What you need to know
With cases of HIV up 3,147 percent in the last 10 years, it is fair to say the Philippines is in the grip of an epidemic.
Wanggo Gallaga, son of critically acclaimed filmmaker Peque Gallaga, was working as the features editor for a college magazine when he learned he was HIV positive.
"[My family] all knew my lifestyle, I was gay, sleeping around," Gallaga told Rappler in 2015. "They were always telling me to use protection. I didn't." Gallaga, like many in the Philippines, had thought HIV/AIDS was something that only happens to people overseas. Now, as the country has seen HIV cases jump by a shocking 3,147 percent in the past 10 years, he wants his compatriots to be aware of the threat.
Within a few months of his diagnosis, Gallaga, who now teaches screenwriting at Manila's College of Saint Benilde, became a public advocate for HIV+ people in the Philippines, where conservative social mores keep open discussion about HIV/AIDS muted.
"Soon after I was diagnosed with HIV," Gallaga tells The News Lens, "I told my family, my friends, and my employers, and they all accepted me." Now 38, the writer and poet recalls his participation in an exhibit by his friend, photographer Niccolo Cosme. Titled "Headshot Clinic: AWARE," it marked the day that Gallaga revealed his status to the press.
"I was not the common idea of a person who had HIV in the country," says Gallaga, in large part because of his famous and supportive father. He's spent the last 10 years raising awareness of HIV/AIDS, working directly with the Philippines Department of Health (DOH), and advising other HIV+ Filipinos who reach out to him in confidence in a society which, he tells us, remains "rife with stigma and discrimination."
Data from the Philippines DOH and the World Health Organization (WHO) shows that HIV cases continue to surge in the country, and HIV positive workers in the country face regular workplace discrimination. The News Lens reached out to Gallaga via email, who shared his thoughts on being HIV+ in the Philippines, President Rodrigo Duterte's public jokes about not using condoms, and the importance of getting tested. (The interview has been condensed and lightly edited for clarity.)
The News Lens: Being HIV positive, what personal challenges have you experienced?
Wanggo Gallaga: To be honest, I'm very privileged and very lucky. My family, friends, and colleagues were very supportive. The biggest challenge I had to face was dealing with the infections that came because I found out so late. I was fighting for my life with meningitis. It was expensive, but people were very helpful.
If I had found out earlier about my status, I could have taken better care of myself and started treatment earlier. I probably would not have gotten meningitis, which I got twice.
Despite this, I'm still here. That's the most challenging thing I had to deal with as a person living with HIV/AIDS (PLHIV). It's small, really. Expensive, for sure, but manageable. I have a support system and my parents are helping me out with all my expenses.
It's not a typical story, though. There are so many people who do not have that sort of support and help from the people around them. Mine is a very special case, and I think it's important to stress that. People are struggling everyday with the stress of being discovered. They have to take care of themselves on their own without support. They fear discrimination and stigma. As a person who doesn't suffer from any of these challenges, it is easy for me to take charge and manage my condition. It should be this way for everybody.
TNL: The Philippines has the fastest growing HIV epidemic in the Asia-Pacific region. What do you think is the reason for this overwhelming increase in numbers?
WG: There are a lot of factors that contribute to the rise of the growing HIV epidemic. This is all based on my personal experiences only and my interactions with other advocates, the DOH, and other people living with HIV, who have shared their stories with me.
In the Philippines, there is a constant battle to have a mature, medical conversation about sex and sexual habits in the country. There is still a huge inability to have an elevated discussion about sex in the country because it's very conservative. We still carry with us many of our old value systems that hinders a more scientific approach to dealing with topics about sex. It's still very conservative and very patriarchal.
There is the pervading obstacle from the more rigid members of the Catholic church who believe that sex outside of marriage is a sin and that abstinence is the only way to prevent HIV. [Ed's note: About eight in 10 Filipinos are Roman Catholic Christians.] They refuse to allow anybody else to use any other method to protect themselves. And they have backing from government officials – both elected and appointed – who do not take a scientific approach to sex and reproductive health. We cannot get full support to teach proper sex education at an age-appropriate levels and make condoms more accessible.
This inability to have a healthy, mature conversation about sex has stopped us from making progressive strides with HIV awareness and prevention. We still meet so many hurdles and obstacles from various sectors in society. We are always walking on eggshells, trying our best to not offend people so that we can give proper sex education and make condoms more accessible to people.
This sort of environment regarding sex and reproductive health is a breeding ground for discrimination, stigma, and misinformation to spread. It makes it difficult for people to get themselves tested, to have access to proper information, and to access condoms, should they need this.
It's still something people are afraid to talk about in public, and there will always be opposition.
TNL: President Duterte joked that Filipinos should not use condoms as they 'aren't pleasurable.' What are your thoughts on this? Is the administration supporting the DOH's campaign and efforts to take the HIV crisis seriously?
WG: I find that statement to be very ignorant, insensitive, and misinformed. Honestly, it's a dumb thing to say. I've been very unhappy with how the administration has been addressing the HIV epidemic in the country. Since the meteoric rise of infections beginning in 2008, not one president has mentioned the HIV crisis in their [annual] State of the Nation Address (SONA).
Instead, they have left it with the DOH to handle. They don't speak about it openly in fear of inviting criticism from opponents of proper sex education and reproductive health education and policies. With men who have sex with men (MSM) being the largest population with HIV infections, talking about their safety and health would sound like an all-out endorsement of our gender identity, which is itself a hotly contested topic.
