In May 2015, the World Health Organization announced that the Philippines had the fastest growing HIV rate in the world. The epidemic has grown among young people and men who have sex with men (MSM) in particular. The current Miss Universe, Pia Wurtzbach of the Philippines, has chosen HIV as a focus of her advocacy work and has been named an HIV Prevention Ambassador in the Miss Universe partnership with Aid for AIDS. She also supports the advocacy activities of the New York City-based Gay Men’s Health Crisis (GMHC). Ms. Wurtzbach has been commended for bringing greater attention to HIV by UNAIDS Asia-Pacific, the Philippine Red Cross, and Love Yourself Inc., an advocacy group in the Philippines. On a recent visit to the New York City offices of amfAR, she discussed her HIV/AIDS work.
TA Report: What made you choose to lend your voice to the issue of HIV/AIDS?
Pia Wurtzbach: The Miss Philippines pageants work with UNICEF, and through that connection I’ve had the opportunity to visit people affected by HIV/AIDS. There are actually several pageants and reigning titleholders in the Philippines. We visit as advocates, to encourage people, and also to educate ourselves. During our visits, I often sensed a feeling of discomfort and hesitancy among some of my fellow reigning queens. To me, I think it’s just lack of knowledge. Many people in the Philippines believe that hugging or sharing a meal with people with HIV, or just being in a room with them, is unsafe. I remember thinking: “How come we’re put in this position where we are supposed to be the voice, but we don’t know much about it?” And even I have to admit that, at first I didn’t really know much either.
TA Report: Why do you think there has been such a large increase in new cases of HIV in the Philippines in recent years? Why have certain regions been especially hard hit?
“When young people are held back from learning, they start to struggle and explore and make mistakes. So I think that’s why it’s hitting the younger generation more now.”
Wurtzbach: In Cebu in particular, the number one source of HIV infection is not sexual transmission but the sharing of needles, for drug use. And it is mostly youth who are affected. The second largest transmission route is through male-to-male sexual contact. There are drug problems throughout the Philippines, often influenced by lack of opportunity and education for young people, boredom, and poverty. There is also a significant sex trade in the Philippines, which fuels the HIV epidemic.
TA Report: UNICEF has reported that much of the growth in HIV cases in the Philippines affects people under the age of 25. Why do you think young people are especially vulnerable?
Wurtzbach: In addition to boredom and lack of education which often leads young people to take drugs, the Philippines is a very conservative, Catholic country; no one ever talks about sex. It is considered taboo to even ask your parents about sex. When young people are held back from learning, they start to struggle and explore and make mistakes. So I think that’s why it’s hitting the younger generation more now.
Pia Wurtzbach at the 31th annual AIDS Walk New York in 2016, which benefits GMHC and other AIDS service organizationsAlso, it is difficult to find a place where you can buy a condom. They are not on display at pharmacies—you have to ask. And then the person beside you can hear it. So what if I'm a woman and I want to buy a condom to protect myself? The gentleman or grandma or mother beside me, they’re going to give me a look. It’s like you almost have to whisper it to the pharmacist—even with contraceptives. If it is a challenge for me to get access to these things, it is more so for people living in poverty, who can't even afford to buy their meals for the day. And unfortunately, there are many people living in poverty in the Philippines.
It is only recently that the Philippines government passed the Reproductive Health Bill, which funds the distribution of free contraceptives, including condoms, to people who need them the most, especially youth. But people, both women and men, are worried about being seen accessing these services—they don’t want others to know they are having sex. So I can’t say there have been no efforts to distribute condoms—there have been. I just think we could be doing so much more.
TA Report: The 2013 Young Adult Fertility and Sexuality survey showed that many Filipino youth lack basic information about HIV/AIDS. What strategies should be adopted or strengthened to improve awareness of the risks for contracting HIV as well as procedures for testing and treatment?
“To improve understanding, more people need to talk about it. And that’s exactly what I’m doing.”
Wurtzbach: To improve understanding, more people need to talk about it. And that’s exactly what I’m doing. I am definitely not an expert but I'm slowly starting to learn, and I still ask questions. Everyone needs to be educated, including advocates, so that we may spread the message more clearly and accurately. People also need to understand that the disease cannot be transmitted through sharing a glass of water or hugging or being in the same room with an infected person.
TA Report: What should be done to enable people in Asia of all ages to better protect themselves from HIV/AIDS?
Wurtzbach: One issue that needs to be addressed is the human trafficking problem. Also, Asia in general tends to be a conservative continent, where people are hesitant to be judged by other people. This restricts people from talking openly and from getting the information they need to protect themselves. There are also a variety of religious beliefs in Asia that influence the way different countries handle the problem of HIV.
I hope that the people who win in the upcoming [Philippine] elections will do more to address HIV. A lot of the candidates are aware of the problem and include efforts to address it as part of their platform. I hope their promises translate into concrete education, testing, and treatment programs that are directly useful to the citizens, and that funding for the programs is transparent.
Ms. Wurtzbach is an ambassador for the New York-based Aid for AIDS, a non-profit organization committed to empowering communities at risk of HIV.TA Report: How can regional campaigns targeted to help especially vulnerable groups, such as men who have sex with men (MSM), be made more effective?
Programs need to provide anonymity. A model I know of is a hospital in Quezon City that offers discreet HIV services. I was very impressed with how they are dealing with this issue. There need to be more programs like it.
One of our ideas at the Miss Universe organization is that we will pass out leaflets during my public appearances that contain, in addition to my photo as a souvenir, information on how and where people can get tested for HIV. Then they could follow up without their privacy being compromised.
TA Report: How do you think we can better utilize social media to educate young people around the world about HIV prevention and treatment and influence their risk behaviors?
Wurtzbach: I know for a fact that people won’t click on a link to read a long paragraph on a website. The information has to be really short and to the point. As Miss Universe, I am in a good position to reach people, especially in the Philippines, where beauty pageants are very important. As of now I have the biggest social media following of any Miss Universe winner so far. As a “pretty face” who’s wearing a crown, I can reel people in. Once I get their attention, that’s when we throw the message in.
TA Report: How does stigma affect global efforts to combat HIV?
Wurtzbach: I think stigma exists in different degrees throughout the world. Different regions require different strategies. There are places where people are more open about discussing HIV, more accepting. And some countries are much less accepting of gay relationships than others. Because of this, I think that efforts need to be targeted to each region’s culture and religion, and in the context of the area’s access to medicine, testing, and prevention.
“Efforts need to be targeted to each region’s culture and religion, and in the context of the area’s access to medicine, testing, and prevention.”
TA Report: In the course of your travels, have you seen differences in how the HIV epidemic is affecting Asia compared with other parts of the world?
Wurtzbach: Compared to parts of Africa and South America, the overall rate of HIV infection in Asia is not as high. But the rates are increasing. It’s a growing epidemic. Every day around 15 people are diagnosed in the Philippines alone. And these are the people who had themselves tested. The statistics don’t include those who don’t know that they have it, or are afraid to find out.
As Miss Universe and a titleholder from Asia, I think I represent not just the Philippines but the Asian continent, as well as other parts of the world. And I hope that I can inspire other nations to increase their efforts to deal with HIV. I have seen how I can touch the lives of people from different parts of Asia, through their letters or private messages on my social media accounts, just saying thank you. I really appreciate this. I may not be able to educate each person in Asia about how they should get themselves tested, but I’m trying to be a voice for those who don’t feel they can use their own.