SAFE PRACTICES AND PROCEDURES
Section 21 Universal Precautions
Universal Precautions is the basic standard of infection control. The underlying principle is to assume that all patients and staff are potentially infected with blood-borne pathogens such as HIV and hepatitis B virus. Universal Precautions is intended to prevent transmission of infection from patient to staff, staff to patient, staff to staff, and patient to patient.
The procedures for Universal Precautions shall include:
- Standard hygienic procedures, especially handwashing, should be followed at all times.
- Hospital or medical center guidelines for disinfection and sterilization should be consulted and followed faithfully.
- Any skin disease or injury should be adequately protected with gloves or impermeable dressing to avoid contamination with a patient's body fluids.
- Any spills of blood or other potentially contaminated material should be liberally covered with household bleach (dilution of 1 to 10), left for 30 minutes then carefully wiped off by personnel wearing gloves.
- Gown, gloves, mask and protective eyewear should be worn, if possible, during surgery, childbirth and other procedures where contact with blood or body fluids is likely.
- Needles and sharp objects should be discarded immediately after use in puncture-proof containers marked BIOHAZARD. Do not bend or break needles by hand. Do not recap used disposable needles.
- Reusable needles and syringes should be handled with extreme care and safely stored prior to cleaning and sterilization or disinfection
- Linen soiled with blood or other body fluids should be handled as little as possible. Gloves and a protective apron should be worn while handling soiled linen.
- Specimens of blood and body substances should be handled as potentially infectious.
All hospitals and other appropriate health care facilities shall establish an HIV/AIDS Core Team (HACT).
HACT is multi-disciplinary group of health workers with policy-making, implementing, coordinating, assessing, training, research and other project development functions on matters related to the diagnosis, management and care of HIV/AIDS patients and the prevention and control of HIV/AIDS infection in the hospital. Its primary objectives are to facilitate the provision of safe, comprehensive and compassionate care to HIV/AIDS patients by properly trained personnel; to mobilize hospital and community resources towards minimizing the impact of HIV/ AIDS infection on the patient and his family; and to coordinate all efforts to prevent and control the transmission of HIV/AIDS infection.
The functions of HACT include:
HACT shall be composed of five (5) to seven (7) members, which may include, but is not limited to, the following:
- Implement hospital guidelines on the comprehensive care and management of HIV/AIDS patients;
- Provide care and counseling to HIV/AIDS patients;
- Promote prevention and control measures/strategies such as health education and hospital infection control;
- Facilitate inter- and intra- departmental/agency coordination including referral system and networking;
- Perform training and research activities on HIV/AIDS;
- Provide recommendations on hospital planning and development related to HIV/AIDS;
- Monitor compliance of ethico-moral guidelines for HIV/AIDS including confidentiality of records and reports and release of information;
- Update records and submit reports to concerned offices; and
- Conduct monitoring and evaluation activities.
The criteria for selecting HACT members include:
- Medical social workers; and
- Medical technologists
In addition to the criteria for a HACT member, the criteria for the selection of a HACT leader include:
- Commitment to accept responsibilities and perform the tasks of HACT members;
- With permanent position, resident physician or specialist;
- Willingness to undergo training in clinical management and care of HIV/AIDS patients; and
- High respect for medical confidentiality
- Commitment to accept responsibilities and perform the tasks of a HACT leader;
- High level of knowledge of the program, including positive attitudes for the clients of the program;
- Preferably an infections disease consultant or an internist with a permanent specialist position in the hospital; and
- Preferably has a direct involvement in the care and management of patients in the hospital
Only blood, tissue or organ testing negative (-) for HIV shall be accepted by any laboratory or institution for transfusion or transplantation.
Before transfusion or transplantation, the recipient or his/her immediate relative may demand, as a matter of right, a second HIV test; except in an emergency case, as determined by the physician, when testing is not practical, feasible or available: Provided, That said recipient or immediate relative consents, in writing, to the HIV test waiver.
Donations of blood, tissue or organ testing positive (+) for HIV shall be disposed of properly and immediately; or accepted for research purposes only by qualified medical research organizations, and subject to strict sanitary disposal requirements as contained in the DOH Manual of Nosocomial Infections and Hospital Waste Management.
