St. Luke’s Medical Center treatment hub: Things to know

Last updated on 10 June 2017

For those who might still be unaware, St. Luke’s Medical Center (SLMC) recently opened its own HIV treatment hub in Global City. The hub is called Clinic 1276.

Here are some FAQs:

1. What are the requirements to enroll in the hub?

For newly-diagnosed patients who will enroll in a treatment hub for the first time:

  • Confirmatory test result from SACCL
  • Latest laboratory results
  • Philhealth MDR and other applicable documents such as certificate of contribution and CF1 signed by HR (Note: no photocopies and e-sig allowed)

For patients who will transfer from other treatment hub, additional requirements are as follows:

  • Clinical Abstract and Referral
  • EB DOH form B and C
  • Health regimen booklet
  • OHAT transfer certificate

2. What are the standard annual benefits under PhilHealth with regard to consult, refill, and laboratory procedures?

If the patient files OHAT PhilHealth Package Claims with the hub correctly and consistently (i.e. every quarter):

  • On the 2nd Filing, the patient is eligible to avail CD4 testing (6th month).
  • On the 4th Filing, the patient is eligible to avail Viral Load testing (12th month).
  • Consult with ID specialist every quarter
  • ARV Funding
  • On the 2nd year, patient may optionally choose the CBC, CREA, SGPT, SGOT, & FBS package instead of CD4

The standard testing for CD4 is conducted daily with a cutoff at 3pm. Results are released after 2-3 days.

Viral Load extraction is every Friday and the cutoff is at 10 am. Results are released on the following Monday. Both testing can be done anytime if patient is unable to comply with the schedule but the turnaround time of the results are always as mentioned.

3. Are there charges I should be aware of?

The pharmacy charges a fee of Php100/bottle of refill for storage handling.

4. What are the operation hours of Clinic 1276?

Tuesdays and Thursdays: 1pm-9pm
Wednesdays & Fridays: 8am-4pm
Saturdays: 9am-5pm
Sunday/Monday/ Holiday: Closed

5. Do you have a list of affiliated ID consultants?

Salvador M. Abad Santos, MD  (M T Th F 2-3pm)
Ferdinand G. Alcala, MD  (M T W F 9:30-12nn)
Ma. Charmian M. Hufano, MD  (T Th Sat 10-12nn)
Ryan M. Llorin, MD   (M W F 10-3pm; Sat 10-12nn all by appointment)
Mario M. Panaligan, MD  (Call for appointment)
Suzanne V. Santos, MD  (M 1-5pm; Th 11-1pm; F 1-5pm)
Carmenchu Marie E. Villavicencio, MD  (M 2-4pm; W F 11-1pm; Sat call for appointment)

6. Are anti-tb prophylaxis medicines available and free for the newly diagnosed? Which baseline tests are covered?

Yes, INH is available in SLMC. Since Clinic 1276 was just launched February 14 of this year, no baseline testing is being covered. All prescribed tests are shouldered by the patient.

Source: Clinic 1276, SLMC (Email correspondence on 10 June 2017)

For more inquiries, Clinic 1276 may be reached through 0939-930-3182 or (02)789-7700 local 8276. Their official email address is room1276.bgc(at)stluke.com.ph

If you believe there have been errors or changes from the time this post was last updated, or if you have questions, please feel free to comment here or email me on gpositivelife(at)gmail.com

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Makati Medical Center treatment hub: Things to know

Last updated on 18 March 2018 (Prices updated)

Makati Medical Center’s HIV treatment hub is called Center for Tropical and Travel Medicine – or CTTM for short. It is located in Tower 1, 1st Floor Hall C.

Here are some things one might want to know before choosing MMC as their treatment hub:

  1. CTTM is open Monday-Saturday from 9am-5pm except for holidays and last week of the year. Schedule of HIV doctors are readily available and a majority of them have their own clinic rooms, while a few have their clinics inside CTTM. Consult with most of them can be covered by their respective HMO affiliations, though this is highly discouraged (y’know why).
  2. Annual PhilHealth benefits under CTTM are limited to two (2) laboratory tests and quarterly consult with an infectious disease doctor. These are obtained through LOAs certified by CTTM. For each lab test benefit, a client like myself can choose whether to have CD4 Count or Viral Load. Since Viral Load is more expensive but is only needed once a year, 1 CD4 count and 1 Viral Load annually is a practical choice. And as it is recommended albeit not required to have CD4 count determined twice a year, most hub clients would prefer having the second CD4 count outside CTTM. It is currently cheapest to avail the second CD4 test in The Medical City (Php1,883), which also has a treatment hub of its own.
  3. CD4 count or CD4/CD8 immunoassay panel includes CD4/CD8 ratio and CBC w/ platelet count. If one wishes to pay instead of using their PhilHealth benefit, the cost is Php6,000. The result is available in 2-3 days can either be picked up or directly emailed to the client. For new enrollees, they will start to be eligible for a CD4 test after the 2nd quarterly filing of PhilHealth claims with CTTM.
  4. Viral Load or HIV-1 RNA viral load assay costs Php8,835. The result is available after 5 working days up to 2 calendar weeks. Again, this is deductible against the OHAT benefits so those who are enrolled in CTTM don’t have to pay. PWD discount is applicable (Php7,068 after discount). The standard cost of Viral Load in other laboratory facilities is Php7,500. For new enrollees, they will start to be eligible for a VL test after the 4th quarterly filing of PhilHealth claims with CTTM.
  5. As with all other treatment hubs, having the CD4 count or Viral Load done outside MMC will not be reimbursable with CTTM. Exception arises if MMC’s laboratory service is not available.
  6. Antiretroviral medication refill costs Php 100/bottle. Since I have two pill bottles (Lamivudine/Zidovudine and Efavirenz), that’s Php 200/month x 3 months. In other words, I spend an extra Php 600 (ouch!) every quarter of ARV refill. For those on a 3-in-1 pill, a quarterly refill would cost Php 300.

Below are the requirements for enrollment:

1. Copy of HIV Test confirmatory result from SACCL

2. PhilHealth Membership Data Record (MDR)

3. Proof of Contribution

4. CF1

5. If transferring from another hub, clinical abstract from doctor, medical charts and history records, and clearance to transfer

6. Other documents which can be accomplished within CTTM clinic

For enrollment and PhilHealth filing concerns, look for Ms. Kat or nurse Kevin at CTTM. They can be reached through 09178014314 or cttm(at)makatimed.net.ph

If you believe there have been errors or changes from the time this post was last updated, or if you have questions, please feel free to comment here or email me on gpositivelife(at)gmail.com

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706 (Isang Dagli)

Pinaghandaan kong magiging matatag sa anumang mangyayari. Ngunit… sa sandaling iyon ko lang naunawaan kung bakit hindi pa rin matigil ang aking pagluha.

Umiiyak ako sapagkat para akong walang iniwan sa isang nagluluksa. Ito ay para bang pag-uudyok sa aking sariling makalimot sa isang tao sapagkat hindi ko na siya muling makikita kailanman.

Ang pagsingkit ng kaniyang mga mata at ang nakatutunaw na mga ngiti;
ang lapad ng kaniyang mga braso at ang init ng mga yakap;
at ang amoy ng sigarilyo sa bawat halik.

Lahat ng iyon ay wala na.
Ang taong pinanggagalingan ng lahat ng ‘yon ay wala na.

Kasabay noon ay ang realisasyong ito ay hindi lamang pagtatapos ng isang yugto ukol sa ideya ng isang relasyon. Bagkus, sa isang tao na minsan kong pinahalagahan nang lubos.

Ang pinakamahirap na bahagi ng paglimot… Ay ang pagtuturing sa isang tao bilang patay na kahit nabubuhay pa. Dahil katumbas din nito ang pagpapatiwakal ng isang bahagi ng aking sarili.

Wala na siya.

Kailangan na ring mawala ang parte ng aking sarili na nakakabit sa kaniya upang magpatuloy. Na para bang hindi ko siya nakilala.

Ngunit paano?

Ngayo’y alam ko na kung bakit hindi matigil ang aking pagluha.

Isinulat isang gabi ng Disyembre 2014 habang nasa impluwensya ng efavirenz

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Things I learnt from a serodiscordant relationship

They say true love knows no age, gender, faith, race, or HIV status.

We may think that most things are simple and straightforward, then find out they are actually more complicated in real life. Given that, however, it is not impossible to find people who believe in such ideals.

I do not claim whatever I learnt from this relationship to be universal truths – I would never claim they are. I just want to share from my experience with J.