We have misinformed and dismissive legislators like Vicente "Tito" Sotto III and Manny Pacquiao who constantly oppose and hinder progressive legislation like the Reproductive Health Law (RH Law), the Anti-Discrimination Bill, and the Divorce Bill. This is symptomatic of an old-school, uninformed, antiquated patriarchal conservative frame of mind that has kept the country from addressing necessary issues. HIV is one of those issues.
I think the DOH is doing the best that they can, but there are so many people in the administration, and in past administrations, that have constantly impeded on policies that could have made a significant effect in the slowing of the HIV crisis.
TNL: Do you agree with the DOH's previous plan, since halted in schools, to distribute condoms to students aged 15 to 24?
WG: I do. I think that students of that age will have sex whether anyone tells them they should or shouldn't. I remember being that age. They will do what they want, regardless. I think it's better to properly educate them, talk to them about what they are getting themselves into, and arm them properly so that they can stay protected.
There is a belief that if you give people condoms, it will promote promiscuity. The truth of the matter is that people will do it anyway, with or without the distribution of condoms. It's better to normalize the behavior and to teach the proper ways to protect yourself. When something becomes less of a taboo, the mystery disappears, and people will begin to see it for what it is and to ask the right questions. When you withhold something or tell people they can't do it, it only makes people think more about doing it.
Many times, I will talk to a stranger who messaged me on social media with a fake account asking for advice. They often tell me they are sexually active but they don't get tested regularly and they don't use condoms. Many of these people are young. They are not properly educated about the risks involved. This has to change. – Wanggo Gallaga
Remove the temptation. From all the stories I've been hearing, it's already happening, so it’s better to just arm them with the necessary tools (education, access to condoms) so that they can do it with as little possible consequence as possible.
TNL: How important is sex education in schools?
WG: I think sex education is very important. Especially now. We are living in a very hyper-sexualized society. You have half-naked bodies on billboards selling everything from tuna to pineapple juice so no matter how old you are, you will always be seeing images of the human body. In television and movies, love and sex go hand-in-hand. If we do not educate children at an early age about sex – and remove any thought that this is an issue of morality – than they can make better choices about what they do with their body that will help them stay healthy.
The problem, I feel, about dealing with sex in the arena of morality (whether sex is good or bad) is that it's so abstract, especially for a teen or a child. But once they realize that it's merely biology, they’ll treat it without much fanfare. They can deal with it scientifically, with logic, rather than just their feelings.
In a country like the Philippines where over 90 percent of new HIV transmissions are through sexual contact, a conversation about sex is not far behind. You cannot talk about one without the other. You have to look at what people know about sex to understand how they got infected with HIV. Many times, I will talk to a stranger who messaged me on social media with a fake account asking for advice. They often tell me they are sexually active but they don't get tested regularly and they don't use condoms. Many of these people are young. They are not properly educated about the risks involved. This has to change.
TNL: What do you think the government has to improve to prevent the spread of HIV?
WG: I think there should be a bigger budget dedicated to HIV so that we can get more social hygiene clinics in various parts of the country and make sure that more people with HIV get their treatment medicine.
I think the government should stop listening to conservative, non-scientific based arguments against sex education in schools and make it mandatory at a younger age. There should be proper training of teachers on how to effectively teach sex education to children. It's not enough to give materials to the teachers to use as instructional material. They need to be properly oriented to navigate these situations. If parents are going to have children, they should be able to properly parent their children and teach them and allow the educators to aid them in preparing them for the future.
We bring our kids to school so that they can learn. It's not enough to teach them math and reading. We also have to teach science, the human body, and to inspire critical thinking and these are all important building blocks to proper sex education.
TNL: The RH Law allows teenagers to purchase condoms, but it requires parental consent for teens below 18 years old. What can you say about this?
WG: This sounds silly to me. I know so many people who have had sex before they turned 18 and who never told their parents about it. I know very few people who are open-minded about their children's sexual activities when they are still teens. I understand that it makes sense, but I don't believe it's realistic.
Again, anybody who wants to do something will do it, whether we want them to or not. I wish we lived in a better world. But wishing isn't going to do anything. Wishing and praying has never done anything, really. We have to take action. We should allow teenagers to buy condoms and to take an HIV test, without parental consent.
I think experience will tell us that teenagers will not talk about sex with their parents. And I think a teenager's health is more important than offending a parent's sensitivity. If allowing them to purchase a condom or to take a test will protect them, then at least we will have kept them alive, healthy, and well.
TNL: Are antiretroviral drugs (ARVs) available in the country? Are they still free for HIV patients?
WG: Yes, they still are. As long as you are paying for your national health insurance (PhilHealth), you can have access to free ARVs.
TNL: Due to social stigma, HIV positive individuals are often afraid to get treatment or to come out. What's your message to them?
WG: I have no message, really. It was easy for me to come out because my family, my friends, and my work were all supportive of me when I revealed my HIV status. I didn't lose a family member, a friend, or a job because of my status. So it's not a stressful situation for me.
But I know so many people who have lost family, friends, and livelihoods because of their status. And it's not fair. As our country is still rife with stigma and discrimination, I think that each person living with HIV should make that decision to come out on their own. I just hope that they can build a support system of trusted friends who will know of their status so that they have people to run to if they need help or support. I think that's essential.
But – regardless of the stigma and discrimination – treatment is necessary and non-negotiable. Regardless of your fears, you have to take your meds or you will get sick and you will not have an easy time living with your condition. There are so many studies now that prove that if your viral load is undetectable, it is impossible for you to transmit the virus to anybody else, and that's important. Your quality of life is dependent on your treatment.
Your status is your own decision but taking your meds should not be. That's what I believe.
Editor: Nick Aspinwall (@Nick1Aspinwall)
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