In the Philippines, the HIV seroprevalence is still low even among the traditional groups that are monitored for HIV like the female sex workers, men having sex with men and injecting drug users. The Department of Health would like to ascertain that other HIV vulnerable groups are identified and studied. As one of the more common opportunistic infections in HIV-infected people, pulmonary tuberculosis (PTB) may be the earliest sign of HIV infection. Addressing TB offers the opportunity for early HIV intervention. This study was undertaken to determine the prevalence of HIV among TB cases, to quantify co-infection of HIV and TB and to identify HIV risk practices.
A total of 387 sputum (+) TB cases in NCR enrolled in the Directly Observed Treatment, Short Course Chemotherapy (DOTS) of the DOH were randomly selected to be study participants. They were interviewed for risk behaviors and tested for HIV and syphilis. Two hundred sixty four (68%) study participants were men. Age ranged from 14-81 years with a median of 37 years. Majority were married and reached or finished secondary level of education. Sixty-two (16%) had PTB in the past, of which, 26% defaulted from the prescribed treatment regimen.
In the past year, 6% of the study participants had blood transfusion. In the past five years, 16% had ear or body piercing and 13% subscribed to tattooing. Eighteen study participants were previously tested for HIV, mostly for employment purposes. STI signs and symptoms were reported by 28 (11%) men and 21 (17%) women.
One in every four study participants used prohibited drugs in the past although only 2 admitted to using injectable drugs for recreation. Both shared injecting equipment and did not use the prescribed cleaning solution (bleach nixed with water).
Fifty-eight (47%) of the 123 women had sex with men in the past 6 months. They all had 1 regular partner, usually their husbands or live-in partner.
One hundred two (39%) of the 264 men had sex in the past 6 months. All had sex with women, of which, 15% had higher-risk sex partners (female sex workers and non-commercial/ non-regular partners). Only 1 consistently used condoms. Nineteen men had sex with other men. Only 1 MSM consistently used condoms during sex.
All blood samples tested negatively for HIV. Seven or 2% (95% Cl 1-4) were positive for syphilis, of which, 4 were men.
Prevalence of HIV among TB patients is less than 1%. The existence of co-infection between HIV and TB had been documented in several countries but this theory remains to be proven in the Philippines. It is more likely that Filipinos are getting TB not because their immune systems are weakened due to HIV but because of the endemicity of TB in the Philippines. This, coupled with a full-blown HIV epidemic is a scenario that the country cannot afford to happen.
