quiet geeky introvert

[quiet geeky introvert @renjo012]

@iampaolodomingo Hot ng hingal

[quiet geeky introvert @renjo012]

@HaplosSarap Sarap naman nyan

[Michael @neolithicrumba2]

This is, and has been my issue all along:

There is no transparancy. There is no mechanism where the voices of PLWH can be heard. This guy with DOH, LY posts on X, are absolutely tone deaf.

CBOs that provide HIV testing, prevention, and care in the US have CABs—community advisory boards—comprised of patients. These quarterly or monthly meeting give updates to patients on any changes to the system that keeps them alive. It’s a system that allows for feedback and input from the community of PWLH that they work for.

In the US and other places, regional and national governments have mechanisms for consumer input, from testing to treatment to prevention. It’s why programs work better and HIV rates are going down in other places and up in the Philippines where it’s all top down and opaque.

It’s why mpox in the US was stopped in it’s tracks: the gay community are informed consumers of healthcare. Our protests created a system that incorporates the voices of PLWH in research, clinical trials, and prevention and care in the local community. It’s why we all came in and got vaccinated for mpox in record time, averting a catastrophe.

Look at it this way:
Another arm of the government, PAGASA, warns of impending cyclones and typhoons.

Meanwhile DOH waits until the metaphorical roofs have blown off the one thing that keeps PWLH alive—our pills.

Can you imagine PAGASA not warning of a tyhoon, and only showing up two weeks later to say that everything will be fixed by September?

Ugh!

[Michael @neolithicrumba2]

For folks who aren’t going to read through all four pages, here are a few thoughts and highlights:

First, this memo was released more than two weeks ago, so it wasn’t written in response to PLWH freaking out because they’re getting a small handful of pills, instead of the normal 90-day refill. Those little baggies of pills started appearing after this memo came out, so the rationing of ARVs may be seen a response to the guidelines? Who knows.

Next, it’s important to point out that DOH expects shortages through September—or another three months. The DOH points out that an earlier memo, dated January 28, foretold of the impending shortages.

While local hubs blame DOH, DOH blames the US/Iran war fucking up shipping and deliveries. Buried in the second paragraph are statements about pharmaceutical manufactuerers needing to buy precursor chemicals, so you can’t simply oder 1.2 million bottles of TLD and expect them to show up like a book ordered over Amazon.

This implies that DOH has no experience ordering ARVs, since past supplies magically appeared, courtesy of USAID, who managed procurement timelines in the past. DOH saw the SNAFU comming in January, and told the hubs they couldn’t depend on the DOH for ARVs, so they should look elsewhere.

This is not in the document, but since some hubs are still giving out 3-bottle refills, while others hand out 7 pills, some hubs did a better job of heeding DOH’s warning than others.

There’s a tremendous amount of finger pointing, but zero in the way of mea culpas. In a just world, folks @DOHgovph, @LoveYourselfPh, and others should apologize to #PLWH. Finger pointing is not helping to put drugs in bodies. Neither are your past efforts. Saying I’m sorry lets us know that you recognize that you’re hurting the people you’re supposed to serve, you recognize the problem, and you’re not pretending the problem isn’t there.

There’s a lot in the document about alternative regimens. They point out effective 2-drug combos, and that FTC and 3TC are interchangable. They forgot to point out that TAF and TDF work identically as well. For folks who switched from LTE to TLD—and not because of resistance—they could be switched back. They also point out that people on 2-drug combos should be tested first for HBV and all persons switched should get another VL in 3 to 6 months, just to make sure the new combo is working. Part of me thinks that the alternative regimens are probably not going to happen in any substantial way. If the TLD storage facilities are empty, the LTE storage facilites are empty too.

They say if shortages should get worse (this is the part where it sounds like PLWH are passengers on the Titanic), priority should be given to pregnant women and people with AIDS. They offer no advice on people who are newly diagnosed who haven’t started ARVs. Another way of looking at this: if you want to continue of life-saving medication, get pregnant or get AIDS. Yikes!

The underlying message in this memo is that the DOH wants to avoid the catastrophy of the appearance of community-wide dolutegravir resistance. Explicitly DOH warns against intermittant dosing and treatment interruptions that would make the number one treatment in the Philippines unusable.

They point out HIV is getting worse. The number of new positives keeps increasing, so there’s exponential growth in the number of people needing ARVs. There’s also exponential growth in the number of people dying of AIDS. This means too many folks find out they’re HIV positive because they become symptomatic with some opportunistic infection, and die of those infections before their immune system can recover.

