When we talk about women’s rights, access to healthcare services for HIV and AIDS rarely take center stage. However, we can no longer ignore it. Not if we want to continue on the path that safeguards the autonomy and health of women and protects them from abuse.
For National Women and Girls HIV/AIDS Awareness Day, we spoke with the AIDS Society of the Philippines (ASP) on the state of the country’s fight against AIDS as well as the measures being made to highlight the needs of women and children living with it. Here’s how our chat with social worker and ASP president Irene “Iff” Fonacier-Fellizar and project officer Elsa Chia went.
Tell us a bit about the AIDS Society of the Philippines.
Tita Iff: This is our 26th year. As a professional, I’ve been part of it since it started. ASP started out as a membership organization. HIV and AIDS were [mainly] medical concerns at the time. [The advocacy] has evolved [to looking] into the rights of the people living with HIV (PLHIV) and the persons we reach out to who are most vulnerable.
Kasama po natin ang mga advocates who are really pushing for human rights and lobbying for changes in policies, programs, and services related to HIV and all its relevant concerns.
ASP is a member of the Philippine National AIDS Council (PNAC). Presently, we are accompanying a vulnerable population na kailangan mabigyan ng boses—the community of people who use drugs. This is one of our focuses.
Hindi [rin] nawalala sa mga mata namin ang usapin ng mga kababaihan at mga kabataan. Now, we have mechanisms made up of inter-agency organizations under the Council for the Welfare of Children that are helping ensure that the concerns of young people will also be on the table. I’m a children’s rights defender. I don’t just see children as just children—but children with gender, with parents, and with communities.
“If you knew that you were exposed through sexual abuse, there’s another layer of stigma.”
Is it fair to say that the narratives of women and children living with HIV/AIDS are severely underrepresented?
Tita Iff: Before I go into the question, may nais lang akong i-advocate sa paggamit natin ng semantics. If we refer to a group, we don’t use “[HIV] positive.” We say people, women, or a child living with HIV. It’s hopeful and it indicates how much they go through to be able to pursue their goals.
We agree with you. It isn’t fair that women and girls exposed to HIV aren’t well represented in terms of numbers in the national data. The reason isn’t “not being able to” report it. The [report] comes from the Epidemiology Bureau of the Department of Health [but the data] comes from different service facilities. [Facilities] ang nakakatulong at nakakapag-identify through screening. That alone tells us that not many women come forward to really seek help and determine their status.
This has also disturbed us because we want to do much work with regards to women who are living with HIV and using drugs. Looking at the data with those qualifiers, halos hindi mo magamit ito to say na marami ang affected. It’s not helpful in terms of programming.
Bakit kaya? There’s stigma attached to HIV/AIDS. Women who feel that they’ve been exposed don’t easily come forward. If you knew that you were exposed through sexual abuse, there’s another layer of stigma. It’s what is attached to knowing your status and being known to have sought these facilities. Nakakatakot kasi na we still have these as reasons why many of the persons living with HIV have not disclosed even with their closest family members. And for women and children using drugs, they [feel that they] cannot come forward because there’s also a security concern which is even more fearful. Even if they are able to get out of their house, they may not reach the facility alive.
Our country renewed its commitment early last year to [join the United Nations] global agenda to have zero HIV/AIDS cases by 2030. Now we know that we can work at it by looking at it in terms of human rights, quality access to services. We are now breaking barriers at this point in time.
Does HIV/AIDS in women and girls have distinct characteristics?
Ate Elsa: Tinitignan namin yung intersectionality, the multiple burdens of women lalo na ’yung access niya sa health kung living with HIV rin ang kanyang husband and she’s also looking after their children. Neglected ’yung personal niyang pag-seek ng health services. Base sa kwento ng mga kababaihan, mas priority nila ’yung kanilang mga asawa’t anak. Lalo na kung nakatira sila malayo sa city, mas prefer nila na sa bahay na lang.
