HIV originated from chimpanzees in West Africa and was transmitted to humans. The earliest known case of HIV in a human was detected in 1959 in the Democratic Republic of Congo. Antiretroviral therapy uses HIV medicines to treat infection and suppress viral load, preventing transmission. Factors like viral load, condom use, and adherence to medication determine likelihood of HIV transmission. Common signs of HIV infection include fever, fatigue, swollen lymph nodes, and skin rashes.

2. IF LEFT UNTREATED THIS
CAN LEAD TO AIDS !!

3. HISTORY OF HIV
Scientists
identified a
type of
chimpanzee
in West
Africa as the
source of
HIV
infection in
humans.
They believe that
the chimpanzee
version of the
immunodeficiency
virus most likely
was transmitted
to humans and
mutated into HIV

4. The earliest known case of infection with HIV-1 in
a human was detected in a blood sample collected
in 1959 from a man in Kinshasa, Democratic
Republic of the Congo.
(How he became infected is not known.)

5. TREATMENT
 Antiretroviral therapy is the use of
HIV medicines to treat HIV infection.
 People on ART take a combination of
HIV medicines (called an HIV
treatment regimen) every day.
 ART can’t cure HIV, but HIV medicines
help people with HIV live longer,
healthier lives.

6. Does HIV Viral Load Affect
Getting or Transmitting HIV?
Taking HIV medicine (antiretroviral
therapy) daily as prescribed can make the
viral load very low—so low that a test
can’t detect it ; Undetectable Viral Load
People with HIV who take HIV medicine daily
as prescribed, get and keep an undetectable
viral load have effectively no risk of
transmitting HIV to an HIV-negative partner
through sex.
YES!
VIRAL LOAD IS THE AMOUNT OF HIV IN
THE BLOOD OF AN INFECTED.
SO, FOLLOW THE PRESCRIBE MEDICINE!

7. HIV AIDS

8. (AUTOIMMUNE DEFICIENCY
SYNDROME)
late stage of HIV infection
Occurs when the body’s immune
system is badly damaged
because of the virus.
the number of their CD4 cells
falls below 200 cells per cubic
millimeter of blood (200
cells/mm3)

9. WHAT ARE CD4 CELLS?
WHITE BLOOD CELLS
YOUR BODY'S NATURAL
DEFENSE SYSTEM AGAINST
PATHOGENS, INFECTIONS
& ILLNESSES.
CD4 COUNT OF A
HEALTHY IMMUNE
SYSTEM ARE BETWEEN 500
& 1,800 CELL/mm
3

10. YOU CAN'T CATCH AIDS!
AIDS is the most advanced stage of
HIV infection.
People with AIDS have such badly
damaged immune systems that
they get a number of severe
illnesses, called opportunistic
infections.

12. INCIDENCE AND PREVALENCE
According to UNAIDS: There was
approximately 36.9 million people
worldwide living with HIV/AIDS in
2017.
1.8 million were children (<15 years old)
Estimated 1.8 million individuals
worldwide became newly infected with
HIV

13. PHILIPPINES
The Philippines is a low-HIV-prevalence
country, with less than 0.1 percent of the
adult population estimated to be HIV-
positive, but the rate of increase in infections
is one of the highest.
Country with fastest growing HIV
epidemic in Asia and the Pacific

14. One of eight countries that account
for more than 85% of new HIV
infections in the region
In April 2015, 560 new cases were
reported showing a 42% increase
compared to the same period in the
previous year
PHILIPPINES

15. • In the year 2014, a total of 6,011 cases
of HIV were reported with 91% of the
cases being asymptomatic at the time
of reporting while 543 cases were
diagnosed as AIDS.
• From 2001 to 2015 the number of
cases diagnosed per year increased 37
times, from 174 cases diagnosed in
2001 to 6,552 for the first 10 months
on 2015.

16. • May 2018, there were 950 new
HIV antibody seropositive
individuals reported to the
HIV/AIDS & ART Registry of the
Philippines (HARP) . Seventeen
percent (166) had clinical
manifestations of advanced HIV
infection.

18. • As of June 2018, the
Department of Health
(DOH) AIDS Registry in the
Philippines reported 56,275
cumulative cases since
1984.

19. • Ninety-three percent (882)
of the newly diagnosed were
male. The median age was
27 years old (range: 2 - 68
years old).
• Almost half (49%, 461) were
25-34 years old and 31%
(293) were 15-24 years old
at the time of testing.

