Philippine HIV and AIDS Policy Act

Policy and purpose framework

HIV and AIDS are declared public health concerns with wide-ranging social, political, and economic repercussions.
The HIV and AIDS response must be anchored on principles of human rights upholding human dignity.
Discrimination based on perceived or actual HIV status, sex, gender, sexual orientation, gender identity and expression, age, economic status, disability, and ethnicity is declared inimical to national interest.
HIV and AIDS education and information dissemination must form part of the right to health.
The law guarantees, unless otherwise provided, confidentiality and the non-compulsory nature of HIV testing and HIV-related testing.
The State must ensure delivery of non-discriminatory HIV and AIDS services by government and private providers and must develop redress mechanisms for persons living with HIV to protect their civil, political, economic, and social rights.
The State shall:
- establish policies and programs to prevent HIV spread and deliver evidence-based treatment, care, and support;
- adopt a multi-sectoral approach with a whole-of-government approach and meaningful community and PLHIV participation;
- eliminate stigma and discrimination to ensure access to HIV- and AIDS-related services; and
- address conditions that aggravate HIV spread, including poverty, gender inequality, marginalization, and ignorance.

Core definitions and key concepts

Acquired Immune Deficiency Syndrome (AIDS) means a health condition from HIV infection that causes susceptibility to opportunistic infections.
Anti-retroviral Therapy (ART) is treatment that stops or suppresses viral replication of a retrovirus like HIV, slowing disease progression.
Bullying covers severe or repeated verbal, written, electronic, or physical acts/gestures that cause reasonable fear of harm, create a hostile environment, infringe rights, or materially and substantially disrupt institutional operations.
Civil Society Organizations (CSOs) are nongovernmental and noncommercial groups of individuals or legal entities engaged in non-coerced collective action around shared interests, purpose, and values.
Community-Based Research refers to studies in community settings involving community members in the design and implementation of research projects.
Comprehensive Health Intervention for Key Populations consists of evidence-based policies and programs that reduce HIV transmission and harmful health and social/economic consequences.
Compulsory HIV Testing is HIV testing imposed without consent, using force or intimidation, using testing as a prerequisite for employment or other purposes, or when informed choice is absent.
Discrimination is unfair treatment that distinguishes, excludes, restricts, or shows preferences based on grounds including HIV status (actual or perceived) and other protected characteristics, impairing recognition or exercise of rights.
Evolving Capacities of the Child is the framework recognizing children’s developmental changes and increasing self-determination capacity under the Convention on the Rights of the Child.
Gender Expression is how a person communicates gender identity through behavior, clothing, hairstyles, communication, speech patterns, or body characteristics.
Gender Identity is a personal sense of identity in relation to masculine or feminine conventions; a person may have a male or female identity with physiological characteristics of the opposite sex.
Health Maintenance Organizations (HMOs) are legally organized entities providing pre-agreed or designated health care services for a fixed pre-paid fee for a specified period.
High-risk Behavior refers to activities that increase risk of transmitting or acquiring HIV.
Human Immunodeficiency Virus (HIV) is a retrovirus infecting immune system cells, destroying or impairing their function and causing progressive immune deterioration.
HIV Counseling is dynamic communication by a trained counselor guided by ethics to support coping, planning, adherence prevention, and motivation-making in the context of positive or negative results.
HIV and AIDS Counselor is an individual trained by an accredited institution or organization to provide counseling on HIV and AIDS emphasizing behavior modification.
HIV and AIDS Monitoring is documentation and analysis of the number of infections and the pattern of spread.
HIV and AIDS Prevention and Control refers to measures protecting non-infected persons from contracting HIV and minimizing impact on PLHIV.