1. Disclosing your HIV status after you’ve shared countless intimate moments can be really, really bad – even the nicest person in the world could transform into an unimaginably horrible person. I would also feel the same, had it happened to me. Well, it’s really the fear for the person’s own health. Or the discrimination against people living with HIV. J wasn’t afraid he would get the virus, or so he said. But I was certain he was afraid of the stigma surrounding the condition.

How many times I thought ending whatever we had at that time against risking to tell him was always the better decision. I still risked it, though. A calculated risk. And after less than a month, he said yes.

However, J told me that if I had disclosed my status to him earlier before our feelings for each other became mutual, most likely he wouldn’t have considered pursuing a relationship with me. He was the only child of his parents and in a matter of 5 years or less, he would eventually have to marry and have kids. That’s an important thing we all have to consider.

But perhaps this whole thing doesn’t hold true if after you disclose to your partner, he also discloses that he is HIV-positive. What are the odds, right? Regardless, it’s a NO-NO not to disclose your HIV status at all.

2. Suppose the person you are dating assures you his feelings wouldn’t change after you disclosed your HIV status: You need to trust his words. There is no point getting paranoid. More often than not you will be the first to snap just because of overthinking, and not your HIV-negative partner. I need to emphasize though that it is okay to worry sometimes.

3. When the two of you are getting intimate, have the initiative to make sure you are engaging in safer sex and you’ve crossed off the list every possible measure to reduce the chance of transmission. Foreplay has to become more enjoyable. Use condom and lots of water-based lubricants. When in doubt if the condom is still intact, pull it out.

4. Do not frequently talk about HIV.

5. Most importantly, end of the relationship does not mean end of responsibility. You might still need to accompany your ex for HIV testing at least 3 months after your last sexual encounter. In my opinion, your partner being informed about your HIV status does not mean you are not accountable if your partner seroconverts. Though I only mean to imply “moral accountability”. You know what I mean – giving him support and knowledge about where to go, how to start treatment, amongst many other things.

J and I had our last intimate encounter towards the end of November 2014 and broke up three weeks after). We visited Klinika Benardo after 6 months. Of course, the result was still non reactive. The last HIV test result I was accountable for.

6. One of the reasons you might choose not to date HIV-negative guys is the fear the person you love will seroconvert, and it’s okay to feel that way (heart, heart). But please make sure your partner is well-educated about sexually transmitted infections, most importantly about HIV. At any rate, just go back to #3.

What if things do not go as you hoped? Well, I can’t really speak of the many what-if’s when it’s the other way around.

J and I broke up for a totally different reason. Yes, it was never because of my HIV status.

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I am an adult with HIV, which vaccines should I avail?

Last updated on 20 October 2017

Contents are up to date with most recent significant clinical findings on immunization’s efficacy and safety at the time of publication. This article only serves as a guide for HIV-positive men (who are at least 21 years of age but not older than 65) and does not intend to substitute for professional medical advice.

Regardless of CD4 count:

1. Flu vaccine (annually) to protect against seasonal flu

2. Td or Tdap vaccine (1 Tdap dose, then Td booster every 10 years)

This may protect against whooping cough and tetanus.

3. Pneumococcal vaccine

There are two types of this vaccine: PCV13 (Prevnar) and PPSV23 (Pneumovax). Note that 12 of the 13 strains in PCV13 are already included in PPSV23, though PCV13 seems to be more effective and offers longer lasting immunity (Hayward et al, 2016). Immunization schedule is recommended as follows:

Case A: I have not received either of the two. Get a PCV13 shot first, followed by PPSV23 at least 8 weeks after. A second dose* of PPSV23 is recommended 5 years after the first PPSV23 dose.

Understanding PPSV23 and PCV13 - Case A

Case B: I have been previously vaccinated with PPSV23. Get a PCV13 shot at least one (1) year after PPSV23. If the doctor recommends a second dose* of PPSV23, avail it at least 5 years after first PPSV23 dose. Also, this second dose must be at least 8 weeks after the PCV13 shot.

Understanding PPSV23 and PCV13 - Case B

Case C: I have been previously vaccinated with PCV13. Follow Case A logic.

*A second dose of PPSV23 is usually optional. The second dose is usually recommended when CD4 count is 200 cells/cu.mm. or less at the time of administering the first dose.

