- 3 months ago
Today on Vital Signs, we’re talking about HIV awareness and Pediatric HIV — understanding how the virus affects both adults and children, the importance of early testing, treatment, and community support.
Joining us is Dr. Kathleen Joyce “Kitkat” Del Carmen, a compassionate Pediatrician and advocate for child health and wellness.
Let’s work together to build awareness, fight stigma, and ensure that every child has a healthy future.
Joining us is Dr. Kathleen Joyce “Kitkat” Del Carmen, a compassionate Pediatrician and advocate for child health and wellness.
Let’s work together to build awareness, fight stigma, and ensure that every child has a healthy future.
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LifestyleTranscript
00:00Good afternoon everyone and welcome to VitalScience.
00:24VitalScience is Sunstar Cebu's health and wellness program in collaboration with the Cebu Provincial Government.
00:32I'm Mildred Galarpe.
00:34Today we shed light on the critical public health program, HIV, with a special focus on pediatrics.
00:42Despite advances in medicine and awareness, HIV continues to affect individuals and families,
00:48including children who face unique challenges in prevention, diagnosis, and treatment.
00:55Understanding how HIV impacts both adults and young patients is key to promoting early detection,
01:02proper management, and stigma-free approach to care.
01:06To help us navigate the important discussion, we are honored to have with us Dr. Kathleen Joyce Kitkat Del Carmen,
01:13a dedicated pediatrician who works at the HIV-AIDS core team at the Kaambag Hub or an HIV hub
01:25at the Vicente Soto Memorial Medical Center.
01:29She also is a consultant on post-graduate internship monitor at the Department of Pediatrics,
01:35team lead of research contests, research committee at the Chongwa Hospital, Mandawe.
01:41Dr. Kitkat is also a professor at the Department of Pediatrics, Department of Biochemistry, and Physiology
01:49at the Gullias College of Medicine.
01:52Dr. Kitkat finished her Doctor of Medicine at the Cebu Institute of Medicine, BOTCH 2017,
01:59and finished her Master of Arts in Health Professions Education at the Xavier University, Ateneo de Cagayan, in 2024.
02:08So, Doc, Kitkat, good afternoon.
02:12Mura magig-chocolate magig-register sa kung huna-ang-huna sa Kitkat, oi.
02:16Doc, maing-ud, hapon?
02:17Maayong hapon, maayong hapon, maayong hapon, mamildred, and satanan nga, naminaw na to karoon hapon.
02:23Okay, so very interesting na topic on HIV.
02:27Kay, ang kultura sa Pilipinas, it's kind of taboo to discuss about this, mga pre-marital or extra,
02:36majority of translation associated mangig siya on a certain stigma.
02:43So, before we proceed, can you just, balik lang taas sa basic, what is HIV?
02:51So, HIV or the HIV virus, isa na siya kagaw, no, or virus giyod, na mo yung nakaka-cause sa AIDS.
03:01Okay?
03:02So, ang HIV ang virus, ang AIDS ang sakit.
03:06Okay.
03:06Okay, so it's a spectrum.
03:08Kalinga virus, or kagaw, sa itong lawas, makuha ni na to mas commonly through sex giyod, no?
03:17It's a sexually transmitted infection.
03:20And then, however, a lot of people don't know that it can also be transmitted through other means,
03:26such as through IV, no?
03:30Which is also common in Cebu.
03:31Yes, when you do drugs, no?
03:34IV, specifically IV drug use.
03:37Also, if the mother is infected, the mother can transmit vertically to her baby through three things.
03:46During her pregnancy, no?
03:48When there is circulation of your utero-placental fluids.
03:54During labor, when, for example, they are delivered vaginally, and then they are exposed to the blood of the mother,
04:02and they go to the mucosa, or the eyes, or they swallow something in the mouth, or whatever the fluids there is, no?
04:10Because basically, they're in the fluids.
04:12And also, through breastfeeding postpartum.
04:16So, fluids, the exchange of body fluids to the body.
04:21So, is it also possible, na, naasad ka nang from mother to, conscious ang mother, conscious na tabang, ang mother is infected.
04:30Naabay instances in a way nga, pagawa sa bata, HIV-free na siya?
04:35Yes.
04:36Oh, okay.
04:37Yes.
04:38So, we have that.
04:41There are mothers who have babies na actually negative.
04:46So, how do they do that?
04:48First, they have to know that they are positive.
04:51Because when they are positive, they can take necessary the meds.
04:55Usually, their transmission rate decreases to as low as less than 1%.
05:01When they took their medications, what we call the ART, or the antiretroviral therapy, at least four weeks before delivery, okay?
05:11And if their viral load, or meaning kaka-taas sa virus ilang lawas, is actually less than 1,000 copies per ml.
05:21So, when we have those, then their viral load is undetected, no?
05:25When they are compliant to their medications, the risk is so low, less than 1%.
05:31And so, when we test the baby, we test them at four weeks or one month old.
05:37And then we test them again at four months old.
05:39And the last test is at 18 months old, which is the antibody test.
05:44And that's when we graduate them from the Kaambag program, where they are monitored as they are HIV-exposed infants.
05:53So, they are called HIV-exposed infants.
05:57Yes.
05:58Automatic, if the mother has HIV.
06:00Whether the mother is diagnosed prenatally, during labor, even postnatal.
06:07Yes.
06:07Especially if she doesn't know.
06:09So, it is really our, sort of, we really want to get them tested.
06:15So, a lot of, before, the practice is when they give birth to lying centers, sometimes they don't have the test.
06:22Yes.
06:22Wala.
06:23Wala.
06:24So, kasagaran na sa mga hospitals gud, no?
06:27So, we want to push that part of the prenatal care, part of the prenatal tests that mother get is HIV.
06:37Because there is something we can do to prevent the mother-to-child transmission.
06:43And what we call that the PMTCT, or Prevention of Mother-to-Child Transmission.
06:49And this happens when we know that the mother is positive, she's taking her meds.
06:54And so, therefore, this baby, who is now an exposed infant, could also take a prophylaxis, natambal, to prevent HIV.
07:06Okay.
07:06Because HIV can be prevented now.
07:09Oh.
07:09Yes.
07:10So, nanay-tambal.
07:11So, aside from the treatment itself, meaning you already have the virus, so you are treated with the ARD.