Currently there are about 98,000 PLWH on mostly TLD. But there are a quarter of a million PLWH. That means that DOH can’t serve the existing population, let alone the 150,000+ who will need treatment, if DOH ever gets the problem under control ❤️

[quiet geeky introvert @renjo012]

@mountainjudeee Tbf naman, historically Fort Bonifacio was a military camp before being redeveloped to what is BGC today. Surrounding EMBOs (Enlisted Men’s Barrio) were the residential area for the military personnel and their families. Bago pa maging CBD, may community na sa surrounding areas

[Michael @neolithicrumba2]

I’m sorry, but this is shit reporting.

The headline states: DOH buys 1.2M bottles or ARVs to address shortage, but the procurement was made in March—long before there was a shortage. DOH is not doing anything to address the current shortage, but rather diverting attention from the fact that the ARVs are still not here!

The article reports that the first shipment was supposed to arrive on May 23, and that the provider asked for an extension today (July 5). The article doesn’t mention anything about when the new delivery date is or when it’s expected!

The article also falsely states that there are 97,000 PLWH in the Philippines. There are around that number who are on medication. Current estimates show there are more than a quarter million people living with HIV, and most don’t even know it.

Since 2010, new infections have grown 418%, the fastest growth of any country in the Pacific region. The death rate from AIDS has grown 538%, which shows that most people find out they have HIV in the late stages of AIDS, when their immune system has collapsed.

DOH has not only failed to procure medications, they’ve failed to offer enough testing to identify those who need ARVs in the first place.

By comparison, Cambodia has acheived 95-95-95 targets, where 95% of those living with HIV have had a positive test result, 95% of those are in care, and 95% of those in care are virally suppressed.

The key to good reporting is speaking truth to power, and holding those responsible to account ❤️

[quiet geeky introvert @renjo012]

@iampaolodomingo X-deal 😂

[quiet geeky introvert @renjo012]

@edens320 You might want to look into one of the most common causes - low stomach acid. If that’s your case, apple cider vinegar might help.

[quiet geeky introvert @renjo012]

@CarlosMiguel652 Actually habang tumatagal nagkaka appeal sya sa akin. Especially now mas lumalabas personality nya.

[quiet geeky introvert @renjo012]

@LoveYourselfPh Why walk-in lang? It’s worrying enough na may shortage, and then the burden is placed on us pa to visit every 2 weeks?

[PozitiveReality @PozitiveReality]

The memo explicitly told the facilities mos ago to secure a half-year buffer precisely so patients wouldn't get caught in the crossfire of a natl supply gap. If a major hub is suddenly panicking and rationing medicine down to two weeks, it exposes a massive failure on their end.

[quiet geeky introvert @renjo012]

@myhubcares Hello. What are the requirements if I want to transfer to your hub?

[quiet geeky introvert @renjo012]

@wildflower_2021 @jm_lago I’m from Taguig. Binigyan naman ako noong 2024.

[Michael @neolithicrumba2]

First, let’s talk about HIV transmission.

If anyone becomes HIV-positive, five things need to be true. If just one of the five is missing, it is impossible for for sexual transmission to occur:

1 One person is positive and one is negative
2 No condom is used
3 The negative person is not using PrEP
4 The positive person is not taking ARVs
5 The two people are having vaginal or anal sex

Notice I didn’t mention orgasm. That’s because there’s HIV in pre-ejaculate as well as semen. You don’t need an orgasm to transmit HIV.

You probably also noticed I didn’t mention oral sex. In the past, oral sex was considered a low, but “possibly” risky activity. In the US, where about 40K people became positive each year (in the 90’s and 00’s), about 5-10 were considered to have aquired HIV through oral sex. But it you think about it, would that be likely to happen to a gay man who takes care of his health and appearance—or to a prostitute who is homeless, smokes drugs that leave burn sores on her lips, doesn’t take care of her oral health, so she has gingivitis and bleeding gums, and gives 20-30 blow jobs a day?

Ultimately, the CDC realized that oral sex as a transmission route is self-reported, so those few who say they got HIV from oral sex may be doing other high risk activity like anal sex or injecting drugs, that they’re embarrased to admit to. If it was possible to transmit HIV orally, we’d be seeing far more that five cases a year.

Today, the CDC’s web page on HIV transmission says that the risk from oral sex is negligible—meaning the risk is so low, it’s hypothetical and not worth considering.

