MANILA—HIV is spreading faster in the Philippines than anywhere in the world.
The estimated number of new infections in this Southeast Asian nation has more than doubled from 2013 through 2018, reaching epidemic proportions among young men, according to the United Nations’ AIDS agency. The surge in the virus that causes AIDS stands out against the decline in estimated world-wide infections.
Determining the cause can be difficult and inevitably involves some guesswork among epidemiologists seeking answers.
But health advocates think a major driver has been dating apps, which have encouraged promiscuity in a country where traditional social norms have kept people from using contraception and learning about responsible sexual practice.
More than three-quarters of the 67,395 people diagnosed HIV positive in the Philippines between January 1984—when the first infection surfaced in the country—through May this year were diagnosed in the past five years.
Some 96% of the people diagnosed over this five-year period contracted the virus after a sexual encounter, according to the government. The vast majority were gay and bisexual men aged between 15 and 34.
The government doesn’t report how people met their partners, but patients, doctors, epidemiologists and activists said in interviews that most of them met online.
Jigg, who prefers to go by his first name, was diagnosed HIV positive in 2017. Now 27 years old, Jigg says he thinks he contracted the virus after having unprotected sex for the first time with a man he met on Grindr, the gay dating app.
“Young people are on dating apps these days, and they will have sex,” said Jigg, who took to social media to share his experience, and now has about 57,000 Twitter followers. “We need to equip them with the knowledge and resources that come with it.”
The Philippines accounts for less than 1% of the world’s new HIV infections, but the number is growing faster than anywhere else.
New HIV infections in 2018 estimates
Rest of the world
Change in new HIV infections since 2008
Average number of Filipino people newly diagnosed with HIV per day
Millions of young Asians have come online in recent years thanks to low-end smartphones, cheap data plans and intuitive apps that allow easy navigation despite poor literacy.
In the Philippines, a conservative Catholic country, the internet has empowered the gay community to find support online while making it easy to date the same gender for the first time. The newfound social freedom has collided with a lack of sex education, HIV screening and, until recently, a preventive drug given to high-risk groups.
Lawmakers responded to the epidemic this year by passing a bill that encourages sex education in schools and lowers the legal age for HIV screening to 15 from 18.
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The nation’s health ministry is joining with nonprofits that offer rapid finger-prick HIV tests outside gay clubs and on the sidelines of popular events, such as gay beauty pageants.
The government said last year that people who test positive through those tests are eligible for antiretrovirals, which halt the virus’s progression, although UNAIDS says its adoption has been slow. Doctors and major treatment facilities continue to insist people undergo a confirmatory laboratory test before prescribing antiretrovirals.
The problem is that the confirmatory test is done only at an overcrowded federal laboratory in Manila, delaying results often by months. Many potential patients—particularly those outside the capital—don’t collect results or forgo the test altogether.
The majority of documented HIV cases in the Philippines were gay and bisexual men aged between 15 and 34.
Total cases reported*: 67,395
Transmitted through sexual encounters
Men having sex with
men and women
UNAIDS estimates that more than 77,000 people are living with HIV in the Philippines compared with the 67,395 diagnosed.
A separate challenge is ensuring that patients adhere to antiretrovirals, whose course runs for life. Less than half of those tested positive are currently on treatment, government data show.
Heterosexual encounters were the predominant mode of HIV transmission in the Philippines between 1984 and 2007, when the trend shifted to men having sex with men. Some 84% of the new infections reported in the Philippines last year were among gay and bisexual men, according to government data, compared with the 17% UNAIDS estimated world-wide. The demographic is younger in the Philippines too.
Desi Andrew Ching was diagnosed HIV positive in 2007, the year infections began to rise among his gay peers. The internet opened an avenue for the gay community to meet and experiment, he said, but infections skyrocketed a few years later as cheap smartphones flooded Filipino homes. By 2012, AIDS had claimed the lives of many friends.
“I couldn’t sit around and do nothing,” Mr. Ching said. He quit his job at JPMorgan Chase & Co. that year to found HIV Awareness and Support Group, a nonprofit that works with the government to encourage HIV screening. The group is now called HIV & AIDS Support House, or HASH.
But convincing gay men to go to a screening center was tough. HIV was still a taboo topic and many men weren’t publicly revealing themselves as gay.
So, Mr. Ching brought the tests home and began reaching the community through the same technology that he saw fueling its rise: social media. He created a profile on Grindr and summoned men—particularly those who said they offered paid-sex services—to his home.
“People would come expecting a sexual encounter. Instead, I’d ask them to join me in a little finger-prick experiment,” he said. Many people agreed to take the test provided Mr. Ching pay their sex fees even though he wouldn’t avail them. It was getting expensive.
The social-media strategy was working, though, and UNAIDS issued funds to train volunteers. Many volunteers created profiles on Tinder and Grindr, asking people to swipe right for a free HIV test.
Others took to Facebook and Twitter to encourage people to get tested. This year in Manila alone, Mr. Ching’s volunteers screened 2,800 people. Most people reached out for assistance on Grindr.
A Grindr representative said the company is separately pushing free ads on the app about HIV outreach programs in the Philippines. It has translated its online resource center, which encourages safe sex, to a local language.
At a gay beauty pageant in Manila one recent evening, Mr. Ching—who was a judge—announced a cash prize for the person who encouraged the most number of attendees to get tested.
More than three dozen people got tested that night, lining up to be finger pricked by his nonprofit’s volunteers.
“Many people are afraid to get tested,” said Marigona, a 29-year-old call-center worker who took the test and goes by one name. “I’d rather know than live in fear.”
Some screening volunteers, like Romar Valentine Torres, are social-media stars. The 39-year-old software engineer has 13,000 followers on Twitter, where he dispels myths around HIV and encourages safe sex practices. Sometimes, his sexually explicit Facebook posts provoke threats and hate mail.
“A lot of Filipinos are still very conservative and they don’t like to see people talking about sex,” he said.
That kind of conservatism has made it tough roll out PrEP, a preventive HIV medicine approved in the U.S. in 2012. The drug is given to high-risk groups, such as sex workers, drug users and gay men, in much of the Western world.
“We’ve tried for years to bring it here,” said Danvic Rosadino, a program manager at nonprofit LoveYourself, which is authorized by the government to distribute antiretrovirals. “But people were opposed because they believed it would encourage more promiscuous behavior,” he said.
The Filipino drug regulator approved it earlier this year, but pharmacies don’t stock it and government insurance doesn’t cover the cost. LoveYourself is the only one that distributes it.
On a recent afternoon, dozens of patients arrived at the Research Institute for Tropical Medicine—the largest treatment center for HIV patients—to collect their antiretrovirals. Among them was Ico Johnson, an HIV patient who holds awareness workshops at multinational companies and this year convinced a large energy firm to place condom dispensers inside restrooms.
Mr. Johnson, also a motivational speaker, talked doctors into letting him visit the wards of the AIDS patients admitted here. The doctor of the youngest patient, a 19-year-old man, said she wasn’t sure how long he will live.
Wearing a surgical mask, Mr. Johnson leaned over the teen’s bony frame. A tube carried nutrients through his nose.
“I looked just like you,” Mr. Johnson said. “Look at how fat I’ve become now,” he added, pointing to his growing belly. “Don’t lose hope. You’re going to look like me very soon.”
Write to Preetika Rana at firstname.lastname@example.org
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