Medical research organizations qualified to accept HIV-positive (+) blood, tissue or organ are those research institutions that have an ethics review board that reviews the process by which the donation of said blood, tissue or organ was done and have the facilities to properly handle and dispose of HIV-positive (+) blood, tissue or organ donations.
Procedures and standards regarding donation, transport, handling and disposal of blood, tissue or organs as contained in the DOH Manual on Nosocomial Infections and Hospital Waste Management which are not in conflict with this IRR shall continue to be in effect. Revisions in said procedures and standards shall be made known to all concerned personnel.
Standards for the prevention of HIV transmission enumerated in the procedures for Universal Precautions found in Section 21 of this IRR shall be observed during the following procedures:
A separate manual for each procedure shall be developed and printed by the DOH within one (1) year from the effectivity date of this IRR.
- Handling and disposition of cadavers, blood, organs or wastes of HIV (+) persons;
- Tattooing; and
- Other similar procedures
The development of the said manuals shall be in consultation and coordination with:
The manuals shall be formally signed and dated by the Secretary of Health and shall be incorporated as an integral part of this IRR.
- Hospital associations;
- Accredited professional organizations;
- NGOs; and
- Experts from the academe
The manuals shall be distributed to the national, regional and local agencies regulating the establishments where surgical, dental, embalming, tattooing or similar procedures are performed, to be used for the following:
The regulatory agencies issuing permits or accreditation shall be responsible for the monitoring of the compliance to these guidelines.
- Issuance of sanitary permits,
- Accreditation, or
- Renewal of permits
Each manual shall be reviewed and revised periodically. Every revision or updated edition shall be distributed to the regulatory agencies for enforcement.
Pending the official issuance of the manuals by the DOH, the following issuances, provided they are not in conflict with this IRR, shall continue to be in effect:
- Administrative Order No. 18, s. 1995 "Guidelines for the Management of HIV/AIDS in Hospitals" (DOH, 21 November 1995);
- IRR of Chapter XXI of the Code of Sanitation of the Philippines (1997);
- Guidelines for Infectious Disease Control in Hospitals by the Committee Members for Hospital Policies on HIV/AIDS (DOH, July 1997); and
- Chapter 8, pages 39 to 44 of the Manual on Nosocomial Infections (DOH, December 1993)
Unsafe practices and procedures shall refer to the non-compliance with the recommended universal precautions in Section 21 of this IRR
The penalties of an individual committing unsafe practices and procedures shall be imprisonment for six (6) to twelve (12) years, without prejudice to the imposition of administrative sanctions such as, but not limited to the following:
Failure of the institution or agency to maintain safe practices and procedures as maybe required by the guidelines to be formulated in compliance with Section 13 of RA 8504, and Section 24 of this IRR shall suffer the:
- Fines; and/or
- Suspension or revocation of license to practice the profession
- Cancellation of the permit or license of the institution or agency; or
- Withdrawal of the accreditation of the hospital, laboratory or clinic
TESTING, SCREENING AND COUNSELING
Section 26. Consent as a Requisite for HIV Testing
A written informed consent shall be obtained before HIV testing. Said consent shall be made by the:
It is acceptable for a person being tested to use an assumed name or code name instead of the real name and written informed consent using said assumed or code name shall constitute lawful consent.
- Individual to be tested;
- Parent of a minor; or
- Legal guardian of a mentally incapacitated person except for unlinked and voluntary anonymous testing as provided for in Section 29 of this IRR.
In case the person is unable to write, a thumbprint shall substitute for the signature on said consent.
A written consent of a person to act as a volunteer or donor of his/her blood, organ or tissue for transfusion, transplantation, or research shall be deemed a consent for HIV testing as provided in Section 23 of this IRR.
The DOH, through SHAPCS shall develop a prototype informed consent form in English and any locally used Filipino dialect which may be modified accordingly. The prototype consent form shall include this excerpt from Section 16 of RA 8504: "RA 8504 prohibits the imposition of HIV testing as a precondition for employment, admission to an educational institution, freedom of abode, entry or continued stay in the Philippines, the right to travel or the provision of medical service or any other kind of service".