07:20But if you are negative, but you are high risk for exposure, for example, infants who have mothers who are positive,
07:29or if you have a partner even, positive siya, and ikaw dili.
07:34So, you can take, okay, let's talk first about the adult.
07:38Okay.
07:39For the adults, if you want to protect yourself, there is such a thing as pre-exposure prophylaxis.
07:49Okay.
07:49Okay.
07:50We call it PrEP.
07:51It's available now.
07:53Most specifically this year.
07:54So, this is an oral medication taken before you get exposed.
08:02So, assuming, for example, you have a high risk behavior, you don't know when you'll get exposed.
08:08So, you can take something para ma-protect na ka.
08:11Now, in case something happened, whatever the circumstances were, you can also take a post-exposure prophylaxis.
08:20Oh, so, before and after.
08:23Even if na-anaka, na-anai treatment for that.
08:27Di na ka tong, just, inom lang ka ato, but you are forever, ma-anaka?
08:32Yes, okay.
08:33We have partners, of course, eventually, if they want to get married, they want to have kids, but they got HIV at an earlier age.
08:45So, but their partner is negative.
08:47So, their partner, of course, they are married, they will do this, they will do sexual intercourse.
08:54And so, there is a way to protect the partner who is negative.
08:57Katong negative?
08:58Yes.
08:58She can take the prophylaxis to avoid getting the HIV virus.
09:03Katong na positive na, naanaba siya yung treatment?
09:05Okay.
09:06Yes, there is a treatment to control the virus, but not to cure it.
09:12At this point, wala pa tahanan na technology for a cure.
09:15So, kanang regular nila nga medicine, that is to control for further progression.
09:20Yes.
09:21To avoid the disease, the AIDS, the acquired immunodeficiency syndrome.
09:26Yes.
09:26So, murag, katong mga partners, na tanaw ninyo, murag, wag yun tayo mabuhat sa pag high profile sa imong usapang partner.
09:34Managang na lang ka, or you mean, whether or unsa in yung partners, it's better gudna gud kayo regular check sa imong self.
09:42No, kay wak man takabaw.
09:43Yes.
09:44Marag di takabaw kung binuangan ta, or unsa na ay lahir.
09:49And then you get, you get a sickness na wala kay gibuhat.
09:55Yes.
09:56So, I think it's more practical now to be more proactive imong thinking to protect yourself.
10:01Especially if naaka sa age of childbearing.
10:05Yes.
10:06Yes.
10:06Yes.
10:06Because statistics show that there is an increasing trend of pregnant mothers who are actually positive or living with HIV.
10:15So, I think awareness is key that you have, when you already engage in sexual activity, you have to get tested.
10:25Okay.
10:25Of course, we want to trust our partners, but we also want to empower ourselves to be the leader of our own health.
10:34Now, going back for the infants, so earlier, if you have a partner, right, you can take a prep, pre-exposure, or a post-exposure, a PEP.
10:43For infants, there is also a prophylaxis.
10:47We call it the HIV infant prophylaxis.
10:51They take it, 6 to 12 weeks medication, until we test them for HIV.
11:00Can the medications and everything available, can government provide this for free or for a fee?
11:08Okay.
11:09So, the good news is it's free.
11:11Okay.
11:12Absolutely free.
11:13So, what a great deal is in town.
11:16Yes.
11:16If you have a problem, I think, the office of Doc Itcat, who is Vicente Soto, is the only place in the office.
11:27Maybe, I mean, you can seek help there.
11:30Good if negative, but at least you have yourself tested.
11:33Yes, we offer, actually, any hub.
11:36We offer this free HIV testing and counseling, and also the medications.
11:41How many hubs do we have again?
11:43The total number of hubs is available online.
11:46You can search it, the DOH HIV hubs, and it's categorized per region.
11:53So, specifically for region 7, we have 20 hubs, both in public and private hospitals.
11:59So, for public hospitals, we have, of course, we have, of course, a DSMMC.
12:03Sumuat to lang sila, Doc.
12:04Even if in private, they can still, there's a free service.
12:10Yes, it's free service.
12:12Doc, do we have a figure, or how does HIV picture for Central Visayas or for Cebu, for that matter, compared to previous years?
12:25Okay, so, our data is from, it's a compilation, from, you have the UNAIDS, you have the WHO.
12:34And for the past years, ang ihalang recent data is the 2024, and they recorded, so far as of 2024, a total of 40.8 million people worldwide are living with HIV.
12:49And of that 40.8 million, the women is 21 million.
12:56To more than men?
12:59Oh, no, sorry.
13:00The adults is 39.4, and of the adults, 21 are women, and 18.5 million are men.
13:09It's like, Shafir, what's the most important thing about men?
13:11What's the most important thing about men?
13:13What's the most important thing about men?
13:15Okay, Doc.
13:16For this census, yes, it's true.
13:19The women are women, usually 15 years and above.
13:2321 million are women.
13:25So, it's alarming because they are childbearing.
13:28And therefore, they can also pass it down to their children.
13:31The chance of transmission is more double.
13:33The chance of transmission, right?
13:35Yes, you have your transmission through sex, and also vertically when you are pregnant, or breastfeeding.
13:43And then, for the children, it's approximately 1.4 million.
13:47Now, although this is a smaller percentage compared to the entire population, but still, there is something we can do, mangood.
13:56Kaya sayang ang ma-prevent ka itong itong ginatawag na prophylaxis.
14:01Kaya pwede yung manegative ang baby, even if positive ang mother.
14:05Yes.
14:06So, naagay ang, nagey chance to protect your baby if aware lang, giyad ka, no?
14:13I mean, even, para siguro, bisang siguro, ano, kanang, for ako, managang na lang, giyad ka, no?
14:18Managang na lang, giyad, whatever it is, managang na lang, and you know, dealt with the discussions later,
14:23is better be safe than sorry. So, what about the Philippines?
14:28Unsa man po ang figures sa Philippines, doc?
14:30So, currently, our data is from, of course, the OH, and also in line with the UNH2023 data.
14:42So, from Govali, 40 million, no? In the Asia-Pacific, it's around 6.7 million.
14:48And in the Philippines, we have a total of 189,000.
14:53So, this is as of 2023.
14:57Now, but if you can see from the previous years, this is actually a 550% increase.
