ALBAY, Philippines - Decades ago, the fight against Human Immunodeficiency Virus (HIV) in Albay was marked by silence. Raising awareness about HIV, let alone getting tested, was seen as "filthy," "disgusting" and taboo.
Fear of social judgment was so strong it silenced even those who had unknowingly contracted the virus. Many regarded the condition not only as a disease but also as a life sentence -- a form of punishment for perceived moral failings.
For Richard Hayag, who tested positive for HIV in 2015, the hardest part of his diagnosis was not the treatment but fear of judgment. He was ready to start medication, but the thought of his family and peers finding out weighed heavily on him.
"The fear I felt came from my surroundings. I knew that back in 2015, the community wasn't as open about HIV. My biggest enemy wasn't the virus itself -- it was the judgment and disgust directed at me," Hayag said.
Back then, there were no active community groups in Albay providing counseling and safe spaces for people living with HIV. Hayag's story of fear and social rejection wasn't the exception - it was the norm.
Ten years on, stigma still casts a long shadow over people living with HIV (PLHIV). According to Initiatives for Dialogue and Empowerment through Alternative Legal Services (IDEALS) Inc., a local non-profit and legal-focused advocacy and service organization established in 2005, stigma is what stops people from getting tested for HIV, increasing the risk for transmission.
"Addressing the HIV surge in Bicol requires dismantling stigma, expanding inclusive and stigma-free health services, and strengthening legal safeguards. Guaranteeing everyone's right to health is not only a matter of justice and equality -- it is a public health necessity that protects the entire community," IDEALS Bicol CARE Officer Jade Holen said.
According to Holen, the challenges extend beyond PLHIV to everyone at risk. She said that because HIV prevention isn't commonly taught in schools, a new generation lacks proper and age-appropriate sex education.
This educational gap fuels misinformation, unsafe practices, and stigma, ultimately discouraging people from seeking care and driving the HIV transmission surge.
"By providing young people and at-risk groups with accurate, age-appropriate, and stigma-free information, comprehensive sex education helps individuals understand modes of transmission, recognize risky behaviors, and adopt preventive practices such as consistent condom use, regular testing and early treatment," Holen continued.
According to the Department of Health-Bicol, 79% of new HIV cases in the region from January to April 2025 were among younger people. Of these, 37% were aged 15-24 and 42% were from the 25-34 age group.
Adrian, who is 21 and asked to remain anonymous, has been sexually active with strangers for some time but has always been hesitant to get tested for HIV. He also mistakenly believed that PrEP (pre-exposure prophylaxis) was only for those who have already tested positive.
PrEP is a medicine that people who are HIV-negative can take to help prevent getting HIV from sex or injection drug use.
"I have been engaging in hook-ups even when I was younger," he confessed, "but I've been hesitant to get tested for HIV because I'm shy and I don't think I have it. And for so long, I wasn't taking PrEP because I thought it was only for people who have already tested positive for HIV."
Hayag pointed out that such misconceptions are common, regardless of age. He believes that instead of shaming sexually active people, communities should focus on addressing HIV misinformation and preventing further transmission.
"While abstinence is considered helpful, this solution isn't for everyone," Hayag said. "It's high time that we drop our judgments against sexually active people and stop demonizing sex. Instead, let's help each other access services that will make us all safer from transmission."
With the support of his peers, Adrian wasa finally tested and is now taking PrEP and other services to protect himself from contracting HIV.
"When paired with accessible health services - including Social Hygiene Clinics, PrEP distribution, and counseling - this knowledge translates into safer sexual practices, reduced vulnerability, and stronger community-level protection," Holen said.
Hayag now heads Gentlemen Bicol, a local non-profit organization focused on sexual and reproductive health and rights that he established in 2015 after realizing how hard it was for PLHIV to have access to treatment and also the need for more accessible testing to prevent transmission.
Through the years, the organization pioneered HIV screening, linkage to care, and psychosocial support in the area. With support from both local and global organizations like the Joint United Nations Programme on HIV/AIDS or UNAIDS and IDEALS, they provide confidential access to prevention and care services, helping PLHIV combat both the virus and the persistent stigma.
"I didn't immediately come out as someone living with HIV, but I knew that one day, someone had to speak up and fight the stigma. That silence is what stops people from getting the prevention and treatment services they need," Hayag said.
As Bicol faces a surge in HIV cases, Gentlemen Bicol and other local groups are intensifying their outreach efforts to raise awareness and promote prevention. DOH-Bicol reported that cumulative cases have now reached 3,441, highlighting a growing public health burden that requires urgent regional attention.
"The Bicol Region recorded 244 new HIV cases from January to April 2025, with 43 new cases in April alone. This reflects a steady increase in reported cases, indicating improved case finding, but also persistent transmission," DOH-Bicol said.
Renz Robinson Alvaro, regional project officer for Sustained Health Initiatives of the Philippines, explained that while the rising number of cases is alarming, it also indicates that HIV testing initiatives are working in Bicol. The surge in reported cases means more people are learning their status, a critical step toward the UNAIDS' "95-95-95" targets.
"The increase in numbers shows that our efforts in Bicol to help people living with HIV know their status are working," Alvaro pointed out. "Because of the initiatives by both local and international groups, we are getting closer to the UNAIDS' goal of creating and supporting better solutions for HIV."
According to UNAIDS, the 95-95-95 strategy is a global goal to end the AIDS epidemic by 2030. It aims for a future where:
Based on the latest records from the DOH-Bicol, the region is making strides toward the 95-95-95 global HIV prevention strategy. As of the first quarter of 2025, Bicol's care cascade shows that:
According to UNAIDS Philippines Country Director Dr. Louie Ocampo, they operate in the Bicol region through its participation in the Philippine Country Coordinating Mechanism, a multi-sectoral national committee that directs the development of funding requests to the Global Fund, oversees its grant implementation, and ensures coordination between Global Fund grants and other national health programs.
"Local NGOs and community-led organizations, especially those led by key populations, play an essential role in advancing the UNAIDS 95-95-95 targets. Many of these groups operate and manage community centers, often supported by donors who provide resources for service delivery and operational support," he explained.
Hayag is an example that HIV is not a life sentence. He has achieved viral suppression and is living a full life. He is happily married to a spouse who remains HIV-negative, and they have a four-year-old child through in vitro fertilization who was also born HIV-negative.
For him, it is crucial to debunk the myth that HIV is a damnation or curse. "HIV is not a life sentence, but a manageable condition," he said. "We can still live happily, like anyone else, with the right access to medication, care, and a kinder, more understanding society that helps instead of judging or shaming. We deserve to live and be happy."
While Gentlemen Bicol and other groups are doing their best to reach more people, Hayag encourages everyone to join the cause by fighting stigma and promoting awareness. He believes that this will encourage more people to get tested, which will significantly decrease HIV transmission not just in Albay, but everywhere.
"We need people to speak and take action because we want everyone to realize that to achieve an HIV-free world, we need to reach more people, encourage them to get tested, and prevent the spread of transmission," Hayag said. "It all starts with testing and courage." - Rappler.com
Note: The people in the photos consented to their images being published.