The duly accomplished informed consent record shall be kept confidential in accordance with Section 41 of this IRR. Except for a valid medical or legal need for this record, no access shall be allowed as provided in Sections 39 and 42 of this IRR.
HIV Testing shall not be imposed as a precondition for the following:
- Admission to an educational institution;
- Exercise of freedom of abode;
- Entry or continued stay in the country;
- Right to travel;
- Provision of medical service or any kind of service; and
- The enjoyment of human rights and civil liberties, including the right to enter into marriage and conduct a normal family life
The prohibition on compulsory HIV testing shall be lifted in the following instances:
- Upon a court order when a person is charged with the crime specified in the following:
- R.A. 3815, as amended, or the "Revised Penal Code" specifically the following Articles:
- Article 264 -- Administering injurious substances;
- Article 335 -- Rape;
- Article 337 -- Qualified seduction; and
- Article 338 -- Simple seduction
- R.A. 7659, or the "Death Penalty Act," specifically Section 11, paragraph 5 -- Rape, when the offender knows that he is afflicted with AIDS; and
- R.A. 8353 or the "Anti-Rape Law of 1997," specifically Section 2 --Rape, when the offender knows that he is afflicted with Human Immuno-Deficiency Virus HIVAIDS or any other sexually transmitted disease and the virus or disease is transmissible to the victim;
- Upon order of the court when the determination of the HIV status is necessary to resolve relevant issues under Executive Order No. 209, otherwise known as the "Family Code of the Philippines", particularly:
1. "Art. 45. A marriage may be annulled for any of the following causes, existing at the time of the marriage:
(3) That the consent of either party was obtained by fraud, unless such party afterwards, with full knowledge of the facts constituting the fraud, freely cohabited with the other as husband and wife; and
(6) That either party was afflicted with a sexually-transmitted disease found to be serious and appears to be incurable.
Art. 46. Any of the following circumstances shall constitute fraud referred to in number 3 of the
(3) Concealment of sexually transmissible disease, regardless of its nature, existing at the time of the marriage; or
- When complying with the provisions of Republic Act No. 7170, otherwise known as the "Organ Donation Act" and the Republic Act No. 7719, otherwise known as the "National Blood Service Act".
Anonymous HIV testing is a procedure whereby the identity of the individual being tested is protected or not known. Two methods of anonymous HIV testing are the unlinked anonymous and the voluntary anonymous.
Any person who submits to anonymous HIV testing shall not be required to provide a name, age, address or any other information that may potentially identify the same. In the case of voluntary anonymous HIV testing an identifying symbol is substituted for the person’s true name or identity. The symbol enables the laboratory doing the test and the test person to match the test result with the said symbol.
No person, firm, corporation, center, hospital, clinic, blood bank or laboratory shall perform HIV testing without accreditation by the DOH, through the BRL, in the Office for Health Facilities, Standards and Regulation (OHFSR).
The accreditation standards for performing HIV testing provided in Administrative Order No. 55-A, s. 1989 in ANNEX A shall be an integral part of this IRR, except for Sections 7.1.6 and 9.3 which are amended to read:
Section 7.1.6. Reagents: The laboratory shall utilize reagents, such as HIV kits, which have been registered with the BFAD, and evaluated and recommended by RITM.
Section 9.3. The names, age, sex and addresses of persons confirmed to be seropositive (by Western blot, immunofluresence and radioimmune precipitation assay) shall be reported to AIDSWATCH as provided in Section 38 of this IRR.
SHAPCS and RITM shall convene a forum for consultation and review of the technical and other related issues concerning HIV testing annually or as needed. Participants of the forum shall include representatives of DOH, Philippine Association of Medical Technologists (PAMET), Philippine Society for Pathologists (PSP), HIV test kit suppliers, clinical laboratories and blood banks, and individuals actively involved in HIV testing.
RITM shall serve as the national reference center for HIV testing.
All individuals, centers, clinics, blood banks or laboratories offering HIV testing shall provide, free of charge, pre-test and post-test counseling for persons who avail of their HIV testing services.
