Philippines Peoplve Living With HIV Stigma Index Report Cond FromOctober 2009 To January 2010

A CLOSER LOOK:
THE STIGMA AND

DISCRIMINATION
EXPERIENCES OF PEOPLE
LIVING WITH HIV AND
AIDS IN THE PHILIPPINES1
MR. NOEL QUINTO

Pinoy Plus Philippines
LUIS M. PEDROSO
Independent Consultant
MS. MILDRED DUQUE

Babae Plus
MR. RANIER NALDOZA

Pinoy Young Positives
and
JULIAN HOWS
GNP+
1 People Living with HIV Stigma Index is a tool that measures stigma and discrimination experienced by people living with HIV. This is a
joint initiative of the Global Network of People Living with HIV/AIDS (GNP+), the International Community of Women Living
with HIV/AIDS (ICW); the International Planned Parenthood Federation (IPPF); and the Joint United Nations Program on
HIV/AIDS (UNAIDS) who have worked together since 2005 to develop this survey. This was spearheaded by Pinoy Plus in
collaboration with PAFPI, Babae Plus, Sister Plus (Angeles City) Crossbreeds (Bacolod), Pinoy Young Positives and Mindanao
Advocates
1|Page Draft not for Quotation

A CLOSER LOOK: THE STIGMA AND DISCRIMINATION EXPERIENCES
OF PEOPLE LIVING WITH HIV AND AIDS IN THE PHILIPPINES
Table of Contents Page

Table of Contents
Acknowledgements
Acronyms and Abbreviations
Executive Summary
1. Introduction 3
1.1 What is HIV-related stigma and discrimination? 5
2. Background and Rationale of the Study 6
2.1 Research Objectives 7
2.2 The Research Methods and Process 8
2.3 Purposive Sampling 9
3. Findings 10
3.1 Profiles of the Respondents 10
3.1.1 Socio-Demographic Characteristics 11
3.1.2 Economic Status of Respondents 14
3.2 Experience of Stigma and Discrimination from Other People 16
3.2.1 Social Stigma and discrimination 17
3.2.2 Perpetrators and Reasons of Physical Assaults 18
3.2.3 Verbal stigma 19
3.2.4 Institutional stigma 20
3.2.5 Why are PLHIV stigmatized and /or discriminated 23
3.3 Access to Work, Health and Education Services 25
3.4 Internal Stigma Index 30
3.5 Knowledge on Rights, Laws and Policies 36
3.6 Effecting Change 38
3.7 Testing an Diagnosis 42
3.8 Disclosure and Confidentiality 43
3.9 Treatment 45
3.10 Having Children 48
4. Consequences and impact of stigma 49
4.1 Problems and Challenges
4.2 Consequences of stigma for the families of people living with HIV
and AIDS (secondary stigma)
4.3 Consequences of stigma for HIV and AIDS treatment and prevention
efforts
4.4 Limitations of the study 52
5. Conclusions
6.Recommendations
6. References 53
Annex tables 1-6 54

I. Introduction
HIV-related stigma and discrimination have long been recognized as one of the main
obstacles to the prevention, care and treatment of HIV and AIDS (Ogden and
Nyblade, 2005; Aggleton, 2002; Parker and Aggleton, 2003). It has accompanied the
AIDS epidemic from the start. Fear of and actual experience with stigma and
discrimination reduce an individual’s willingness to practice prevention, seek HIV
testing, disclose his or her HIV status to others, ask for (or give) care and support, and
begin and adhere to treatment.
On a personal level, stigma and discrimination not only makes it more difficult for
people trying to come to terms with HIV and manage their illness but it also make
individuals reluctant to access HIV testing, treatment and care, thus, interferes with
attempts to fight the AIDS epidemic as a whole. Stigma and discrimination deter
individuals from finding out about their HIV status. And they inhibit those who know
they are infected from sharing their diagnosis and taking action to protect others and
from seeking treatment and care for themselves.
On a national level, stigma and discrimination can discourage governments from

taking fast, effective action against the epidemic. PLHIV have experienced stigma
and discrimination in various aspects of their lives and are often unable to work
because of fear of disclosure of their HIV status. Overseas Filipino workers who were
tested positive for HIV can no longer work abroad, hence resulting in substantial loss
of income.
According to UN Secretary-General Ban Ki Moon, "Stigma remains the single most

important barrier to public action. It is a main reason why too many people are afraid
to see a doctor to determine whether they have the disease, or to seek treatment if so.
It helps make AIDS the silent killer, because people fear the social disgrace of
speaking about it, or taking easily available precautions. Stigma is a chief reason why
the AIDS epidemic continues to devastate societies around the world."2
HIV is often negatively viewed and heavily stigmatized, and social attitudes may be
damaging to those infected or suspected of being infected. Discrimination is defined
more in terms of legal and human rights: when a person loses a job because of the
negative connotation or impression of HIV, overt discrimination has taken place.
People who are infected are rejected and scorned because social prejudice against the
disease runs so deep. In some cases, people are stigmatized simply because of a
suspected association with HIV.
2
Ban Ki-moon op-ed (2008, 6th August), “The stigma factor”, The Washington Times

Globally, HIV-related stigma and discrimination has been identified as a significant
determinant of the spread of HIV (Aggleton, 2002; Parker and Aggleton, 2003).
Discrimination increases the suffering and burden of the disease of PLHIV as it
violates their most basic rights including access to treatment, right to employment,
housing and education. Stigma and discrimination is likely to increase the
vulnerability of others to HIV infection because it discourage PLHIV and others from
contacting health and social services to seek prevention information, get tested and
engage in other prevention strategies.
Failure to measure, monitor and control of HIV stigma and discrimination in the
country coupled with the presence of high level of behavioral risk, my therefore
provide an ideal environment for future increases in the rates of HIV infections.
Implementing the People Living with HIV Stigma and Discrimination Index is a
concrete preliminary step needed to address HIV-related stigma and discrimination in
the Philippines. The evidence obtained from this study will be instrumental in the
development and implementation of national policies that protect the rights of people
living with HIV. The results of the study will help shape the design of program
interventions so that they consider the issue of HIV-related stigma and discrimination
within their content. Many PLHIV do not know what their rights are and how they
can help to change things for the better.
This index aims to collect information on stigma, discrimination and the rights of
people living with HIV that will help in these advocacy efforts. This project has been
developed and implemented by and for people living with HIV. It gathered
information about the experiences of people living with HIV related to stigma,
discrimination and their human rights.
Section 2 of the Philippine AIDS Prevention and Control Act of 1998 (RA 8504)3
specifically declares that “The State shall extend to every person suspected or known
to be infected with HIV/AIDS full protection of his/her human rights and civil
liberties. Towards this end,
1) compulsory HIV testing shall be considered unlawful unless otherwise
provided in this Act;
2) the right of privacy of individuals with HIV shall be guaranteed;
3) discrimination, in all its forms and subtleties, against individuals with HIV or
persons perceived or suspected of having HIV shall be considered inimical to
individual and national interest, and;
4) provision of basic health and social services for individuals with HIV shall be
assured”
But despite these policies, very little has been done on large scale how to address
stigma and discrimination being experienced by PLHIVs. Programs aim to combat
HIV-related stigma and discrimination is not even part of the national agenda.
There is a great need to ensure that those above-mentioned state policies are enforced.
The end goal of these policies is to change attitudes towards infected people and their
3 Republic Act 8504 The Philippine AIDS Prevention and Control Act of 1998
families. More supportive attitudes should translate into more supportive behavior,
transforming a hostile world into one that is compassionate and constructive. They
seek to break the silence surrounding the disease, partly by involving people living
with HIV and their communities in an active response. More open discussion, it is
hoped, will reduce the fears and misconceptions that reinforce high-risk behavior.
Because of its association with behaviors that may be considered socially

unacceptable by many people, PLHIVs are subject to stigma and discrimination. They
may lose their employment and livelihoods, property, social status, children and
friends as a consequence. They may be given substandard care or even refused care at
health facilities or subjected to discrimination and human rights abuses: many have
been thrown out of jobs and homes, rejected by family and friends, and some have
even contemplated of committing suicide due to severe stigma and discrimination
experience.
1.1 What is HIV-related stigma and discrimination?
HIV/AIDS-related stigma and discrimination is a “process of devaluation” of people

either living with or associated with HIV and AIDS, according to UNAIDS
(www.unaids.org). Discrimination follows stigma and is the unfair and unjust
treatment of an individual based on his or her real or perceived HIV status.
Discrimination occurs when a distinction is made about a person that results in him or
her being treated unfairly and unjustly on the basis of belonging, or being perceived to
belong, to a particular group (UNAIDS 2003).
Stigma has been defined as holding and expressing derogatory social attitudes and
beliefs or hostile behavior towards members of a specific group. Discrimination
concerns the legal, institutional and procedural ways people are denied access to their
rights because of their real or perceived HIV status.
HIV and AIDS-related stigma and discrimination refer to prejudice, negative

attitudes, abuse and maltreatment directed at people living with HIV and AIDS. They
can result in being shunned by family, peers and the wider community; poor treatment
in healthcare and education settings; an erosion of rights; psychological damage; and
can negatively affect the success of testing and treatment.
Stigma and discrimination are of concern to AIDS programs for two main reasons: (1)
because stigma and discrimination can make life unbearable for those who live with
the disease and (2), because stigma and discrimination affect prevention and care
efforts. People who have been exposed to HIV through their behavior or that of their
partner may be unwilling to be tested or to change their behavior in any way for fear
of being suspected of being HIV-infected. If they are indeed infected, they may
continue to spread the virus and will not be able to access adequate care. There are
many ways that stigma can undermine prevention and care efforts. An HIV-positive
woman may know that breastfeeding carries a risk of transmitting the virus to her
infant, for example. But she may refuse alternative feeding methods (even when they
are provided at no cost) because bottle feeding will brand her as HIV-infected and
carry the risk that she will be thrown out of the family. Where stigma is high, people
may avoid an HIV test that could provide an entry point for necessary care and
support. Active discrimination has consequences for prevention, too. If a person is
fired from their job because they are HIV-infected, they may have to resort to survival
strategies such as selling sex, which further fuel the epidemic.
The roots of HIV-related stigma and discrimination run deep, and stigma-reduction
means talking openly about issues and behaviors that are all too often silenced or
taboo: sex, sexuality, drug use, sex work, gender inequality and poverty.
It is widely agreed that PLWHA experience different forms of stigma and

discrimination as a result of their sero-positive status. Some people have defined
stigmatization as an act of identifying, labeling, or attributing undesirable qualities to
those who are perceived as being “shamefully different” and deviant from the social
ideal. It is an attribute that is significantly discrediting and used to set the affected
persons or groups apart from the normalized social order (separation meaning
devaluation). Discrimination refers to any distinction, exclusion, or preference that is
based on any ground such as race, HIV sero-positive status, gender, sexual
orientation, age, and so on. Discrimination has the purpose or effect of nullifying or
impairing the recognition, enjoyment, or exercise of all rights and freedoms by all
persons on an equal footing. Such acts come in the form of sanctions, blame,
harassment, and violence based on, for example, infection or association with
HIV/AIDS.
2. Background and Rationale of the Study
The People Living with HIV Stigma Index is a tool that measures stigma and
discrimination experienced by people living with HIV. In the initiative, the process is
just as important as the product. It aims to address stigma relating to HIV while also
advocating on the key barriers and issues perpetuating stigma - a key obstacle to HIV
treatment, prevention, care and support.
The People Living with HIV Stigma Index documents how people have experienced -
and been able to challenge and overcome - stigma and discrimination relating to HIV
over a 12 month period. This is the first robust attempt to establish a baseline for
documenting the stigma and discrimination experienced and overcome by people
living with HIV in the Philippines.
This study would determine whether HIV related stigma is attributable to HIV status
or because of associated behavior (e.g. sexual orientation; sex work; injecting drug
use) or a combination of these factors which is very useful information in developing
or revising program response. The 'People Living with HIV Stigma Index' - used
participatory and operational research methodologies and utilized both qualitative and
quantitative analyses.
The People Living with HIV Stigma Index is the joint initiative of several
organizations who have worked together since 2005 to develop this survey. These
include:
• the Global Network of People Living with HIV/AIDS (GNP+);

