REPUBLIC ACT 8504

THE PHILIPPINE AIDS

PREVENTION AND
CONTROL ACT OF 1998
Prepared by: Jemuel C. Barlaan, RMT
Human Immunodeficiency Virus
- From a family of virus called as retroviruses.
- Causative agent of a unique disorder called as Acquired Immune Deficiency Syndrome
(AIDS)
- Infects CD4 cells commonly known as T-helper cells.
- Has 3 enzymes contributing to its virulence: 1.) reverse transcriptase 2.) integrase 3.)
protease
- Glycoprotein: gp120 and gp41
- Has period of latency of 6 months to even several years.

Transmission and Symptoms of AIDS

HIV is considered as a fragile virus meaning it cannot survive outside the host cell. They
can be transmitted through the following secretions:
• Semen
• Vaginal Fluid
• Blood
• Breastmilk
 Although the virus is present in other secretions such as tears, urine,
feces, and sweat, the viral load isn’t enough to cause infection. The most
common transmission of HIV is through sexual contact. Sharing of needles by
drug addicts, blood transfusion of infected blood products, and accidental
skin puncture are also possible causes of transmission but only account for
small portion of HIV positive population. HIV is not transmitted through any of
the following: hugging and massage, masturbation, dry kissing, and living daily
with someone with HIV (if there is no intimate contact).
Stages of AIDS
1. Early Stage (2-4 weeks after initial infection) – describe as “worst flu ever”
also known as acute retroviral syndrome (ARS).
i. high fever
ii. lymphadenopathy
iii. rash
iv. fatigue
v. headache
2. Latency Stage – virus starts to replicate inside the host’s body. Detectable
through serologic tests. Patient may or may not manifest symptoms.
3. Progression to AIDS – if an HIV positive person hasn’t undergone
treatment, it may progress to AIDS which is considered to be the final
stage. Drastic decrease in CD4 count is observed making the immune
system not responsive. Symptoms may include:
i. Rapid weight loss
ii. Recurring fever or profuse night sweats
iii. Extreme and unexplained tiredness
iv. Diarrhea lasting for a month
v. Pneumonia
vi. Memory loss, depression, and other neurological disorder
vii. Sores in the mouth (candidiasis), anus, or genitals.
AIDS COUNCIL AND AGENCY

Philippine National AIDS Council (PNAC)

- Created in December 1992 through Executive Order No. 39

Role of Educational Institutions and Other Agencies in AIDS Awareness

The role of educational institutions in AIDS awareness is focused on educational counseling and health
informative advisory. In educational counseling, it can be discussed with the public through teachings
(seminars and trainings). Early detection of AIDS is necessary for immediate treatment.
Clinical ethics, however, calls for the application of the following ethical considerations:
• Confidentiality of results
HIV-related medical records and persons with HIV are protected by the law. HIV-related medical
records should not be disclosed, except to the healthcare providers.
• Informed consent for HIV testing
Most hospitals follow this protocol. However, many states in the US allow testing of patients
without their permission after a significant exposure of emergency response workers or
healthcare providers.
• Pre-natal HIV testing
This is being done for the early detection of HIV infection due to vertical transmission.
Philippine National Aids Council (PNAC)
- an agency attached to DOH that is primarily tasked to ensure the
implementation of the country’s response to the HIV and AIDS.

Chairperson DOH Secretary

Vice Chairperson Elected among themselves

PNAC as per Number of members Term

RA 8504 26 2 years
RA 1116 21 3 years
Ethical Considerations and Moral Issues

A society may simply isolate any person with AIDS or HIV and
discrimination is evident anywhere. In the workplace, physical
fitness is a requirement for hiring an applicant. For this reason,
HIV/AIDS patients have been excluded from the workplace thinking
that it is an infectious disease. HIV/AIDS can only be transmitted via
intimate body contact such as sexual activity.
The most important principles in bioethics include respect for
persons, beneficence, and justice. Respect for persons signifies
respecting the decisions of others and protecting those who lack the
decision-making capacity. Beneficence involves the obligation to
impose positive acts in the best interest of patients. And bioethics of
justice calls for fair treatment.
 Republic Act 8504: Philippine AIDS Prevention and Control Act of 1998

“An Act Promulgating Policies and Prescribing Measures for the Prevention and Control
of HIV/AIDS in the Philippines, Instituting A Nationwide HIV/AIDS Information And
Educational Program, Establishing A Comprehensive HIV/AIDS Monitoring System,
Strengthening the Philippine National AIDS Council and For Other Purposes”