Pre-test counseling shall include the following:
Post-test counseling after a negative test result shall include the following:
- Purpose of HIV testing;
- Other diseases that should be tested, if applicable;
- Window period;
- HIV test procedure;
- Meaning of a negative and a positive test result;
- Guarantees of confidentiality and risk-free disclosure;
- When the result is available and who can receive the result;
- Basic information on HIV/AIDS infection: nature, modes of transmission, risk behaviors and risk reduction methods; and
- Informed consent and prohibition of compulsory testing under most circumstances.
Post-test counseling after a positive test result shall include the following:
- Release of the test result to the test person or legal guardian of minor;
- Review of the meaning of negative test result;
- Discussion of the test person’s immediate concerns;
- Review of the basic information on HIV/AIDS infection; and
- Provision of HIV/AIDS information literature and arrangement for a community referral, if necessary.
Pre-test and post-test counseling shall be done in a private place away from possible interruptions. It may be done at the bedside of an ill person, in a counseling room or in a person’s home, and preferably in a pleasant atmosphere.
- Release of the test result to the test person or legal guardian of minor;
- Assistance and emotional support to the person in coping with the positive (+) test result;
- Discussion of the person’s immediate concerns;
- Review of the meaning of a positive test result;
- Review of HIV/AIDS infection transmission and risk reduction;
- Explanation of the importance of seeking health care and supervision;
- Arrangements for referral to health care and other community services and to any organization of people living with HIV/AIDS; and
- Assistance with the disclosure of HIV status and health condition to the spouse or sexual partner, as soon as possible
When tests are undertaken of OFWs prior to their employment overseas, group pre-test and post-test counseling may be done. However, individual counseling shall be provided for an OFW with an HIV positive (+) result.
Only health workers who had undergone HIV/AIDS counseling training shall provide pre-test and post-test counseling. The DOH, through the SHAPCS shall produce a training kit and a trainer’s training kit for HIV/AIDS counseling. The SHAPCS shall conduct national and regional trainer’s training and may utilize the expertise of the academe and the NGOs for this activity. In turn, the trainers shall conduct HIV/AIDS counseling training for counselors at the provincial and institutional levels.
The DOH through the SHAPCS shall coordinate the training of medical technologists, pathologists and other health workers who will staff the testing centers.
The SHAPCS, through RITM, BRL, accredited professional organizations and societies, qualified NGOs and experts from the academe, shall conduct training courses and workshops on HIV testing at least twice a year.
Content of the training course/workshop shall include:
SHAPCS, in collaboration with RITM, BRL, PAMET, LGUs, NGOs and the academe, shall form a network of HIV testing centers to facilitate the assessment of support needs and the delivery of support services, including the promotion of continuing professional education and quality assurance. Network members shall meet at least once a year.
- HIV biology;
- Principles and methods of HIV testing;
- Laboratory safety and precautions;
- Counseling; and
- Quality assurance
HEALTH AND SUPPORT SERVICES
Section 33. Hospital-Based Services
A manual on the Standard Operating Procedures (SOP Manual) for the provision of a comprehensive and compassionate hospital-based care services for PLWHAs shall be developed by the SHAPCS, through a Committee, within 90 days from the effectivity date of this IRR.
The SOP Manual shall ensure the accessibility of basic hospital services and shall contain the technical, managerial, quality and procedural requirements for the physical, physiologic, psychological, socio-economic and spiritual care in the hospital of the person living with HIV/AIDS (PLWHA) and the family. The services shall include:
The Committee shall be composed of representatives from the following offices/sectors:
- emergency treatment;
- laboratory services; and
- diagnosis and treatment of HIV/AIDS, STD, other infections and complications
Pending the official release and effectivity date of the SOP Manual, the provision of hospital services for PLWHAs in government hospitals shall follow the Guidelines in:
- Hospital Operations and Management Service (HOMS);
- San Lazaro Hospital (SLH);
- Accredited professional association (APOs);
- Academe; and
The SOP Manual shall be reviewed periodically and revised accordingly by the SHAPCS, through the DOH Committee for Hospital Policies on HIV/AIDS Prevention and Control.