• the International Community of Women Living with HIV/AIDS (ICW);
• the International Planned Parenthood Federation (IPPF); and
• the Joint United Nations Program on HIV/AIDS (UNAIDS).
This study was conducted from October 2009 to January 2010. This section will
discuss the findings and looks at the stigma society has placed on HIV/AIDS and how
this affects the lives of PLWHAs. It also looks at the experiences of discrimination of
people living with HIV/AIDS (PLWHAs) as a result of this stigma.
In the Philippines, Pinoy Plus in collaboration with a team of researchers from the
networks of people living with HIV (PAFPI, Babae Plus, Sister Plus (Angeles City)
Crossbreeds (Bacolod), Pinoy Young Positives and Mindanao Advocates) has carried
out the research. They were asking questions about stigma, discrimination and living
with HIV. This is the only true test of whether stigma and discrimination because it
measures the opinions of PLHIV themselves.
However, it would be very helpful if family members, community and healthcare

providers would also be asked about their attitudes towards PLHIVs. The experiences
of people living with HIV (PLHIV) can then be compared to allow a comprehensive
picture of stigma and discrimination to emerge. This can be used for informing policy
and program change and addressing HIV related stigma.
People living with HIV often face stigma and discrimination. Many of them do not
know what their rights are and how they can help to change things for the better.
There are a number of organizations that are campaigning against stigma and
discrimination and fighting for improved rights for people living with HIV. This
index aims to collect information on stigma, discrimination and the rights of people
living with HIV that will help in these advocacy efforts.
The index will increase the understanding of how stigma and discrimination are
experienced by PLHIV. The evidence gained will then shape future program
interventions and change policy. Policy and program managers have long recognized
that action is needed to address stigma and discrimination.
The information gained from the index will provide evidence for the success, or
otherwise, of current programs and highlight neglected areas requiring future action.
Consequently, the index will be a powerful advocacy tool, which will support the
collective goal of governments, non-governmental organizations and activists alike to
reduce the stigma and discrimination linked to HIV.
2.1 Research Objectives
This People Living with HIV Stigma and Discrimination Index is a project that has
been developed and implemented by and for people living with HIV. It aims to collect
information about the experiences of people living with HIV related to stigma,
discrimination and their rights. The information gathered from PLHIV will allow us
to:
 Document the various experiences of people living with HIV in the
Philippines regarding HIV-related stigma and discrimination;
 Compare the situation of people living with HIV in the Philippines across
different countries with respect to a particular issue;
 Serve as baseline data to monitor the progress and impact intervention
programs to eliminate HIV-related stigma and discrimination in the country
 provide an evidence base for policy change and program interventions
The main aim of collecting this information and presenting it in the form of an index
is to broaden our understanding of the extent and forms of stigma and discrimination
faced by people living with HIV in different countries. The intention of the
participating organizations is to make the index widely available so that it can be used
as a local, national and global advocacy tool to fight for improved rights for people
living with HIV. This index progressed from the concept to scale-up phase, and may
be adopted by different groups in different communities, countries and continents.
II. The Research Methodology
The People Living with HIV Stigma Index documents how people have experienced -
and been able to challenge and overcome - stigma and discrimination relating to HIV
over a 12 month period. It is the first robust attempt to establish a baseline for
documenting the stigma and discrimination experienced and overcome by people
living with HIV in the Philippines.
A total of 80 individuals took part in the People Living with HIV Stigma Index
research, which championed a community research model, and involved people
giving responses to an in-depth questionnaire conducted by 8 trained PLHIV
researchers. Interviews were carried out in different locations around the country,
from Angeles City, Puerto Princesa City and Metro Manila including Cavite and
Bulacan in Luzon; Iloilo and Bacolod in Visayas; and Davao City in Mindanao.
Standard structured survey questionnaire was used and was translated into Filipino.
Pinoy Plus employed the services of PLWHAs as researchers/ interviewers. The
researchers/interviewers underwent a three-day basic training on research, especially
in the area of data gathering, which included administering guided interviews through
a questionnaire.
The qualitative method entailed interviews and write-up of case studies of seven
identified respondents. The respondents were also participants of the survey and were
purposely selected because their responses in the survey revealed that they had
experienced some form of discrimination. Thus, the interviews were meant to probe
into their specific experiences and were conducted separately from the survey.
Involving PLHIV in Data Gathering Process
The index is a tool used by, as well as for, PLHIV. The index supports the GIPA
(Greater Involvement of People living with HIV and AIDS) principle through being
driven by PLHIV and their networks. Based on this principle the index will empower
the individuals and communities most affected by the epidemic.

As the index moves from concept to implementation, this has been adopted by a
variety of different PLHIV groups. It is hoped that the use of the index over time, in
conjunction with surveys, will increasing our collective understanding and detecting
changes and trends.
The benefits of the index for those conducting it go further than collecting much-
needed evidence. The process of empowering PLHIV, their networks and
communities is crucial – a critical ingredient of ensuring that the GIPA principle is
used. The index is hoped to be both a catalyst for and foster change in the
communities in which it is used as well as being a tool to advocate for the broader
changes needed according to the index data.
Ultimately, it is hoped that the index will be a powerful advocacy tool that acts to
support the collective goal of governments, community-based organizations, activists
and people living with HIV alike to reduce the stigma and discrimination linked to
HIV. The use of the index over time, in conjunction with surveys, is critical to
increasing our collective understanding and detecting changes and trends.
There were a number of other key stakeholders that played an important part in
implementing the People Living with HIV Stigma Index at a country or community
level. These include:
• the interviewers, who are people living with HIV;
• the interviewees, who are also living with HIV; and
• those supporting the implementation of the index in a managerial or
technical capacity, for example, the team leaders, the data capturers
and the data analysts, who may or may not be living with HIV.
Purposive Sampling
Respondents were chosen to explore and document unique or diverse variations of

stigma and discrimination experiences. They were known by or referred to the
researcher/interviewer due to their involvement or contact with PLHIV network and
were willing to be interviewed. The study purposefully picked up a wide range of
variations in terms of age, sex distribution, educational attainment, geographical
locations, and socio-economic status in life. The ultimate aim is to identify important
common patterns of stigma and discrimination experiences that cuts across variations.
Simply put, the study specifically consider age group, sexual orientations, past
membership of most-at-risk population or group, and economic, social and
educational backgrounds factors that may normally have a bearing on the
susceptibility of PLWHA to stigma and discrimination.
Purposive sampling, a non-probability sampling technique was employed in selecting

the respondents based on some pre-specified criteria. Since the use of any of the
probability sampling techniques is not feasible in conducting survey among PLHIV,
strictly speaking, purposive samples do not allow for generalizations to the population
of PLHIV in the Philippines. The logic and power of purposeful sampling lies in
selecting information-rich cases which one can learn a great deal about stigma and
discrimination that is central to the research purpose.

The sample is not representative of the epidemiological profile of HIV infection in
each country. Most people who are infected with HIV are not aware of it. People who
are tested for HIV are a skewed sample of actual infections. They may represent, for
example, higher numbers of migrant workers, women attending antenatal clinics or
military personnel than in the general population because certain groups of people are
more likely to be tested for HIV than others, with or without their consent. Of the
people who do test HIV-positive, most keep their status secret for fear of the stigma
and discrimination they may face if they reveal their status. Many do not access
medical care and/or do not reveal their status to anybody, even their family.
The sample size was determined by the maximum number of positive people that
interviewers could reach in each country at the time the study was conducted.
Interviewers cast their nets widely from peer support groups, testing sites, hospitals
and AIDS service organizations to capture the experiences of as many positive people
as possible.
The findings may not be representative. People interviewed may have suffered greater
amounts of discrimination than others, or people who have no contact with AIDS
organizations may have experienced more discrimination and been silenced to a
greater extent and are harder to reach. Nevertheless, because of the large sample size,
it can be assumed that the findings reflect the experiences of thousands of people
living with HIV in the country.
For this research, the study intended to gather 80 respondents from people living with
HIV to fall within the minimum required size on which statistical tests could be
meaningfully conducted and within the maximum that the study resources could
support.
Research Key Findings
Section 1: Socio-Demographic Profiles of the Survey Respondents
Figure 1: Percent Distribution of Respondents

by Sex
62.5
37.5
10 | P a g e D r a Male
f t n o t f o r Q u Female
otation
Figure I above shows the background characteristics of the 80 survey respondents
who participated in the study. Majority (61.3%) are men, and four in ten (37.5%) were
women and only one respondent self-identified as transgender4.
Figure 2: Percent Distribution of Respondents by Age

group
50.0
50.0
45.0
P40.0
e35.0
r
30.0
21.3
c25.0
e20.0 12.5 13.8
n15.0
10.0
t 1.3
1.3
5.0
0.0
15.-19 20-24 25-29 30-39
Age-group 40-49 50+
A great majority of the respondents (63.8%) are in the prime or at the peak of
economic productive age of 30 to 49 years old. The age ranged from 17 to more than
50 years old, with only one (1) respondent belonging to teenage group and one for
over fifty years old.
Figure 3: Percent Distribution of Respondents by number of years living with HIV

50
P
40
e
r 30
c
45
e 20
31.3
n
10 17.5
t 5 1.3
0
0-1 2-4 5-9 10-14 15 +
Number of Years
Nearly half (45%) of the respondents are living with HIV in less than two years and
the other half (48.8%) has been living with HIV within two to nine years. Very few
(only 5) respondents were living with HIV for more than ten years already. This
finding is reflective of the average life expectancy of PLHIV were only very few
could last beyond ten years especially if they could not avail of the expensive
antiretroviral treatment.
4 This is due to the very limiting definition of transgender in this study where it was translated as “operada” colloquial term for
having undergone sex surgery. In the Philippine context, one is considered transgender if a gay or lesbian have undergone sex
transplant.
11 | P a g e Draft not for Quotation

Figure 4: Current Status of Relationship
Married/coh
abiting;partn Married/coh
Widowed, 6. er in abiting;
3 HH, 26.3 partner away
from HH, 2.5In a
Divorced/se
parated, 3.8 relationship
but not
living
together, 20
0
In terms of current status of relationship,

Single, 41.3two in five (41.3%) are single, one in four
(26.3%) are married/cohabitating with partner living in the household, one in five
(20%) are in a relationship but not living together, the rest were either
married/cohabitating; partner temporarily away from household, divorced/separated
and or widowed. Among those who are married/cohabitating with partner living in
household (n=21), only two (2) are in honeymoon stage (one-year or below), 6 are
married for 2 to 4 years, 9 are in these relationship for 5 to 9 years and 4 were
married for ten or more years already.
Figure 5: Educational Attainment

No formal
Primary
schooling, 3.8
school, 6.3
Secondary
school, 26.3
Technical
college/univer
sity, 63.8
Figure above shows that a great majority of the PLHIV study sample are highly
educated. Only one in four has secondary level of eduction and measly around one in
ten have elementary education or below.

Figure 6: Currently Sexually Active
65.0
35.0
Three in ten of the respondents reported that they are sexually active. It is surprising
to note that only one of every 10 married male/cohabitating with partner living in the
household reported that is currently sexually active compared to 8 among their female
counterpart. One plausible explanation for this may be that these male PLHIV are
abstaining sex to protect their partners from contracting HIV, while the women
PLHIV might have HIV-positive partner. Age and physical health plays an important
role that affect sexual appetite or Yes Notwo who are in a
being sexually active. Of the
relationship but partner temporarily away from household, one self-report to be
sexually active while the other one report otherwise. More than half (n=9) of the 16
who are in a relationship but not living together respondents are self report to be
sexually active. All of the 7 single male respondents are currently sexually active
while it is only one of the five among widowed/ separated.
To ascertain the interviewee’s current or past association with a specific group, which
in itself might be considered by society as different and, in some cases, deviant or
morally wrong, the respondents were asked to identify the interviewee’s membership
or association with this group might very well be underlying or contributing to their
experience of HIV-related stigma and discrimination.