• Public awareness through comprehensive nationwide educational and information

campaign.
• Full protection of the human rights and civil liberties of every person suspected or
known to be infected with HIV and AIDS.
• Safety and universal precautions in practices and procedures that carry risk of HIV
transmission.
• Positively address and seek to eradicate conditions that aggravate the spread of HIV
infections.
• Participate of affected individuals in propagating vital information and educational
messages about HIV/AIDS.
Approved on February 13, 1998
Approved by Former President Fidel V. Ramos
Mandated by The Philippine National AIDS Council (PNAC)
Created on December 3, 1992, by Executive Order No. 39

Republic Act No. 11166: Philippine HIV and AIDS Policy Act
Approved on December 20, 2018
- Strengthen the Philippine Comprehensive Policy on HIV and AIDS
prevention, treatment, care and support
- Reconstitutes the Philippine National AIDS Council (PNAC)
- Repeals RA 8504
Republic Act 8504: Philippine AIDS Prevention and Control Act of 1998

Article 1. Education and information

Article 2. Safe practices and procedures
Article 3. Testing, Screening and Counseling
Article 4. Health and support services
Article 5. Monitoring
Article 6. Confidentiality
Article 7. Discriminatory acts and policies
Article 8. The Philippine National AIDS Council
Article 9. Miscellaneous provision
HIV counseling – refers to interpersonal and dynamic communication process
between a client and a trained counselor

Two phases
Pre-test counseling Refers to the process of providing an individual
with information on the biomedical aspects of
HIV/AIDS, and an emotional support for any
psychological implications of undergoing HIV
testing and the test result itself before the
individual is subjected to the test
Post-test counseling Refers to the process of providing risk-reduction
information and emotional support to a person
who submits to HIV testing at the time the result is
released
HIV testing

• Confidential, voluntary in nature, and must be accompanied by

counseling prior to and after the test and carried out only with the
informed consent of the person.
• The non-compulsory nature of HIV testing and HIV-related shall
always be guaranteed and protected by the government.
• Any person who compels someone to undergo HIV testing without
his/her consent is considered a criminal act.
Consent
• Express consent – written consent from a person taking the test and which must be
obtained first before HIV testing
• Implied consent – consent that is indirectly given by reason of operation of law
• Informed consent – refers to the voluntary agreement of a person to undergo or be
subjected to a procedure based on full information, whether such permission is written or
conveyed formally

Who can give consent?

• Any person who is at least 15 years of age has the authority to give consent to take HIV
testing.
• If below 15 or mentally incapacitated, consent may be obtained from the child’s parents
or legal guardian.
• If child’s parents or legal guardian cannot be located or refused to give consent, the
consent must be obtained from a license social or health worker.
• A person below 15 can give consent as long as:
✓ Minor is pregnant
✓ Engaged in high-risk behavior
Comparison of the current HIV testing algorithm and the proposed rHIVda

Current HIV algorithm for reactive Proposed Rapid HIV Testing

result in the Philippines
• A reactive result from the
screening test will be sent to
SACCL for confirmatory testing
where 2 parallel tests are
performed
• A reactive result on either of these • Includes 2 immunoassay test and
tests will then require western blot
and/or nucleic acid test as
supplemental confirmatory test
Diagnostic Algorithm (rHIVda) in
the Philippines
• The rHIVda algorithm shall be done
in sequence of three WHO pre-
qualified and FDA registered HIV
Rapid Diagnostic Tests (RDT)
preselected by NRLSLH/SACCL
3 RDTs for local validation of
sensitivity and specificity on
general and key population in the
country.
 Disclosure of HIV-related results
RA 8504
All results of HIV/AIDS testing shall be
confidential and shall be released only to the
following persons:
✓ Person who submitted himself/herself to
such test
✓ Either parent of a minor child who has been
tested
✓ Legal guardian in the case of insane persons
or orphans
✓ Person authorized to receive such results
with the AIDSWATCH program
✓ Justice of the Court of Appeals or the
Supreme Court
RA 11166
Result of any test related to HIV shall be
disclosed by the trained service provider who
conducts pre-test and post-test counseling to:
✓ Individual who submitted to the test
✓ If the patient is <15 years old and not
suffering from any mental incapacity, has
given voluntary and informed consent to the
procedure, the test result shall be disclosed
to the child, provided that the child should
be given age-appropriate counseling and
access to health care and sufficient support
services.
✓ Person authorized to receive such results in
conjunction with the DOH monitoring body.
Note:

• Any person who knowingly or negligently causes another to get infected with HIV
in the course of practice of profession through unsafe and unsanitary practice
and procedure, or who compelled any person to undergo HIV testing without his
or her consent, upon conviction, suffer the penalty of imprisonment of six (6) to
twelve (12) years, without prejudice to the imposition of fines and administrative
sanctions, such as suspension or revocation of professional license.