20. • About one third (31%, 294) were
from the National Capital Region
(NCR).
• Region 4A (17%, 163 cases)
• Region 7 (10%, 94)
• Region 3 (9%, 86)

21. • Region 6 (6%, 61) round off
the top six regions with the
most number of newly
diagnosed cases for the
month, together accounting
for 73% of the total.

22. • Among the newly diagnosed
females this month, five were
pregnant at the time of
diagnosis, three of the cases
were from Region 7 and one
each from NCR and Region
4A.

24. CEBU
• The Department of Health (DOH) 7
said three people get infected with
the human immunodeficiency virus
(HIV) every day in Central Visayas
• Van Baton, DOH 7 focal person for
HIV/AIDS, said the state of HIV cases
in the country, especially in Central
Visayas, is now very alarming.

25. CEBU
• In February 2019, 90 cases were added to
the recorded data of the DOH in Region 7
alone.
• Based on DOH 7 records, there were 8,104
people living with HIV in the region in 2018,
and there is a 7% increase in the first five
months of 2019. If this trend continues, by
2022, there will be an estimated 10,279
people living with HIV in the region.
• Baton said Cebu remains with the highest
number of HIV cases in Central Visayas.

26. CURRENT DATA
Men who have sex with men
Sex workers and their clients
Individuals with multiple
heterosexual sex partners in the last
year
The spouses of individuals with
higher-risk behaviour and individuals
in stable heterosexual relationships
Injecting drug users

27. • Sexual contact remains the
predominant mode of
transmission (96%, 914).
• Among this, eighty-three
percent were from males who
have sex with males (MSM).

28. • Other mode of transmission were
needle sharing among injecting
drug users (3%, 28)
• mother-to-child transmission
(<1%, 3).
• There were five cases that had no
data on mode of transmission.

29. • Most newly-infected individuals
diagnosed in 2018 come from the
younger millennial generation:
– 4,344 were aged 25-34
– 2,505 were aged 15-24.
• This phenomenon, health experts and
advocates said, was brought by
developments in social media that
make finding sexual partners easier.

30. SIGNS AND SYMPTOMS
• Within a month or two of HIV
entering the body, 40% to 90% of
people experience flulike symptoms
known as acute retroviral syndrome
(ARS).
• But sometimes HIV symptoms don't
appear for years—sometimes even a
decade—after infection

31. 1. Fever
• The fever, usually one of the first
symptoms of HIV, is often
accompanied by other mild
symptoms, such as fatigue,
swollen lymph glands, and a sore
throat.

32. 2. Fatigue and headache
• The inflammatory response
generated by your besieged
immune system can cause you
to feel tired and lethargic.
Sometimes it can make you
feel winded while walking or
generally feel out of breath.

33. 3. Swollen lymph nodes, achy
muscles and joint pain
•They tend to get
inflamed when there’s an
infection

34. 4. Skin rash
• Skin rashes can occur early
or late in the course of HIV
seroconversion. In some
cases the rash can appear
similar to boils with itchy,
pink breakouts.

35. 5. Nausea, Vomiting and
Diarrhea
•Diarrhea that is
unremitting and not
responding to usual
therapy might be an
indication of HIV.

36. 6. Sore throat and
dry cough
• A severe, dry cough that can
last for weeks to months
without seeming to resolve
(even with antibiotics and
inhalers) is a typical symptom
in very ill HIV patients.

37. 7. Night sweats
• Many people will get night
sweats during the early stages
of HIV. These can be even
more common later in
infection and aren’t related to
exercise or the temperature of
the room.

38. COMMON TESTS OR
LAB FINDINGS
• CD4 count (how well your
immune system is functioning
)
• HIV viral load (how rapidly
HIV is replicating, or
multiplying )
• Resistance test. HLA B*5701

39. • Complete blood count.(This is a
measure of the concentration of red
blood cells, white blood cells, and
platelets in a sample of your blood)
• Blood chemistry tests
• Fasting lipid profile.(These tests
measure your lipid levels, including
cholesterol and triglycerides)

40. • Tuberculosis test.(This blood
test checks for TB infection)
• How well your body is
functioning (tests to look at
your kidneys, liver,
cholesterol, and blood cells)

41. • Whether you have other diseases
that are associated with HIV
(tests for certain infections)
• STD screening (These screening
tests check for syphilis,
gonorrhea and
chlamydia)Hepatitis A,B and C
(check for current or past
infection with Hepatitis A, B, or
C)

43. WHAT ARE SOME
IMPORTANT TESTS?

44. DRUG RESISTANT
HIV can change form,
making it resitant to some HIV
medicines. A drug resistance test
helps your health care provider
choose the HIV medicines that will
work for you.