Figure 7: Category of Respondent (Multiple Respo
MSM
Gay/Lesbian 6.3
Transgender 1.3
Sex worker 27.5
IDU 2.5
Refugee/Asylum seeker 1.3
IP Member 2.5
Migrant worker 20
About half of the respondent classified themselves to belong to men having sex men
Prisoner 1.3
(MSM), one in four classified as sex workers, one in five belong migrant workers, the
Do
rest were not gay
either belong (n=5) injecting drug user (n=2), member of18.8
to any
or lesbian IP group
(n=2), transgender (n=1) and prisoner (n=1). It is important to note that around 1 in 5
do not belong to any of the categories 0 because5 they are
10either 15 20 who
wife of PLHIV 25 30 35
died, or they are straight heterosexual female or male.
There was no internally displaced person (IDP) and other categories mentioned by
respondents are: spouse of PLHIV who died, woman and man (straight or
heterosexual). It is good to note that no respondent had reported any physical
disability.
Section 2: Economic Status of Respondents
Figure 8: Respondents' Current Employment Status

NA, 2.5
Unemployed, 2 Full-time
8.8 employee, 27.5
Around one in four were employed full-time, the same proportion were employed part
time. Three in ten PLHIV are unemployed and the rest are self-employed.
Part-time self-
Some interviewees may be formallyemployed,
employed for5.0
three days a week and would then
Full-time self-
consider themselves “in part-time employment (as an employee)”. They may,Part-time
however, also beemployed, 8.8on other days and thus it would also be appropriate
doing odd jobs employee, 27.5
to classify “doing casual or part-time work (self-employed)” is very likely to happen
among PLHIV is necessary to understand the employment status of the interviewees.
The self-employed option includes informal and/or manual labor-type activity; and
household activities such as cleaning, cooking or looking after children or the elderly
not included in this list. While we recognize these as important aspects of work, we
are interested to find out at this point whether the interviewee works outside of the
home.
Figure 9: Household Location
Live in drop-
in center
1% A rural area
A large
town/city 30%
44%
A location of household is important factor in the study of stigma

A smalland discrimination
experience. PLHIV residing in a rural province setting might experience more stigma
town/village
and discrimination because almost all in the neighborhood can recognize the person.
25%
Almost half of the study sample resides in large town or city and thirty percent lived
in rural areas.
Ten respondents have children who are AIDS orphans. Seven respondents have one
(1) child each, two respondents have two children each and 1 respondent have 3
children who are AIDS orphans.
Each interviewee was asked to estimate the average monthly income of their
household over the last 12 months in peso. The monthly income included the total
income in money, plus any in-kind payments for which a money value can easily be
estimated.
Generally it is considered to be difficult to get accurate information on income

through surveys like this one. This occurs for a range of reasons. For example, tax
collection might be an issue and interviewees might be reluctant to share what they
earn out of a fear that, once recorded, their income will come under investigation.
Many people also feel that what they earn is a private matter and would not feel
comfortable sharing this information with someone that they did not know. Others
might struggle to talk about their income as it might be very low and/or intermittent,
and they might find it difficult to work out what an average amount is for a month.
These concerns were minimized due to the reassurance by the interviewers to the
interviewee that this, as with other information in the questionnaire, will be kept
confidential.
Table below shows that the median annual income of PLHIV households is around
$2,000 US dollar per annum. This might be a very conservative estimate given the
above-mentioned reasons. To some, this is not appropriate because they don’t belong
to any household anymore due to stigma and discrimination.
Table 1: Respondents’ household average annual income, 2009 Philippines

Central tendency In Philippine Peso In US Dollar $ (at Php 47=$1)
measure
Mean 140,485.90 2,950.20
Median 96,000.00 2,016.00
Mode 72000 a
1512a
Range 14,400-700,000 302-14,700
N 78 78
a. Multiple modes exist. The smallest value is shown
A number of the respondents self-reported that they experience having no food to eat
for at least a day. The average number of days without food is 3 days and reaches to
as high as 11 days for a particular respondent.
Chapter II: Experience of Stigma and Discrimination from Other People
This section reveals the indicators focusing on the reported experience over the last
year of people living with HIV of HIV-related stigma and discrimination; internal
stigma; the protection of the rights of people living with HIV through law, policy
and/or practice; and effecting change.
Social stigma index here refers to have experienced any of the following
discriminatory acts such as exclusion from social, religious, family gatherings, aware
of being gossiped about, experience of verbal insult, harassment and threat, physical
harassment, physical assault, psychological pressure or manipulation and sexual
rejection as a result of HIV+ status in the last 12 months.
This section focused on the interviewee’s perceptions of the causes of stigma and
discrimination. The causes do not have to be objectively verified as it is more about
what the interviewee perceives or feels happens rather than what actually happens.
Stigma and Discrimination experience are progressively differentiating between the

interviewee being:
• talked or gossiped about;
• being confronted and verbally insulted, harassed and/or threatened;
• being harassed and/or threatened physically; and
• being attacked or assaulted.

Table 2: Percent Distribution of PLHIV who experienced enacted stigma last year because of
HIV status by Magnitude of Experience, Philippines, 2009
Indicators Never Once A few times Often times
Excluded from social gatherings 82.5 3.8 5.0 8.8
Excluded from religious activities 88.8 6.3 1.3 3.8
Excluded from family activities 88.8 6.3 2.5 2.5
Aware of being gossiped about 51.3 10.0 27.5 11.3
Been teased, insulted or sworn at 71.3 15.0 8.8 5.0
verbally harassed
Physically harassed 83.8 8.8 6.3 1.3
Physically Assaulted 83.8 8.8 5.0 1.3
Subjected to psychological pressure 90.0 2.5 2.5 5.0
or manipulation by partner in which
HIV+ status was used against
respondent
Sexually rejected as a result of 90.0 2.5 1.3 6.3
HIV+ status
Discriminated by other people 90.0 6.3 2.5 1.3
living with HIV
Discriminated by other household 78.8 6.3 10.0 5.0
member as result of HIV+ status
Forced to change residence or 90.0 5.0 2.5 2.5
inability to rent
Social Stigma and Discrimination
Of the 80 respondents, 17.5% (n=14) reported to have been excluded from social
gatherings in the last 12 months. Of these, half were excluded often, four said they
were excluded a few times and three excluded once. Five of the fourteen respondents
were excluded from social gatherings because of HIV status, four both because of
HIV and other reasons, three for other reasons, while the two were unsure. Nine were
excluded from religious activities in the last 12 months, most of which were excluded
once (n=5).
Likewise, nine of the respondents were excluded from family activities. Four of
which shared that the reason is because of both HIV and other reasons while three
said that this exclusion is because of their HIV status. About half (n=39) of the
respondents were aware of being gossiped about in the last 12 months. Majority of the
reasons are because of their HIV status (n=16) and both because of HIV and other
reasons (n=9)
One in four (n=23) of the respondents experienced verbal insult, harassment and
threat in the last 12 months; nine of which shared that this is because of HIV status
while eight said that this is because of both HIV and other reasons as well. There were
13 respondents who experienced physically harassed in the last 12 months, seven of

them shared that this is because of their HIV status; four said that this is because of
another reason while three said that this is because of both HIV and other reasons.
Likewise, 13 respondents were physically assaulted in the last 12 months and this is
mainly because of other reasons (n=7). Most of the respondents were assaulted once
in the last 12 months (n=7). Majority of those who were physically assaulted once
were assaulted by another member of household or person outside the household
known to the respondent due to other reasons.
The two respondents who were physically assaulted a few times were assaulted by
person outside the household known to him/her because of HIV status while the other
two were assaulted by either husband/partner or another member of household
because of other reasons. The reason for the assault to one respondent by another
member of the household is because of HIV status. One respondent refused to answer
frequency of physical assault but shared that a person known to him was the
perpetrator for reason not known to the respondent.
Eight respondents were subjected to psychological pressure or manipulation by

partner in whom their HIV+ status was used against them. Half of them revealed that
this happened often in the last 12 months. Ten percent of the respondents were
sexually rejected as a result of HIV+ status in the last 12 months. Of these, five
revealed that this happened often in the last year.
Some of the discrimination was also inflicted by other people living with HIV in the
last 12 months as revealed by eight respondents. And in most of them (n=5), this
happened once in the last 12 months. More than 20% (n=17) were discriminated
against by the members of their household as a result of their HIV+ status in the last
12 months. For most of them (n=8), this happened a few times.
Fear of and preoccupation with transmission through everyday casual contact leads
directly to stigma in the form of isolation of persons living with HIV and AIDS in all
aspects of daily life. It occurs everywhere, from within the home, to social gathering
places in the neighborhood, to the market place, health facilities and even sometimes
in places of worship.
Person who physically assaulted, reason for the physical assault and frequency of
assault
Majority of those who were physically assaulted once were assaulted by another
member of household or person outside the household known to the respondent due to
other reasons. Four interviewees reported that they have been assaulted several times
by another member of household or person outside the household known to the
respondent due his/her HIV status. Two respondents were physically assaulted a few
times by either husband/partner or another member of household because of other
reasons. The reason for the frequent assault to one respondent by another member of
the household is because of HIV status. One respondent refused to answer frequency
of physical assault but shared that a person known to him was the perpetrator for
reason not known to the respondent.

Who among the study samples have more severe stigma and discrimination
experiences?
Figure 10: Stigma and Discrimination experience by sex
Social Stigma by Sex

40.0 36.0 36.7
33.3 34.0
35.0
30.0 30.0
30.0
25.0
20.0
15.0
10.0
Women PLHIV have experienced more stigma and discriminations compared to men
5.0
PLHIVs. While both men and women are stigmatized for breaking sexual norms,
women experienced more discrimination than men did.
0.0
Figure 11: Stigma and Discrimination experience by Age -group
None Have experienced Have experience
some stigma frequent stigm
Male Female

Figure 11: Social Stigma Experience by Age gr
60.0
50.0
50.0
41.2
40.0 36.4 37.5 36.4
30.0
30.0 27.3
23.5 25.0
20.0
10.0
Those who belong to the younger age-group in the study sample are more prone to
experience stigma compared to the older age group.
0.0
75.0 None Have
Fiure 12: Social Stigma by experienced
Educational Attainmentsome Have ex
80.0
70.0 57.1 stigma
60.0
50.0 37.3 39.2
40.0 28.6 25.0 23.5
30.0
20.0
14.3 <24 25-29 30-39 40+
10.0 0.0
0.0
None Have experiencedHave experienced
some stigma frequent stigma
Primary school & below Secondary school Technical college/university
Those with secondary education have experienced more frequent stigma and
discrimination compared to those with higher educational attainment. Those with
elementary education or below reported that they have not experience stigma. This is
expected because less educated PLHIVs might not yet familiar or knowledgeable of
their rights as PLHIV.