- Administrative Order No. 18, s. 1995 "Revised Guidelines in the Management of HIV/AIDS Patients in the Hospital" (DOH, 21 November 1995); and
- Administrative Order No. 9, s. 1997 "Amendment to Administrative Order No. 18, s. 1995 regarding the Guidelines in the Management of HIV/AIDS Patients in the Hospital" (DOH, 10 May 1997) in Annex B1 and Annex B2 of this IRR, which shall continue to be in effect until further notice of revision by the SHAPCS.
The LGUs, through its health, social welfare and population officers, in collaboration, cooperation or partnership with the following:
These services or programs include, but are not limited to:
- Concerned government agencies;
- Private sector organizations and establishments;
- People living with HIV/AIDS; and
- other vulnerable groups shall develop and support services for the prevention and control of HIV/AIDS and care of PLWHAs and their families in the community.
Community-based HIV/AIDS prevention, control and care services shall be integrated into the development plans and the existing programs of the province, city, municipality and barangay.
- HIV/AIDS/STD education and information campaign;
- Home-based care;
- Organizing community-based HIV/AIDS support groups including PLWHAs;
- Networking of HIV/AIDS support groups; and
- HIV/AIDS referral system
Government agencies such as the Department of Social Welfare and Development (DSWD), DOLE, DECS, TESDA and Department of Trade and Industry (DTI) and private agencies, as well, shall provide opportunities for PLWHAs to participate in skills training, skills enhancement and livelihood programs. No PLWHA shall be deprived of participation by reason of HIV/AIDS status alone.
Skills training and enhancement programs along the interest and capacity of the PLWHAs and livelihood assistance in the form of capital assistance, marketing assistance and job placement shall be rendered.
The DSWD with DOLE, DILG and private agencies, and utilizing existing mechanisms and strategies, shall jointly set up a referral system to assist PLWHAs in accessing skills training and livelihood assistance programs at the regional and provincial levels.
To help contain the spread of HIV infection, the DOH, in coordination and cooperation with other concerned government agencies, LGUs and NGOs, shall pursue the prevention and control of sexually transmitted diseases as provided in:
Further, the DOH shall ensure the periodic conduct of studies on the prevalence of STDs, levels of anti-microbial drug resistance and new treatment modalities for STDs. DOH shall submit a report of the results of these studies to PNAC.
- a. Administrative Order No. 2, s. 1997 "National Policy Guidelines for the Prevention and Management of Sexually Transmitted Diseases (STDs)" (DOH, 20 February 1997); and
- Administrative Order No. 5, s. 1998 "Implementing Guidelines in STD Care Management at the Different Levels of the Health Care System" (DOH, 13 February 1998)
- Administrative Order No. 17-B, s. 1998 "Implementing Guidelines for STD Case Management for Children". (DOH, 17 October 1998) in Annex C1 and Annex C2 of this IRR, which shall continue to be in effect, until further notice of revision by the SHAPCS.
Within 60 days of the effectivity date of this IRR, the Secretary of Health and the Commissioner of the Insurance Commission shall create a Task Force that shall oversee a study or studies on the feasibility of offering a package of insurance benefits for PLWHAs in accordance with the guiding principles of Sections 26 and 39 of RA 8504.
The composition of the Task Force may include, but not limited to, the representatives of the following offices, agencies, or organizations:
- Insurance Commission;
- Philippine Hospital Association (PHA);
- Philippine Health Insurance Corporation (PHIC);
- Association of private insurers;
- Association of actuaries;
- Health maintenance organizations (HMOs); and
- Other groups, as needed
A report of the results of the feasibility study or studies shall be submitted by the DOH to PNAC within one year of the creation of the Task Force.
Should the study or studies find that insurance coverage for the PLWHA is feasible, the program shall be implemented by the concerned agencies. The PHIC shall oversee the implementation of the said insurance program.
Section 41. Medical Confidentiality
Medical confidentiality shall protect and uphold the right to privacy of an individual who undergoes HIV testing or is diagnosed to have HIV. It includes safeguarding all medical records obtained by health professionals, health instructors, co-workers, employers, recruitment agencies, insurance companies, data encoders, and other custodians of said record, file, or data.
