Philippine AIDS Prevention and Control Act of 1998 PDF

RA 8504 Philippine AIDS Prevention and Control Act of 1998 - Mark Anthony O. Idio, RMT, MLS (ASCPi) RA 8504 approved on FEBRUARY 13, 1998 An act promulgating policies and prescribing measures for the prevention and control of HIV/AIDS in the Philippines, instituting a nationwide HIV/AI...

RA 8504 Philippine AIDS Prevention and Control Act of 1998 - Mark Anthony O. Idio, RMT, MLS (ASCPi) RA 8504 approved on FEBRUARY 13, 1998 An act promulgating policies and prescribing measures for the prevention and control of HIV/AIDS in the Philippines, instituting a nationwide HIV/AIDS information and education program, establishing a comprehensive monitoring system, strengthening the Philippine National AIDS Council, and other purposes. In 1984, the first case of HIV infection in the PHILIPPINES was reported  Definition of Terms TERM DEFINITION AIDS (Acquired Immune Deficiency Syndrome) ▪ Condition characterized by combination of signs and symptoms, caused by HIV contracted from another person and which attacks and weakens the body’s immune system, making the affected individual susceptible to other life-threatening infections. Anonymous testing ▪ HIV testing procedure whereby the individual being tested does not reveal his/her true identity. An identifying number or symbol is used to substitute for the name and allows the laboratory conducting the test and the person on whom the test is conducted to match the test with the identifying number or symbol. Compulsory HIV testing ▪ HIV testing IMPOSED upon a person attended or characterized by the lack of or vitiated consent, use of physical force intimidation or any form of compulsion. Contact tracing ▪ Method of finding and counseling the sexual partners of a person who has been diagnosed as having sexually transmitted disease Human Immunodeficiency Virus ▪ Virus which causes AIDS HIV/AIDS monitoring ▪ Documentation and analysis of the number of HIV/AIDS infections and the pattern of its spread. HIV/AIDS Prevention and Control ▪ Measures aimed at protecting non-infecting persons from contracting HIV and minimizing the impact of the condition of persons living with HIV  Definition of Terms TERM DEFINITION HIV Positive ▪ Presence of HIV infection as documented by the presence of HIV or HIV antibodies in the sample being tested. HIV Negative ▪ Absence of HIV or HIV antibodies upon HIV testing HIV Transmission ▪ Transfer of HIV from one infected person to an uninfected individual, most commonly through SEXUAL INTERCOURSE, BLOOD TRANSFUSION, SHARING OF INTRAVENEOUS NEEDLES, DURING PREGNANCY High-Risk Behavior ▪ Person’s frequent involvement in certain activities which increase the risk of transmitting or acquiring HIV Informed Consent ▪ Voluntary agreement of a person to undergo or be subjected to a procedure based on full information, whether such permission is written, conveyed verbally, or expressed indirectly Medical Confidentiality ▪ Relationship of Trust and confidence created or existing between a patient or a person with HIV and his attending physician. Person with HIV ▪ Individual whose HIV test indicates, directly or indirectly that he/she is infected with HIV  Definition of Terms TERM DEFINITION Pre-Test Counselling ▪ Process of providing an individual information on the biomedical aspects of HIV/AIDS and emotional support to any psychological implication of undergoing HIV testing and the test result itself BEFORE he/she is SUBJECTED TO THE TEST. Post-Test Counselling ▪ Process of providing Risk-reduction information and emotional support to a person who submitted to HIV testing at the time that TEST RESULT IS RELEASED. Prophylactic ▪ Any agent or device used to prevent the transmission of a disease Sexually transmitted disease ▪ Any disease that may be acquired or passed on through sexual contact Voluntary HIV testing ▪ HIV testing done on an individual who, after having undergone pre-test counselling, willingly submits himself/herself to such test. Window period ▪ Period of time, usually lasting from 2 weeks to 6 months during which an infected individual will test “NEGATIVE” upon HIV testing but actually transmit the infection. HIV vs AIDS Sec. 12 : Requirement on the donation if blood, tissue, or organ. No laboratory or institution shall accept a donation of tissue or organ, whether such donation is gratuitous or onerous, unless a sample from the donor has been tested negative for HIV. ALL DONATED BLOOD shall also be SUBJECTED TO HIV TESTING AND HIV (+) BLOOD shall be DISPOSED OF PROPERLY AND IMMEDIATELY. Sec. 15 : Consent as a requisite for HIV Testing No compulsory HIV testing shall be allowed. Provided, that written informed consent must first be obtained. Such consent shall be obtained from the person concerned if 1. He./she is of LEGAL AGE 2. From the parents or legal guardian in the case of a