CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

Hiv- originated in Democratic Republic of Congo  HIV - a retrovirus that infects cells of immune system
-transmitted from chimpanzees to humans (1900) and destroy and impairs cell function. Progressive
1984- First case of HIV infection in the Philippines. deterioration of the immune system leads to
1989- HIV testing- Administrative Order No. 57, Series of immune deficiency.
1989
Aids  AIDS- a deficiency caused by HIV that makes an
1979- AIDS was first described. individual susceptible to opportunistic infections.
1982- first case of transfusion-associated AIDS in an
infant.  OPPORTUNISTIC INFECTIONS- diseased that do NOT
cause illness in persons with healthy immune
December 3, 1992- PNAC (Philippine National AIDS system. (ex: tuberculosis)
Council) was created according to E.O. No. 39, Series of
1992. PNAC provide prevention and control of HIV/AIDS  HIV TRANSMISSION- transfer of HIV from infected to
in the Philippines. uninfected person through:
February 13, 1998- R.A. No. 8504 (Philippine AIDS -unprotected sexual intercourse
Prevention and Control Act of 1998) came into law. (first -blood transfusion
law) To prevent and control the spread of AIDS. -sharing contaminated intravenous needles
Reconstituted the PNAC. -during pregnancy
-delivery
R.A. No. 11166 -breastfeeding

“Philippine HIV and AIDS Policy Act”

Approved and became a law: DECEMBER 20, 2018  Safe Sex Practices- choices and behaviors to reduce

- a prevailing law in regulating matters relating to HIV and or minimize the risk of HIV transmission.

AIDS. Also reconstituted the PNAC. It includes:

It is a law that: -postponing sexual debut

1. Strengthen the Philippine Comprehensive Policy on - non-penetrative sex

human immunodeficiency virus (HIV) and acquired - correct and consistent use of male or female

immunodeficiency syndrome (AIDS) prevention, condoms

treatment, care, and support. - minimizing the number of sexual partners

2. Reconstitute the Philippine National AIDS Council

(PNAC).
3. Repeals R.A. No. 8504
CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

PNAC “Philippine National AIDS Council” SECRETARY OF HEALTH- permanent Chairperson of the
- agency attached to DOH PNAC.
- to ensure the implementation of country’s response to CSOs members- term of three years for maximum of two
HIV and AIDS situation. consecutive terms.
The ff. Agencies and CSOs shall be represented in PNAC:
1. DOH- Department of Health The PNAC shall perform the ff. Functions:
2. DepEd- Department of Education 1. Develop the AIDS Medium Term Plan (AMTP)
3. DOLE- Department of Labor and Employment 2. Ensure the operationalization and implementation of
4. DSWD- Department of Social Welfare and AMTP
Development 3. Strengthen the collaboration between government
5. DILG- Department of Interior and Local Government agencies and CSOs.
6. CSC- Civil Service Commission 4. Develop and ensure the implementation of the
7. CHED- Commission on Higher Education guidelines and policies.
8. NYC- National Youth Commission 5. Monitor the progress of response to HIV and AIDS
9. PIA- Philippine Information Agency situation.
10. DBM- Department of Budget and Management 6. Monitor the implementation of AMTP.
11. The Chairperson of the Committee on Health and 7. Mobilize sources of funds for the AMTP.
Demography of the Senate of the Philippines or 8. Mobilize members to conduct monitoring and
his/her representative. evaluation of HIV-related programs, policies, and services.
12. The Chairperson of the Committee on Health of the 9. Coordinate, organize, and work in partnership with
House of Representatives or his/her assigned proxy. foreign and international organizations.
13-14. Two representatives from organizations of 10. Advocate for policy reforms to congress and other
persons living with HIV and AIDS. government agencies.
15. One representative from a private organization with 11. Submit an annual report to the office of the President,
expertise in standard setting and service delivery. Congress, and members of the Council.
16-21. Six representatives from NGOs working for the 12. Identify gaps in national response.
welfare or identified key populations. 13. Recommend policies and programs.
Memorize these agencies mga bugoks!!! “The country’s response to HIV and AIDS situation shall
be anchored on the principle of human rights and
human dignity”.
PNAC members shall be appointed by the President of Coverage of the information, education, and
the Philippines. Heads of gov. agencies shall not lower communication campaign of PNAC
that an Assistant Secretary or its equivalent. PNAC seeks to address the ff. topics:
1) Prevention Program
CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