Tita Iff: ’Yung distinct characteristics niya are very cultural. ’Yung expectations sa mga kababaihan, mature man or hindi, ay kailangan na rin sigurong mabago.
Kung papag-usapan natin ang services for women living with HIV/AIDS who were identified earlier in their lives, nag-iiba rin ang kanilang mga pangangailangan as they mature. Inaayon hindi lamang sa iyong gender kundi pati sa [age]—womb to womb.
Does the women’s rights legislation that we have today provide ample support for women living with HIV/AIDS?
Tita IFF: ’Yung Responsible Parenthood and Reproductive Health law (Republic Act No. 10354), malaki rin ang hurdle niya. Ang AIDS law (Republic Act No. 8504) na mas nauna sa kanya ay nakapagset-up ng systems and structures needed para sa services na magmumula sa batas ng reproductive health. May bagong batas ang HIV na mas malakas kasi human rights-based na siya. Kapag nagkapit-bisig [ang mga batas na ito], malakas. But we have to strengthen it so other actors can legitimately come forward.
R.A. No. 11166 has provisions specific for women and girls. It opened the gate so wide that children themselves could seek help. Tumaas ang [recorded] population living with HIV/AIDS coming from the youth sector [when it was passed]. As of January this year, ang taas. Nakakakilabot talaga. We can now say that children are extremely at risk.
“So many are falling through the cracks and when they do, the continuing spread of HIV will be there.”
How do we make these laws truly work with each other? One of our many challenges is to really make the state invest more in our work. We’ve been here for a long time and so much of what is provided in terms of resources come from outside [the country]. Ang question ko as a human rights defender, when can we determine ourselves? When can we say this is ours? Ang hirap kasi nung feeling ng dependency.
What are some of the women-led groups and organizations providing free or accessible HIV/AIDS services?
Ate Elsa: Dito sa NCR, we have one. ’Yung Association of Positive Women Advocates Inc. Membership organization ’yun. From the regional level, [may] general support groups. Kasama doon ang groups for MSM (men who have sex with men), straight individuals, youth, and women.
Pagdating sa affordable and free services, na-notice ko sa sharing ng mga kapatid naming kababaihan na malaking tulong ’yung libreng access sa Malasakit Centers na mainly located sa government facilities, lalo na sa mga manganganak. Kasi sa guidelines natin, once ang mother ay PLHIV at hindi pa undetectable viral load ay kailangan siya i-Caesarean [section] to prevent transmission sa baby.
Any messages for legislators?
Tita Iff: I guess they should just [see this], right [laughs]? Nakita ko na talagang effective kapag sabay-sabay tayong naglalakad at pinag-uusapan natin ang lalakaran natin. Para sa mga legislators at darating pang legislators, duty n’yo ’yan eh [laughs]. You are the duty bearers and we, the civil society organizations, will help you. Make it easy for us to work with you. We truly have to invest more. As it is, we cannot reach our target in 2030. So many are falling through the cracks and when they do, the continuing spread of HIV will be there. Attention lang. We’re here and we’re not your enemies. We’re your partners.
Any messages for PLHIV and their families?
Ate Elsa: Ang ASP ay nandito para gumabay at tumulong sa lahat ng nangangailangan in terms of disclosure, counseling, and referrals to facilities. Pwede ninyo kaming ma-contact sa aming hotlines para i-refer namin kayo kung saan kayo comfortable. Kasi ang ibang mga Pilipino, kunwari kung ako ay taga-Antipolo, hindi ako sa Antipolo mag-a-access ng services kasi maraming Marites at baka makwento ako. May ganoong mga pangyayari sa facilities.
Tita Iff: For my part, nais ko ang i-share sa mga kababaihan at batang babae, nandito ang isang tita at ate. Kung gusto nilang malaman kung sinu-sino ’yung maaari nilang mapagkatiwalaan para maging kabalikat nila sa journey nila to health, maari namin iyon i-provide. Aalalayan namin ‘yung relationships with other trusted facilities. Kakayanin natin ’to, anuman ang edad o kasarian.