Saturday, March 11, 2017

"What's Going to Happen to Me?'


A newly diagnosed with HIV would always ask what would happen to him or her? Will there be future or relationships? Will his or her life end?

These are the familiar general questions that a Project Red Ribbon Counselor would normally receive from a new client. It is normal though. Questions arise because up to now, the Philippines has limited information about the path of life that a person living with HIV will undergo. This is not being taught up to now in the educational institutions even though promises have been made to do this.

Project Red Ribbon just needs to educate people through this blog and during all its awareness talks. The Foundation, has all the wisdom to share the lives of people living with HIV past diagnosis.

First Month

The first thing that a newly diagnosed will do is to get a consultation in the HIV and AIDS Treatment Hub in the country (Please see the listing of the hubs in the tab in this website). Usually a referral is made by the HIV testing facility to the hub. 

Once in the hub, the client will fill out forms and the hub will provide a “code” for the client for confidentiality purposes.There will then be  an HIV consultation with a prescription to undergo baseline testing. A list of baseline tests is done to assess the health status of the client, to identify possible opportunistic infections and to know the level of CD4 not the client.

Upon interview and physical assessment of the doctor, if there were assumed infections, additional tests will be done. Client can also be referred to specialized doctors handling specific infections.

During this time, the clients is given counseling on the process of treatment, on ARV adherence, on PhilHealth filing and on ARV side effects.

A week or two after the result of the baseline tests, a second consultation will be made with the doctor. The most important part of this is the CD4 test result which will determine if the client needs to start with antiretroviral medicines (ARV). Also, based on the lab test result and the interview, the doctor will also determine which combination or cocktail will be given to the client. As a rule in the Philippines (although the World Health Organization in its Arv guidelines that once diagnosed, the client should start with ARV immediately, irregardless of the CD4), a CD4 with 500 and below should be recommended to start with the ARV’s and those with 300 and below should immediately start with the medicines.

Once a client is prescribed with ARV’s, there is a 2 week observation period for the possible emergence of side effects. Common acute side effects that the Project Red Ribbon Counselors and Care Managers have seen are fever and body malaise, vomiting and dizziness, skin rashes, vivid dreams. Extreme cases show for instance, yellowing of skin and anemia. During this time, additional lab tests may be recommended by the doctor.

With the occurrence of side effects, doctors will then switch one medicine in the combination and once again observe for 2 weeks. This is repeated until there are no side effects reported by the client. Also, when there are no more side effects, the doctor can then prescribe a month to three months supply of the ARV. This means that the client will start taking the prescribed meds on a daily basis. This also means that the client will come to the hub as soon as his supply of ARV is about to run out.

NOTE:

In addition, a client after diagnosis will need to bring the following to the hub:

  1. HIV test result and HIV confirmatory result
  2. Referral to the hub for assessment even without the confirmatory result especially if the client has potential opportunistic infections.
  3. PhilHealth ID or contribution receipt
  4. For medical assistance for opportunistic infections, an economically challenged individual should get a barangay indigency certificate (while on treatment of the OI and confinement)

Every 3rd Month Hub Visit

Usually the hubs prescribe ARV for 3 months, thus the client will go back to the hub every 3 months for a “refill”. Unless, there are additional side effects, the client doesn’t need to be seen by his or her doctor. This refill is done every 3 months then. In some occasions where a client has to travel abroad for a long period, the client can request from his hub to give up to six months to 1 year supply.

NOTE:

Requirements: 
  1. Bring and submit to the hub your PhilHealth membership or proof of contribution
  2. Start with additional vaccinations (ask the HIv doctor about this)

Every 6th Month Visit.

Most hub, up to now, conducts a semi annual CD4 testing and monitoring of blood chemistry. The Out-patient HIV and AIDS Treatment Package of PhilHealth covers these tests, as long as the client regularly files his contribution to the hub.


Requirement:

  1. CD4 Test and blood chem
  2. Chest X-Ray
  3. Submit your PhilHealth membership or proof of contribution

Yearly Visit.

Every year, the doctor prescribes the Viral Load Test. This test determines  the amount of virus a person has. This is the goal of the antiretroviral therapy. If the Viral Load becomes undetectable after 1 year, then the AVR treatment is successfu. A client with an undetectable viral load can be tagged as “functionally cured”, as the virus has been attenuated and controlled. This means that no opportunistic infections born AIDS related conditions can come out anymore and the client will live a healthy and normal life as before.

Requirements:

  1. CD4 and Viral Load tests
  2. Blood Chem
  3. Chest X-ray
  4. Submit your PhilHealth membership sir proof of contribution

Regular Visitation Until there is a CURE.

This process is then repeated. Quarterly ARV refill, Semi-annual CD4 test and lab tests, and yearly VL test, CD4 test and other lab tests.

Life During Treatment

People living with HIV still has a life even with HIV, even during treatment. His or her HIV status is confidential and only him or her will know unless he or she will disclose the status. Nobody can disclose vital information from his or her hub as this is against the law. Because the HIV test is not a requirement for employment or a persons current employment, HIOv becomes not an obstacle to his job. These are all protected by the Republic Act 8504  which provides protection to the identity of every PLHIV. This is also true for schools. 

If a PLHIV wants to work abroad, only a few countries don’t allow an HIv status. These are the muslim countries and Singapore.So overseas Filipino workers are advised not to go to these countries or succumb to accosts and deportation once the country finds out his or her status. This also happens to OFW’s who find out later through the annual physical exam, a year or two later, thus they are prone to these policies of these countries.

Because of technology, PLHIVs can now have children. For women,  as long as the mother has undetectable viral load, she can give birth to an infant without HIV. For a man, he can have sperm washing, an advanced technology that removes the seminal fluid (the fluid that contains HIV) and through in vitro fertilization can have HIUv negative children. Also, treatment as prevention has been a guideline now, as the transmission of HIV becomes minuscule as long as the  man or woman’s viral load is undetectable.

Because of modern technology and advancement in the antiretroviral medicines, PLHIVs now live long lives. This proves the fact that as long as the PLHIV is adherent to his ARV treatment, he or she can have a long life like normal individuals and can be socially productive.


HIV is not a death sentence anymore. It is not an obstacle to becoming a student or a worker. It is not a deterrent to any relationship or a hindrance to having a family. It is not an obstacle to reaching one’s potential to work abroad. 

Today, HIv is similar to any other disease. It just takes one to be adherent to his or her antiretroviral therapy and life will be as normal as anybody’s elses’.




QUESTIONS ABOUT HIV AND AIDS?
WANT TO GET TESTED?
CALL US!

TRR HIV Hotline Numbers 

0915-427-3407
0906-390-1031
0927-287-8210
0975-387-3173

Office: TThS Phone Counselling
9am-4pm
(02) 656-7297


If you want to join a private HIV support group in Facebook, please add Darwin Tenoria, the TRR Program Director and request to be added in the group. We have a lot of PLHIV, counselors, HIV doctors, advocates and supporters who you can talk to.


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-Project Red Ribbon-



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