15:07Ang 2023 na data?
15:09Yes, ang 2023 na data.
15:11Okay? So, Gabi, it's an alarming, it's high, it's high-geared.
15:19But what triggered this increase? Is it because there is more documentation and more testing now compared to before?
15:27Fortunately, because of the testing, I think that's because of the rise also.
15:34It affects the increasing trend in HIV, most likely because there is more testing.
15:39And I think, I'm happy that maybe people are more open to this now, to test them.
15:46A lot of hospitals are part of their protocols for pregnant women.
15:50They already incorporate HIV testing with the first prenatal visit.
15:57So, Murag, the number is a number, but you can address it.
16:01I don't know if it's a good side, but you can address it, and then precautions can be considered before further infecting other people, right?
16:13Because of their more testing, and therefore, they can catch them.
16:17And interventions.
16:18And interventions.
16:19They're linked to care.
16:20Yeah, okay.
16:21Yeah, okay.
16:23Kanilang saday atong iklaro, if those who are watching,
16:29kung unsure mo, it's better be safe than sorry,
16:35pwede na gitang mo add to Soto, have ourselves tested,
16:39and para there will be early intervention,
16:42kaysa, you know, imulang ipalabay when in fact,
16:45there is already government intervention on this aspect.
16:49Pero for Cebu, katong 500% increase,
16:53that's even for the global or just for the Philippines?
16:56That's for the Philippines.
16:59Okay, that's for the Philippines.
17:01Sorry for my voice.
17:02Nga nung, kumusta man sad ang pediatric infection, doc?
17:08I mean, unsa man pilaman ka percent,
17:10unsa gani ang age considered pedia?
17:15So, we treat the pediatric population less than 19 years old.
17:22So, 19 below?
17:23Below.
17:23Okay.
17:24Or technically, 18 years and 364 days.
17:30One year old, no?
17:31One year old.
17:33So, kanisyang, katong masabtan to na to ang babies, doc,
17:37kay Gikan Magid,
17:38wakamagid sa sila'y nabuhat ato,
17:41kay Gikan man to sa ilahang mamanga transmission.
17:44What about, unsa man ang other kanang edad,
17:48ang pinaka-early or pinaka-young pediatric patient na to,
17:55for HIV, so far?
17:57Okay.
17:58I can only speak for our own hub.
18:02We have positive babies as early as neonates.
18:05So, paggawas yun.
18:08But this is because ilang mom is infected.
18:11But what about those kanang...
18:13Ah, okay.
18:14So, we have pediatric patients.
18:19If you're talking about the transmission through the mother,
18:23it's as early as the baby.
18:25But if transmission through sex,
18:29in Cebu, our youngest is 15.
18:34When's it grade 15?
18:36Grade what?
18:37Grade 7?
18:40Grade 7.
18:41Dook, man, kung batulataan ni dook.
18:43Based on history,
18:48their first sexual encounter is usually 12 years old.
18:53So, as early as that,
18:54they would experiment already.
18:56So, it's an alarming way of knowing na...
19:00As early as this age,
19:02as early as 11 to 12 years old,
19:04they are experimenting already.
19:06Because maybe, of course,
19:08social media or pressure
19:10or not really talking about it at home.
19:16Because it's a taboo.
19:17Yes.
19:17Because nobody wants to talk about it.
19:19Tinood gini.
19:20Kanang...
19:21Mother myself,
19:23I think kita karoon mga mama, no?
19:25In the new generation,
19:26we need to be more open to our children.
19:29In terms of discussions,
19:31wala ka nag-ingo,
19:32nag-encourage mo na,
19:33hala, say, pag-apil-apil din to, dili.
19:34But to guide them,
19:36to keep in their mind,
19:38if you go to that level,
19:41make sure to protect yourself.
19:43Kanang...
19:44Hindi man ginat ni mo...
19:45Wala man ka nag-butang-ug-tracker si imong anak
19:48kung unsay iyang buhaton the whole day.
19:50But I think that's the more sensible thing
19:52to educate your children.
19:55Kanabang...
19:56Dili, let's call red,
19:59red, not other colors.
20:01Kanang part of education ginat siya.
20:02What do you think about Anidok?
20:04You know, there is a 100% solution
20:08that will produce a 100% avoidance ginat
20:13or abstinence.
20:14Oh, yes.
20:14Magin na.
20:15Magin na ang...
20:16Ayaw ginat.
20:16Pinaka-effective.
20:18Yes.
20:18Before the treatment,
20:20before the prophylaxis.
20:22It's really abstinence.
20:23Yes.
20:23For...
20:24Before you get married.
20:25And you stick to one person.
20:26Oh.
20:28Magin na.
20:28So, when you...
20:29But of course,
20:31since this already happened
20:33for whatever circumstances,
20:36there are ways to protect themselves.
20:39And they should know about this
20:40as early as the point
20:42that they can understand
20:43what sex is,
20:45what HIV is,
20:47what having that virus is.
20:49Do we need to,
20:51you know,
20:52explain this more
20:53in the schools?
20:54I mean,
20:55naabani sa atong
20:56juvi?
20:57Naabani sa atong iskwilahan?
20:59Is this being explained
21:00by the teachers?
21:01It's actually a good point,
21:03no?
21:04Because,
21:05in our hub,
21:07of course,
21:07we do HIV 101,
21:09but usually,
21:10it's for those
21:10who are positive already
21:13or their families,
21:15no?
21:15But,
21:16I don't...
21:17I'm not sure
21:17around the...
21:18in the school setting,
21:20no?
21:20If it's already
21:20being talked about.
21:22But,
21:23I think,
21:23maybe by doing so,
21:25this,
21:25no?
21:25Mga interviews like this,
21:27we can
21:28have our presence
21:30you know,
21:32this awareness
21:32where HIV is really,
21:34it's here.
21:36And it's increasing
21:36that we can probably
21:39start conversations
21:40so that people
21:41could take steps
21:42to protect themselves.
21:44And it's a virus
21:45that can be
21:46avoided.
21:48Yes.
21:49Osa na gigisulti ni Doc
21:50na 100%
21:52effective
21:53is abstinence.
21:54Ayaw giyod.
21:56Yes.
21:56Kung pwede na
21:58kamubuhatan,
21:59stick to one.