Pneumococcal vaccines may protect against certain types of pneumonia and pneumococcal diseases such as ear inflammation, sepsis, and meningitis.

4. HPV vaccine (Three doses at 0-1-6 month or 0-2-6 month schedule, but the latter is preferred)

There are two types of this vaccine for men: Gardasil (covers 4 strains) and Gardasil-9 (this is a new vaccine that covers 9 strains, including those 4 that have been previously covered by Gardasil). Only one type of Gardasil vaccine (either the quadrivalent or the 9-valent) must be availed and completed.

If the vaccination schedule is interrupted, there is no need to restart to first dose.

5. Hepatitis-A vaccine (Two-dose schedule at 0-6 months but can be as late as 12 months)

6. Hepatitis-B vaccine (Three double-dose schedule at 0-1-6 months)

Not to be administered to those with active hepatitis or have developed immunity to Hepatitis-B.

7. Meningococcal vaccine (Two-dose schedule at 0-5 years, then booster every 5 years thereafter)

This may protect against bacterial meningitis.

8. Haemophilus influenzae type B vaccine (single shot)

This is not automatically recommended for HIV-positive individuals and must be consulted with doctor first. It may protect against bacterial meningitis.

Should not be availed if CD4 count is below 200 cells/cu.mm. or CD4 percentage is below 15%:

1. MMR vaccine (Two-dose schedule at 0-1 months)

2. Varicella vaccine (within 3-5 days after exposure but can be as late as 10 days, then a second dose after 28 days)

This is not automatically recommended for HIV-positive individuals and must be consulted with doctor first. It may protect against chickenpox or make it less serious in the future.

Which vaccines should I NOT AVAIL regardless of my CD4 count?

1. Dengue vaccine

2. BCG vaccine (for tuberculosis)

3. Herpes zoster vaccine

Sources:

Aberg, J et al. IDSA Primary Care Guidelines for the Management of People Infected with HIV: 2013 Update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014; 58(1).

CDC. Prevention and Control of Haemophilus influenzae Type b Disease: Recommendations of the Advisory Committee on Immunization Practices.  2014; 63.

CDC. Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices. 2013; 62.

CDC. Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccination Recommendations of the Advisory Committee on Immunization Practices. 2015; 64(11).

Hayward S., Thompson L.A., McEachern A. Is 13-valent pneumococcal conjugate vaccine (PCV13) combined with 23-valent pneumococcal polysaccharide vaccine (PPSV23) superior to PPSV23 alone for reducing incidence or severity of pneumonia in older adults? A Clin-IQ. J. Patient Cent. Res. Rev. 2016;3:111–115. doi: 10.17294/2330-0698.1214.

Philippine Society for Microbiology and Infectious Diseases. Philippine Guideline on Immunization for Adults Living with Human Immunodeficiency Virus (HIV). 2010.

Related searches: pinoy, HIV, AIDS, vaccination

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I will do even better!

Prior to getting my CD4+ count result, I told myself I can only have two possible reactions once I get the stat:

  • If it’s an increase, I will do better on taking care of my health!
  • If it’s a decrease, I will do even better!

I always try my best to condition myself that if my new CD4+ count is lower, I shouldn’t be sad (which I was successful on doing when it happened March of last year). I have noticed that most PLHIVs really take the CD4+ count result seriously whether it increased or decreased. If it’s lower and one gets sad, it kinda makes the T-helper cells sadder, y’know. Hehe.

While there is strong clinical evidence to rely on this laboratory test as a description of the current state of immune system and a guide for infectious disease specialists to make judgments the likelihood of disease progression, a lot of other factors affect the dynamics of one’s immunity to infections. So I don’t just focus on a number that is written on a piece of paper.

By the way, here’s my fourth result!

CD4-Mar2015

(It’s a big mistake to connect them with lines. Scientists and researchers would understand why. :P)

So, uhm yeah. That’s about it! 🙂

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Living with HIV

Last week at work, we had an information session about health and one of the topics was on sexually transmitted infections. When the speaker talked about HIV, I was surprised that I didn’t feel nervous. I took down notes like I would usually do. I didn’t feel any pounding of my heart… Or any discomfort while I was with my colleagues as we listened to the lecture.

That’s when I realized, “Hey self, you’re something now.”

Continue reading

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