45. TESTS FOR OTHER INFECTIONS
HIV weakens the immune
system, leaving people vulnerable to
other infections. Health care providers
test for tuberculosis, hepatitis B & C
infections, and other potential illnesses.
The treatment for another
infection may affect HIV treatment.

46. BLOOD CHEMISTRY TESTS
This group of tests measures
sevral different chemicals in your blood
to help monitor the health of your
organs, especially your heart, liver &
kidneys.
Health care providers use
blood chemistry tests to look for side
effects caused by HIV medicines.

47. CLINICAL MANAGEMENT:
• Using antiretroviral therapy for HIV positive
patient.
. Earlier initiation of drug regimens and
simplified programming for the prevention
of pregnant women and mothers living with
HIV and preventing HIV infection among
their children.
• Priority should be given to individuals with
severe or advanced HIV disease.

48. OCCUPATIONAL RISKS
RELATED TO HIV
Surgeons, Nurses and Nurses Aids
• should take precautions to avoid
needlestick injuries, cuts with sharp
instruments and exposure through
skin lesions to potentially infectious
blood and body fluids

49. Physicians and Laboratory Workers
• These people continuously handle
infectious samples. Doctors, in
diagnosing HIV patients, carry
out physical examinations and
collect blood samples. Laboratory
technicians analyze potentially
infected samples.

51. Ambulance Workers
Ambulance workers are potentially at
risk because they attend accidents and
fatalities. Ambulance workers perform
first aid on individuals for whom no
medical information is available. Blood
contact is a possibility for workers
when removing injured people from the
scene of an accident.

52. Embalmers
Embalming the bodies of
persons with a HIV infection
presents a risk because HIV can
live for hours in a deceased
body.

53. DENTAL
MANAGEMENT

54. Dental Workers
Dental workers are exposed daily
to the blood and saliva of patients.
Precautionary measures should be
adopted because of possible
exposure to HIV, and because the
mouth can be the vehicle for the
transmission of many infectious
diseases.

55.  There are several points to note
when managing a patient with
HIV/AIDS in the dental setting
 The first concern is what
laboratory values the office needs
& the interval at which they
should be made available.

56. The following laboratory
should be collected:
1)Platelet count
2)Absolute Neutrophil Count
3)CD4 Count
4)HIV Viral Load

57. The second question Dental
Professionals may ask if patient
with HIV have low CD4 counts
or high viral loads need
Antibiotic Premedicatioin

58. As long as the Dental Proffesionals
follow recommended infection
prevention protocols to prevent
pathogenic exposure, there are no
safety concerns regarding the use
of Handpieces & Ultrasonic Scalers
& these devices should be used
when indicated HIV is
BLOODBORNE not an AIRBORNE
DISEASE.

59. • Available information
indicates that the risk of HIV
transmission in the dental
office is very low.
• Transmission of HIV from
three healthcare workers to
patients has been confirmed,
including a dentist who
infected six patients.

60. • There are >300 reports (102
confirmed) of occupational
transmission to healthcare
workers, including nine dental
workers (unconfirmed).
－PubMed

61. Exposure to HIV has been
reported by 0.5% dentists/year.
The risk of HIV infection after
percutaneous exposure (0.3%)
can be reduced by 81% with
zidovudine PEP.

62. ORAL COMPLICATIONS &
MANIFESTATIONS
• Oral lesions have been reported to be
early clinical features of HIV infection.
They are multiple and varied, and are
occasionally the first sign that
patients harbour the virus.
• Some of these lesions may have a
predictive value, warning of a
progression from HIV seropositivity
to clinically manifest as AIDS.

63. They are often indicators of
immune suppression and can be
used for early testing, diagnosis
and management of patients with
HIV/AIDS. Oral lesions in HIV may
serve as markers for immune
deterioration and disease
progression and may also indicate
poor prognosis.