• Six (6) months to two (2) years of imprisonment for any person who breaches
confidentiality, and/or a fine not less than fifty thousand pesos (P50,000), but
not more than one hundred fifty thousand pesos (P150,000), at the discretion of
the court.
 REPUBLIC ACT 9288
NEWBORN SCREENING ACT OF 2004
Newborn Screening Test is the process of collecting a few drops of blood from the newborn
onto an appropriate collection card and performing biochemical testing to determine if the
newborn has a heritable condition/s. (RA 9288). The blood is drawn or collected after the
24th hour of the newborn’s life. It is non-diagnostic for it requires series of follow-up tests to
verify abnormal results. Some of the other procedures are done to the newborn within 2
weeks of birth:

• Hearing Screening – Usually done before the newborn leaves the hospital.
• Screening for Critical Congenital Heart Defects – Usually done using oximetry on the
baby’s hands and feet. Newborns with critical CHD are at a significant risk of disability or
fatality. The procedure is painless and takes up only 5 minutes.
• Circumcision – Newborn male babies may be circumcised at their parents’ request. The
advantages of this procedure include lower risks for urinary tract infection, prostate cancer,
and acquiring sexually transmitted disease.
• Comprehensive Screening Test for Jaundice – Jaundice is the yellowing of the skin caused
by the high levels of bilirubin in the blood.
R.A. 9288: Newborn Screening Act of 2004
Approved on April 7, 2004
Approved by former President Gloria Macapagal-Arroyo

Diseases screened
1.Congenital hypothyroidism
2. Congenital adrenal hyperplasia
3. Galactosemia
4. Phenylketonuria
5. G6PD deficiency

DOH Memo. 2012-0154 (May 15, 2012)

• Inclusion of MSUD in newborn screening panel of disorders.
Steps in Sample Collection
1. Properly document all information about the baby and his/her family.
2. Ensure the complete identification of the baby.
3. Collect the blood sample within 24-72 hours after birth. Capillary puncture via heel stick is the
preferred technique.
4. Massage and warm the puncture area as it would increase the blood flow sevenfold.
5. Cleanse the baby’s heel with an alcohol or cotton swab. Air-dry the heel before puncturing.
6. Prick the heel (slight angle) and wipe the first drop of blood. Have the heel dependent facing downward.
7. Wait for the spontaneous flow of blood. Wait for the blood to drop in the filter card. Allow the blood to
soak completely and saturate the circle on the card as shown below.
 DANGEROUS DRUGS ACT

RA 6425: Dangerous Drugs Act of 1972

RA 9165: Comprehensive Dangerous Drugs Act of 2002
Commonly Abused Drugs in the Philippines

➢ Methamphetamine Hydrochloride (shabu)

o Street names: ice, meth, crystal, kristal, basura (trash), and tawas.
o Has the ability to impair verbal learning and reduce motor skills.
o Blocks the neurotransmitter such as dopamine.
o People under the influence of shabu experience weight loss, confusion,
insomnia, mood disturbances, and, to some extent, violent behavior.
➢ Cannabis sativa (Marijuana)
o Commonly known as: weed, jutes, pot, grass, damo, and chongke.
o Impairs the ability of a person to focus.
o Disrupts coordination, balance, and reaction time due to the active ingredient
tetrahydrocannabinol (THC).
o Chronic users are likely to acquire lung cancer and other respiratory problems,
o Marijuana users also experience a distorted perception, problems with memory
and learning, a loss of motor coordination, and increased in heart rate.