2) Education in learning institutions 2. Establishments and enforcement of right-based

3) Education of parents and guardians mechanisms.
4) Education as right to health and information 3. Establishment of standard precautionary measures
5) HIV and AIDS information as a health service in public and private health facilities.
6) Education in the workplace 4. Accessibility of ART (Antiretroviral Therapy) and
7) Education for Filipinos going abroad management of opportunistic infections.
8) Information for tourists and transients 5. Mobilization of communities of PLHIV for public
9) Education in communities awareness and stigma reduction activities.
10) Education for key populations and vulnerable 6. Establishment of comprehensive human rights and
communities evidence-based policies, programs, and approaches
11) Information on phrophylactics to reduce transmission of HIV.
12) Misinformation on HIV and AIDS
Guidelines and standard precautions for the donation of
 Workplace- office, premises, or work site for workers blood, tissues, and organs:
employed. 1. All donated blood shall be subjected to HIV Testing.
 Vulnerable Communities- groups suffer from 2. Donations of tissue or organ, whether gratuitous/
unequal opportunities, social exclusion, and political simple donation (given for free of charge/ mere
conditions that increase HIV and AIDS infections. liberty or generosity) or onerous (burdened with
 Key Affected Populations- groups/persons with charges or future services) shall be accepted after
higher risk of HIV exposure or affected groups. donor has been tested negative for HIV.
 Prophylactic- agent or device to prevent 3. All donors whose blood, tissue/s, or organ/s test
transmission of infection. positive shall be deferred from donation, notified of
their HIV status, counseled, and referred for care and
clinical management ASAP.
4. Donations of blood, tissue, or organ that test
positive for HIV may be accepted FOR RESEARCH
PURPOSES ONLY and subject to strict sanitary
disposal requirements.
5. A second test may be demanded before transfusion
Preventive Measures for HIV: or transplant, except during emergency cases.
1. Creation of rights-based and community-led  Donation- an act of liberty where a person
behavior modification programs among PLHIVs gratuitously of a thing or right in favor of another,
(People Living with HIV) who accepts it
CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

 Under R.A, No. 7719, once a blood unit has been (cognitive abilities and capacity for self-
tested or screened by blood centers, it shall not be determination of children as they grow up).
retested.  “Mature Minor Doctrine” or Gillick Principle/Gillick
Competence (1986 by English House of Lords)- legal
NATURE OF CONSENT UNDER RA NO. 11166 principle for some minors to consent independently
Lawful consent to HIV testing of donated human body to medical procedures, where they have been
organ, tissue, or blood shall be considered as having assessed by qualified heath professionals to make
been given when: decisions on their own.
1. A person volunteers or freely agrees to donate for Under the Mature Minor Doctrine, minor refers to:
transfusion, transplantation, or research. 1. A child who is less than 15 years of age
2. A legacy and a donation are executed in accordance 2. A young person who is pregnant or engaged in high-
to Section 3 and 4 of R.A. No. 7170 (Organ Donation risk behavior.
Act of 1991). 3. a person who is duly assisted by a licensed social or
health worker at the time of testing.
The HIV/AIDS law provides for two types of consent or
waiver: In securing the consent of a person, theh ff. guidelines
1. Express Consent (express waiver)- written consent must be observed:
from the person taking the test must be obtained before 1) Person 15 below 18 years of age needs consent from
HIV testing. (Section 29) him/her without the need of parent or guardians
2. Implied consent (implied waiver)- consent was consent. (according to the Principle of the Evolving
indirectly given by reason to operation of law (such as in Capacities of the Child)
the voluntary act of donation). (Section 27) 2) Person below 15 y/o and is pregnant/ engaged in
 Informed consent- voluntary agreement of a person high-risk behavior must be eligible for HIV testing
to undergo procedure, whether permission is written and counseling, provided that the minor is duly
or verbally. assisted by a licensed social/health worker. (based
on Mature Minor Doctrine)
-under MMD “the parental right to determine whether or
not their minor child below the age of 16 will have
WHO CAN GIVE CONSENT: medical treatment terminates if and when the child
 “Evolving Capacities of the Child”- a child/person achieves sufficient understanding and intelligence to
who is 15 to below 18 years old, consent to understand fully what is proposed”.
voluntary testing obtained by him/her without the - High-risk behavior- a person’s involvement in certain
parents’ or guardian’s consent. It is enshrined in activities that increase the risk of transmitting or
Article 5 of the Convention on the rights of the Child acquiring HIV.
CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