64. They can therefore be used as an
entry or end-point in therapy and
vaccine trials and can be
determinants of opportunistic
infection and anti- HIV therapy,
staging and classification systems

65. Seven cardinal lesions:
• Oral candidiasis
• Hairy leukoplakia
• Kaposi sarcoma
• Linear gingival erythema
• Necrotizing ulcerative gingivitis
• Necrotizing ulcerative periodontitis
• Non-Hodgkin lymphoma which are
strongly associated with HIV infection

72. DENTAL MANAGEMENGT OF
ANGINA
1. Medical consultation
2. appointment
3. reduction of stress & anxiety
4. Local anesthesia
5. General anesthesia
6. treatment procedures
7. Drugs used in treatment
8. if the attck developed

73. MYOCARDIAL
INFARCTION
DENTAL MANAGEMENT :
As angina pectoris
except; Drugs used in
treatment

74. CONGESTIVE HEART FAILURE
DENTAL MANAGEMENT :
Same as Angina except;
1. Preoperative antibiotic
2. drugs used in treatment
3. Management of complications
if developed (attack)

75. HYPERTENSIVE DISEASE
DENTAL MANAGEMENT:
same as angina except ;
1. Local anesthesia
2. General anesthesia
3. Treatment procedure

76. LIVER DISORDERS
DENTAL MANAGEMENT:
1. Medical consultation
2. Avoid drugs metabolized in liver:
 L.A － Lidocaine, Mepicaine
 Sedatives － Valium
 Antibiotics － Ampicilin
Analgesics － Aspirin

77. 3. Vitamin K － 10 mg/day
before surgery
4. General Anesthesia －
causes bleeding

78. VIRAL HEPATITIS
DENTAL MANAGEMENT :
1. Patient with active
hepatitis
2.Caries :
a) Low risk patient
b) High risk patient

79. ORAL MANIFESTATIONS
of diabetes mellitus
1. Gingivitis
2. Alveolar bone resorption
3. Xerostomia
4. Delayed wound healing
5. Pulpitis in non carious tooth
6. Burning sensation in tongue
7. Acetone smell in breath

80. DENTAL MANAGEMENT
of diabetes mellitus
1. Appointment
2.Premeditation
3.Local anesthesia
4.Treatment procedure
5.Patient Assessment

81. How Do You Get or
Transmit HIV?

82. You can only get HIV by coming
into direct contact with certain
body fluids from a person with HIV
who has a detectable viral load.
These fluids are:
• Blood
• Semen and pre-seminal fluid
• Rectal fluids
• Vaginal fluids
• Breast milk

83. • For transmission to occur, the HIV
in these fluids must get into the
bloodstream of an HIV-negative
person through a mucous
membrane (found in the rectum,
vagina, mouth, or tip of the
penis); open cuts or sores; or by
direct injection.

84. • People with HIV who take HIV
medicine daily as prescribed
and get and keep an
undetectable viral load have
effectively no risk of sexually
transmitting HIV to their HIV-
negative partners.

85. • Having vaginal or anal sex
with someone who has
HIV without using a
condom or taking medicine

86. • Sharing
injection drug
equipment
(“works”),
such as
needles, with
someone who
has HIV.

87. Less common ways are:
• From mother to child during pregnancy,
birth, or breastfeeding. However, the
use of HIV medicines and other
strategies have helped lower the risk of
mother-to-child transmission of HIV

88. • Getting stuck
with an HIV-
contaminated
needle or other
sharp object.
This is a risk
mainly for health
care workers.

89. HIV is spread only in extremely
rare cases by:
• Having oral sex
• Receiving blood transfusions, blood
products, or organ/tissue transplants
that are contaminated with HIV.
• Being bitten by a person with HIV.
• Deep, open-mouth kissing if both
partners have sores or bleeding gums

90. Ways HIV Cannot Be Spread
• Air or water
• Mosquitoes, ticks or other insects
• Saliva, tears, or sweat that is not mixed with the
blood of a person with HIV
• Shaking hands; hugging; sharing dishes,
silverware, or drinking glasses; or engaging in
closed-mouth or “social” kissing with a person
with HIV
• Other sexual activities that don’t involve the
exchange of body fluids (for example, touching).
• HIV can’t be passed through healthy, unbroken
skin.

92. CHAPTER II
THE PROBLEM

93. DENTISTS AND HEALTH
CARE PROVIDERS
• Refusal to treat patients with HIV was
primarily associated with lack of
ethical responsibility and fear related
to cross-infection. This fear is mostly
because of lack of proper knowledge
to deal with such patients," according
to a survey report.