HIV-Negative is absence of HIV or HIV antibodies upon testing.
HIV-Positive is presence of HIV infection as documented by HIV or HIV antibodies in the tested sample.
HIV Testing includes facility-based, mobile, or community-based screening to determine HIV presence/absence; it is confidential, voluntary, accompanied by counseling prior and after testing, and conducted only with informed consent.
HIV-related Testing is any laboratory testing or procedure done relating to a person’s HIV condition.
HIV Testing Facility is any DOH-accredited on-site or mobile testing center, hospital, clinic, laboratory, and other facility capable of voluntary HIV counseling and HIV testing.
HIV Transmission is transfer of HIV through unprotected sexual intercourse, blood transfusion, sharing contaminated intravenous needles, and transmission that may occur during pregnancy, delivery, and breastfeeding.
Informed Consent is voluntary agreement based on full information, written or verbal.
Key Affected Populations are groups/persons at higher risk of HIV exposure or whose behavior makes exposure/transmission more likely.
Laboratory is an area or place, including community-based settings, where research studies are undertaken to develop local evidence for effective HIV response.
Mature Minor Doctrine recognizes certain minors’ capacity to consent to medical procedures when assessed by qualified health professionals to understand nature and consequences.
Medical Confidentiality is the duty that patient information and health status remain private, except among involved medical practitioners bound by confidentiality, and applies to all persons acquiring such information in official capacity.
Opportunistic infections are illnesses caused by organisms that often do not cause disease in persons with healthy immune systems.
Partner Notification is the process supporting an “index client” to notify and advise partners exposed to infection, including mechanisms to encourage counseling/testing; confidentiality must be observed.
Person Living with HIV (PLHIV) is any individual diagnosed with HIV infection.
Pre-exposure Prophylaxis is optional use of prescription drugs to prevent HIV infection for HIV-negative people with substantial higher-than-average risk.
Pre-test Counseling is counseling and information on biomedical aspects and emotional implications prior to HIV testing.
Post-exposure Prophylaxis is preventive medical treatment started immediately after HIV exposure to prevent infection and disease development.
Post-test Counseling provides risk-reduction information and emotional support upon release of HIV test results.
Prophylactic is any agent or device used to prevent transmission of infection.
Provider-initiated Counseling and Testing is when a health care provider initiates HIV testing after conducting HIV pre-test counseling for persons practicing high-risk behavior or vulnerable to HIV; the person may elect to decline or defer such that consent is conditional.
Redress is compensation for unfairness, grievance, and reparation.
Safer Sex Practices are choices/behaviors that reduce/minimize HIV transmission risk, including postponing sexual debut, non-penetrative sex, correct/consistent condom use, and reducing number of sexual partners.
Sexually Transmitted Infections (STIs) are infections spread through transfer of organisms due to sexual contact.
Sexual Orientation covers emotional/sexual attraction or conduct toward same sex, both sexes, opposite sex, or absence of attraction.
Social Protection is policies/programs reducing poverty and vulnerability through efficient labor markets, risk reduction, and enhanced capacity to protect against hazards and interruptions/loss of income.
Stigma is dynamic devaluation and dehumanization that results in discrimination when acted upon.
Treatment hubs are DOH-accredited private and public hospitals/medical establishments with capacity for PLHIV treatment and care services.
Voluntary HIV testing is HIV testing after pre-test counseling when a person willingly submits.
Vulnerable communities are communities/groups facing vulnerabilities like unequal opportunities, social exclusion, poverty, unemployment, and other socio-economic/cultural/political conditions increasing HIV/AIDS susceptibility and development.
Workplace is an office/premise/work site where workers habitually work, including reporting offices for those without a fixed work site.