minor, or a mentally incapacitated individual. Lawful consent to HIV testing of a donated human body, organ, tissue, or blood shall be considered as having been given when: a. A person VOLUNTEERS or freely agrees to donate his/her blood, organ, or tissue for transfusion, transplantation or research b. A person has executed a legacy in accordance with section3 of RA 7170, also known as the “ORGAN DONATION ACT OF 1991” c. A donation is executed in accordance with section 4 RA 7170 Compulsory HIV testing ❑ Compulsory HIV testing may be allowed only in the following instances a) When a person is charged with any of the crimes b) When the determination of the HIV status is necessary to resolve the relevant issues under Family Code of the Philippines c) When complying with the provisions of the RA 7170 “ORGAN DONATION ACT” and RA 7719 “NATIONAL BLOOD SERVICES ACT” Exceptions to the mandate of CONFIDENTIATILITY a) When complying with REPOTORIAL REQUIREMENTS in conjunction with the AIDSWATCH PROGRAMS b) When informing other health workers directly involved or about to the involved in the treatment or care of a person with HIV/AIDS c) When responding to a subpoena duces tacum and subpoena and testificandum issued by a court with jurisdiction over a legal proceeding where the main issue is the HIV status of an individual. Release of HIV/AIDS test results a) The person who submitted himself/herself to such test b) Either parent of a minor child who has been tested. c) A legal guardian in the case of insane persons or orphans d) A person authorized to receive such results in conjunction with the AIDSWATCH program e) A justice of the court of appeals or the supreme court  RA 11166 Philippine HIV and AIDS Policy Act - Mark Anthony O. Idio, RMT, MLS (ASCPi) RA 11166 Approved on December 20, 2018 An act strengthening the Philippine comprehensive policy on HIV and AIDS prevention, treatment, care, and support, and reconstituting the Philippine National Aids Council, Repealing for the purpose for the RA 8504 and appropriating funds Philippine National AIDS Council ▪ An agency attached to DOH that is primarily tasked to ensure the implementation of the country’s response to the HIV and AIDS situation ▪ Who appoints? All member of the council shall be appointed by the PRESIDENT OF THE PHILIPPINES, except for: Representative of the senate – appointed by the senate president Representative house of representative – appointed by the house speaker Philippine National AIDS Council CHAIRPERSON DOH SECRETARY (PERMANENT) VICE CHAIRMAN ELECTED AMONG THEMSELVES PNAC as per # of members Term RA 8504 26 2 YEARS RA 11166 21 3 YEARS  Definition of Terms TERM DEFINITION Anti-Retroviral Therapy ▪ Treatment that stops or suppress viral replication of a retrovirus like HIV, thereby slowing down the progression of infection Discrimination ▪ Unfair or unjust treatment Key affected population ▪ Group or persons at higher risk of HIV exposure, or affected population whose behavior make them likely to be exposed to HIV or to transmit the virus Mature minor doctrine ▪ Legal principle that recognizes the capacity of some minors to consent independently to medical procedures, if they have been assessed by qualified health professionals to understand the nature of procedure and their consequences to make a decision on their own. Opportunistic infections ▪ Illness caused by organism, many of which do not cause disease in person with healthy immune system Pre-Exposure prophylaxis ▪ Use of prescription drugs as a strategy for the prevention of HIV infection by people who do not have the HIV and AIDS Post-Exposure prophylaxis ▪ Preventive medical treatment started immediately after exposure to pathogen in order to prevent infection by the pathogen and the development of the disease.  Definition of Terms TERM DEFINITION Redress ▪ Act of compensation for unfairness, grievance, and reparation Safer sex practices ▪ Choices made and behaviors adopted by a person to reduce or minimized the risk of HIV transmission Sexual orientation ▪ Direction of emotional , sexual attraction or conduct towards people of the same sex or people of both sexes. Social protection ▪ Set of policies and programs designed to reduce poverty and vulnerability by promoting efficient labor markets. Stigma ▪ Dynamic devaluation and dehumanization of an individual in the eyes of others, which may be based on attributes that are arbitrarily defined by others as discreditable or unworthy, and which results in discrimination when acted upon Treatment hubs ▪ Private and public hospitals or medical establishments accredited by the DOH to have the capacity and facility to provide treatment and care services to PLHIV Voluntary HIV testing ▪ HIV testing done on an individual who, after having undergone pre-test counsel willingly submits to such test HIV testing ❑ HIV testing shall be made available under the following circumstances 1. If the person is 15 TO BELOW 18 YEARS OF AGE consent to voluntary HIV testing shall be obtained the child without the need of consent from a parent or guardian. 