3) Consent to voluntary HIV testing is obtained from a (both of Act No. 3815 (The Revised Penal Code) as
child’s parent or legal guardian if the person is below amended, and as also amended by R.A. No. 8553 (The
15 years of age or is mentally incapacitated. Anti-Rape Law of 1997).
 Article 264 and 266- serious and slight physical
HIV TESTING- any facility-based, mobile medical injuries. Injurious Substance is potentially
procedure, or community-based screening modalities to deleterious to the human body and is incurable.
determine the presence/absence of HIV in person’s body.  Article 335 and 338- rape and simple seduction
- it is confidential, voluntary in nature, and must be 2. When it’s necessary to resolve relevant issues under
accompanied by counseling prior to and after the test, E.O. No. 209 (The Family Code of the Philippines).
and carried out only with the informed consent of the HIV may be a ground for the annulment of marriage.
person. 3. As a prerequisite in the donation of blood under R.A.
 HIV-negative- absence of HIV/HIV antibodies upon No. 7170 (Organ Donation Act of 1991), and R.A. No.
testing. 7719 (National Blood Services Act of 1994). HIV
 HIV-positive- presence of HIV infection as confirmed testing for donated blood under this acts are
by the HIV/HIV antibodies present in the sample compulsory in nature.
tested
HIV testing may be voluntary or compulsory. HIV testing covers two aspects:
 Voluntary HIV testing- testing done on an individual  Screening test- initial serologic test performed to
who willingly submits to such test after having determine the presence of antibodies against HIV
undergone pre-test counseling. 1 and HIV 2. It includes:
 Compulsory HIV testing- occurs when the test is  Enzymes Immunoassay (EIA)
imposed upon an individual without consent, and  Particle Agglutination Test (PA)
utilizes force or intimidation, requiring the test a  Rapid Immunoassays
prerequisite for employment, and other  Other screening tests for HIV antibody
circumstances when an informed choice is absent.  Confirmatory test- test performed on samples
As a general rule, compulsory HIV testing is prohibited reactive to the screening test to ensure if results are
by law. Any person who compels someone to undergo true positive. It includes:
HIV testing without his/her consent is considered a  Western Blot (WB)
CRIMINAL ACT.  Line Immunoassay (LIA)
As an exception to this rule, compulsory HIV shall  Immunofluorescence Assay (IF)
allowed only in the ff. instances:  Polymerase Chain Reaction (PRC)
1. When it’s necessary to test a person charged with  Rapid HIV Diagnostic Algorithm (rHIVda)-
any of the offenses under: used at present as DOH recommended for
new confirmatory testing in the Philippines.
CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