Figure 13: Social Stigma by Employment Status
70.0 63.6
60.0
50.0
40.9 40.9
40.0 36.4 36.0 36.4 36.4
30.0 24.0 22.7 22.7

20.0
10.0
0.0
0.0
A great majority of the self-employed have experienced some stigma and
discrimination. As expected those who are unemployed have suffered from severe
None
stigma compared to those PLHIV who have means Have experienced
of livelihood some
or employed. Have experi
stigma frequent st
Figure 14: Social Stigma by Whether Sex Worker or No
Full-time Part-time Self-employed Unemployed
60.0
50.0
50.0
41.4 40.9
40.0
29.3
30.0
20.0
9.1
10.0
0.0
The interviewees who belonged to sex categories in the past have experienced
None because it is believe
heightened stigma and discrimination Have thatexperienced
even if someone is no Have expe
longer, a sex worker, the community might still stigmatizesome
them forstigma
having been a sex frequent
worker in the past. In other words, so long as someone is seen as having belonged to a
particular group – even if they are no longer a member of that group now– the attitude
of the community towards that person might still reflect their past membership of a
particular group rather than their current situation. Yes No
Figure 15: Social Stigma by Whether MSM or No
40.0 37.2
35.1
35.0 32.4 32
30.2
30.0
25.0
20.0
15.0
10.0
5.0
0.0
None
Figure 16: Social Stigma by Whether Migrant
Have experienced some Have expe
50.0 stigma
43.8
45.0 40.6 Yes No
40.0
35.0
29.7
30.0
25.0
20.0
15.0 12.5
10.0
Non-migrant
5.0 PLHIV has experienced more stigma and discrimination from other
people compared to migrant study sample.
0.0
In summary, those who belong to the younger age-group (below 24 years old), with
secondary education, unemployed, sex workers, and migrant have experienced more
None Have experienced some Ha
22 | P a g e Draft not for Quotation stigma
Yes No
discrimination compared to the older age group, with college education, employed,
non-MSM, non-sex workers and non-migrant respectively.
Why are PLHIV stigmatized and/or discriminated against?
Table 3: Percent Distribution of PLHIV who experienced enacted stigma by reasons for being
discriminated against, Philippines, 2009
Reasons for being discriminated against Frequency Percent
People are afraid of getting infected with HIV from me 21 26.3
People do not understand how HIV is transmitted and are afraid I will 19 23.8
infect them with HIV through casual contact
People think that having HIV is shameful and they should not be 12 15.0
associated with me
Religious beliefs or "moral" judgments 5 6.3
People disapprove of my lifestyle or behavior 4 5.0
I look sick with symptoms associated with HIV 10 12.5
I do not know/I am not sure of the reason(s) 32 40.0
Table above shows the reasons for being discriminated against, half are clueless or
unsure about the reasons, while a significant 26% said that this is because people are
afraid of getting infected with HIV from the respondent and 24% said that this is due
to lack of understanding of people on how HIV is transmitted and are afraid that they
can get infected with HIV through social contact.
About 15% said that this is because people think that having HIV is shameful and
thus they should not be associated with the respondent while 13% said that this is
because the respondent looks sick with symptoms associated with HIV.
The main causes of stigma relate to incomplete knowledge, fears of death and disease,
sexual norms and a lack of recognition of stigma. Insufficient and inaccurate
knowledge combines with fears of death and disease to perpetuate beliefs in casual
transmission and, thereby, avoidance of those with HIV. The knowledge that HIV can
be transmitted sexually combines with an association of HIV with socially "improper"
sex, such that people with HIV are stigmatized for their perceived immoral behavior.
Finally, people often do not recognize that their words or actions are stigmatizing.
Fear that HIV could be transmitted through ordinary, daily interactions with people
living with HIV and AIDS that involve no exchange of body fluids. Examples include
contact with an HIV-positive person through simple touch (shaking hands, kiss on the
cheek, sitting next to); eating food prepared by or which may have come in contact
with those living with HIV and AIDS; breathing infected air; or using objects that
someone living with HIV and AIDS had touched (e.g. clothing, bedding, or eating
utensils).
While in small percentage, worth mentioning are the 6% (n=5) who said that the
reason for the discrimination is due to religious beliefs or “moral” judgments while
5% (n=4) said that this is because people disapprove of the respondent’s lifestyle or
behavior. Unexamined values, norms and moral judgment of equating people who get
AIDS did something to deserve it also play an important role in fueling stigma.

One in eight of the respondent said that they did not experience any discrimination
and two respondents have no answer. Almost one in four (24%) of the respondents
(n=19) do not fall into the given category and have answered the following:
• Because she was about to be transferred to another department (n=1)
• Because of HIV and I have a lot of women (n=1)
• Because of my HIV+ status (n=2)
• Because of personal conflict and wrong accusations (n=1)
• Blackmail (n=1)
• Did not experience discrimination except in 2007 when I got very sick and
became very thin (n=1)
• During a pregnancy examination, genital warts were seen in my vaginal area, I
also had nodes on my neck. That is when they concluded that I am an HIV+
(n=1)
• I am not fit to work based on the findings of the medical exam, also not for job
promotion because my drug test revealed traces of marijuana content (n=1)
• I deal with other people formally and professionally (n=1)
• I feel neglected and avoided conflict. Anyway, I am to blame for what
happened (n=1)
• I was blamed for the death of a partner who died of HIV (n=1)
• It was a disagreement among children involving my own and then my in-law
said that my child and I are both HIV-positive (n=1)
• My sister and I had a disagreement, she was yelling about my being HIV+
status (n=1)
• My spouse got infected because of me and among my relatives it is a reminder
of being a PLHIV (n=1)
• They found out I have AIDS (n=1)
• They thought that I am contagious (n=1)
• They thought they can get infected with HIV by sharing things with me (n=1)
• Work-related, individual differences (n=1)
Table 4: Category that best explains why stigmatized and/or discriminated against,
Philippines, 2009
F Percent
Sexual orientation (men who have sex with men, gay or lesbian,
29 36.3
transgender)
Sex worker 14 17.5
Injecting drug user 1 1.3
Migrant worker 9 11.3
None of the above 27 33.8
Total 80 100.0

One of the reasons why the respondents were stigmatized and/ discriminated against
was because of their sexual orientation i.e. MSM, gay, lesbian or transgender (36%)
followed by occupation as sex worker (18%) and migrant worker (11%). One
responded that this is because of his being an injecting drug user.
ACCESS TO WORK AND SERVICES
The study try ascertain whether the interviewee perceives that their access to work
(and in some cases the access of members of their household) and to basic services
such as health and education has been limited or reduced because of their HIV-
positive status.
Given that we are not interviewing the interviewee’s neighbors or landlord, work
colleagues or the school teachers, principals or health workers that they have
interacted with, we will not be able to find out whether any of the incidents that were
perceived by the interviewee to be discriminatory because of their HIV-positive status
were in fact a result of their status or not. Thus it is the interviewee’s perceptions,
feelings and interpretation of their experience that count in this instance.
Figure 16: Work Deprivation by Sex

100%
90%
80% 40 40 Without Deprivation
70%
With Deprivation
60%
50%
40%
30% 60 60
Six in 20%
ten of the PLHIV study sample have lost their jobs because of their HIV status.
10%
The same proportions for both men and women have been deprived of their jobs. Ten
percent of the respondents (n=8) were forced to change residence or were unable to
0%last 12 months mainly because of both HIV and other reasons (n=5).
rent in the
About one in five (21%)Male said that they lose their Female
job once in the last 12 months, nine
said they experienced this a few times while four said that they often lose their job in
the period of study. Of the 30 respondents who experienced losing their job at least
once, 10 said that this is because of HIV status.

Those who said that they lose their job because of their HIV status (n=8), losing their
job is because of the following:
o Because of discrimination by employer or co-workers (n=3)
o Because felt obliged to stop working due to poor health (n=3)
o Because of combination of discrimination and poor health (n=2)
Thirteen percent said that they were refused for changing of job description or being
refused promotion in the last 12 months
Figure 17: Work Deprivation by Age

100%
90%
27.3 29.4
80% 42.5
70% 58.3
60%
50%
40%
72.7 70.6
30% 57.5
20% 41.7
Seven 10%
in ten among the younger age-group respondents have experienced to have
deprived of their jobs while it is relatively lower proportions have experienced work-
0%
related discriminations among the older age groups.
<24 provided reasons25-29

About 22 respondents, though 30-39 did
for being refused employment, 40+
not answer the frequency of such refusal. Of these, 17 said that the refusal was
because of other reasons, while two said this is because of discrimination by employer
With
or co-workers and another two said Deprivation Without
that their state of poor health Deprivation
prevented them from
doing certain things. Those who were refused once (n=5) shared that this is because of
other reasons (n=2) and because of discrimination of employer or co-workers (n=1),
poor health (n=1) and combination of discrimination and poor health (n=1).

Figure 18: Work Deprivation by Educational Attai
Technical/college/university 60.8
Secondary school 47.6
Primary school & below 87.5

It is doubly hard for less educated PLHIVs to access employment opportunities.
Almost all of the respondents who in this category have been deprived of work or
means of livelihood. Six in ten among those who have college degree or higher still
experience work deprivation. 0% 20% 40% 60%
One respondent was refused employed a few times for other reasons while two were
With ofDeprivation
often refused in the last 12 months because Without
discrimination by employer or co- Deprivatio
workers and poor health. Only one respondent was suspended or prevented from
attending educational institution because of HIV status and this happened once in the
last 12 months.
No child was dismissed or suspended or prevented from attending educational

institution because of HIV status.

Figure 19: Work Deprivation by Employment Status
100%
90%
80% 31.8
40.9 45.5 44.0
70%
60%
50%
40%
30% 68.2
59.1 54.5 56.0
20%
Those 10%
who have full-time or part-time work have more work-related stigma and
0% compared to those who are self-employed or unemployed.
discrimination
Full-time
Table 5: Frequency of being
HIV status, Philippines, 2009
Part-time
denied health services, Self-employed
including dental care, because of Unemplo
Indicators of Access to Health Services Yes No Not
With Deprivation WithoutApplicable
Deprivation
Denied health services, including dental care, because 7.5 87.5 5.0
of HIV status
Denied FP services because of HIV status in the last 12 6.3 57.5 36.3
months
Denied sexual and RH services because of HIV status 3.8 96.3 0
Major area of discrimination is within the health settings where almost half of those
surveyed experienced some form of discrimination. Six respondents were denied once
of health services, including dental care, because of HIV status. Five respondents
were denied of FP services because of HIV status. Three respondents were denied of
sexual and RH services because of HIV status.

Figure 20: Work Deprivation by Whether MSM or
Not
100%
80% 43.2 37.2

60%
40%
56.8 62.8
20%
The MSMs PLHIV interviewees have relatively lower work-related deprivation
0%
compared to the non-MSMs interviewees.
Yes No
Figure 21: Work Deprivation by Whether Sex
With Deprivation Without Deprivation
Worker or Not
100%
90%
27.3
80% 44.8
70%
60%
50%
40%
72.7
30% 55.2
20%
10%
It is the sex workers who directly suffered from work-related discrimination because
they would be the first to be laid off by their employers in order to protect their
business0%interests.
Yes No
29 | P a g e D r a fWith
t n o tDeprivation
f o r Q u o t a t i o n Without Deprivation
Figure 21: Work Deprivation by Whether Migrant or No
100%
90%
80% 37.5
70%
50.0
60%
50%
40%
30% 62.5
20%
50.0
There is lower work-related deprivation among migrants because most of them do not
10%
have employment here, what they usually loss is employment opportunities abroad
when they are found HIV positive as a result of compulsory HIV testing.
0%
Section 2C: INTERNAL STIGMA Yes No
“Internal stigma”—also described as felt, imagined, or self stigma—is the product of
the internalization of shame, With Deprivation
blame, hopelessness, Without
guilt, and fear Deprivation
of discrimination
associated with being HIV-positive. It can affect caregivers and family members, who
also may internalize feelings of shame, guilt, or fear. Internal stigma can have a
profound effect on HIV prevention, treatment, and care. Internal stigma is intrinsically
linked with external stigma, as the fear of judgment or discrimination from others can
profoundly influence the way in which people living with HIV view themselves and
cope with their HIV status.