Confidentiality shall encompass all forms of communication that directly or indirectly lead to the disclosure of information on the identity or health status of any person who undergoes HIV testing or is diagnosed to have HIV. This information may include but is not limited to the name, address, picture, physical description or any other characteristic of a person which may lead to his/her identification.
To safeguard the confidentiality of a person's HIV/AIDS record, protocols and policies shall be adopted by concerned officials, agencies and institutions.
The requirement for medical confidentiality shall be waived in the following instances:
Health workers who are exposed to invasive procedures and may potentially be in contact with blood and bodily fluids likely to transmit HIV shall be informed of the HIV status of a person, even without his/her consent. This information is vital to their protection against acquiring and transmitting the HIV infection through safe practices and procedures in accordance with Sections 21 and 24 of this IRR.
- When responding to a subpoena duces tecum and subpoena ad testificandum issued by a court with jurisdiction over legal proceedings where the main issue is the HIV status of an individual;
- When complying with the reporting requirements for AIDSWATCH as provided in Section 39 of this IRR; and
- When informing other health workers directly involved or about to be involved in the treatment or care of a person with HIV/AIDS and such treatment or care carry the risk of HIV transmission
Those who are not at risk of transmission, must not be informed of a person’s HIV status.
All health workers shall maintain shared medical confidentiality.
The result of HIV/AIDS testing shall be confidential and shall be released only to the following:
- Person who was tested;
- Parent of a minor who was tested;
- Legal guardian of an insane person or orphan who was tested;
- Person authorized to receive said result for AIDSWATCH in accordance with Section 39 of this IRR; and/or
- A Judge of the Lower Court, Justice of the Court of Appeals or Supreme Court Justice
Penalties for violating medical confidentiality, as provided in Sections 30 and 32 of RA 8504, include imprisonment for six (6) months to four (4) years. Administrative sanctions may likewise be imposed, such as:
- Suspension or revocation of license to practice the profession; or
- Cancellation or withdrawal of the license to operate of any business entity, and the accreditation of hospitals, laboratories or clinics.
Any person with HIV shall be obligated to disclose his/her HIV status and health condition to his/her spouse or sexual partner at the earliest opportune time.
PLWHA may seek the assistance of health workers or counselors providing the post-HIV test counseling on the matter of disclosure of HIV/AIDS and health status to spouse or sexual partner.
As a general policy, post-test counseling of PLWHA shall aim to assist him/her in informing his/her spouse or sexual partner of his/her HIV status and health condition at the earliest possible time.
DISCRIMINATORY ACTS AND POLICIES
Section 46. Discrimination in the Workplace
Discrimination in any form, from pre-employment to post-employment, including hiring, promotion or assignment, based on the actual, perceived or suspected HIV status is prohibited.
All individuals seeking employment shall be treated equally by employers who shall not make any distinction among job applicants on the basis of their actual, perceived or suspected HIV status.
Persons with HIV/AIDS already employed by any public or private company shall be entitled to the same employment rights, benefits and opportunities as other employees, namely:
Termination from work on the basis of actual, perceived or suspected HIV status is deemed unlawful.
- Security of tenure;
- Reasonable alternative working arrangements, when necessary;
- Social security, union, credit and other similar benefits; and
- Protection from stigma, demotion, discrimination and termination by co- workers, unions, employers and clients.
HIV-infected employees shall act responsibly to protect their own health and prevent HIV transmission.
Acts of discrimination against an individual seeking employment, or in the course of employment, because of his/her actual, perceived or suspected HIV status, shall be reported to the DOLE by those in the private sector and to the CSC by those in the government offices and government-owned corporations. DOLE and CSC shall resolve any such matters brought to their attention, including the implementation of administrative sanctions, as may be appropriate.
No educational institution shall refuse admission to any prospective student or discipline; segregate; deny participation, benefits or services to; or expel any current student on the basis of his/her actual, perceived or suspected HIV status. This shall include any perception or suspicion of HIV status which may arise from a person being a friend, relative or associate of a PLWHA.
The right to full participation shall include the right to take part in all school activities, including all sports activities.
HIV-infected students shall act responsibly to protect their own health and prevent HIV transmission.
