Manila, Philippines - A cramped office on a four-storey rundown building in one of the Philippine capital's crime-ridden neighbourhoods serves as an unlikely oasis for people living with HIV/AIDS in Asia's Catholic stronghold that has emerged as a critical hot spot for the disease.
Gaunt elderly men and women shuffle up its dark staircase to reach the Positive Action Foundation Philippines, a non-sectarian, non-profit organisation manned by HIV-positive personnel who provide not only care and support, but also listening ears, to those who have no one else to turn to in a society where some sectors remain doggedly conservative.
"It is important that we try and give them a positive outlook," said Roberto Ruiz, a 50-year-old former hotel and club manager who has been living with AIDS for over two decades and who cofounded the foundation in 1999.
"Many of those who come in here are from far away provinces and who have no other place to stay. The majority have not come out yet in their own communities, while there are others who are abandoned by their relatives and friends."
There is a need to strengthen the services on the medical side, and the involvement of the community and of the government.
While he said that the government, in conjunction with non-profit organisations like his, recognised the gravity of the situation and is doing something to combat the rising tide of HIV/AIDS, there remains a huge disparity between their objective and what actually is taking place on the ground.
The politically influential Catholic church, which had tried to block a crucial birth control law that made it mandatory for sex education in schools and free distribution of state subsidised contraceptives, is also seen as partly to blame due to its aggressive campaign against the use of condoms, which could have helped control the spread of the disease.
The historic birth control law was signed in 2012 by President Benigno Aquino, but was quickly challenged by church-led groups at the Supreme Court. The high court however declared it constitutional early this year, ending a nearly 15 year legal battle.
Leaders of the Catholic faith, the religion of more than 80 percent of the country's 100 million population, however, have continued to campaign from the pulpit, urging healthcare professional against implementing the law on pain of being excommunicated or censured.
Ruiz said that many of the newly diagnosed patients were young students who were not properly made aware of the perils of HIV/AIDS. Those coming out, he said, also suffered from being stigmatised in a society where the opinion of the church often dictates public perception.
"The commitment in implementing the HIV/AIDS programme here in the Philippines is not that strong," said Ruiz, a wiry man with an easy-going smile who has been living with HIV for nearly half his life thanks to anti-retroviral drugs partly subsidised by the Global Fund, an international financing institution that finances the fight to curb the disease.
Ruiz's group manages two "drop-in centres" where people can visit and get tested for free, with those testing positive for HIV given counselling and referrals to any of the Philippines 18 health centres that specialise in the disease.
Public awareness lacking
Ruiz said there are enough anti-retroviral drugs, but public awareness on the issue, in many impoverished quarters of the country, remains very low.
"Based on the number of people who are diagnosed - one for every two hours - it [the national HIV/AIDS plan], is not enough," he said. "We really need to add more effort. There is a need to strengthen the services on the medical side, and the involvement of the community and of the government."
The Philippines is in the spotlight for a spike in confirmed cases of HIV/AIDS, which goes against the global trend. Official data show the number of new HIV cases rose to 495 in May alone, a 19 percent increase from the same period in 2013.
Cumulatively, there were nearly 19,000 HIV/AIDs cases reported in the Philippines from 1984, when the counting began, to the present.
While that number represents a small percentage of the total population, experts say what is worrying is that the rate of infections has risen annually by an average of 25 percent or more since 2001, making the Philippines one of several countries in recent years where there has been a marked rise in incidents, according to the national HIV/AIDS registry and figures from the UN.
The majority of those infected are young males in their 20s and 30s, who engage in sex with other males, and Filipino overseas workers who unknowingly contract the virus abroad, and possibly transmit it to their wives or girlfriends back home.
From January 1984 to May 2014, there have been 992 deaths due to HIV/AIDS with 55 so far this year, the health department said.
An 'alarming increase'
"If you try to compare the figures this year from last year, definitely there is an alarming increase, and we are seeing many male patients right now in their 20s and 30s said Doctor Rosario Jessica Abrenica, who heads the HIV Department at the state-run San Lazaro Hospital in Manila.
She said that part of the fear is that, with sex remaining a largely taboo topic in public discourse, there could actually be many more people living with HIV who do not know they're infected and who could have transmitted it to their sexual partners.
"The major challenge is for people infected with HIV to go to the treatment hubs for evaluation and get started with ARV (anti-retroviral) drugs," she said. "(But) we need more people and other centres to be in partnership with us and that is why we are trying to connect more with social hygiene clinics who can give us referrals to patients needing treatment."
But Humphrey Gorriceta, a public health advocate who has been living with HIV for six years, said the fear of getting marked could be a factor in the reason why many have chosen to live with the disease silently.
"HIV/AIDS is like leprosy, except it is hidden," Gorriceta, 38, said. "I have friends who couldn't go to schools, or are barred from going to church because of it."
"A lot of things have changed for sure - people can have more access to drugs, there are 24-hour hot lines for depressed HIV positives to call, and because of regular information campaigns the disease is discussed in the public," he said.
"What remains however, is the stigma," Gorriceta said.
Gorriceta knows what he's talking about. He tested positive in 2008, but never found out who among his multiple sex partners gave it to him or how many he may have given it to.
"I've lost count of those who I had unprotected sex with. I tried tracing those I could remember to warn them, but never got a reply and never found out," he said. "It's a ripple effect and I think there are many more out there who have it but do not know."