Figure 22: Internal Stigma by Sex
Men 23.5 35.3 41.2
Women 0 36.4 63.6

All or hundred percent of women interviewees have felt internal stigma. One third of
them some internal stigma and two in three have heightened self-blaming or internal
stigma. Around one fifth of the men have surpassed the self-blaming stage two-fifths
have their self to blame.
0% 20% 40% 60% 80%
Figure 23:
LowInternal Stigma
Medium by Age
High
40+ 41.7 16.7 41.7
30-39 12.5 52.5 35
25-29 23.5 35.3 41.2
<24 0 36.4 63.6

0% 20% 40% 60% 80%
Low Medium High

The experience of internal stigma varies across age group. Higher proportions among
the younger age group have experienced more severe internal stigma while it is of
much lesser proportions among the older age group.
Figure 24: Internal Stigma by Educational Attainmen
Technical/ college/university 15.7 39.2 45.1
Secondary School 23.8 47.6 2
Primary school & below 12.5 37.5 50.0

As expected, the less educated interviewees have more heightened internal stigma
compared to those with higher educational attainment. This is primarily due to
inadequate or lack of understanding on their rights as PLHIV s well as the nature of
the disease.
0% 20% 40% 60% 80
PLHIV face physical and social isolation from family, friends, workplace and
community; gossip, and a loss of rights, decision-making power and access to
Low Medium
resources and livelihoods. PLHIV internalize these experiences and consequently High
feels guilty, ashamed and, as a result, isolate themselves and lose hope and even some
have even attempted of committing suicide.
The idea behind asking these questions is not whether the interviewee has experienced
tangible or obvious forms of stigma or discrimination, but rather that they have
anticipated or feared what other people might do or think, and this might very well
have changed the way they behaved or felt, or caused them anxiety.
For example, when someone is HIV-positive they might decide not to go to the local
health clinic or hospital to seek medical care or counseling advice because they
anticipate and/or fear that they will have to disclose their HIV-positive status – even if
the disclosure of their HIV status is not required or they are unlikely to be asked about
their HIV status.

Figure 25: Internal Stigma by Employment Status
Unemployed 8.0 48.0 44.0
Self-employed 27.3 36.4 36.4
Part-time employee 22.7 31.8 45.5
Full-time employee 18.2 45.5

Those who are unemployed have the greater tendency to have felt deep internal
36.4
stigma or self-blame.
Experience of the following feelings in the last 12 months (yes only)

0% 20% 40% 60% 80%
Table 5: Frequency of experiencing the following feelings in the last 12 months,
Philippines, 2009
Low Medium
Frequency Percent High
Felt shame because of HIV status 59 73.8
Felt guilty because of HIV status 61 76.3
Blamed self because of HIV status 52 65.0
Blamed others because of HIV status 25 31.3
Have low self esteem because of HIV status 44 55.0
Felt should be punished because of HIV status 26 32.5
Felt suicidal because of HIV status 30 37.5
Respondents were asked about their certain experiences in the last 12 months because
of HIV status. Feeling guilty because of HIV status has the highest percentage of
experienced feeling in the last 12 months at 76%, followed by feeling shameful at
74%, blaming self at 65% and having low self esteem at 55%. Felt suicidal had 38%,
felt should be punished at 33% and blamed others at 31%.
A great majority of the study samples felt ashamed, guilty and blame their selves
because of HIV status. More than half of the respondents have very low self-esteem
as a result. One in three of them blamed others of their HIV status and felt that they
should be punished and felt suicidal because of HIV status.

Fiure 26: Internal Stigma by Whether Sex Worker or
Not
No 17.2 39.7 43.1
Yes 18.2 45.5 36.4

Whether MSM or not, there is no difference in the experience of heightened internal
stigma and discrimination.
Actions last 12 months
0% because of 20%
Table 5: Actions 40%
HIV status in the last 60% 2009
12 months, Philippines, 80% 100
F %
Did not attend social gatherings because of HIV 39 48.8
status
Low
Isolated self from family/friends because of HIV Medium
24 High
30.0
status
Decided to stop work because of HIV status 30 37.5
Decided not to apply work/for promotion because 24 30.0
of HIV status
Withdrew from education/training or did not take 10 12.5
up opportunity for training/education because of
HIV status
Decided not to get married because of HIV status 30 37.5
Decided not to have sex because of HIV status 30 37.5
Decided not have (more) children because of HIV 47 58.8
status
Avoided going to local clinic when respondent 28 35.0
needed to because of HIV status
Avoided going to hospital when I needed to 20 25.0
because of HIV status

Likewise, respondents were asked of their actions because of HIV status in the last 12
months. The highest percentage of positive response is deciding not to have (more)
children at 59%. About 49% did not attend social gatherings because of HIV status.
About 38% each stopped work, decided not to get married and decided not to have
sex because of HIV status. Thirty-five percent (35%) avoided going to local clinic
while 25% avoided going to hospital when respondent needed to. Some isolated self
from family/friends or decided not to apply work/promotion because of HIV status
(30% each). Ten respondents withdrew from education/training or did not take up
opportunity for training/education because of HIV status
Figure 27: Internal Stigma by Whether Migrant or Not
No 15.6 42.2 42.2
Yes 25 37.5 37.5
Internal stigma is relatively more pronounced among the migrant PLHIV compared to
non-migrants.
0% 20% 40% 60% 80%
Table 6: Fears of the following things happening to respondents in the last 12
months, Philippines, 2009
Low Medium
F %High
Fearful of being gossiped about 57 71.3
Fearful of being verbally insulted, harassed and/or 47 58.8
threatened
Fearful of being physically harassed and/or 38 47.5
threatened
Fearful of being physically assaulted 34 42.5
When asked of fears of respondent, whether or not they actually happened, and seven
out of 10 respondents are fearful of being gossiped out while six out of 10 are fearful
of being verbally insulted, harassed, and/or threatened. About 48% are fearful of
being physically harassed and/or threatened and 43% are fearful of being physically
assaulted.

Table 6: Afraid of someone who would not want to be sexually intimate because of HIV
status in the last 12 months, Philippines, 2009
Frequency Percent
Yes 31 38.8
No 47 58.8
Refused to answer 1 1.3
Not applicable 1 1.3
Total 80 100.0
Around two in five were afraid that someone would not want to be sexually intimate
with them because of HIV status.
Section 2D: RIGHTS, LAWS AND POLICIES
This section refers to an international agreement from 2001 called the Declaration of
Commitment on HIV/AIDS. In the Declaration of Commitment on HIV/AIDS,
governments affirmed that the realization of human rights and fundamental freedoms
for all is essential to reduce vulnerability to HIV, and that respect for the rights of
people living with HIV drives an effective response.
Table 7: Respondent heard of the Declaration of Commitment on HIV/AIDS, which

protects the rights of people living with HIV in the last 12 months, Philippines, 2009
Indicator Yes No Not
Applicable
Heard of the Declaration of Commitment on HIV/AIDS, 80.0 20.0

which protects the rights of PLHIV
Discussed the content of the declaration 78.1 21.9
Heard RA 8504 which protects the rights of people living 85.0 15.0
with HIV in the country
Discussed the content of RA 8504 85.3 14.7
Have any rights of respondent as PLHIV abused in the last 22.5 56.3 21.3
12 months
If yes, tried to get legal redress for any abuse of 3 14 1

rights as person living with HIV
Eight in ten (80%) of respondents have heard of the declaration of commitment on

HIV/AIDS, which protects the rights of people living with HIV. Of these, 78% (n=50)
read or discussed the content of the declaration

The percentage of those who heard RA 8504 which protects the rights of people living
with HIV in the Philippines is a bit higher at 85%. Of those who heard RA 8504, 85%
ever read or discussed its content. Republic Act 8504 The Philippine AIDS
Prevention and Control Act of 1998 refers to a national law or guideline that protects
the rights of people living with HIV.
Government Employee Action against the Abuse
Of the 18 who said that their rights as persons living with HIV was abused in the last
12 months, three tried to get government employee to take action against an abuse
against them. Two said that this happened in the last 12 months. But while the matter
has been dealt with for one respondent, nothing happened/the matter was not dealt
with for the other.
Local/National Politician Action against the Abuse
Of the 18 whose rights as persons living with HIV were abused in the last 12 month,
three tried to get local or national politician to take action against such abuse. Two
said that this happened in the last 12 months. One of the filed cases has been dealt
with while the other one is still in the process of being dealt with
When asked if any of the events happened in the last 12 months, the event with the
highest percentage of ticked response is being forced to submit medical or health
procedure (including HIV testing) at 59%. Three were denied health insurance or life
insurance because of HIV status. Also, three were detained, quarantined, isolated or
segregated
Rights as person living with HIV abused in the last 12 months
About 23% (n=18) said that their rights as persons living with HIV was abused in the
last 12 months.
Legal Redress for Abuse
About 23% (n=18) said that their rights as persons living with HIV was abused in the
last 12 months. Three of those whose rights were abused tried to get legal redress for
any abuse of rights as person living with HIV. The process of legal redress has begun
in the last 12 months for the two filed cases. One of the cases has been dealt while the
other one is still in the process of being dealt with
Fourteen of those whose rights were abused did not try to get legal redress for any
abuse of rights as person living with HIV. The main reason is that they felt
intimidated or scared to take action (n=4), followed by insufficient financial resources
to take action (n=2), no/little confidence that the outcome would be successful (n=2)
and the process of addressing the problem appeared too bureaucratic (n=1).
Stigma and Discrimination Events in the last 12 months

When asked if any of the events happened in the last 12 months, the event with the
highest percentage of ticked response is being forced to submit medical or health
procedure (including HIV testing) at 59%. Three were denied health insurance or life
insurance because of HIV status. Also, three were detained, quarantined, isolated or
segregated
Table 8: Stigma and Discrimination episodes/events happened to respondent

because of HIV status in the last 12 months, Philippines, 2009
Frequency Percent
Forced to submit medical or health procedure 47 58.8
(including HIV testing)
Denied health insurance or life insurance because 3 3.8
of HIV status
Was detained, quarantined, isolated or segregated 3 3.8
None of these things happened to me 36 45.0
EFFECTING CHANGE
This section focused on action or what one does in order to bring about positive
change. Question 4 specifically provides interviewees with an opportunity to describe
some action that they might have taken in attempting to resolve or challenge an
incident of HIV-related stigma and discrimination.
Interviewees are asked to explain in detail firstly what the issue was about, secondly
whether others provided assistance (and if so, who they were), and thirdly what they
did to resolve the issue. Interviewees should be encouraged to provide as much detail
about the incident as possible as this will provide richness to the data and assist in the
analysis process. If the interviewees prefer, they can write their answers to this
question; or the interviewer must listen carefully and record the details in as much
detail as possible.
The interviewer should note that it is important not to make interviewees feel
uncomfortable or bad if it is clear that they are not active in effecting change. If this is
the case and you feel it appropriate, you might at the end of the interview provide the
interviewee with the contact details of a local organization or network of people living
with HIV that they might want to contact and get involved in.
This section provides a space for interviewees to identify the type of support they
have given to another person or people living with HIV. This could be emotional
support, which includes the provision of counseling, giving hope, sharing and
listening to personal stories; physical support, which includes providing someone with
money, making a meal for someone, doing housework for someone, accessing
medication and condoms for someone; and/or referral, which includes helping
someone access a grant or a support group, or referring someone to a treatment clinic
or a home-based care organization.