HIV is not among the dangerous, loathsome or contagious diseases referred to in the Immigration Code (Section 29). The freedom of abode, lodging and travel of a person with HIV shall not be abridged. No person shall be quarantined, placed in isolation, or refused lawful entry into or deported from Philippine territory on account of his/her actual, perceived or suspected HIV status.
The right to seek an elective or appointive public office shall not be denied to a person with HIV.
All credit and loan services, including health, accident and life insurance shall not be denied to a person on the basis of his/her actual, perceived or suspected HIV status: Provided, That the person with HIV shall not conceal or misrepresent his or her HIV status to the insurance company upon application. Extension and continuation of credit and loan shall likewise not be denied solely on the basis of said health condition.
No hospital or other health institution shall deny access to health care services to a PLWHA or those perceived or suspected to be HIV-infected, nor charge the said persons higher fees. Access to health services must be on an equal basis for all people, regardless of perceived, suspected or actual HIV status.
Refusal to admit a person to a hospital or health care facility and refusal to provide health care or perform health services to a person in a hospital or health care facility on the basis of perceived, suspected or actual HIV status are prohibited acts.
Subject to the observance of universal precautions as outlined in Section 21 of this IRR, any deceased person who was known, suspected or perceived to be HIV positive shall not be denied any kind of decent burial services. Decent burial services include any ceremonial, burial or cremation practices that conform to culturally acceptable religious beliefs and norms.
Pending the development and implementation of the Guidelines/Manuals/ Protocol stipulated in Rule 3, section 24 of this IRR, the following recommendations on undertaking, embalming and cremation of the remains who died with HIV shall apply:
- The remains of persons who died with HIV shall be buried or cremated within 24 hours after the time of death.
- No embalming of the remains of persons who died with HIV shall take place except:
When the family requests for embalming provided that the procedure will be done by a licensed embalmer, qualified and previously trained by the National AIDS/STD Prevention and Control Service (NASPCP) on HIV/AIDS and the observance of the practice of universal precautions.
- The HIV status of an individual shall not be a consideration in the issuance of permits for the transfer of such remains.
All discriminatory acts and policies referred to in Sections 46 to 52 of this IRR and in accordance with RA 8504 shall be punishable with a penalty of:
In addition, licenses or permits of schools, hospitals and other institutions found guilty of committing said discriminatory acts and policies shall be revoked.
- Imprisonment for six (6) months to four (4) years; and
- A fine not exceeding Ten thousand pesos (P10,000.00).
THE PHILIPPINE NATIONAL AIDS COUNCIL
Section 54. Establishment
The Philippine National AIDS Council or PNAC shall be reconstituted and strengthened to enable the Council to oversee an integrated and comprehensive approach to HIV/AIDS prevention and control in the Philippines. For all intents and purposes, PNAC shall be attached to DOH.
The Council shall be the central advisory, planning and policy-making body on the prevention and control of HIV/AIDS in the Philippines. The Council shall have the following functions:
- Secure from government agencies concerned recommendations on how their respective agencies could operationalize specific provisions of RA 8504. The Council shall likewise ensure that there is adequate coverage of the following:
- The institution of a nationwide HIV/AIDS information and education program;
- The establishment of a comprehensive HIV/AIDS monitoring system;
- The issuance of guidelines on medical and other practices and procedures that carry the risk of HIV transmission;
- The provision of accessible and affordable HIV testing and counseling services to those who are in need of it;
- The provision of acceptable health and support services for persons with HIV/AIDS in hospitals and in communities;
- The protection and promotion of the rights of individuals with HIV; and
- The strict observance of medical confidentiality.
- Monitor the implementation of these rules and regulations, issue or cause the issuance of orders or make recommendations to the implementing agencies as the Council considers appropriate;
- Develop a Strategic Plan and update regularly, through a process of multisectoral consultation, that details a comprehensive national HIV/AIDS prevention and control program. The Plan shall be integrated into the Medium-Term Development Plan. Said Plan shall include indicators and benchmarks against which PNAC shall monitor its implementation;
- Coordinate the activities of, and strengthen working relationships between all partners in the response including GO, NGOs, private sectors, academe, media, vulnerable communities and p