22:00Stillang doha.
22:03Stillang doha.
22:04Stillang doha.
22:04Stillang doha.
22:04Stillang doha.
22:04Yes.
22:05So,
22:05kanya siya Doc.
22:06What is the current status
22:08of pediatric HIV infections
22:10for pediatric
22:11in the Philippines
22:12and how does it compare
22:14to previous years?
22:16Okay.
22:16So,
22:16for pediatric,
22:18so,
22:19currently,
22:20globally,
22:21we are having,
22:22experiencing,
22:22mga 1.2
22:24to 2 million
22:25estimate
22:26of pediatric age
22:27living with HIV.
22:28because,
22:31of course,
22:31less than 19
22:32is still considered
22:33koan man.
22:35But,
22:35yeah,
22:36they actually
22:37divided
22:38mangod ang census
22:39na ay
22:39less than 15
22:40or more than 15.
22:41And that is because
22:42usually,
22:42more than 15,
22:43they have their own
22:44consent na mangod.
22:46if you're basing it
22:48with the entire pediatric,
22:52including the 19
22:53and below,
22:54that would estimate
22:55to 2.4.
22:56Okay.
22:57And of that 2.4 million,
22:59actually,
23:0057% are between
23:01the age group
23:02of 0 to 14 years old.
23:0457?
23:05Yes,
23:0557%.
23:06And then,
23:0750%
23:09of children
23:10born with HIV,
23:12usually,
23:12they die
23:13before their second birthday
23:14if no treatment.
23:16If no treatment.
23:17It's possible
23:17to detect.
23:19It's not.
23:19And of course,
23:21it starts with the mother.
23:22So,
23:23if the mother doesn't know
23:24until there is
23:25clinical apparent illness,
23:27it's not going to treat
23:28the child.
23:29Okay.
23:30And then,
23:3212%
23:32of AIDS-related
23:33deaths
23:34occur in children.
23:35Even if
23:36the small population
23:37lang sila,
23:38but the death,
23:39the mortality
23:39is high.
23:40So,
23:42of course,
23:43a lot of
23:43interplay
23:44with malnutrition,
23:46of course,
23:46there are circumstances,
23:48but it's really
23:50high morbidity
23:51and high mortality
23:52in the pediatric age group.
23:54Kanang,
23:55na-i-data din,
23:56katong mapakita
23:57ni na to,
23:58kanang,
23:59Eric,
23:59kaning monthly census,
24:01bitaw nga,
24:02there are
24:021,373
24:04alive
24:05on ART.
24:07So,
24:07kanis siya,
24:07as of
24:08September 25,
24:092025,
24:11pero,
24:11onsa,
24:11for the month lang ni siya,
24:12Luke,
24:12or for the,
24:14as of September
24:15na currently
24:16are patients.
24:18Pero,
24:19onsa,
24:19from what period
24:20to,
24:21from what period,
24:22I'll check,
24:23usually,
24:23it's from January 1984
24:26to,
24:27to the
24:28current period.
24:30Kaning atong
24:31under ART,
24:32wala pa,
24:32na-pila nakapurk
24:34kuan-ani niya
24:35ang,
24:35like,
24:36you know,
24:36ni progress
24:36good to AIDS
24:38or namatay gan sila
24:39or what?
24:40Okay.
24:41Oh,
24:41no,
24:41alive money,
24:42137,
24:43yes.
24:43But currently,
24:44so,
24:46kanis sila ang data na to,
24:48ng monthly census,
24:49you usually update it,
24:51for those who want to keep updated
24:52of the census,
24:53we posted it in our
24:55VSMMC Facebook page,
24:57official page,
24:58and also in our
24:59Kaambag Facebook page.
25:02So,
25:02this is the latest census
25:03of September 2025,
25:04and as you can see,
25:07we have a total of
25:08those we are
25:09treating right now
25:11with the positive
25:11na gidni sila,
25:13they are alive,
25:14they are total
25:15of 1,373.
25:17And of those
25:181,373,
25:2311%,
25:24no,
25:24sa Fibu ni nga census,
25:26sa Amu ang hab,
25:27it's 11%
25:28ang females,
25:2989%
25:29ang males.
25:31In our local,
25:32local setting.
25:34And,
25:35you can see also
25:36in the census,
25:37there are 11 of which
25:38kay pregnant.
25:39Yes.
25:39Yes,
25:40and then 77%,
25:42see,
25:43the key population here,
25:45the highest,
25:46is the MSM,
25:48the men having sex with men.
25:50And,
25:51like we said earlier,
25:53they have their
25:53first sexual encounters
25:54at an earlier age now.
25:57So,
25:58since 12
25:59is still pediatric
26:00age group,
26:02no,
26:02this age group,
26:03this 15,
26:0416 years old
26:05who engage in sex,
26:07and they are,
26:09here,
26:10they are in the
26:10key population
26:11na taas.
26:13Naas na sila
26:14at least.
26:15Contribute sila
26:16and me.
26:17So,
26:17there are also
26:17pediatric patients
26:18who are MSMs.
26:20So,
26:21okay,
26:21for example,
26:23you get
26:23tested,
26:25you're positive.
26:26What will happen next?
26:27Okay,
26:28if you're tested
26:29and you're positive,
26:31we have a test
26:33called screening pa.
26:34Okay,
26:35screening is the one
26:36we do when we do
26:39opt-out testing,
26:40the one you receive
26:41the results
26:43within the day
26:44or the next day.
26:46Once we have
26:47the screening positive,
26:48we clinically
26:49consider them
26:51as positive na.
26:51But we,
26:52of course,
26:53tested them
26:53for the confirmatory.
26:55Okay,
26:55so,
26:56fortunately,
26:58VSMMC
26:59is a
27:00DOH-accredited
27:01RIVD testing center
27:03and that is
27:04the confirmatory.
27:05Okay,
27:05aside from
27:06the ones
27:07in Luzon,
27:09which is
27:10the San Lazaro
27:11and the RITM.
27:13So,
27:13for confirmatory,
27:14it's really
27:15for the Visayas,
27:16it's VSMMC.
27:17Now,
27:18once they are
27:19even so
27:20screening positive,
27:21we link them
27:23to a HIV hub.