Table 9 presents the percent distribution of people living with HIV/AIDS
(PLHIVs) in the Philippines by ‘effecting change’ indicators. Of the 80 respondents,
barely 28 percent had the courage to confront, challenge or educate someone who was
stigmatizing and/or discriminating against them. Almost all (96%) of them know of
any organizations or groups that they can go to for help if they experience stigma or
discrimination. Most known organizations or groups for PLHWA respondents are:
People living with HIV support group (90%) and Local non-governmental
organization (65%), while the least known for them are: ‘A legal practice’ (4%) and
‘A human rights organization’ (14%). Only one out of five respondents sought help
from any organization or group to resolve an issue of stigma or discrimination.
Seventy-nine percent (79%) of the 80 respondents have supported other PLWHAs,
and almost all of them have given emotional support (e.g. counseling, sharing
personal stories and experiences). Two-thirds (2/3) of PLWHA respondents or 66
percent are currently a member of a people living with HIV support group and/or
network, and half of them have been involved in any program or project that provides
assistance to people living with HIV. Fifty-nine percent (59%) of the respondents
have been involved in efforts to develop legislation, policies or guidelines related to
HIV. Among the aspects that the PLWHA respondents most felt they have power to
influence in decision making are: ‘Legal/rights matters affecting people living with
HIV’ (59%) and ‘Local projects intended to benefit people living with HIV’ (50%).
Respondents were also asked regarding recommendations in addressing stigma and/or
discrimination; ‘Advocating for the rights of all people living with HIV’ (45%) and
‘Raising the awareness and knowledge of the public about AIDS’ (26%) are the top 2
recommendations of PLWHA respondents.
The top 5 organizations or groups that these 77 respondents know about are: People
living with HIV support group (90%), local NGO (65%), network of people living
with HIV (38%), national NGO and UN organization at 23% each. Other
organizations are: faith-based organization (22%), national AID council/committee
and international NGO (20% each), human rights organization (14%) and legal
practice (4%). Eighteen percent said that they know of other groups as well
Other support groups that respondent know about are: Alagad (n=10), Remedios
AIDS Foundation (n=2), PAFPI (n=2), HACT (n=2), HAIN (n=1), HIV/AIDS Core
Team (n=1), Cebu Plus (n=1), Mindanao Advocates and Church (n=1). However,
while they know of these organizations, only 21% of the 77 respondents sought help
from them to resolve issue of stigma or discrimination. Six out of 10 respondents are
currently member of people living with HIV support group and/or network
Fifty percent of the respondent were involved either as volunteer or as employee in

any programme or project that provides assistance to people living with HIV. Fifty-
six percent were involve in any efforts to develop legislation, policies or guidelines
related to HIV. Respondents said that the most important thing that should be done as
an organization to address stigma and discrimination are: advocating for the rights of
all PLHIV (45%), followed by raising the awareness and knowledge of the public
about AIDS (26%), providing support to PLHIV by providing emotional, physical and
referral support (19%), educating PLHIV about living with HIV (5%) and advocating
for the rights and/or providing support to particularly marginalized groups (4%).
Section 2E: EFFECTING CHANGE
Table 9. Percent Distribution of People Living with HIV/AIDS by ‘Effecting
Change’ Indicators, Philippines, 2009
Indicator Categories Frequencies Percent
Confronted, Yes 23 28.8
challenged or 57 71.3
educated someone No
Knowledge of Yes 77 96.3
Organizations or 3 3.8
groups No
Kind of People living with HIV 69 89.6
Organization* (N support group
Cases=77) Network of people living 29 37.7
with HIV
Local non-governmental 50 64.9
organization
Faith-based organization 17 22.1
A legal practice 3 3.9
A human rights organization 11 14.3
National non-governmental 18 23.4
organization
National AIDS council or 15 19.5
committee
International non- 15 19.5
governmental organization
UN organization 18 23.4
Other 14 18.2
Sought help from 16 20.8
any of the above Yes
organizations or
groups to resolve an No 60 77.9
issue of stigma or
No answer 1 1.3
discrimination
Supported other Yes 63 78.8
people living with 17 21.3
HIV No
Types of support* Emotional support 62 98.4
(N=63) Physical support 23 36.5
Referral to other services 22 34.9
Member of a people 53 66.3
Yes
living with HIV
support group and/or 27 33.8
No
network
Involved in any 40 50.0
program or project Yes

that provides 40 50.0
assistance to people No
living with HIV
8. Involved in any 34 42.5
efforts to develop Yes
legislation, policies or
No 45 56.3
guidelines related to
HIV No answer 1 1.3
9. Felt that have the Legal/rights matters affecting 47 58.8
power to influence people living with HIV
decisions in any of Local government policies 25 31.3
the following affecting people living with
aspects* HIV
Local projects intended to 40 50.0
benefit people living with
HIV
National government policies 26 32.5
affecting people living with
HIV
National program/projects 27 33.8
intended to benefit people
living with HIV
International 13 16.3
agreements/treaties
None of these things 15 18.8
10. Respondent’s Advocating for the rights of 36 45.0
Recommendation all people living with HIV
Providing support to people 15 18.8
living with HIV by providing
emotional, physical and
referral support
Advocating for the rights 3 3.8
and/or providing support to
particularly marginalized
groups
Educating people living with 4 5.0
HIV about living with HIV
Raising the awareness and 21 26.3
knowledge of the public
about AIDS
No answer 1 1.3
TOTAL 80 100.0
Table 10 displays the percent distribution of PLWHAs by ‘testing/diagnosis

indicators. Almost half (36/80) of the PLWHA respondents were tested as a
requirement for a job. Though there were 56 percent of the respondents voluntarily
tested for HIV there were also 24 respondents (30%) who was tested without their
knowledge and only found out after the test had been done. Only 29 out of 80
respondents or 36 percent received both pre- and post-HIV test counseling while 25
respondents or 31 percent did not receive any counseling. These findings shows
violation against RA 8504, which states that testing must be voluntary and that it has
to undergo pre-test and post-test counseling.
Reasons for HIV testing
Respondents were asked for the reasons why they underwent HIV testing.The primary
reason is employment at 45%, twenty percent (20%) said that they are just curious
and wanted to know. About 13% said that this is because of illness or death of
husband, wife, partner or family member (16%) and because of referrals due to
suspected HIV-related symptoms (15%). A meager 9% said that this is a result of referral
by a clinic for STI and 1.3% said that this is because of pregnancy. Other reasons are blood
donation (n=6) and by accident, two respondents shared that when they had medical check-up
and pap smear, they were suspected of having HIV and thus were tested.
Decision to be tested for HIV is respondent’s own decision
More than half (56%) said that they were the once who decided to be tested for HIV
while a significant 30% said that they were tested without their knowledge and only
found out after the test has been done. Four respondents, though took the decision to
be tested, did so under pressure from others while 7 were coerced to take the test.
Received counseling when tested with HIV
Of those tested, only 36% received both pre- and post-HIV test counseling while 31%
received post-test counseling only. Three in ten (31%) did not receive any counseling
after tested of HIV.
Section 3A: TESTING/DIAGNOSIS

Table 11. Percent Distribution of People Living with HIV/AIDS by
‘Testing/Diagnosis’ Indicators, Philippines, 2009
Reasons why Employment 36 45.0
tested for HIV Pregnancy 1 1.3
To prepare for a marriage/sexual
relationship
Referred by a clinic for sexually 7 8.8
transmitted infections
Referred due to suspected HIV- 12 15.0
related symptoms (e.g.
tuberculosis)
Husband/wife/partner/family 10 12.5
member tested positive
Illness or the death of 13 16.3

husband/wife/partner/family
member
I just wanted to know 16 20.0
Other 8 10.0
Was the Yes, I took the decision myself to 45 56.3
decision to be be tested
tested for HIV I took the decision to be tested, 4 5.0
up to you? but it was under pressure from
others
I was made to take an HIV test 7 8.8
(coercion)
I was tested without my 24 30.0
knowledge-I only found out after
the test had been done
Received I received both pre- and post-HIV 29 36.3
counseling test counseling
when were I only received pre-test HIV
tested for HIV counseling
I only received post-test HIV 25 31.3
counseling
I did not receive any counseling 25 31.3
when I had an HIV test
No answer 1 1.3
DISCLOSURE and CONFIDENTIALITY
This section relates to disclosure and confidentiality, has a more complex set of
possible responses. It is thus important that you make the interviewee familiar with
the range of possible responses.
The interviewees were asked to consider the most common or frequent reaction that
the different groups or categories of people had toward them on finding out they were
HIV-positive. Possible responses range from “Very discriminatory” to “Very
supportive”. This question intends to try and have the interviewee describe, however,
is the most common or frequent attitude that members of each group or category of
people had when finding out they were HIV-positive. If the interviewee does not
associate or interact with any one of these groups, a “Not applicable” choice can then
be made.
Tables 12 show the percent distribution of PLWHA respondents by ‘disclosure and

confidentiality’ indicators. First table presents percent distribution of respondents by
description of how people or groups of people were first told about their HIV status.
Generally, most of the people or groups of people were told by the respondents
themselves. Nevertheless, comparing the percentages across people or group of
people in terms of how they were told, expectedly, other people living with HIV got
the highest percent (74%) that were told by respondents themselves. However, across
people who were told by someone else with respondents’ consent other adult family
members were the highest percent (16%) while their friends and health care workers
got the highest percent (7.5%) for people who were told by someone else without
respondents’ consent.
Respondents were asked about their disclosure to family and non-family members,
following were the results:
o 39% told their husband/wife/partner
o 58% told their adult family members
o 33% said that they do not know of their HIV status while only 28% said
they told their children
o 39% said they told their friends/neighbors while 35% said that their
neighbors do not know of their HIV status
o 29% said that their co-workers do not know of their HIV status while 24%
said that they told their co-workers about their HIV status
o 23% said that they told their employer(s) or boss(es) about their HIV status
while 19% said that they their superiors do not know of their HIV status
o 74% said they told other PLHIV
o 28% said that the clients do not know of their HIV status while only 4%
said that they told the clients about this
o 34% said that the religious leaders do not know of their HIV status while
only 10% said that they told their religious leaders about their HIV status
o 34% said that the religious leaders do not know of their HIV status while
only 10% said that they told their religious leaders about their HIV status
o 38% said that the community leaders do not know of their HIV status while
only 3% said that they told their community leaders about this
o 43% said that they told health workers about their HIV status and 20% said
that the health workers do not know of their HIV status
o 55% said that they told social workers/counselors about their HIV status
o 11% said that someone else told the social workers/counselors with their
consent while another 11% said that the social workers/counselors do not
know of their HIV status
o 31% said that the media do not know of their HIV status
o A measly 11% said that they told the media about their HIV status
When asked about how confidential the medical records of the respondents relating to
their HIV status are, 65% said that they are sure that their medical records will be kept
completely confidential. About 28% said that they do not know of their medical
records are confidential. Almost 8% said that it is clear to them that their medical
records are not being kept confidential. One in five (21%) revealed that health care
professionals told about their HIV status to others without their consent while 34%
are not sure about this. A meager 2.5% said that the government officials are
discriminatory, 2% said that they are supportive and another 2% said that there is no
difference. When asked if their disclosure of their HIV status is an empowering
experience for them, 86% answered in affirmative, 11% said no.
Section 3B: DISCLOSURE AND CONFIDENTIALITY

Percent Distribution of People Living with HIV/AIDS by ‘Disclosure and Confidentiality’

Indicators, Philippines, 2009. (For each of the following people or group of people, please
describe how they were first told about your HIV status, if they have been told).
People or Group of I told Someone else Someone They don’t Not
People them told them, else told know my applicable
WITH my them, HIV status
consent WITHOUT
my consent
Your
husband/wife/partner 38.8 5.0 2.5 10.0 43.8
Other adult family
members 57.5 16.3 6.3 10.0 10.0
Children in your
family 27.5 2.5 3.8 32.5 33.8
Your
friends/neighbors 38.8 3.8 7.5 31.3 18.8
Other people living
with HIV 73.8 10.0 3.8 2.5 10.0
People who you work
with 23.8 3.8 3.8 28.8 40.0
Your employer/boss 22.5 2.5 3.8 18.8 52.5
Your clients 3.8 1.3 27.5 67.5
Injecting drug
partners
Religious leaders 10.0 2.5 33.8 53.8
Community leaders 2.5 1.3 1.3 37.5 57.5
Health care workers 42.5 11.3 7.5 17.5 21.3
Social
workers/counselors 55.0 11.3 3.8 8.8 21.3
Teachers 2.5 1.3 30.0 66.3
Government officials 1.3 2.5 3.8 33.8 58.8
The media 11.3 2.5 2.5 31.3 52.5
Table 13 below displays other indicators of disclosure and confidentiality.

Generally, most of the respondents never felt pressure to disclose their HIV status
either from other individuals living with HIV/groups or networks of PLWHA (70%)
or from other individuals not living with HIV (72%). However, there is a notable
percent who felt pressure at least once from other individuals living with HIV or from
groups/networks of people living with HIV (30%) and from other individuals not
living with HIV status (28%) to disclose HIV status. Seventeen (17) respondents
stated that a health care professional has ever told other people about their HIV status
without their consent. Twenty-eight percent (28%) of the respondents doubt the
confidentiality of medical records relating to their HIV status, and there are at least 6
respondents who stated that it is clear to them that their medical records were not
being kept confidential. The survey results just show that still there are violations
against RA 8504 that protects disclosure and confidentiality of PLWHA status.
Hence, not all (87%) found the disclosure of their HIV status an empowering
experience.