94. WHAT DO THE DENTISTS
REALLY THINK?
Some practitioners had no reservations:
“If a person needs dental care
and you’re able to provide treatment,
then you are responsible to provide it,
providing it doesn’t put you at risk, and
I don’t see that HIV does that.”

95. Some practitioners said they were
concerned about the reactions of their
staff:
• “Even if you explain everything – HIV
has such a psychological aura about it
– if they genuinely do go home and
have sleepless nights…you could
potentially have tribunal concerns on
your hands.”

96. DENTAL AUXILLARIES/STAFFS
With the spread of human
immunodeficiency virus (HIV) infection
dental care workers like:
• Dentists
• dental hygienists
• dental assistants
fear to contact with people infected
with the virus

97.  Greatly contributed to discrimination by
some health care workers, including
Dentists against HIV-infected persons.
 The dental team can play an important role
in all phases of the human
immunodeficiency virus care continuum —
from diagnosis to disease management.
 The oral health care team should be vigilant
in recognizing oral manifestations that may
be related to HIV infection, so they can link
patients to appropriate care.

98. COLLABORATION IS KEY:
• There are many opportunities for
dental, medical, and support teams to
collaborate to ensure patients with
HIV are linked to medical and dental
care, retained in care, and adhere to
their prescribed treatment regimens.
This is where the intersection of oral-
systemic associations is important.

99. The oral health care team can also help
achieve an AIDS-free generation. In
2010, the White House released the
National HIV/AIDS Strategy with three
goals for 2015:
• Reduce the number of people who
become infected with HIV
• Increase access to care and optimize
health outcomes for individuals with
HIV/AIDS
• Decrease HIV-related health
disparities

100. PEOPLE LIVING WITH HIV
(PLHIV)
Some of the most common oral problems for
people with HIV/AIDS are:
• chronic dry mouth
• gingivitis
• bone loss around the teeth
(periodontitis)
• canker sores
• oral warts
• fever blisters
• oral candidiasis (thrush)
• hairy leukoplakia (which causes a rough,
white patch on the tongue)
• dental caries.

101. Oral conditions can be :
• Painful
• Annoying
• lead to other problems.

102. • The American Dental Association
recommends that dental health care
be part of all HIV/AIDS treatment
plans.
• That’s because people living with
HIV/AIDS are more susceptible to
infections including dental infections,
which can affect their overall health.

103. PRIVATE SECTORS
• In this day and age of easily accessible
information, it’s a sad that some people
still have extremely skewed notions and
beliefs about HIV and AIDS.
• It’s an even bigger pity that we live in a
third world country that has little to no
support when it comes to sexual education,
resulting in a 50% increase in HIV cases
over a single year.

104. HIV/STI PREVENTION
PROGRAM
Objective:
• Reduce the transmission of HIV
and STI among the Most At Risk
Population and General
Population and mitigate its
impact at the individual, family,
and community level.

105. PROGRAM ACTIVITIES
With regard to the prevention and fight against
stigma and discrimination, the following are the
trategies and interventions:
1. Availability of free voluntary HIV Counseling and
Testing Service;
2. 100% Condom Use Program (CUP) especially for
entertainment establishments;
3. Peer education and outreach;

106. 4. Multi-sectoral coordination through
Philippine National AIDS Council
(PNAC);
5. Empowerment of communities;
6. Community assemblies and for a to reduce
stigma;
7. Augmentation of resources of social
Hygiene Clinics; and
8. Procured male condoms distributed as
education materials during outreach.

107. Program Accomplishments:
• As of the first quarter of 2011, the
program has attained particular
targets for the three major final
outputs: health policy and program
development; capability building of
local government units (LGUs) and
other stakeholders; and leveraging
services for priority health programs.

108. • For the health policy and program
development, the Manual of Procedures/
Standards/ Guidelines is already finalized
and disseminated. The ARV Resistance
surveillance among People Living with HIV
(PLHIV) on Treatment is being
implemented through the Research
Institute for Tropical Medicine (RITM).
Moreover, both the Strategic Plan 2012-
2016 for Prevention of Mother to Child
Transmission and the Strategic Plan 2012-
2016 for Most at Risk Young People and
HIV Prevention and Treatment are being
drafted.