27:25So,
27:26once they do
27:26if they are
27:27in Mandawe,
27:28if they are
27:29in Cebu,
27:29Talisay,
27:30so there are
27:30specific hubs
27:32for that area.
27:33And then,
27:33once we link them
27:34to the area,
27:36they will be
27:37tested for
27:38other opportunistic
27:39infections
27:40because you have
27:41to treat also
27:42sexually transmitted
27:44infections
27:45like syphilis,
27:46you know,
27:47we test them
27:48for that.
27:49And then,
27:50we start them
27:51on the ART,
27:53antiretroviral therapy.
27:55Okay?
27:55And then,
27:56of course,
27:56we follow them up.
27:58Usually,
27:59if they are
28:00newly diagnosed,
28:01of course,
28:02mas frequent
28:03ang follow-up
28:04because we're
28:04monitoring side effects.
28:06The good news
28:06is the
28:07meds nowadays,
28:09the ones we have,
28:11the preferred regimen
28:13as per WHO,
28:14as per DOH,
28:15is what we call
28:16the LTD
28:17or the
28:18Lamibudine,
28:20Tenofovir,
28:21Dolotegravir regimen.
28:23And this is only
28:24a one tablet
28:25once a day.
28:26Mara siya
28:26vitamins.
28:27And compared
28:28to the previous
28:29regimens
28:29before,
28:30years before,
28:31this has
28:32a lesser
28:33side effect.
28:34Almost,
28:35wala mi kaayu,
28:37wala mi report nga.
28:38Even if you
28:39monitor them,
28:40wala mi serious
28:41side effects
28:41good ani nila.
28:43Just the occasional
28:44ani nila
28:45but a lot of times
28:46they subside.
28:48And so,
28:50they have their
28:51consults every
28:52two weeks
28:52or monthly
28:53for the first
28:54six months.
28:56And then,
28:56we repeat
28:57the baseline
28:57labs that we get.
28:59So,
28:59of course,
28:59we get the
29:00CD4.
29:01The CD4
29:01is a marker
29:02of how strong
29:04your immune
29:04system is.
29:05So,
29:06we want it
29:06to be high.
29:07And then,
29:08we also have
29:08a baseline
29:09of viral load
29:10to check
29:11their,
29:12this is in
29:13the pediatric
29:13group,
29:14to check
29:15their virus,
29:16the level
29:16of virus
29:16in their blood.
29:17So,
29:18that is your
29:18viral load.
29:19And then,
29:19we compare it
29:20six months
29:21after treatment.
29:22And then,
29:23once they improve,
29:24especially with
29:25good compliance,
29:28every three
29:29months
29:29is the follow-up.
29:30And then,
29:31a lot of times,
29:32if they are
29:33what we call
29:34undetected
29:35or virally
29:36suppressed,
29:37it's so low
29:39that the
29:40laboratory
29:40cannot detect
29:41it.
29:42But,
29:42of course,
29:43it's in the
29:43system.
29:44We know that.
29:45It's just
29:46really
29:46controlled.
29:47So,
29:48when it's
29:48undetected,
29:50usually,
29:51it's once
29:52a year
29:52or twice
29:53a year.
29:54Yes,
29:54just for
29:55monitoring.
29:56For all
29:56these labs
29:57and everything,
29:58it's free.
29:59Yes,
30:00they're free.
30:01for us,
30:03aside from
30:04the HIV test,
30:06the CD4
30:06viral load,
30:07if you have
30:08a concomitant
30:08infection,
30:09even if you
30:10have comorbidities,
30:12hypertension,
30:13diabetes,
30:14if you are
30:15under our hub,
30:17and of course,
30:18as a tertiary
30:19hospital,
30:19public tertiary
30:20hospital,
30:20it's also
30:21free.
30:22Yes.
30:23So,
30:23may nakaayin siya
30:25nga mga
30:26developments,
30:27especially,
30:28in fairness,
30:30may ngaayin
30:30ang expansion
30:32sa Vicente Soto
30:34karun.
30:34So,
30:34congratulations
30:35to Dr. Aquino
30:37kay,
30:38di ba,
30:39we have already,
30:39daghan na ang
30:40Soto,
30:40we have a
30:41cancer center,
30:42and naapani
30:42ang HIV
30:43hub.
30:44Yes.
30:45Di na tamis
30:46still mularga
30:46pag Manila
30:47because it's
30:48already here.
30:49Just,
30:49pwede na gin,
30:50kung nakadali
30:50sa Sunstar,
30:51pwede na gin mo
30:52lakwon.
30:53Pwede na gin dito.
30:54Parehan ni Publio
30:55Briones,
30:55na magsigig,
30:56jogging all the way,
30:58pwede na gin yung
30:58lakwon.
30:59So,
30:59I think,
31:00this is good news
31:01nga,
31:02kanang,
31:03di ta maguol,
31:04magpatambal kay
31:05Watay Quarta
31:05because government
31:06is providing it
31:07for free.
31:08Yes.
31:08And also,
31:09we are thankful
31:10that our presence
31:12is more palpable
31:14in a way that
31:15since Governor
31:17Baricuatro
31:18had the medical
31:20missions
31:21prior to,
31:22of course,
31:23the earthquake.
31:24So,
31:25we were part,
31:25HIV testing
31:26was part of
31:27the medical mission
31:32in the countryside.
31:33Yes.
31:34Yes.
31:34Yes.
31:35So,
31:36we empower
31:38people to get tested.
31:40We are also
31:41offering our services
31:42through these
31:43medical missions also.
31:44And thank you
31:45for the invite.
31:46Yes.
31:47And right now,
31:49people are more
31:50open for testing.
31:52So,
31:52if you will have
31:53a surgery
31:54for an elective
31:55or
31:56kung ano
31:56surgery,
31:57they also
31:58usually test na
31:59with the consent
32:01of the patient.
32:02So,
32:03at least,
32:04mas kabalos
32:04na,
32:05baka protect
32:05sa to self,
32:06di ba?
32:07So,
32:07sakto na,
32:08kaya katubit
32:09ang jury
32:09sa COVID-19
32:10ka pwede
32:10operahan
32:11or any
32:12procedure
32:13o di ka mag
32:13COVID test,
32:15di ka ano.
32:16So,
32:16I think,
32:17kung anpo ni siya,
32:18I think,
32:18safe rapod nga
32:19mag-HIV test ka,
32:20kaya dugo
32:22mangod siya.