Felt pressure from other Often 8 10.0
individuals living with HIV A few times 11 13.8
or from groups/networks of Once 5 6.3
people living with HIV to 56 70.0
Never
disclose HIV status
Felt pressure from other Often 2 2.5
individuals not living with A few times 10 12.5
HIV to disclose HIV status Once 10 12.5
Never 58 72.5
Has a health care Yes 17 21.3
professional ever told other No 36 45.0
people about your HIV status
without consent? Not sure 27 33.8
How confidential do you I am sure that my 52 65.0
think the medical records medical records will
relating to your HIV status be kept completely
are? confidential
I don’t know if my 22 27.5
medical records are
confidential
It is clear to me that 6 7.5
my medical records
are not being kept
confidential
Did you find the disclosure Yes 69 86.3
of your HIV status an No 9 11.3
empowering experience? Not applicable 2 2.5

Description of the reactions of the people (in general) when they first knew about your HIV status
People or Group of People Very Discrimin No Supportiv Very Not
discrimin atory different e Supporti Applica
atory ve ble
Your husband/wife/partner 1.3 11.3 22.5 22.5 42.5
Other adult family
members 7.5 5.0 12.5 26.3 27.5 21.3
Children in your family 1.3 1.3 6.3 13.8 13.8 63.8
Your friends/neighbors 8.8 6.3 6.3 25.0 8.8 45.0
Other people living with
HIV 1.3 1.3 10 52.5 33.8 1.3
Your co-workers 1.3 3.8 8.8 13.8 5.0 67.5
Your employer/boss 1.3 2.5 3.8 16.3 5 71. 3
Your clients 1.3 1.3 3.8 1.3 2.5 90.0
Injecting drug partners
Religious leaders 1.3 1.3 5.0 7.5 3.8 81.3
Community leaders 2.5 5.0 1.3 1.3 90.0
Health care workers 2.5 7.5 41.3 17.5 31.3
Social workers/counselors 1.3 5.0 41.3 22.5 30.0
Teachers 2.5 3.8 2.5 91.3
Government officials 1.3 2.5 2.5 2.5 1.3 90.0
The media 3.8 1.3 5.0 1.3 1.3 87.5
Table 14 depicts the percent distribution of PLWHAs by description of reactions of

the people (in general) when they first knew about their HIV status. Generally, more
respondents stated that reactions of each group of people are positive (supportive and
very supportive) particularly other people living with HIV (86%), social
workers/counselors (64%), and health care workers (54%). Nevertheless, negative
reactions of people or group of people according to PLWHAs are found higher among
their friends/neighbors (15%) and other adult family members (12%).
As can be seen in table 15, which presents the percent distribution of PLWHAs by
treatment indicators, almost half of the respondents (45%) described their health
condition as fair or poor. Only 19 out of 80 respondents stated that their health
condition is very good or excellent. Two out of three are taking antiretroviral (ARV)
treatment and almost all (91%) said that they have access to it. A great majority (58%)
are not taking any medication to prevent or to treat opportunistic infections.
Nevertheless, eighty-three percent (83%) said that they have access to medication for
opportunistic infections. As regards to constructive discussion with health care
professionals, there are good number of respondents (about 70%) who had a
constructive discussion with a health care professional on the subject of their HIV-
related treatment options and on other subjects such as sexual and reproductive health,
sexual relationship, emotional well-being, drug such and the like. However, there are
still about 30% who had no constructive discussion with health care professional,
which is essential for PLWHAs who are vulnerable to illnesses.
Respondent’s description of his/her health at the moment

Forty percent of the respondent assessed that their health at the moment may be
described as fair (40%). Three out of 10 said that their health at the moment is good.
Nine respondents said that their health is good and 10 said that it is excellent . Four
said that at the moment, they describe their health as poor.
Respondent currently taking anti-retroviral treatment
Six out of ten respondents are currently taking anti-retroviral treatment. Nine out of ten
(91%) of respondents have access to anti-retroviral treatment even if not currently
taking it.
Only 43% of respondents are currently taking any medication to prevent or treat
opportunistic infection. However, 83% of the respondents have access to medication
for opportunistic infection, even if not currently taking it.
About 79% have had constructive discussion with health care professional(s) on the
subject of HIV-related treatment options. Seventy percent (7 out of 10) respondents
have had constructive discussion with health care professional(s) on other subjects
such as sexual and RH, sexual relationship(s), emotional well-being, drug use, etc.
Section 3C: TREATMENT

Table 15. Percent Distribution of People Living with HIV/AIDS by Treatment
Indicators, Philippines, 2009
1. Health Condition Excellent 10 12.5
Very good 9 11.3
Good 25 31.3
Fair 32 40.0
Poor 4 5.0
2a.Currently taking Yes 53 66.3
antiretroviral treatment No 27 33.8
2b. Access to Yes 73 91.3
antiretroviral treatment No 7 8.8
Don’t know
3a. Currently taking any 34 42.5
medication to prevent or Yes
to treat opportunistic
infections No 46 57.5
3b. Access to Yes 66 82.5
medication for No 11 13.8
opportunistic infections
Don’t know 3 3.8
4. Had a constructive 63 78.8
discussion with a health Yes
care professional on the
subject of HIV-related 17 21.3
No
treatment options

5. Had a constructive Yes 56 70.0
discussion with HCP on 24 30.0
other subjects No
HAVING CHILDREN
Table 16 shows percent distribution of PLWHAs by ‘having children’

indicators. Of the 80 respondents, forty-two percent (42%) have a child or children,
and 8 respondents said that their child or children are known to be HIV-positive. Two
out of five respondents received counseling about reproductive options. Thirty-five
percent (35%) of all the respondents, i.e., 28 respondents were advised by health care
professionals not to have a child. Three (3) respondents were coerced by health care
professional into being sterilized since they were diagnosed as HIV-positive. Only 8
respondents said that their ability to obtain antiretroviral treatment is conditional on
the use of certain forms of contraception. Nine (9) mother PLWHA respondents
experienced coercion by health care professional in relation to method of giving birth.
Eleven (11) PLWHA mothers are coerced by health care professional in infant
feeding practice. Only five (5) of PLWHA mothers have been given ARV treatment
to prevent mother-to-child transmission of HIV during pregnancy, and all of them
were given information about healthy pregnancy and motherhood as part of the
program to prevent mother-to-child transmission of HIV.
About 43% (n=34) said that they have a child/children. Of these, 24% (n=8) said that
these children are known to be HIV positive. Two in five (41%) said that since being
diagnosed as HIV positive, they received counseling about reproductive organs.
One in three (35%) said that health care professionals (ever) advised them not to have
a child since diagnosed as HIV positive. Three respondents said that health care
professional (ever) coerced respondents into being sterilized since diagnosed as HIV
positive. Only 8 respondents are able to obtain ARV conditional on the use of certain
forms of contraception.
No respondents were ever been coerced to terminate pregnancy. Nine were (ever)
coerced on method of giving birth and 11 respondents were (ever) coerced on infant
feeding practices.
Given anti-retroviral treatment to prevent mother-to-child transmission of HIV

during pregnancy (Female respondents only: N=30)
Among the 30 female respondents asked, five received ARV treatment to prevent
mother-to-child transmission of HIV during pregnancy. Four do not have access to
ARV treatment while five said that they did not know that such treatment existed. All
five who received treatment were given information about healthy pregnancy and
motherhood as part of the programme to prevent mother-to-child transmission of HIV

Table 16. Percent Distribution of People Living with HIV/AIDS by ‘Having
Children’ Indicators, Philippines, 2009
1a. Have a child/children Yes 34 42.5
No 45 56.3
Adopted 1 1.3
1b. If Yes, are any of these Yes 8 23.5
children known to be HIV- 26 76.5
positive (N=34) No
2. Received counseling about Yes 33 41.3
your reproductive options No 4 5.0
3. Ever advised by HCP not Yes 28 35.0
to have a child No 23 28.8
No answer 1 1.3
4. Ever coerced by HCP into Yes 3 3.8
being sterilized No 36 45.0
5. Ability to obtain ARV Yes 8 10.0
treatment conditional on the No 20 25.0
use of certain forms of
contraception
Don’t know 10 12.5
6. Experience coercion by a
HCP in relation to any of the
ff.: (N=30)
6.1 Termination of Yes
pregnancy (abortion) No 8 26.7
6.2 Method of giving birth Yes 9 30.0
No 6 20.0
6.3 Infant feeding practices Yes 11 36.7
No 3 10.0
7a. Ever been given ARV Yes-I have received 5 16.7
treatment to prevent mother- such treatment
to-child transmission of HIV No-I did not know 5 16.7
during pregnancy that such treatment
exist
No-I was refused 4 13.3
such treatment
No-I did not have 10 33.3
access to such
treatment
No- I was not HIV- 6 20.0
positive when
pregnant
7b. If yes, were you also Yes 5 100.0
given information about
healthy pregnancy and No
motherhood..? (N=5)
PROBLEMS and CHALLENGES
In relation to question 1 (testing/diagnosis), interviewees should be encouraged to

provide information about both their first HIV test as well as other testing experiences
such as CD4 count tests, viral load tests, as well as testing relating to opportunistic
infections.
As a result of stigma and discrimination associated with HIV/AIDS, a number of

challenges have arisen:
 There is denial of HIV status – individually, socially, and nationally, leading
to delayed treatment, care and support.
 There is fear, anxiety, depression, apathy, anger, suicidal attempts, and
revengeful behaviors.
 The social integration process for PLWHA is disrupted.
 Certain groups are also marginalized.
 Old prejudices have resurfaced and new resentment towards HIV-positive
individuals, households, or community members has emerged.
(Note: actual quotes of the open-ended questions are to be supplied to substantiate

this portion).
The undesirable differences and spoiled identities that HIV/AIDS stigma causes do
not naturally exist; they are created by individuals and by communities. HIV/AIDS-
related stigma simply builds upon and reinforces existing prejudices. It creates and is
reinforced by social inequality. Due to stigma and discrimination the rights of
PLWHA and their families are frequently violated. Every individual, organization,
community, and state has an obligation to respect and protect the rights of people
infected or affected by HIV/AIDS.
Reducing stigma and discrimination will therefore empower people (particularly

PLWHA) to recognize the benefit of the various services and, therefore, be more
willing to seek voluntary HIV counseling and testing; access care, treatment, and
support services; and disclose their sero-status.
The findings suggest that denouncing, resisting, and abolishing discriminatory

practices perhaps the most important tool to fight diseases like HIV/AIDS that breed
on social injustice, and inequality. Action plans must be formulated to develop
policies and strategies to counter AIDS-related discrimination and to change attitudes

within the health sector. People diagnosed with HIV need to be educated about their
fundamental and non-negotiable rights and available redress if rights are violated. Due
to complexities of stigma, approaches to reduce stigma and discrimination will face
many challenges, but, at the same time, there exist many entry points and strong,
positive foundations for change that interventions can immediately build on.
Limitations of Study
Respondents were not asked how they contracted HIV, as this was seen to be
intrusive. No data is therefore available to compare levels of discrimination
experienced by people who contract HIV by different modes. Although mode of
transmission was not recorded, particular attention was paid to recruit respondents
from specific populations (women, transgenders, injecting drug users, ethnic
minorities, sex workers, men who have sex with men) and from both rural and urban
sites.
The study sample does not, however, represent the epidemiological profile of HIV
infection in each country. Most people infected with are not aware of it. People who
have been HIV tested are a skewed sample of actual infections. They may represent,
for example, higher numbers of migrant workers or women attending antenatal clinics
than in the general population, because certain groups of people are more likely to be
tested for HIV than others, with or without their consent. Of the people who do test
HIV-positive, most keep their status secret and have no contact with other people
living with HIV, for fear of the discrimination they may face. This hinders the
selection of a representative study sample.
References:
Health Action Information Network, National Economic and Development Authority,

and United Nations Development Programme (2000) Living with HIV/AIDS: Case
Study on Filipinos Living with HIV/AIDS, Paradigm Printers, Pasig City
Health Action Information Network, National Economic and Development Authority,

and United Nations Development Programme (2000) In the Shadows: Men Who Have
Sex With Men, Paradigm Printers, Pasig City
Positive Action Foundation Philippines Inc. (no date) Beyond HIV & AIDS: The
(Un)told Stories and Experiences, The Ford Foundation
Commission on AIDS in Asia, (2008) Redefining AIDS In Asia: Crafting an Effective