Like I said above, if a PLWH is taking ARVs, they can’t transmit HIV. From a public health perspective, the main driver of new HIV cases are people who are positive but they don’t know it yet.

Maybe they’ve never tested. Or maybe they test every year, say, on January One. Then hypothetically, they aquire HIV on January 10. So for the rest of January, and all of February, March, April, May, June, etc., they are telling their sex partners that they are negative because their last test was negative. They will say they’re negative unitl they get tested again.

When a HIV attaches to a CD4 cell, it takes just 20 minutes before newly made HIV viruses start emerging from the cell. In someone with uncotrolled HIV, a billion new viruses are produced every single day. Those viruses can be found in their blood, in their lymph nodes, and in their semen. Our prostate pulls fluid from our bloodstream to make pre-ejaculate that leaks out when we’re aroused. Along with the fluid, the prostate also pull in some HIV.

Interesting fact: The majority of our CD4 cells are not in our blood. The majority can be found in our intestinal tract. They’re there to keep microbes from passing into our blood stream. All those CD4s in our ass are potential targets for HIV transmitted through anal sex, or potentially, pass HIV into the top through a small cut or tear in the penis or a sore opened up by an STD.

In a perfect world, it would be nice to know who gave you HIV. You could contact them and tell them that it’s important to take an HIV test so they can start ARVs and stay healthy.

But honestly, if we’re to move forward, and live a good life with friends who support us, and move forward with educational, career, and other goals, then it’s important for us to stop looking backwards. There is absolutely nothing we can do to change the past. Life is lived in the present. Our head and heart holds our dreams for the future.

One last thing.

In many religions, there is no name for God. It’s believed that when their God a name, their power is then limited: they become contained in a word. In Hebrew, the term is “Shem HaMeforash” which is literally, “the thing that cannot be named.”

In your post, I noticed you never mentioned HIV. My feeling is that when I say “HIV” I contain it; I keep it from becoming something bigger and overwhelming ❤️

[Dr. Deano @sexdoctordeano]

Why do smart people still get HIV?

One of the biggest misconceptions about HIV is that it only happens to irresponsible people. The reality is that many of the patients I diagnose are some of the most educated, successful, and accomplished people I have ever met. I've diagnosed CEOs, lawyers, engineers, healthcare workers, and other doctors. HIV has never cared about how intelligent you are.

What HIV cares about is exposure.

In many ways, the people who have the most opportunities in life often have the most opportunities for exposure as well. If you're attractive, socially connected, successful, confident, and sexually active, you may simply encounter more situations where HIV transmission can occur. That's not a moral judgment. It's just statistics.

This is something we learned very early during the AIDS crisis. HIV didn't target the weakest members of our community. In many cases, it took some of the brightest, most talented, most creative, and most beloved people first. Entire generations of artists, activists, academics, professionals, and community leaders were lost. HIV was never a disease of intelligence. It was a disease of exposure.

What continues to drive HIV today is not a lack of intelligence. It's fear. It's shame. It's stigma. People delay testing because they're afraid of what they might find. People avoid PrEP because they're worried about being judged. People convince themselves that HIV happens to somebody else.

Until one day it doesn't.

The good news is that we are no longer living in the 1980s. We have tools that previous generations could only dream of. We have accurate testing. We have PrEP. We have highly effective treatment. We know that U=U. We have the ability to prevent HIV and, if diagnosed, allow people living with HIV to live long, healthy, normal lives.

The smartest thing you can do is not assume you're immune to HIV. The smartest thing you can do is know your status.

Get tested regularly. Protect yourself. Use PrEP if you're at risk. Have the sex you want to have and live the life you want to live.

— Sex Doctor Deano

[GMA News @gmanews]

A total of 15,000 doses of injectable Lenacapavir (LEN) for use as a pre-exposure prophylaxis (PrEP) against HIV are expected to arrive in the country through a Philippine-United States partnership, the Department of Health (DOH) said Monday.

https://t.co/651CqM2jxu

[Paolo @paoloquimbo]

Hi guys, Nutribun Republic here. Mahaba ito btw and will delete this. Anyway…

Sa tagal ko nang nagsusulat and doing political work behind the scenes through different fights and threats, let me say this casually:

WinRi works.

But it must be used with caution pa rin, syempre.

[quiet geeky introvert @renjo012]

@futilityfunc Not a good strategy. Leni and Risa have the same voter base. You need a tandem that would boost each other.

[quiet geeky introvert @renjo012]

@gmanews Tang inang yan ayaw talaga tumigil