32:22Di ba?
32:23To protect you
32:24and also the people
32:25nga mo,
32:25mo handle ni mo.
32:27Yes.
32:27So,
32:27protection gina siya
32:28sa everybody,
32:29mga igala.
32:30So,
32:30Kanisha,
32:30Doc,
32:31naanamantaan
32:32ning mga
32:33government services,
32:34no?
32:34But what about
32:35supporting HIV
32:36prevention,
32:38treatment,
32:38and education
32:39specifically for
32:40children
32:41and,
32:42you know,
32:42the young adults,
32:44the younger adults,
32:44the older adult.
32:48Yes.
32:50In Kaamag,
32:51we do have
32:52our platform.
32:54We call it
32:55Teach Shibu.
32:57It's via
32:58Facebook Live.
32:59So,
32:59every Thursday...
33:00Ah,
33:00it's a regular
33:02webinar program
33:04every Thursday,
33:067 p.m.
33:07via our Teach Shibu
33:08Facebook
33:09that we go online
33:11to address
33:12certain key topics
33:14related to HIV.
33:15Everything related to HIV.
33:16Pwede na gina'n mo
33:17na-share sa improve
33:18Facebook page
33:18sa tour Sheibu
33:19para mga
33:20widen na to
33:21ang pagpahibaw
33:22kalabot
33:23aning HIV
33:24kay
33:24ah,
33:26nagkadaku
33:26or bagin in town
33:27ang ihang numbers,
33:29So,
33:29I think,
33:30mas maayaw
33:31madagan ang makahibaw,
33:32mas daghan ang makapangandam,
33:34daghan makaprevent
33:35Annie. So that's
33:37on your Facebook page? Yes, on the
33:39Teach Cebu Facebook page.
33:41On the other hand,
33:43un samansad ang challenges
33:44do healthcare providers face
33:47on diagnosing and managing pediatric
33:49HIV cases?
33:51Okay. Specifically
33:53for pediatric PLHIV
33:55because I'm the pediatrician,
33:57a lot of this key population
33:59has really certain
34:01stories, backstories that
34:03you know,
34:05some were abused,
34:07some were
34:09so
34:10a lot of
34:13there are times, it's not really their fault.
34:17Victims of circumstances.
34:20Yes, victims of circumstances.
34:21So
34:21we also
34:23refer them to social workers
34:25and even the SWD
34:27and then
34:28I think for me, the challenge is really
34:31disclosure also
34:33to this population
34:34when their understanding
34:36is still, you know,
34:38their maturity
34:38is still developing.
34:40Do they really understand this?
34:43Especially for the children
34:44who have HIV
34:46at a young age.
34:48When they,
34:49for example,
34:49they got it from their mother
34:50at an early age,
34:51they're taking medications
34:54thinking it is vitamins
34:55because they don't know
34:57infection yet,
34:58they don't know maintenance.
35:00And at a certain age,
35:01usually when we transition them
35:03to an adolescent,
35:05usually 10 years old above,
35:06they will now question
35:10why are they still
35:10taking these vitamins
35:12or these medications.
35:14Although some of them
35:15naandad na,
35:15but then
35:16when they start to question
35:18then of course
35:18this disclosure process
35:20is
35:20the,
35:21one of the more challenging
35:22aspect
35:23in handling
35:24these cases.
35:25is acceptance.
35:27Yes,
35:27that it's,
35:28they got it,
35:29they have all the virus,
35:32they have to,
35:33to take
35:33their medications
35:34until,
35:37as a maintenance.
35:39until there is
35:40such a
35:41treatment.
35:42A cure.
35:43But what,
35:43what,
35:43what,
35:44what's it about
35:45if,
35:45you know,
35:46you're a pediatric
35:48HIV,
35:50does that mean that
35:51trans,
35:52can you carry your
35:53you can,
35:54you can,
35:54you can,
35:55you can,
35:56you can,
35:56you can,
35:57you can,
35:57yes,
35:57of course,
35:59you have the virus,
36:01whether you,
36:02whether how you
36:03ever got it,
36:04whether it was
36:05vertically transmitted
36:06to you or
36:06through sex
36:08or through IV.
36:12Yes,
36:12we should be,
36:13that's why
36:14when,
36:14when we educate them,
36:15we have to
36:16also educate them
36:18about how they
36:19could prevent
36:20transmitting it
36:21to others.
36:22Okay,
36:23they already have it.
36:24So,
36:25when you,
36:26of course,
36:27we advocate for,
36:28again,
36:29abstinence,
36:30no?
36:30But,
36:31for those who are
36:32desiring family,
36:34no?
36:36Aside from the
36:36prophylaxis
36:37that their partners
36:38can take,
36:39we still encourage
36:40them barrier
36:41methods,
36:42we give condoms,
36:44we provide
36:45lubricants
36:46to really
36:47discourage,
36:48prevent
36:48blood,
36:50or fluid
36:50contact.
36:51Yes,
36:52contact.
36:53Kaguol ba
36:54di ay net,
36:54o eh?
36:55Kung ako'y naguol,
36:56yes,
36:56ma-stop
36:57ang progression,
36:59but,
36:59murabag naanagit,
37:00murabag siya,
37:00naanagit siya.
37:02Un sige,
37:02anong magsakit sa tiyan,
37:03kanang
37:04amebiasis?
37:06Diba,
37:06murabag,
37:07naanagit,
37:09the,
37:09ano is there,
37:10sakto ba na,
37:11doc?
37:12Ang amoeba na,
37:12pwede mo stay
37:13sa liver,
37:15mag-absess dito.
37:16May gamay yung trigger.
37:17Pero,
37:18treatable.
37:19Pero,
37:19kani,
37:20mo na,
37:21kanang delish siya,
37:22wala siya yung cure,
37:23but it's treatable
37:24in a way
37:25that you can live
37:26long and healthy life.
37:28So,
37:29malanggid na,
37:30career na langgid na.
37:31So,
37:31malingkamot ta,
37:33for,
37:33katong mga,
37:34naaanit,
37:35to be more conscious,
37:36and to be more responsible
37:37sa itong mga
37:38decisions,
37:39sa itong actions,
37:40kayo must risk that
37:42to other people.
