Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY

__
September 13, 2023

DEPARTMENT MEMORANDUM
No. 2023 - 0334

OF
FOR : ALL UNDERSECRETARIE AND ASSISTANT
SECRETARIES, DIRECTORS OF BUREAUS, SERVICES
AND CENTERS FOR HEALTH DEVELOPMENT.
MINISTER OF HEALTH - BANGSAMORO AUTONOMOUS
REGION _IN MUSLIM MINDANAO, EXECUTIVE
DIRECTOR: F_ SPECIALTY HOSPITAL HIEFS
MEDICAL CENTERS HOSPITALS. SANITARIA.
INSTITUTES AND DOH-DESIGNATED HIV TREATMENT

HEALTH
INSURANCE CORPORATION. DIRECTOR OF
HILIPPINE NATIONAL AIDS COUNCIL, AND ALL

PHILIPPINE
PRESIDENT
FACILITIES,
OTHERS CONCERNED

SUBJECT : iteration n___Providin herene nseling and

Employing Multi-Month Dispensing of Antiretroviral (ARV)
Drugs for People Living with Human Immunodeficiency Virus
(PLHIV)

The Department of Health (DOH) released the Administrative Order 2022-0024: “Guidelines on
Differentiated Treatment for People Living with Human Immunodeficiency Virus (PLHIV) and
Prophylaxis for HIV-Exposed Infants”. (Copy can be accessed through this link AO 2022-0024.)

To ensure continuity of treatment and achieve viral suppression of PLHIV on antiretroviral

therapy (ART) and subsequently preventing interruption in treatment and lost to care, the DOH
Disease Prevention and Control Bureau (DPCB) hereby reiterates the following provisions the of
HIV treatment guidelines:

A. Adherence Counseling
“Adherence shall be assessed and reinforced at every follow-up consultation to prevent
drug resistance and treatment failure.”

Adherence counseling refers to “provision of information on HIV, manifestations of

disease, benefits and side effect of ART, how ARV medications shall be taken,
importance of not missing any doses to achieve viral suppression, risks associated with
poor adherence, assessment of adherence including identifying obstacles to adherence,

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 and treatment planning to enhance adherence through face-to-face or digital health
platforms”.

. Employing Multi-Month Dispensing (MMD)

“Patients who are already established on ARTshall be maintained and monitored on their
current ART regimen and providers shall employ multi-month dispensing.”

Established on ARTrefers to “PLHIV stable on ART for more than 6 months who have
no symptoms and concurrent infections, excluding other treated chronic health conditions
with good control; understand the significance of adherence; are provided with adequate
counseling; and with evidence of treatment success, i.e. at least one suppressed viral load
result within the past 5 months (or CD4 cell count >200 cells/mm? in adolescents and
adults or >350 cells/mm’ in children three to five (3-5) years old, if VL is not available),
and weight gain”.

Multi-Month Dispensing (MMD) refers to “a differentiated or person-centered approach

of providing six (6) months’ supply or more of ARV for PLHIV established on ART
depending on the need and situation”.

Relative thereto, the Centers for Health Development (CHDs) and Ministry of Health -
Bangsamoro Autonomous Region for Muslim Mindanao (MOH-BARMM) are hereby requested
to accept the allocation from the Central Office and immediately allocate and provide the ARV
supplies to the HIV Treatment Facilities.

All 203 HIV Treatment Facilities listed in the Department Circular 2023-0284: “Updated
Directory of DOH-Designated Human Immunodeficiency Virus (HIV) Treatment Hubs and
Primary HIV Care Facilities in the Philippines as of May 30, 2023” shall ensure provision of
adherence counseling to all PLHIV and employ multi-month dispensing of ARVs to PLHIV
established on ART. (Directory of HIV treatment facilities can be accessed through this link DC
2023-0284.)

For dissemination and strict compliance.

Awronhy oF ~Pas
Queeriany, oF Woe Vin! d
by

MARIA ROSARIO SINGH-VERGEIRE, MD, MPH,

Undersecretary of Heplth
CESO
II
Public Health Servic¢s Team