Philippine National AIDS Council: structure and powers

Section 4 reconstitutes the Philippine National AIDS Council (PNAC) established under Section 43 of Republic Act No. 8504, and attaches it to the Department of Health (DOH) with a separate budget under the General Appropriations Act (GAA).
Section 4 requires PNAC to have its own secretariat and staffing pattern headed by an executive director.
Section 5 requires PNAC to develop the AIDS Medium Term Plan (AMTP) in collaboration with relevant government agencies, CSOs, the PLHIV community, and other stakeholders.
Section 5 mandates PNAC to ensure operationalization and implementation of the AMTP and to develop and implement guidelines/policies necessary for AMTP implementation.
Section 5 directs PNAC to monitor progress, undertake short-term assessments, evaluate impact, and mobilize sources of funds for AMTP.
Section 5 requires PNAC to coordinate with foreign/international organizations regarding funding, data collection, research, and prevention/treatment modalities, and to ensure foreign-funded programs align with the national response.
Section 5 requires PNAC to submit an annual report to the Office of the President, Congress, and Council members.
Section 6 requires PNAC membership selection based on: (a) government agencies/CSOs with direct contribution to core functions; (b) agencies/CSOs with existing programs/services contributing to AMTP achievement; and (c) agencies/CSOs with existing constituencies targeted by AMTP objectives/activities.
Section 6 mandates representation of: DOH, DepEd, DOLE, DSWD, DILG, CSC, CHED, NYC, PIA, Department of Budget and Management, Senate and House committee chairs (or representatives), two (2) representatives from organizations of persons living with HIV and AIDS, one (1) representative from a private organization with expertise in standard setting and service delivery, and six (6) representatives from NGOs working for the welfare of identified key populations.
Section 6 provides that, except for government agency members, PNAC members are appointed by the President, and agency heads may be represented by an official ranked not lower than Assistant Secretary or its equivalent.
Section 6 requires PNAC appointment not later than thirty (30) days after the date of enactment.
Section 6 mandates PNAC to meet at least once every quarter; quorum requires the Chairperson or Vice Chairperson plus at least ten (10) other members/permanent representatives; a majority vote of those present passes resolutions/decisions.
Section 6 names the Secretary of Health as permanent Chairperson; it requires a Vice Chairperson elected from government agency members for a term of three (3) years.
Section 6 sets CSO member terms at three (3) years, renewable upon Council recommendation for a maximum of two (2) consecutive terms.
Section 7 requires PNAC to be supported by a secretariat with permanent appointments subject to Civil Service rules, headed by an Executive Director under direct supervision of the Chairperson.
Section 7 assigns secretariat duties including day-to-day coordination, assistance in AMTP formulation/monitoring/evaluation, technical assistance and advisory services, serving as a repository of HIV/AIDS information, media dissemination of updated information, administrative support, and coordination/fund implementation for AMTP gaps.

AIDS Medium Term Plan and DOH roles

Section 8 requires PNAC to formulate and periodically update a six (6)-year AMTP as a national multi-sectoral strategic plan to prevent and control HIV and AIDS spread.
Section 8 requires AMTP to include: (a) national targets and strategies; (b) prevention, treatment, care, support, and other response components; (c) operationalization and identification of implementing government agencies including designated oversight offices from national to local levels; and (d) budgetary requirements and a corollary investment plan with identified funding sources.
Section 9 directs the National HIV and AIDS and STI Prevention and Control Program (NASPCP) of the DOH to coordinate with PNAC for health-sector HIV/AIDS/STI response implementation as identified in the AMTP.
Section 9 requires the Epidemiology Bureau to maintain a comprehensive HIV/AIDS monitoring and evaluation program to:
- determine and monitor magnitude/progression and provide lists of priority areas with high magnitude of cases/co-infections;
- receive, collate, process, and evaluate HIV/AIDS medical reports, including HIV-related deaths and relevant data from public/private hospitals and databanks/systems, using a coding system ensuring anonymity and confidentiality; and
- submit quarterly and annual reports to PNAC through the Secretariat.
Section 10 mandates that the response be anchored on human rights and aligned with internationally-recognized human rights instruments and standards.
Section 10 requires PNAC (with CSOs), in cooperation with DOJ and CHR, to ensure non-discriminatory HIV/AIDS services.
Section 10 requires DOJ and CHR, coordinated with PNAC, to lead developing redress mechanisms for PLHIV and key affected populations.
Section 10 requires PNAC to cooperate with LGUs to strengthen local mediation and reconciliation mechanisms.