37:44Okay.
37:44So,
37:45how has the 2018 HIV law
37:48impacted access
37:50to HIV services
37:51for minors?
37:53Okay.
37:54A lot,
37:55of course,
37:57the access to
37:58treatment,
37:59to medications
38:00is more open
38:02now.
38:04So,
38:04for,
38:05for the,
38:06those who are
38:0715 years old
38:08and above,
38:10we actually
38:11offer the prep
38:12to this
38:12population,
38:14not,
38:15specific for that.
38:18And also,
38:20since na naman sila
38:21buot,
38:23they're usually,
38:24they can go to
38:25the hub by themselves.
38:27So,
38:27dili na sila kailangan
38:28mo add two foods
38:29with their parents.
38:31Sometimes,
38:32usually,
38:33mga 18,
38:34sila na lang.
38:37Although,
38:37we encourage
38:38na you can tell
38:39your parents
38:40so you have
38:41a support system,
38:42but it's their
38:43kanang choice
38:45kung muingon sila
38:46or dili.
38:47And also,
38:48kaning,
38:49dili lang
38:50medication na support
38:52ang naana.
38:53We give referrals
38:55to,
38:55if na sila
38:56problema
38:56with abuse,
38:58substance abuse,
39:01even mental health
39:02issues,
39:03kanya age group
39:04na ay psychiatry,
39:06even part of the
39:07group or the team,
39:09yes.
39:10For us,
39:11in Kaambag,
39:12we have that.
39:12and also,
39:14even for referrals
39:14from other
39:15HIV hubs
39:16for certain
39:18multidisciplinary care,
39:20we call it
39:21intensive case
39:22management na.
39:23So,
39:24we assign a case,
39:26we have a case
39:27manager
39:27who follows
39:29them up.
39:30We even have
39:30an own group
39:32chat with them.
39:33That would,
39:34they have their
39:35social media
39:36account,
39:37and then,
39:37a case manager,
39:39a doctor,
39:41a social worker,
39:43and their nurse.
39:44So,
39:45para diigit silang
39:46mawala.
39:46Naambay,
39:47like for example,
39:48ka ng mga
39:49alcoholics,
39:49they have
39:50clubs,
39:51do they also
39:51have that?
39:52They among
39:53themselves can
39:54share their
39:55experiences,
39:56learn from
39:56each other.
39:57Okay,
39:58so,
39:59sa Amo,
40:00as a Pedia,
40:00we have a
40:01monthly
40:02women living
40:04with HIV
40:04support group
40:05with a
40:06growing
40:08activity
40:08for their
40:09children.
40:10It's every
40:11end of
40:13Saturday of
40:13the month
40:14at Kaambag.
40:16So,
40:17it is also
40:18in partnership
40:18with an
40:19organization
40:20called Glory
40:20Reborn.
40:21it is also
40:22their advocacy
40:23to support
40:24women
40:25to empower
40:28them.
40:29Although,
40:30specific
40:30support groups
40:31for alcohol,
40:32it's probably
40:32different
40:33support group,
40:36but we can
40:37channel them
40:38to the
40:39support groups
40:40that we have
40:40already.
40:42But for the
40:42Pedia
40:42and women,
40:44we have it
40:44every end
40:45of Saturday
40:46and Saturday
40:47of the
40:47month.
40:48How long
40:48has been
40:49Kaambag
40:49in existence
40:51in Soto?
40:52Okay,
40:53Kaambag
40:54has been
40:54in VSMMC
40:56since 2009
40:57when VSMMC
40:59employees were
41:00trained by
41:00the DOH
41:01Central Office
41:03for HIV
41:04treatment.
41:04there is
41:05a training
41:06that
41:07those under
41:08the HUB
41:09are underwent.
41:10And then
41:11since then,
41:12in 2009,
41:13and that is
41:14more than
41:15years.
41:166,
41:166,
41:177?
41:172009.
41:20Sorry,
41:202019,
41:21may nagawas
41:21akong
41:22una-una.
41:222009.
41:2310,
41:2310 ang
41:242019
41:25plus
41:26siguro
41:27mga
41:2717,
41:2816 years.
41:29So,
41:31we've been,
41:32it start
41:33from a
41:33small
41:33pang
41:34hub
41:34and then
41:35now
41:35it has
41:36grown
41:37into a
41:38multi-specialty
41:40type
41:41of hub.
41:42So,
41:42for example,
41:43because
41:44HIV is not
41:45just HIV
41:45alone,
41:46na may
41:46complications.
41:48Yes,
41:48complications,
41:49infection,
41:50opportunistic
41:50infections
41:51in the
41:51mata,
41:52in the
41:53lungs,
41:56pneumonia.
41:58So,
41:58infectious
41:59disease
42:00specialists
42:00on board,
42:01pulmonologists,
42:02even surgeons.
42:04Actually,
42:05cancer
42:05has a
42:06higher
42:07prevalence
42:07in
42:08HIV
42:09AIDS
42:09patients.
42:11And then,
42:12so,
42:13we have
42:13grown to
42:14more than
42:1520 plus
42:16of us
42:16already
42:17in
42:17Kaambag
42:18and
42:19also
42:21in
42:21the
42:21Visayas.
42:23So,
42:23the
42:23government
42:24has done
42:38its part
42:38in providing
42:39basic
42:40services,
42:41not even
42:41basic,
42:42expand
42:43into
42:44interdisciplinary
42:45complications
42:47or other
42:49HIV,
42:50and it's
42:50all for
42:51free.
42:52If in
42:54doubt,
42:55just visit
42:55the Kaambag
42:56hub at
42:57Vicente Soto
42:58and have
42:58yourself
42:58tested.
42:59If it's
43:00negative,
43:01hallelujah.
43:02If you're
43:02positive,
43:03I'm not
43:04saying don't
43:05worry,
43:06but there's
43:06a treatment.
43:07just have
43:10yourself
43:11treated
43:11and
43:12take
43:13the
43:13program
43:15so that
43:16life is
43:18not the
43:18end of
43:18thing
43:19with this
43:19kind
43:20of
43:20sickness.
43:22So,
43:22Doc,
43:22I'm not
43:22sure if
43:23they're part
43:36of the
43:3620
43:37in
43:37Kaambag,
43:38Go
43:38Doc
43:38Kit
43:38Kat
43:39from
43:39Kaambag
43:40Family.
