Improving access to HIV testing and treatment services for young people in Davao City

Tracy (not her real name), 16, advocates for access to HIV testing and treatment services for young people. For young people at risk like Tracy, who is a sex worker, having access to HIV testing services means being able to access treatment early and stay healthy. “Early detection means early treatment,” she said. ©UNICEF Philippines/2016/Federico Cruz

Davao City is facing an unprecedented number of cases of young people diagnosed with HIV. There are young people who want to seek treatment, but Philippine law requires those below 18 years old to get written parental consent before they can access HIV testing and treatment services.

Tracy (not her real name), 16, is one of the young people in the city who need access to information about HIV, as well as HIV testing services. As a sex worker, Tracy is at risk of getting infected because she engages with multiple sexual partners. She practices safe sex after learning about it from peer educators and other sex workers, but still fears that she can get infected with HIV.

“It would be good for young people like me to know our HIV status. We need free testing without any age restrictions.”

Although she’s able to help her family with her income, she’s not open about her work. “It’s not easy to get consent for HIV testing from our parents because they will find out that we’re sex workers, or that we have HIV. Many parents are not open to discussing these matters, and they might even be the ones who will discriminate against us,” Tracy said.

Faced with this setback, young people who are sexually active like Tracy are often left not knowing what to do. “They have to cope with being discreet of their situation and hiding the real score from their parents, while attempting to seek treatment services from health centers,” said Jeff Fuentes, City Population Officer at the Davao City Health Office (CHO).

The Philippines has one of the fastest-growing rates of HIV infection in the world. Source: Department of Health Epidemiology Bureau

Harmonization

The Philippines has one of the fastest-growing rates of HIV infection in the world. According to the Department of Health Epidemiology Bureau, there are now 26 newly diagnosed cases of HIV per day in the country — a significant increase from 9 newly diagnosed cases per day in 2012. Twenty-nine per cent of newly diagnosed HIV cases in the Philippines in 2016 are 15- to 24-year-olds.

To support the Philippine government’s national HIV response, the CHO has been aggressively addressing reproductive health, family planning and HIV issues in Davao City, especially among young people. “Together with other government units and civil society organizations, we have pulled our efforts together to come up with a harmonious approach to tackle youth sexuality issues,” Fuentes said.

The focus is no longer just on HIV, but also on related topics such as family planning, violence against women and children, and gender. Several of the city’s adolescent health programs are integrated, resulting in stronger public information and advocacy efforts.

City Population Officer Jeff Fuentes discusses his experience in implementing reproductive health programs for young people in Davao City. “The current national policy limits a lot of young people to access crucial services. It’s difficult to get parental consent for family planning services. How much more for an HIV test?” he said. ©UNICEF Philippines/2016/Federico Cruz

To encourage young people to access these programs and services, the City Government of Davao is putting up adolescent-friendly facilities with staff trained to handle reproductive health, family planning and HIV services for young people. The city also provides free HIV testing services and has its own treatment hub, where people living with HIV receive special care.

UNICEF works with local government units and civil society organizations to improve access to quality HIV services in the Philippines, especially for young people and at-risk populations. UNICEF also advocates for the removal of legal barriers on HIV testing and counseling for those below 18 years old.

“A 15-year-old has to wait for 3 years before they can legally access testing services and treatment on their own. If that person has HIV, they will have already died from complications by that time.”

In Davao City, UNICEF works with organizations and youth facilities like Tambayan Center for Children’s Rights and Brokenshire Women’s Center, which provide young people at risk like Tracy with correct information about HIV, as well as lifesaving health services. These organizations also work with stakeholders like the City Health Office and City Social Services and Development Office to advocate for the amendment of an HIV ordinance in Davao City to enable young people to access HIV testing services.

“UNICEF believes that no adolescent should be denied access life-saving HIV prevention, treatment, care and support. It is our commitment to support the national HIV response of the government, by promoting rapid integration and expansion of HIV education and care into maternal, newborn, child and adolescent health services”, said Mx. Mario Balibago, UNICEF HIV Officer.

15 to 24-year-olds comprise 29% of newly diagnosed HIV cases in the Philippines in 2016. Source: Department of Health Epidemiology Bureau

The need for a stronger policy

As local government units like Davao City continue to improve their HIV response, Fuentes highlights the urgent need to review the law on requiring parental consent for minors.

“The current national policy limits a lot of young people to access crucial services. It’s difficult to get parental consent for family planning services. How much more for an HIV test? A 15-year-old has to wait for 3 years before they can legally access testing services and treatment on their own. If that person has HIV, they will have already died from complications by that time,” said Fuentes.

Because he knows the issue well, Fuentes strongly advocates for changing the law on parental consent for minors and urges policymakers to listen to those who work on the ground. “We are bold enough to challenge the prescriptions of the law,” he said. “After learning that the national government is bent on changing the Philippine AIDS law, we wait with much interest on how this would go through,” he said.

Committed to her advocacy, Tracy has been actively advocating for HIV testing and treatment services for minors since 2013. “It would be good for young people like me to know our HIV status. We need free testing without any age restrictions,” she said.

“I don’t get tired of advocating because I want to reach out and inform others. My voice helps in raising awareness about the situation of young sex workers,” added Tracy.

In November 2016, Tracy was invited by UNICEF to join other young advocates in helping develop the 6th AIDS Medium Term Plan. This plan will guide the Philippines government and stakeholders in developing a strategic response to end AIDS in the country.

Representing sex workers and other young people at risk, Tracy not only calls for access to lifesaving information and services, but also seeks to empower adolescents so they can participate in and decide on issues that affect them.

For young people at risk like Tracy, having access to HIV testing services means being able to access treatment early and stay healthy. “Early detection means early treatment,” she said.


In the Philippines, UNICEF is helping in the HIV response for adolescents through gathering of data and strategic information, advocating for laws that are responsive to the needs of children and young people, giving adolescents life skills and leadership trainings and helping the government, NGOs and youth networks improve service delivery to respond to the crisis.

To learn more, visit www.unicef.ph.