1. this is it! STIR things UP Slow down HIV spread ASAP N A T I O N A L E P I D E M I O L O G Y C E N T E R Strategic Information & Response Planning Workshop 18 November 2009 The Other Inconvenient TRUTH

2. Our Goal: To maintain less than 1% HIV prevalence among most-at-risk populations N A T I O N A L E P I D E M I O L O G Y C E N T E R

3. Number of Cases N A T I O N A L E P I D E M I O L O G Y C E N T E R HIV & AIDS Cases in the Philippines by Year January 1984 – October 2009 (N=4,218 ) Source: Philippine HIV & AIDS Registry

4. 2009: TWO new cases a day! Average Number of Cases per Month 2007: One new case a day 2000: One new case every 3 days N A T I O N A L E P I D E M I O L O G Y C E N T E R Source: Philippine HIV & AIDS Registry

5. Demographic Figures: Jan 1984 – Oct 2009 N A T I O N A L E P I D E M I O L O G Y C E N T E R 2006 (n=309) 2007 (n=342) 2008 (n=528) 2009 (n=629) Cumulative (N=4,218) Asymptomatic cases 273 (88%)314 (92%)508 (96%)604 (96%)3,390 AIDS cases 36282025828 Deaths due to AIDS 18841318 Males 219 (71%)279 (82%)473 (90%)546 (87%)3, 046* Females 906355831,161* Age Range (in years) 2-672-621-621-641-72 Median Age (years) 343229 32 Source: Philippine HIV & AIDS Registry

6. Are the findings from the HIV Registry the true picture of HIV in the Philippines? N A T I O N A L E P I D E M I O L O G Y C E N T E R

7. Philippine Integrated HIV Behavioral and Serologic Surveillance (IHBSS) Done every two years since 2005. This is the 3 rd round. Has two components: 1.Measurement of behavioral risk factors through a face-to-face survey 2.Measurement of HIV and Syphilis prevalence through blood testing 10 Sentinel Sites for trending, 13 additional sites for 2009 N A T I O N A L E P I D E M I O L O G Y C E N T E R

8. Surveillance Sites IHBSS Sentinel Sites (10): Baguio, Angeles, Cebu, Iloilo, Davao, Gen Santos, Zamboanga, Cagayan de Oro, Pasay, Quezon City Global Fund Round 5 Sites (5): Surigao, Makati, Marikina, Mandaluyong, Pasig Global Fund Round 6 Sites (8): Laoag, Tuguegarao, Santiago, Puerto Galera, Puerto Princesa, Butuan, Manila, Caloocan N A T I O N A L E P I D E M I O L O G Y C E N T E R

9. Most-at-Risk Population (MARP) Inclusion Criteria Female Sex Workers (FSW) a. Registered Born female, 15 year or older, accepted cash or “kind” in exchange for sex in the past one month, and is based in an establishment registered at the local Social Hygiene Clinic (SHC). b. Freelance or Street- based Born female, 15 years or older, accepted cash or “kind” in exchange for sex in the past one month, and is based in a cruising site, street, or venue that is not registered at the local SHC. Population of Interest N A T I O N A L E P I D E M I O L O G Y C E N T E R

10. Population of Interest Most-at-Risk Population (MARP) Inclusion Criteria Injecting Drug Users (IDU) Men or women, 15 years or older, who had injected drugs in the past 6 months. Males having Sex w/ Males (MSM) Born male, 15 years or older, who reported having had oral or anal sex with another male in the past one year. N A T I O N A L E P I D E M I O L O G Y C E N T E R

11. Sampling Method *Simple Random Sampling: Registered FSW *Time Location Sampling: Freelance FSW MSM **Respondent Driven Sampling: Injecting Drug User __________ * Same sampling method used for FSW & MSM in 2005 and 2007 IHBSS rounds. **In the past IHBSS rounds, convenient sampling was used for IDUs. N A T I O N A L E P I D E M I O L O G Y C E N T E R

12. Samples collected per Site per MARP SITESRegistered FSW Freelance FSW MSMIDUTOTAL IHBSS Sentinel Sites 2,9922,7692,2819589,000 Round 5 Sites 957497795NONE2,249 Round 6 Sites 1,3738881,466NONE3,727 TOTAL 5,3224,1544,54295814,976 N A T I O N A L E P I D E M I O L O G Y C E N T E R

13. Slides on the national results of the IHBSS have been deleted for the meantime. Results will be released on December 11, 2009 at the National Dissemination Forum in Manila.

14. This is it! HIV is here. And the numbers are rapidly increasing. N A T I O N A L E P I D E M I O L O G Y C E N T E R

15. Slow Down HIV spread A.S.A.P.

16. N A T I O N A L E P I D E M I O L O G Y C E N T E R Slow Down HIV spread A.S.A.P.

17. Use Strategic Information. Respond. STIR things UP. Slow down HIV spread ASAP!