43:41So,
43:41thank you
43:41for
43:41watching.
43:42Jen
43:43Branzuela,
43:44shout out to
43:45Dr. Kathleen
43:45Joyce,
43:46complete name,
43:47Yung Kaayo
43:47Doc
43:47Kit
43:48Kat,
43:48from
43:48Kaambag
43:49Clinic
43:49Family,
43:50Vicente
43:50Soto
43:51Medical
43:52Center.
43:53Joseline
43:54Peliazo,
43:55Go
43:55Doc
43:55Kit
43:56Kat,
43:56Pidya
43:56Doctor
43:57from
43:57Kaambag
43:57Clinic.
43:58So,
43:58proud family
43:59members
43:59ni Doc
44:00Kit
44:01Kat
44:01sa
44:01Kaambag
44:02sa Vicente
44:03Soto.
44:03Thank you
44:04for
44:04watching.
44:06The last
44:06question
44:06will be
44:07what role
44:08does
44:09comprehensive
44:09sexuality
44:10education
44:10in schools
44:11play in
44:12preventing
44:13new
44:13HIV
44:14infections
44:15especially
44:15among
44:16the
44:16young
44:16people?
44:18Of course,
44:22knowledge
44:22is power
44:23and
44:24knowing
44:25about
44:25HIV,
44:26how
44:27it is
44:27transmitted,
44:28how
44:28you can
44:29protect
44:29yourself
44:30or
44:30if
44:31you
44:31have
44:31it,
44:31how
44:31you
44:32can
44:32treat
44:32yourself
44:33is
44:34a
44:35critical
44:36step
44:36towards
44:37your
44:37own
44:38entire
44:39health.
44:40So,
44:41as early
44:41as a
44:42child
44:42can
44:42understand
44:43these
44:44things
44:44that we
44:46are open
44:46to discuss
44:47it,
44:48no sugar
44:48coating,
44:50really
44:50presenting
44:51facts.
44:52I
44:53believe
44:54there
44:55is
44:55good
44:57decisions,
45:03it will
45:04empower
45:04them to
45:04make
45:04good
45:05decisions.
45:06Of course,
45:07they know
45:08that they
45:08can get
45:09it through
45:09sex,
45:10through
45:10this
45:11drug
45:12use,
45:12IV
45:12drug
45:13use.
45:13And so,
45:14they will
45:15not do
45:17these
45:18things.
45:18And of
45:19course,
45:20there is
45:21still hope
45:23if they
45:24already
45:24have it.
45:25So,
45:26they can,
45:27it's,
45:28they are,
45:29there are
45:30welcoming
45:30hubs
45:30around
45:31each
45:32areas.
45:33Very
45:33welcoming,
45:34our
45:35staff.
45:37No
45:37judgment.
45:37No
45:38judgment.
45:38No
45:39judgment.
45:40Because
45:40we
45:42really
45:42want to
45:43empower
45:44testing,
45:45prevention,
45:45and of
45:47course,
45:48treatment for
45:48those who
45:49have it.
45:50So,
45:50if by
45:51an early
45:51age that
45:52it is
45:53already
45:53discussed
45:54to them,
45:55then they
45:56can take
45:57the necessary
45:57steps to
45:58protect
45:58themselves.
45:59Canisha,
46:00from the
46:00schools,
46:01how can
46:03families and
46:04communities
46:05better support
46:05children living
46:06with HIV
46:07to reduce
46:08the stigma
46:08and improve
46:09their quality
46:10of life?
46:11Yes,
46:12because
46:12of course,
46:13there are
46:13other
46:14stigma.
46:14although
46:15it's
46:16better
46:16now.
46:18If
46:19it
46:19becomes
46:20part of
46:21our
46:21normal
46:21conversations,
46:22even
46:23just part
46:23of a
46:24normal
46:24testing
46:25process,
46:25consider
46:26it like
46:26a CBC.
46:28When
46:29you get
46:29sick or
46:30you have
46:30your
46:31schedule
46:31for a
46:32surgery,
46:32okay,
46:33let's
46:33get
46:33tested.
46:34So,
46:34when it
46:35gets
46:35part of
46:35our
46:36system,
46:37we
46:37will
46:38checklist.
46:40Okay,
46:40it's
46:41just really
46:41part.
46:42Then,
46:42it reduces
46:43the stigma
46:43also.
46:44This
46:45is not
46:46just for
46:46families
46:47to really
46:48start
46:48conversations
46:48with your
46:49children,
46:50but also
46:51for us
46:52health
46:52practitioners.
46:54We
46:55empower
46:55our
46:56patients
46:56that,
46:57hey,
46:58you can
46:58get tested.
46:59You want
46:59me to
47:00include
47:00this
47:00in your
47:01test?
47:01Because
47:02this
47:02test,
47:03with our
47:05law,
47:05it has
47:06to have
47:06consent.
47:07so,
47:08when you
47:09make it
47:10a part
47:11of a
47:11routine
47:11type
47:12of
47:12test,
47:13then it
47:13reduces
47:14the
47:14stigma
47:14and empowers
47:15people to
47:15get tested.
47:16So,
47:17for us
47:21to be
47:23aware of
47:24positive
47:25or negative
47:26is just
47:27have yourself
47:27tested.
47:28there are
47:29free
47:29testing
47:31centers
47:31like
47:32the
47:32Kaambag
47:32in
47:33Soto.
47:34So,
47:34don't be
47:34afraid.
47:36I know
47:36it takes
47:36courage
47:37if you're
47:37in doubt,
47:38but again,
47:39it's better
47:40be safe
47:40than sorry.
47:41So,
47:42thank you
47:42Kaayo Kang
47:43Dr.
47:43Kathleen
47:44Kitkat
47:44Del Carmen
47:45for
47:45explaining
47:46and sharing
47:48her
47:48insights.
47:50And,
47:50thank you
47:50to our
47:50viewers
47:51who shared
47:52their shoutouts
47:53to Dr.
47:54Kitkat.
47:54So,
47:55see you
47:55again next
47:56Thursday
47:56for another
47:57episode of
47:59Vital Science.
48:00I'm
48:00Mildred Galarpe.
48:27I'm
48:28Mildred Galarpe.
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