Chris Lagman vividly remembers the night that the human immunodeficiency virus (HIV) came into his life. It was two years ago, and the LGBT activist was at a pre-Christmas dinner party in Quezon City with a dozen gay Filipino professionals. During the course of the evening, a fellow guest and close friend asked if he could speak privately to Lagman. He told Lagman that he had recently tested positive for HIV. Over the next few months the young man seemed to vanish from their social circle. The next time Lagman saw him was at his funeral, where relatives said the friend had died from a “mysterious” ailment. That was the first of many funerals Lagman would attend in 2011 as people he knew began to succumb to complications arising from HIV. “I would hear from other friends, [they would ask] why is it that suddenly a lot of my friends are passing away,” Lagman says.
Although there is still a low prevalence of HIV in the Philippines, with just under 24,000 cases reported in 2012, transmission is now growing rapidly. A decade ago, a new case of HIV was being reported every three days. These days, it’s every three hours — a terrifying statistic that makes the Southeast Asian nation one of only nine in the world where transmission is on the rise. The latest data from the Department of Health shows 415 new HIV cases in May, a 52% spike over the same period last year and the highest since 1984. According to the department, 9 out of 10 new cases are men, mostly under 30. The reason, many health workers say, is poor “prevention coverage” — things like the use of condoms and the availability of HIV testing — coupled with an increase in risky behavior. (Even Lagman admits to an unprotected sexual encounter in 2008 with a man he knew to be HIV positive. Fortunately Lagman later tested negative.)
It doesn’t help that overbearing cultural and social stigma is attached to HIV and homosexuality in the Philippines. “It’s almost like a refusal to acknowledge that this is a sexually related disease and that we have to acknowledge that people have sex,” Senator Pia Cayetano tells TIME. “Seriously, it’s as basic as that.” Lagman, who also used to have a popular blog with thousands of gay readers, believes this stigma helps the epidemic to spread by driving gay sex underground, fueling risky behavior and forcing gay men to act in a “very stealthy and in a very shadowy way.”
The government’s response, in the form of the Reproductive Health Bill that covers the “prevention, treatment and management” of HIV and AIDS, among other sexually transmitted diseases, was stymied earlier this year when the apex court of this deeply Catholic nation held up the bill’s implementation after conservatives and religious groups filed objections. “The Reproductive Health Bill, if passed into law in its present form, will put the moral fiber of our nation at risk,” the national Catholic Bishops’ Conference of the Philippines said in a statement.
The Philippines already has an AIDS prevention and control law that mandates education programs and monitoring systems. However, activists say the 15-year-old law is antiquated, given the changing nature of the disease. “When the HIV law was enacted in 1998, it was designed to address an epidemic for overseas Filipinos and among sex workers,” Jonas Bagas, head of a sexual- and health-rights NGO in the Philippines, tells TIME. “That’s not the situation right now.” Bagas says intervention programs for “stigmatized communities — MSMs [men who have sex with men], transgender, freelance sex workers, injection-drug users and drug users in general” need to be intensified. If the Reproductive Health Bill is upheld by the Supreme Court, the situation should improve. Reproductive and sexual health care will be offered at the village level and free condoms provided.
Other health issues compete for scarce funds and government attention, however. Only about $15 million a year is spent on AIDS-related programs (far less than the dollar per head of population recommended by the Report of the Commission on AIDS in Asia in 2008). Peter Mosende of UNAIDS points out that containing HIV and AIDS will not become a high policy priority while diseases like tuberculosis, which kills 75 people a day in the Philippines, rampage through the country. But things could change fast. Estimates suggest that there will be 50,000 people with HIV in the Philippines in the next three years, with more than 50% of them in need of treatment, unless remedial measures are taken now. HIV testing needs to be drastically expanded, for example. It currently reaches less than 5% of intravenous-drug users and MSMs — the two groups most prone to infection.
Lagman saw his own HIV test as a rite of passage. “It was such a horrible experience. It was kind of an outing experience for me,” he says. Not long afterward, Lagman, with a group of friends, started an NGO called Love Yourself. “When people take care of themselves and they love themselves, they will stay away from risky behavior that can expose them to the virus,” he says, explaining the group’s name. There’s no doubt that a little love can go a long way, but in the fight against HIV the Philippines needs more. It needs money, political will and a readiness to dismantle decades of stigma.