Reactive samples are referred for confirmatory testing to  The test result itself before the individual is
NRL-SACCL/SLH (National Reference Laboratory - subjected to the test.
STD/AIDS Cooperative Central Laboratory of the San  Post-test counseling- the process of:
Lazaro Hospital).  Providing risk-reduction information
Reactive samples for blood units/blood donors are  Emotional support who submits to HIV testing at
turned over for confirmatory testing to the NRL-RITM the time of the result is released.
(National Reference Laboratory - Research Institute for
Tropical Medicine). Proper counseling shall be conducted by a social worker,
health care provider, or other health-care professionals
HIV testing laboratory should have a: accredited by the DOH/DSWD.
-licensed Medical Technologist with training in HIV
proficiency testing certified by the NRL-SACCL/SLH.
-HIV proficiency is valid for THREE YEARS. ANTI-RETROVIRAL THERAPY (ART)
-treatment that stops or suppresses the replication of
 HIV counseling- interpersonal and dynamic retroviruses (HIV), thereby slowing the progression of
communication process between a client and a infection.
trained counselor:
 bound by a code of ethics and practice to The Law mandated the DOH to establish a program that
resolve will provide free and accessible ART and medication for
 personal, social, or psychological problems and opportunistic infections to all PLHIVs who are enrolled in
difficulties the program.
 objective in counseling  Treatment hubs- private and public hospitals or
 In the context of an HIV diagnosis medical establishments accredited by the DOH to
 To encourage the client address his/her anxiety have the capacity and facilities to provide treatment
and stress and care services to PLHIV. It includes:
 Plan for the future (keeping healthy)  Pre-exposure prophylaxis -the use of prescription
drugs as strategy for the prevention of HIV infection
Two phases of HIV counseling: by people who do not have HIV and AIDS.
 Pre-test counseling -the process of:  Post-exposure prophylaxis -a preventive medical
 providing an individual with information on the treatment started immediately after exposure to a
biomedical aspects of HIV/AIDS pathogen (HIV) to prevent infection and the
 Emotional support for any psychological development of disease.
implications of undergoing HIV testing
MEDICAL CONFIDENTIALITY
CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

-the core duty of medical practice where the patient’s  Subpoena duces tecum- to produce and present
information and his health is status is kept private and is documents
not divulged to third parties.  Subpoena ad testificandum- directed to testify on
-applies to attending physician, consulting medical maters relating to HIV status of a person.
specialist, nurses, medical technologists, and all other To fall under this exception, the following requisites must
health workers and personnel involved. be present:
1. A subpoena issued by the court.
The following acts violate confidentiality and privacy: 2. Jurisdiction over a legal proceeding where the main
1. Disclosure of confidential HIV and AIDS information issue is the HIV status of an individual.
without written consent of the PLHIV. 3. Confidential medical record must have been verified
2. Media disclosure without written consent of the for accuracy by the head of the office or department.
PLHIV. 4. Confidential medical record shall remain anonymous
3. When a PLHIV violated Section 4(a) of R.A. No. and unlinked.
10175 (Cybercrime Prevention Act of 2012) and 5. Record shall be properly sealed by its lawful
Section 25 of R.A. No. 10173 (Data Privacy Act of custodian.
2012). 6. Record shall be hand delivered to the court.
7. Record shall be personally opened by the judge.
8. Judicial proceedings shall be held in executive
session.

General Rule: any unauthorized disclosure of patient’s PARTNER NOTIFICATION

identity or information is considered a crime. - the process by which the “index client”, “source”, or
As an exception, HIV and AIDS information shall be “patient” who has a sexually transmitted infection (STI),
released without consent if: including HIV, is given support to notify and advise the
1) Compliance with reportorial requirements of the partner who have been exposed to infection.
national active passive surveillance system of the
DOH.
2) Informing other health workers directly involved in DISCRIMINATION
the treatment or care of a PLHIV. -unfair or unjust treatment that distinguishes, excludes,
3) Responding to subpoenas. restricts, or shows preferences based on any grounds
such as:
CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