Information, education, and communications duties

Section 11 mandates an HIV and AIDS prevention program educating the public to reduce risky behavior, lower vulnerabilities, and promote PLHIV human rights.
Section 11 requires PNAC to promote and adopt, in partnership with CSOs, measures to prevent/halt/control spread in the general population, especially key populations and vulnerable communities, while promoting PLHIV rights, welfare, and participation (including affected children, young people, families, and partners).
Section 11 requires HIV/AIDS education/prevention to be age-appropriate, evidence-based, and to actively promote safer sex practices, risk-reduction practices, universal awareness/access to evidence-based information and education and quality treatment, and knowledge of health/civil/political/economic/social rights of PLHIV and families.
Section 12 mandates DepEd, CHED, and TESDA to integrate standardized, basic, age-appropriate instruction on causes, transmission modes, and prevention in curricula in public and private learning institutions, including alternative and indigenous learning systems.
Section 12 requires learning modules to include human rights-based principles, information on treatment/care/support to promote stigma reduction, coordination with PNAC and education-sector stakeholders, and referral mechanisms including the DSWD Referral System for key populations and vulnerable communities.
Section 12 requires DepEd, CHED, and TESDA to ensure development/provision of psychosocial support and counseling in learning institutions for positive health and reproductive health values/behavior, in coordination with DOH; it also requires allocated funds for training and certification of teachers and school counselors.
Section 13 mandates DepEd, with parent-teacher organizations, to conduct gender-responsive and age-sensitive HIV/AIDS education awareness-building seminars for parents and guardians.
Section 14 declares HIV/AIDS education and information dissemination part of the constitutional right to health.
Section 15 provides that HIV/AIDS education and information dissemination form part of the delivery of health services by health practitioners/workers/personnel and enhances capabilities of public health workers for proper information dissemination; it also imposes a civic duty on private health care providers to make available necessary prevention/control information and correct misconceptions.
Section 15 requires training of health workers to include HIV-related ethical issues, including confidentiality and informed consent and the duty to provide treatment.
Section 16 mandates that all public and private employers and employees, including AFP and PNP, be regularly provided standardized basic HIV/AIDS information and instruction, including workplace confidentiality and stigma/discrimination reduction/elimination.
Section 16 requires PNAC to develop standardized key prevention/control messages.
Section 16 assigns implementation: DOLE for private sector (at no cost to employers/employees for standardized instruction), CSC for public sector, and AFP/PNP for uniformed services.
Section 17 requires seminars for overseas Filipino workers and diplomatic, military, trade, and labor officials/personnel to be assigned overseas on causes, manner of prevention, and impact of HIV/AIDS before certification for overseas assignment, conducted at no cost to OFWs and the concerned officials.
Section 17 requires DOLE, DFA, CFO, and other relevant agencies, in collaboration with DOH, to ensure implementation.
Section 18 requires educational materials at international and local ports of entry/exit, including causes, transmission modes, prevention, consequences of HIV infection, and lists of HIV counseling testing facilities; PIA leads implementation with relevant agencies, in coordination with PNAC and tourism industry stakeholders.
Section 19 requires DILG and relevant local government organizations through LAC or local health board, in coordination with PNAC, to implement locally-based multi-sectoral community responses using evidence-based, gender-responsive, age-appropriate, human rights-oriented prevention tools to stop spread; it authorizes GAD funds and other sources and gives due focus to indigenous communities and geographically isolated and disadvantaged areas (GIDA).
Section 19 requires DILG, coordinating with DSWD and NYC, to conduct age-appropriate HIV/AIDS education for out-of-school youth.
Section 20 requires PNAC to collaborate with LGUs and CSOs to support/provide funding for education programs targeting key populations (peer education, support groups, outreach activities, and community-based research), and requires DOH (in coordination with appropriate agencies and PNAC) to craft guidelines and standardized information messages for peer education, support group, and outreach activities.
Section 21 mandates that every prophylactic offered for sale or donation must have attached/provided information printed in English and Filipino, with literature on proper use and efficacy against HIV and STI.
Section 22 prohibits misinformation on HIV/AIDS, including false and misleading advertising and claims in any media or platforms promoting drugs/devices/agents/procedures without prior DOH approval through FDA and without required medical and scientific basis, including markings/indications claiming to cure or provide fail-safe prophylaxis for HIV infection.