109. • With regard to capability
building, the Training Curriculum
for HIV Counseling and Testing is
already revised. Twenty five
priority LGUs provided support
in strengthening Local AIDS
councils. as of March 2011, there
were already 17 Treatment Hubs
nationwide.

110. • Lastly, for the leveraging
services, baseline laboratory
testing is being provided
while male condoms are being
distributed through social
Hygiene Clinics. A total of
1,250 PLHIV were provided
with treatment and 4,000 STI
were treated.

111. Here are 8 organizations that
are working to educate the
Filipinos
1. TAKE THE TEST (TTT)
2. PINOY PLUS ASSOCIATION
3. THE POSITIVE ACTION FOUNDATION
PHILIPPINES, INC.
4. ACTION FOR HEALTH INTIATIVES, INC.
5. B-CHANGE GROUP
6. THE RED WHISTLE (TRW)
7. AIDS SOCIETY PHILIPPINES
8. LOVE YOURSELF GROUP

112. OTHER ORGANIZATIONS:
• World Health Organization
• UNICEF Philippines
• AMERICAN DENTAL
ASSOCIATION (ADA)

113. Research Methodology
• To explore and describe the experiences
of PLHIV and dentists to stop the stigma
intervention through a qualitative
interpretive description approach in both
HIV victims and in Dental field.

114. Method
Setting
The study is about to be
conducted in selected dental
clinics.
Population
The population consists of two
groups, namely PLHIV and
licensed dentists

115. Sample :
• purposive voluntary sampling is to be
conducted
• recruited through mediators with trust
relationship from local healthcare facilities
and non-governmental organization

116. • For PLHIV, the inclusion criteria
were as follows: Participants
should be male or female and
had to be diagnosed with HIV for
at least six months, able to
communicate freely, be prepared
to disclose their HIV status, and
willing to be interviewed and
recorded
• final sample should be 5-10
people diagnosed with HIV

117. Locale
•The study will be
conducted in Cebu City
on the First Semester of
2019-2020

118. Participants
• PLHIV (people living with
HIV)
• Dentists and healthcare
providers
• Auxiliary and staff
• Private sector that are living
in Cebu City area

120. LIMITATIONS
Here is one of the problems we
discussed in the limitations:
• First,Why are the respondents
afraid to get diagnosed
• Second, Young Adolescent are
more higher risk for having
HIV/AIDS.

121. CONCLUSION
• The majority of people having HIV are
mostly young adolescents, thus this
may present a challenge in getting the
needed surveys because of the ethical
and legal issues that make it difficult
to conduct the awareness on people
under 18 and the need for parental
approval to make the said
participants as subject.

122. • Unprotected sex is the most
common route of HIV infection
among young people. Low HIV
and sexual health knowledge is a
key barrier to reducing HIV
infections among young people a
‘life-cycle’ approach to HIV
prevention can help respond to
the changing challenges people
face at different ages.

124. REFERENCE/S:
• https://www.cdc.gov/hiv/basics/whatishiv.html
• Edward C. Klatt, “Pathology of HIV/AIDS”, v.29, april 16,2018
• https://www.ncbi.nlm.nih.gov/books/NBK64928/
• https://www.who.int/gho/hiv/en/biology.kenyun.edu
• https://www.who.int/bulletin/volumes/90/11/12-102574/en/
• https://www.doh.gov.ph/sites/default/files/statistics/EB_HIV_2018_May.pdf
• https://www.niaid.nih.gov/diseases-conditions/hivaids
• https://www.cdc.gov/hiv/basics/transmission.html
• https://www.intechopen.com/books/current-perspectives-in-hiv-infection/oral-manifestations-of-hiv
• https://www.nidcr.nih.gov/health-info/hiv-aids
• https://www.mouthhealthy.org/en/az-topics/h/hiv-aids-and-dental -health
• https://unicef.org
• https://aidsmap.com
• https://decisionsindentistry.com/article/managing-dental-patients-with-hiv/
• https://amp.rappler.com
• https://medicalxpress.com
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785592
• https://www.jmedscindmc.com/article.asp?issn=1011-
4564;year=2017;volume=37;issue=2;spage=44;epage=49;aulast=Doka
• https://pdf.sciencedirectassets.com
• https://ourworldindata.org/hiv.aids
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785592
• SHIFT_NSA_PHILIPPINES_2018PDF
• https://www.doh.gov.ph