Response Oxford University Press
Family Health International in partnership with Institute for Tropical Medicine

Management Sciences for Health, Population Services International and Program for
Appropriate Technology in Health University of North Carolina at Chapel Hill (2007)
Final Report for the Implementing AIDS Prevention and Care (IMPACT) Project in

the Philippines October 1997–June 2007, USAID’s Implementing AIDS Prevention
and Care (IMPACT) Project
Health Governance Resource Center, (2006) Integrated HIV Behavioral and Serologic
Surveillance System (IHBSS) Manual of Procedures, United States Agency for
International Development (USAID) under the terms of contract No. 492-C-00024-
00.
Mojica, Mariluz P. (ed) (2002) Contemporary Issues in STD_HIV/AIDS Research

and Prevention: Focus on the Philippine Experience, University Center for Women
Studies and Ford Foundation, Quezon City
Philippine National AIDS Council (PNAC) with Support from the UN Theme Group
on HIV and AIDS (2008) Follow-up to the Declaration of Commitment on HIV and
AIDS United Nations General Assembly Special Session (UNGASS) Country Report
of the Philippines January 2006 to December 2007 Manila, Philippines
Tan, Michael. (1997) Shattering the Myths: A Primer on AIDS and the Filipino.
Health Action Information Network and Anvil Publishing Inc.: Pasig City
Tan, Michael. (1999) “HIV/AIDS and STDs Research” in Gender-Sensitive &

Feminist Methodologies: A Handbook for Health and Researchers edited by Sylvia H.
Guerrero, University Center for Women Studies and Ford Foundation, Quezon City
Positive Action Foundation Philippines, Inc. (2002). Report of the First National
Consultation Process and Consensus meeting of Filipinos Living with HIV/AIDS on
Access to Treatment Ford Foundation and PAFPI, Manila Philippines
Marin, Maria Lourdes S, Amara T. Quesada and Carolyn I. Sobritchea For Good: Life
Sories of Filipino Migrant Workers Living With HIV/AIDS (2004) Action for Health
Initiatives (ACHIEVE) Inc. and Coordination of Action Research on AIDS and
Mobility (CARAM)-Philippines
UNFPA Country Technical Services Team for East and South-East Asia, Bangkok.
(2000) HIV/AIDS and STDs: Causes, Consequences and Preventive Programmes,
Occasional Paper Series No. 8
World Health Organization, Regional Office for South-East Asia, (1997) AIDS: No
Time for Complacency. Regional Publication, SEARO, No. 26, New Delhi
World Bank, (1997) Confronting AIDS: Public Priorities in a Global Epidemic, A

World Bank Report Policy Research Report, Washington D.C.
International Council on Management of Population Programmes(ICOMP) (2003)

Report of the 15th ICOMP International Seminar on Strategic Leadership of
HIV/AIDS Programs, ICOMP, Kuala Lumpur, Malaysia

Towards Universal Access to Reproductive Health: Policies, Systems and Capacity
Building Innovations, ICOMP, Kuala Lumpur, Malaysia

Critical Need for Engendered Linked Response to HIV/AIDS and Reproductive
Health: Experiences of ICOMP and Partners in Uganda, ICOMP, Kuala Lumpur,
Malaysia
Annex Table 1: Percent Distribution of People Living with HIV/AIDS by Selected

Background Characteristics, Philippines, 2009
Background Categories Frequencies Percent
Characteristics
Gender/Sexual Orientation Male 49 61.3
Female 30 37.5
Transgender 1 1.3
Age Groups 15-19 1 1.3
20-24 10 12.5
25-29 17 21.3
30-39 40 50.0
40-49 11 13.8
50+ 1 1.3
Number of years living 0-1 36 45.0
with HIV 2-4 25 31.3
5-9 14 17.5
10-14 4 5.0
15+ 1 1.3
Current status of Married/cohabitating;
21 26.3
relationship partner living in HH
Married/cohabitating;
partner temporarily away 2 2.5
from HH
In a relationship but not
16 20.0
living together
Single 33 41.3
Divorced/separated 3 3.8
Widowed 5 6.3
Category of respondent MSM 37 46.3
(multiple responses) Gay or lesbian 5 6.3
Transgender 1 1.3
Sex worker 22 27.5
Injecting drug user 2 2.5
Refugee/asylum seeker 1 1.3
Member of IP group 2 2.5
Migrant worker 16 20.0
Prisoner 1 1.3

Do not belong to any 15 18.8
Currently sexually active Yes 28 35.0
No 52 65.0
Educational Attainment No formal education 3 3.8
Primary school 5 6.3
Secondary school 21 26.3
Technical 51 63.8
college/university
Current Employment Full-time employee 22 27.5
Status Part-time employee 22 27.5
Full-time self-employed 7 8.8
Part-time self-employed 4 5.0
Unemployed 23 28.8
Household members 0-14 1-5 (Range) 44 (N valid)
(multiple responses) 15-19 1-3 33
20-24 1-3 29
25-29 1-7 25
30-39 1-5 34
40-49 1-4 24
50 and above 1-4 39
Household Type A rural area 24 30.0
A small town or village 20 25.0
A large town or city 35 43.8
Live in drop-in center 1 1.3
Total 80 100
Annex Table 2: Percent Distribution of Extent of Action Taken due to Internal

Stigma/Discrimination by Selected Background Characteristics, Philippines, 2009
Control Variable Action Taken due to Internal Stigma/Discrimination
Low Medium High
Sex
Male 42.0 32.0 26.0
Female 56.7 20.0 23.3
Age
<24 45.5 36.4 18.2
25-29 35.3 35.3 29.4
30-39 52.5 20.0 27.5
40+ 50.0 33.3 16.7
Education
Primary school and 75.0 12.5 12.5
below
Secondary School 57.1 23.8 19.0
Technical college or 39.2 31.4 29.4

university
Employment Status
Full-time employee 68.2 13.6 18.2
MSM
Yes 35.1 35.1 29.7
No 58.1 20.9 20.9
Sex worker
Yes 59.1 27.3 13.6
No 43.1 27.6 29.3
Migrant
Yes 62.5 12.5 25.0
No 43.8 31.3 25.0
Annex Table 3: Percent Distribution of Extent of Psychological

Stigma/Discrimination Experience by Selected Background Characteristics,
Philippines, 2009
Control Variable Psychological Stigma/Discrimination
Low Medium High
Sex
Male 40.0 30.0 30.0
Female 23.3 30.0 46.7
Age
<24 63.6 9.1 27.3
25-29 29.4 29.4 41.2
30-39 27.5 30.0 42.5
40+ 33.3 50.0 16.7
Education
below
university
Employment Status
MSM
Yes 37.8 32.4 29.7
No 30.2 27.9 41.9
Sex worker
Yes 22.7 31.8 45.5
No 37.9 29.3 32.8

Migrant
Yes 31.3 37.5 31.3
No 34.4 28.1 37.5
Annex Table 4: Percent Distribution of PLHIV’s Social Stigma/Discrimination

Experience by Background Characteristics, 2009 Philippines
Control Variable Social Stigma/Discrimination Experience Index
None Have experience Have experience
some stigma frequent stigma
Sex
Male 36.0 34.0 30.0
Female 33.3 30.0 36.7
Age
<24 27.3 36.4 36.4
25-29 41.2 23.5 35.3
30-39 30.0 37.5 32.5
40+ 50.0 25.0 25.0
Education
Primary school and 75.0 .0 25.0
below
university
Employment Status
Self-employed 36.4 63.6 .0
MSM
Yes 32.4 35.1 32.4
No 37.2 30.2 32.6
Sex worker
Yes 50.0 9.1 40.9
No 29.3 41.4 29.3
Migrant
Yes 12.5 43.8 43.8
No 40.6 29.7 29.7
Annex Table 5: Percent Distribution of PLHIV’s Experienced Work Deprivation by

Selected Background Characteristics
Control Variable Experienced Work Deprivation
With Without
Sex
Male 60.0 40.0
Female 60.0 40.0

Age
<24 72.7 27.3
25-29 70.6 29.4
30-39 57.5 42.5
40+ 41.7 58.3
Education
Primary school and 87.5 12.5
below
Secondary School 47.6 52.4
Technical college or 60.8 39.2
university
Employment Status
Full-time employee 59.1 40.9
Part-time employee 68.2 31.8
Self-employed 54.5 45.5
Unemployed 56.0 44.0
MSM
Yes 56.8 43.2
No 62.8 37.2
Sex worker
Yes 72.7 27.3
No 55.2 44.8
Migrant
Yes 50.0 50.0
No 62.5 37.5
Annex Table 6: Percent Distribution of PLHIV’s Emotional Internal

Stigma/Discrimination by Background Characteristics, 2009 Philippines
Control Variable Emotional Internal Stigma/Discrimination Index
Low Medium High
Sex
Male 14.0 42.0 44.0
Female 23.3 40.0 36.7
Age
<24 0 36.4 63.6
25-29 23.5 35.3 41.2
30-39 12.5 52.5 35.0
40+ 41.7 16.7 41.7
Education
below
university
Employment Status

MSM
Yes 13.5 32.4 54.1
No 20.9 48.8 30.2
Sex worker
Yes 18.2 45.5 36.4
No 17.2 39.7 43.1
Migrant
Yes 25.0 37.5 37.5
No 15.6 42.2 42.2

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A CLOSER LOOK:

THE STIGMA AND

MR. NOEL QUINTO

MS. MILDRED DUQUE

MR. RANIER NALDOZA

1|Page Draft not for Quotation

Table of Contents Page

2|Page Draft not for Quotation

On a national level, stigma and discrimination can discourage governments from

According to UN Secretary-General Ban Ki Moon, "Stigma remains the single most

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Because of its association with behaviors that may be considered socially

1.1 What is HIV-related stigma and discrimination?

HIV/AIDS-related stigma and discrimination is a “process of devaluation” of people

HIV and AIDS-related stigma and discrimination refer to prejudice, negative

It is widely agreed that PLWHA experience different forms of stigma and

2. Background and Rationale of the Study

6|Page Draft not for Quotation

However, it would be very helpful if family members, community and healthcare

2.1 Research Objectives

II. The Research Methodology

Involving PLHIV in Data Gathering Process

8|Page Draft not for Quotation

Respondents were chosen to explore and document unique or diverse variations of

Purposive sampling, a non-probability sampling technique was employed in selecting

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Research Key Findings

Section 1: Socio-Demographic Profiles of the Survey Respondents

Figure 1: Percent Distribution of Respondents

Figure 2: Percent Distribution of Respondents by Age

Figure 3: Percent Distribution of Respondents by number of years living with HIV

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In terms of current status of relationship,

Figure 5: Educational Attainment

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Section 2: Economic Status of Respondents

Figure 8: Respondents' Current Employment Status

Figure 9: Household Location

A location of household is important factor in the study of stigma

Generally it is considered to be difficult to get accurate information on income

Table 1: Respondents’ household average annual income, 2009 Philippines

Chapter II: Experience of Stigma and Discrimination from Other People

Stigma and Discrimination experience are progressively differentiating between the

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Social Stigma and Discrimination

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Eight respondents were subjected to psychological pressure or manipulation by

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Figure 10: Stigma and Discrimination experience by sex

Social Stigma by Sex

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Primary school & below Secondary school Technical college/university

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30.0 24.0 22.7 22.7

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ACCESS TO WORK AND SERVICES

Figure 16: Work Deprivation by Sex

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Figure 17: Work Deprivation by Age

<24 provided reasons25-29

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