Preventive measures, safe practices, and clinical standards

Section 23 requires PNAC, coordinating with DOH, LGUs, other government agencies, private sector, CSOs, faith-based organizations, and PLHIVs, to implement preventive measures including rights-based community-led behavior modification for PLHIV.
Section 23 requires establishment and enforcement of rights-based mechanisms encouraging newly tested HIV-positive individuals to conduct partner notification and promote HIV status disclosure to partners.
Section 23 requires standard precautionary measures in public and private health facilities.
Section 23 requires accessibility of ART and management of opportunistic infections.
Section 23 requires community mobilization of PLHIV for public awareness campaigns and stigma reduction activities.
Section 23 requires comprehensive human rights and evidence-based policies/programs to reduce transmission and harmful consequences for key affected populations.
Section 23 provides that enforcement must not lead to discrimination or violation of the rights of PLHIV and service providers implementing the program, including peer educators and community-based testing providers.
Section 24 requires DILG and DOH, in partnership with key populations, to establish a human rights and evidence-based HIV prevention policy and program for persons with higher HIV risk and other key populations.
Section 24 prohibits using the presence of used or unused prophylactics as basis for raids or similar police operations in sites and venues of HIV prevention interventions.
Section 24 requires DILG and DOH, in coordination with LGUs, to establish a national policy guaranteeing implementation of these rules.
Section 25 requires DOH to establish a program preventing mother-to-child HIV transmission integrated in maternal and child health services.
Section 26 mandates DOH enforcement of standards for donation of blood/tissue/organ:
- tissue/organ donations (gratuitous or onerous) are accepted only after donor sample tests HIV-negative;
- all donated blood must be subjected to HIV testing;
- donors with HIV-positive test must be deferred, notified of HIV status, counseled, and referred for care/clinical management as soon as possible;
- HIV-positive donations may be accepted for research only with strict sanitary disposal requirements; and
- a second testing may be demanded by blood/tissue/organ recipients or immediate relatives before transfusion/transplant, except during emergencies.
Section 27 provides that lawful consent to HIV testing of donated human body/organ/tissue/blood is considered given when: (a) the person volunteers or freely agrees to donate; and (b) the legacy and donation are executed under Sections 8 and 4 of Republic Act No. 7170 (Organ Donation Act of 1991).
Section 28 requires DOH, after consultation with professional organizations and hospital associations, to issue guidelines on medical management of PLHIV and protocols on precautions against HIV transmission during surgical, dental, embalming, body painting, or tattooing involving needles or similar procedures.
Section 28 requires protective equipment (gloves, goggles, gowns) to be prescribed, required, and available to physicians/health care providers, tattoo artists, and similarly exposed personnel at all times.
Section 28 requires DOH to issue guidelines on handling and disposal of cadavers, body fluids, or wastes of persons known or believed HIV-positive.

