if costed.


CD4 Count and Viral Load testing are covered by the Outpatient HIV/AIDS Treatment (OHAT) Package of Philhealth per Philhealth Circular No. 011-2015.  Per Department of Health Administrative Order No. 2014-0031, CD4 cell count is done to alert physicians if the ART regimen has no effect in immune recovery or potential adherence issues. Declining CD4 count can be used as basis for switching ART combination but the measurement has to be repeated which can be financially straining on PLHIVs.  Also, where viral load monitoring is not available, clinical monitoring and CD4 monitoring are then recommended. A number of countries have either reduced the frequency of or stopped routine CD4 Count monitoring for PLHIV who are stable on ART and rely on viral load alone to monitor the response to ART and detect potential viral failure. As shown in the cost comparison table above, it is quite expensive to have regular CD4 Count monitoring on top of the viral load testing since the OHAT Package of Philhealth only covers the initial CD4 Count testing.


Whether CD4 Count or viral load is used as basis in monitoring ART effectiveness, it is also crucial to have a comprehensive and achievable adherence counselling for our PLHIV to empower them on their journey towards a stable immune status and long term HIV viral suppression.

For more information on HIV Treatment as well Life Coaching Services, you may visit LoveYourself Anglo and Victoria by LoveYourself


References:
  1. Undetectable = Untransmittable Public Health and HIV Viral Load Suppression
  2. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection Recommendations for a Public Health Approach (Second Edition 2016)
  3. The Evolving Role of CD4 cell counts in HIV Care

Illustrations by TJ Gellada Monzon
Storyboard by Franco Moje and Mark de Castro
(Inspired by the Japanese manga series “Cells At Work”)