 Sex - any severe or repeated use by one or more persons of a

 Gender written,, verbal, or electronic expression, pr a physical
 Age act/gesture,or any combination that causes fear of
 Sexual orientation physical or emotional harm/damage to one’s property,
 Gender identity and expression infringing on the rights of another person. A form of
 Economic status discrimination.
 Disability
 HIV status The ff. Discriminatory acts and practices shall be
whether actual or perceived, and which has the purpose prohibited:
or effect of nullifying or impairing the recognition, 1. Discrimination in the workplace.
enjoyment, or exercise by all persons similarly situated, of 2. Discrimination in learning institutions.
all their rights and freedoms. 3. Restriction on travel and habitation.
-R.A. No. 11166 definition of discrimination 4. Restrictions on shelter.
 Gender expression- a person communicates gender 5. Prohibition from seeking or holding public office
identity to others through behavior, clothing, 6. Exclusion from credit and insurance services.
hairstyles, communication or speech pattern, or 7. Discrimination in hospitals and health institutions.
body Characteristics. 8. Denial of burial services.
 Gender identity- personal sense of identity as 9. Act of bullying.
characterized among others(masculine/feminine; 10. Other similar or analogous discriminatory acts.
male/female)
 Sexual orientation- direction of emotional, sexual
attraction, or conduct towards people of the same
sex (homosexual orientation), people of both sexes
(bisexual orientation), or people of the opposite sex Prohibited acts under R.A. No. 11166:
(heterosexual orientation), or absence of sexual 1) Any person who commits the prohibited act on
attraction (asexual orientation) misinformation on HIV and AIDS.
-imprisonment: 1 year but not more than 10 years
STIGMA -fine: 50,000.00 - 500,000.00
- dynamic devaluation and dehumanization of an 2) Any person who violates the police operations vis-a-
individual in the eyes of others. A discreditable or vis comprehensive health intervention = for key
unworthy and which results in discrimination when acted populations.
upon. -imprisonment: 1 year to 5 years
-fine: 100,000.00 - 500,000.00
BULLYING
CHAPTER 6: THE “PHILIPPINE HIV AND AIDS POLICY ACT” AND ITS IMPLEMENTING RULES AND REGULATIONS

3) Any person who knowingly causes another to get 7) Any person who shall violate any of the provisions on
infected with HIV through unsafe and unsanitary Section 49 on discriminatory acts and practices.
practice and procedure, or who compelled someone -imprisonment: 6 months - 5 years
to undergo HIV testing without his/her consent. -fine: 50,000.00 - 500,000.00 and without prejudice of
-imprisonment: 6 - 12 years without prejudice to the administrative sanctions such as fines, suspensions, or
imposition of fines and administrative sanctions. revocation of business permit/license/accreditation, and
4) Any person who violates the protection of HIV and professional license.
AIDS service provides from harassment. 8) Any person who obtained knowledge of confidential
-imprisonment: 6 months - 5 years HIV and AIDS information and uses it to malign or
-fine: 100,000.00 - 500,000.00 cause damage injury, or loss to another person shall
5) Any person, natural or juridical, who violates the face liability (under Articles 19,20,21, and 26 of the
provisions on health insurance and similar services. new Civil Code of the Philippines and relevant
- imprisonment: 6 months - 5 years provisions of R.A. No. 10173 (Data Privacy Act of
-fine: not less than 50,000.00 and without prejudice of 2012).
administrative sanctions such as fines, suspensions, or -imprisonment and fines shall be imposed by responsible
revocation of business permit/license/accreditation, and officers and employees.
professional license.
6) Any person who violates the provisions on
confidentiality:
a. Any person who breaches confidentiality
-imprisonment: 6 months - 2 years
-fine: 50,000.00 - 150,000.00
b. Any person who causes mass dissemination of
the HIV status of a person (spreading online or
making statements to media).
-imprisonment: 2 years & 1 day - 5 years
-fine: 150,000.00 - 350,000.00
c. Any health professional, medical instructor,
worker, employer, recruitment agency,
insurance company, data encoder, and others
engaged in confidentiality/data.
-imprisonment: 5 years & 1 day - 7 years
-fine: 350,000.00 - 500,000.00