➢ Inhalants
o More popular today than the first two because of two reasons: cheap, and
accessible.
o Rugby: most common inhalant.
o Causes slurred speech, lightheadedness, hallucinations, and delusions.
o Irreversible complications may include hearing loss, and damages to the CNS and
the bone marrow.
 Definition of Terms
CLANDESTINE Any facility used for the illegal manufacture of any dangerous drug and/or controlled
LABORATORY precursor and essential chemical
A place where any dangerous drug and/or controlled precursor and essential
DEN, DRIVE, OR RESORT chemical is administered, delivered, stored for illegal purposes, distributed, sold or
used in any form
An act of giving away, selling or distributing medicine or any dangerous drug with or
DISPENSE without the use of prescription
Any person who pays for, raises or supplies money for, or underwrites any of the
FINANCIER illegal activities prescribed under this act.
Any person who knowingly and willfully consents to the unlawful acts provided in this
PROTECTOR/CODDLER Act and uses his/her influence, power or position in shielding, harboring , screening
or facilitating the escape of any person he/she knows.
Any person who sells trades, administers, dispenses, delivers or gives away to
PUSHER another, on any terms whatsoever, or distributes, dispatches in transit or transport
dangerous drugs or who acts as a broker in any such transaction, in violation of this
Act.
Any organized group of two (2) or more persons forming or joining together with the
DRUG SYNDICATE
intention of committing any offense prescribed under this Act.
Dangerous Drug Board or Agency

Established during the term of former President Ferdinand Marcos on

November 14, 1972
Serves as the national clearinghouse on all matters related to solving the
drug problem in the Philippines.
Seven government agencies working with DDB:
o Department of Health
o Department of Social Services and Development (now: DSWD)
o Department of Education, Culture, and Sports (now: DepEd)
o Department of Justice
o Department of National Defense
o Department of Finance
o National Bureau of Investigation
Drug Testing Laboratory (DTL)
- private or government facility that is capable of testing a specimen to determine
the presence of dangerous drugs therein.

Classification of DTL
• Ownership GOVERNMENT OWNED
OR PRIVATE

• Institutional Character
FREE STANDING LABORATORY OR
INSTITUTION BASED/ HOSPITAL BASED

• Service capability
SCREENING OR
COFIRMATION
DRUG TESTING
LABORATORY
 Headship of DTL

Screening DTL Confirmatory DTL

Freestanding DTL • Licensed physician certified in the
- headed by licensed physician with clinical pathology by the PBP with at
certification in clinical pathology from least 2 years of active laboratory
the PBP or certification in clinical experience in analytical toxicology; or
laboratory management training
conducted by DOH • A chemist with master’s degree in
Institution-based DTL chemistry or biochemistry and at
- licensed physician least 2 years of experience in
- chemist anaylitical chemistry.
- medical technologist
- pharmacist
- chemical engineer
Physical plan for DTL
DTL Floor area Work area
Screening DTL 20 sqm. 10 sqm.
Confirmatory DTL 60 sqm. 30 sqm.

Accreditation/Licensing of DTL

The certificate of accreditation shall be valid for a period of:

• Confirmatory DTL = 2 years
• Screening DTL = 1 year
DRUG TESTING
- drug test result is valid for 1 year

CLIENT/DONOR
- individual from whom a specimen is collected

Specimens
1. Urine 60 mL; most common spx NRL for drug test:
East Avenue
2. Blood
Medical Center
3. Fingernails and scalp hair (for long term users)
4. Saliva
5. Sweat
6. Tissue

CHAIN OF CUSTODY
- procedures to account for each specimen by tracking its handling and
storage from point of collection and disposal
 Mandatory drug test Random drug test
• Applicants for driver’s license • Students of secondary and tertiary
• Applicant of firearms school
• Officers and members of the military, • Officers and employees of public and
police and other law enforcers private offices whether domestic or
• Person charged before the overseas
prosecutor’s office with a criminal
offense having an imposable penalty
of imprisonment of not less than six
(6) years and one (1) day
• Candidates for public office whether
appointed or elected both in local or
national government
• Persons apprehended or arrested for
violating the provision of this Act
 REPUBLIC ACT NO. 6425
Article 1. Definition of terms
Article 2. Prohibited Drugs
Article 3. Regulated Drugs
Article 4. Provisions of Common Application to Offenses Penalized under
Articles II and III
Article 5. Educational Measures
Article 6. Rehabilitative Confinement and Suspension of Sentence
Article 7. Treatment and Rehabilitation of Drug Dependents
Article 8. Dangerous Drugs Board
Article 9. Appropriation, Management of Funds and Annual Report
Article 10. Jurisdiction Over Dangerous Drug Cases
Article 11. Final Provisions