HIV screening, testing, counseling, and consent

Section 29 establishes voluntary HIV testing as state policy and requires written consent from the person taking the test before HIV testing.
Section 29 makes voluntary testing available for minors through a consent/assent framework based on age and circumstances:
- For persons fifteen (15) to below eighteen (18) years of age, consent to voluntary testing is obtained from the child without parent/guardian consent.
- For persons below fifteen (15) who are pregnant or engaged in high-risk behavior, they are eligible for HIV testing and counseling with assistance of a licensed social worker or health worker, and consent is obtained from the child without parent/guardian consent.
- For all other cases not covered above: consent to voluntary testing is obtained from parents/legal guardian if below fifteen (15) or mentally incapacitated; if parents/legal guardian cannot be located despite reasonable efforts or refused consent, consent is obtained from a licensed social worker or health worker; the minor’s assent is required to protect best interests.
Section 29 requires proper counseling in every circumstance by a social worker, health care provider, or other DOH- or DSWD-accredited health professional.
Section 29 requires DOH HIV testing guidelines to include guidance for testing minors and involvement of parents/guardians in HIV testing of minors.
Section 29 requires continual review and revision of the HIV diagnostic algorithm based on current technology and evidence.
Section 30 allows compulsory HIV testing only in these instances:
- when necessary to test a person charged with offenses under Articles 264 and 266 on serious and slight physical injuries and Articles 335 and 338 on rape and simple seduction under Act No. 3815 (Revised Penal Code), as amended by Republic Act No. 8353;
- when necessary to resolve relevant issues under Executive Order No. 209 (Family Code of the Philippines); and
- as a prerequisite in donation of blood under Republic Act No. 7170 (Organ Donation Act of 1991) and Republic Act No. 7719 (National Blood Services Act of 1994).
Section 31 requires DOH to accredit public and private HIV testing facilities based on capacity to deliver testing services, and provides that only DOH-accredited facilities may conduct HIV testing.
Section 31 requires DOH to develop counseling/testing guidelines, including mobile counseling/testing and routine provider-initiated counseling/testing, ensuring HIV testing is based on informed consent, voluntary and confidential, available at all times, and provided by qualified persons/DOH-accredited providers.
Section 31 requires DOH to accredit institutions/organizations that train HIV/AIDS counselors in coordination with DSWD.
Section 31 requires DOH to accredit HIV/AIDS counselors for persons with disability, including translators for hearing-impaired and Braille for visually-impaired clients, in coordination with NCDA.
Section 31 requires DOH to set counseling standards and work closely with CSOs that train counselors and peer educators, with coordination and participation of NGOs and CSOs-PLHIV.
Section 31 requires DOH to ensure access to routine provider-initiated counseling and testing as part of clinical care in all health care settings.
Section 31 mandates all HIV testing facilities to provide free pre-test and post-test HIV counseling to individuals who wish to avail of HIV testing; it also mandates confidentiality.
Section 31 prohibits HIV testing without informed consent.
Section 31 requires pre-test and post-test counseling to be done by an HIV/AIDS counselor, licensed social worker, licensed health service provider, or DOH-accredited health service provider.
Section 31 provides that in government HIV testing facilities, pre-test and post-test counseling shall be provided for free.
Section 32 requires a health care provider offering pre-natal care to offer provider-initiated HIV testing to pregnant women, with DOH providing necessary guidelines for screening procedures.

Health, ART access, support systems, and insurance

Section 33 requires DOH to establish a program providing free and accessible ART and medication for opportunistic infections to all PLHIV enrolled in the program, designate public and private hospitals as treatment hubs, and develop a manual of procedures for PLHIV management.
Section 34 prohibits depriving indigent PLHIV of access to medical services; DOH and DSWD must establish a program to support access to ART and opportunistic infection medications, including financial support for necessary medical services related to the person’s HIV condition.
Section 35 prohibits deprivation of PLHIV of employment, livelihood, micro-finance, self-help, and cooperative programs due to HIV status; DSWD must develop enabling policies and guidelines (coordinating with DILG, DOLE, and TESDA) for economic empowerment and independence designed for PLHIV.
Section 36 requires DSWD (coordinating with DOH) to develop care and support programs for PLHIV including peer-led counseling and support, social protection, welfare assistance, and case management