HIV surge prompts tighter monitoring of sex workers

By Rjay Zuriaga Castor

The Iloilo City Health Office (CHO) has placed sex workers under closer health watch as human immunodeficiency virus (HIV) cases climb in the city, prompting renewed focus on regular testing and compliance with social hygiene regulations.

Dr. Ma Odette Villaruel, HIV coordinator of the CHO’s Social Hygiene Clinic, recorded around 300 registered sex workers employed in bars, and an estimated 100 freelance sex workers from the city and from neighboring towns operating along streets and coastal areas.

Villaruel said registered sex workers are required to undergo regular social hygiene services, including routine screening for sexually transmitted infections (STIs).

Female sex workers receive weekly Gram-stain testing to detect gonorrhea via urethral or cervical smears, alongside syphilis testing every six months using blood samples.

Male sex workers undergo weekly smear tests for similar STI detection, focusing on urethral discharge.

She added that HIV testing, while encouraged quarterly via rapid or confirmatory methods, is not always strictly mandated but promoted for prevention.

While all tests are provided free of charge, the clinic sometimes asks for a voluntary PHP 10 donation to help sustain operations, according to Villaruel.

The city has an ordinance mandating registered sex workers to undergo regular STI screening.

However, no similar requirement exists for freelance workers. Instead, the Task Force on Moral and Values Formation monitors freelance sex workers by accounting for them and encouraging voluntary testing.

Villaruel said STI testing compliance among registered sex workers is generally high, as bar managers and owners prohibit them from working without proof of recent screening.

“They are compliant because the managers and the owners are not allowed to do their duty if there is no [smear testing], because they have a budget every day. So no smearing, no work, no pay,” Villaruel stressed.

CHO data from 1988 to August 2025 indicated that Iloilo City has recorded a total of 1,770 HIV cases.

The most affected age group is 25 to 34 years old, followed by those aged 15 to 24.

The most common mode of transmission remains to men who have sex with men (MSM), followed by bisexual contact and heterosexual transmission.

“Our HIV cases in Iloilo City are getting younger and younger. There are cases involving individuals aged 17 to 19, some of whom are still students,” Villaruel warned, noting that STIs such as syphilis and gonorrhea are also prevalent among young people.

“It’s very alarming. Not just HIV, but also gonorrhea and syphilis. It seems that these infections are being taken lightly, especially by the youth, including students,” she said.

The CHO said the youngest registered HIV case acquired through sexual contact involved a 16-year-old pregnant sex worker.

Her partner also tested reactive for HIV.

Based on assessments, Villaruel noted that many sexually active individuals do not inform their parents and often engage in unprotected sex.

Iloilo City currently has five HIV treatment hubs, in two private hospitals—St. Paul’s Hospital Iloilo and The Medical City Iloilo, and in two government hospitals—West Visayas State University Medical Center and Western Visayas Medical Center, as well as the Family Planning Organization of the Philippines, a non-government organization.

The CHO also announced plans to reopen its sundown clinic, which caters to clients after office hours.

However, the reopening is pending the hiring and training of additional personnel, as current staffing remains insufficient.

“This sundown clinic is very beneficial […] After 5 p.m., most of the MSM, especially discreet individuals and young professionals, cannot visit the clinic during regular office hours from 8 a.m. to 5 p.m.,” Villaruel said.