2. Any young person age BELOW 15 is pregnant or engaged in high risk behavior shall be eligible for HIV testing and counseling, with the assistance of a licensed social worker or health worker. Consent to voluntary HIV testing shall be obtained from the child without the need of consent from a parent or guardian. 3. Consent to voluntary HIV testing shall be obtained from the child’s parent or legal guardian if the person is below 15 years of age or Is mentally incapacitated. Confidentiality HIV and AIDS information may be released by HIV Testing Facilities without consent a) When complying with reportorial requirements of the national active passive surveillance system of the DOH b) When informing other health workers directly involved in the treatment or care of PLHIV; provided , that such worker shall be required to perform the duty of shared medical confidentiality. c) When responding to a subpoena duces tacum and subpoena ad testificandum issued by a court with jurisdiction over a legal proceeding where the main issue is the HIV status of an individual. Disclosure of HIV-related test results a) Individual WHO submitted to the test b) If the patient is below 15 years old, an orphan or is mentally incapacitated, the result may be disclosed to either of the patient’s parents, legal guardian or a duly assigned licensed social worker or health worker which ever is applicable c) Person below 15 years of age and not suffering from any mental incapacity, has given voluntary and informed consent to the procedure, the result of the test shall be disclosed to child. Provided, further, that the child should be given age-appropriate counseling and access to necessary health care and sufficient support services. HIV Counseling ❑ HIV counseling refers to interpersonal and dynamic communication process between a client and trained counselor. TWO TYPES 1. PRE-TETS COUNSELING Refers to the process of providing an individual with information on biomedical aspects of HIV/AIDS, and and emotional support for any psychological implications of undergoing HIV testing and the test result itself BEFORE the individual is subjected to the test 2. POST-TEST COUNSELING Refers to the process of providing risk-reduction information and emotional support to a person who submits to HIV testing at the time the result is released. Consent 1. Express consent (express waiver) written consent from the person taking the test and which must be obtained first before HIV testing 2. Implied consent (implied waiver) consent that is indirectly given by reason of operation of law Comparison of the current HIV testing algorithm and the proposed rHIVda 1. Current national HIV testing diagnostic algorithm in the Philippines Current HIV testing diagnostic algorithm in the Philippines include screening test from referring labs. ✓ A reactive result from the screening test will be sent SACCL for confirmatory testing, where 2 parallel screening test are pe rformed/ ✓A reactive result on either of these test will then require WESTERN BLOT and or NUCLEIC ACID TEST as supplemental confirmatory test. ❖ The average waiting time of confirmatory test result is around 7-10 days, but may reach up to 3 weeks when referring laboratories pool their specimens before sending to the National Reference Laboratory to lessen the courier service expenses. The long waiting period of confirmatory test leads to delay in HIV treatment initiation. Comparison of the current HIV testing algorithm and the proposed rHIVda 2. Proposed Rapid HIV Testing diagnostic Algorithm (rHIVda) for the Philippines The rHIVda algorithm shall be done in sequence of three WHO prequalified and FDA registered HIV Rapid Diagnostic Test preselected by NRLSLH/SACCL Included 2 immunoassay tests and 3 RDTs for local validation of sensitivity and specificity on general and key population in the country.  Any person who knowingly or negligently causes another to get infected with HIV in the course of the practice of profession through unsafe and unsanitary practice and procedure, or who compelled any person to undergo HIV testing without his or her consent shall, upon conviction, suffer the penalty of imprisonment of 6 – 12 years, without prejudice to the imposition of fines and administration sanction, such as suspension or revocation of professional licenses. Six months to 2 years of imprisonment for any person who breaches confidentiality, and/or a fine of not less than 50,000 but not 150,000, at the discretion of the court RA 11166 vs RA 8504 HIV testing RA 8504 ▪ Compulsory HIV testing shall be considered unlawful unless otherwise provided by this act RA 11166 ▪ HIV testing may be voluntary or compulsary