Aida is a seafarer working on a cruise ship and in 2018, her test results came back positive for human immunodeficiency virus (HIV) and she was deported from the country where they were docked at the time.
“So many changes happened in my life – many of them difficult. I almost lost hope that I would ever be able to board a ship again. I applied to many companies, but I was always rejected because of my HIV status. Two years passed and I was ready to give up when the last company I sent my application to accepted me. They told me that they were willing to take me on despite my HIV-positive status so long as I would be able to do the work,” she said.
“Now it’s been two months and I still cannot believe that I was accepted and that I can still work. I am very relieved and happy, especially because I can continue to earn for my family. My gratitude is also boundless because I have a good doctor who is helping me manage my condition. There is still hope for people like me – people living with HIV.”
HIV advocacy among seafarers
Aida is one of the thousands of Filipinos who contracted HIV and as a seafarer, she considers herself very fortunate to be still working, considering how, even at this day and age, the maritime industry in the Philippines remains close-minded about HIV.
This precisely is one of the reasons why Positibong Marino Philippines Inc. (PMPI) was formed. Its executive director, Jebsen Gamido, explained to Maritime Fairtrade that PMPI is the first and, so far, only non-government organization or network that focuses on HIV advocacy and help for HIV-positive seafarers.
“We want to help address gaps in how Philippine society responds to the HIV pandemic and how it affects Filipino seafarers and the rest of the maritime industry. It’s hard work that we have been doing for the last four years, and every time we succeed in helping an HIV-positive seafarer get back onboard a ship, the importance of our work is reaffirmed,” Gamido said.
Turning personal tragedy into motivation to help other seafarers
Gamido shared that he himself has HIV and contracted it 11 years ago. “I was 18 and still at school studying to become a seafarer. I contracted the virus before sailing for the first time as a deck cadet. When I graduated, I was very fortunate that I was still able to find work despite my HIV status. The shipping line I worked for was Danish and had very liberal views when it came to HIV,” he said.
He worked as a licensed deck officer – an Officer in Charge of Navigational Watch – and he was able to monitor his status and take his antiretroviral drugs regularly while on board.
“It was harrowing in the beginning: finding out that I had HIV, scared about what its effects on my health would be. I was worried about not finding work. I’m really lucky that the company I worked for did not discriminate against people living with HIV (PLHIV),” he said.
As Amido was able to come to terms with his HIV status, he also began to become more aware of how many other seafarers were not as fortunate as he was. He heard stories about other seafarers who were stripped of their contracts or humiliated in health clinics when it was found out that they had HIV.
“There are already laws regarding privacy when it comes to one’s HIV status and it’s against Philippine law and many international statutes to discriminate against PLHIV based on their status, but discrimination is still there. A person makes one mistake or accidentally gets infected through a blood transfusion, and they have to lose their right to be employed? To make a decent living? It’s not right,” he said.
This sentiment is what prompted Gamido and six other individuals to form PMPI in 2017.
“We all met online and got to talking about the issue of HIV and how it affects seafarers and their employment. We wanted to be a support group for them,” he said.
“I have been HIV positive for over a decade. I met so many challenges in getting employment onboard ships, so I know what seafarers living with HIV are going through. The PMPI is a network of HIV-positive seafarers, and we’re here to provide mental and legal support to all HIV-positive seafarers, irrespective of their nationality,” he explained.
Their group is registered as a non-government organization. It is recognized by and works with the Associated Marine Officers and Seamen’s Union of the Philippines (AMOSUP) and the International Transport Workers’ Federation (ITF).
The advocacy and mission of the PMPI center around three Es – education, empowerment, and employment. The PMPI receives technical and financial support from the ITF and AMOSUP, operating as a self-help and support group for HIV-positive seafarers. Primary among their focuses is to defend the rights of HIV-positive seafarers who find it difficult to get employment because of their health status.
Standing against discrimination of HIV-positive seafarers
Currently, there are about 200,000 active Filipino seafarers, down from the peak of 400,000 at pre-Covid-19 pandemic level, and many of them are vulnerable to HIV. While there are no statistics as to the exact number of seafarers affected by HIV, the number of overall Filipinos testing positive for HIV is rising.
As of the end of September, registered cases in the Philippines have reached 90,960, with 54,022 undergoing treatments. An estimated 33 Filipinos are infected with HIV daily, and this is a 50 percent increase from figures in 2020. In total, the estimated number of HIV cases is pegged at 133,000 as per UNAIDS.
One in every six Filipinos is already in the advanced stage by the time they are diagnosed with HIV, and this indicates that they have been HIV-positive for years before they had been tested because HIV-testing in the Philippines is non-compulsory under the law.
Filipinos are only encouraged to do voluntary testing, especially those individuals at a high risk of contracting HIV, and even then, they are required to first give written informed consent.
Among seafarers, however, getting tested for HIV is among the many health requirements when applying for work.
Gamido said: “This is where the problem lies – seafarers have no choice but to divulge their HIV status and run the risk of not getting hired or having their contract suddenly cut short when the company finds out.
“Testing for HIV is not required under the law, but the laws that govern foreign shipping companies are different. Also, it’s the prerogative of employers to require HIV testing, so if you want to get hired, you have to get tested and share the results with the potential employer.”
Not enough HIV awareness among seafaring industry
Sadly, according to Gamido’s estimates, only two out of every 10 shipping companies or hiring agencies they work with have an open mind when it comes to hiring HIV-positive seafarers.
He said: “Let’s face it, the seafaring industry is a ‘macho’ industry, and in the Philippines, many Filipinos still carry, shall we say, less than progressive, views about sex. Most seafarers will not willingly get into a conversation about sex, the use of prophylactics, HIV and testing. These issues are either taboo or the subject of jokes that reek of machismo, homophobia, or chauvinism.
“Specifically, about HIV, there’s still a low level of awareness and there are many misconceptions, and this is also true among the staff of diagnostic clinics and manning agencies. A seafarer who has tested positive for HIV may himself have many wrong beliefs about his condition and ends up in despair, afraid that he will be unemployable. We have to contend with all these considerations when promoting HIV awareness to ensure seafarers with HIV still get hired.”
Public HIV education urgently needed
According to public health specialist Dr. Vic Salas, HIV testing and condom use among the most vulnerable and high-risk populations are still low, and many are still against implementing comprehensive sexuality education in schools.
Testing and sex education are becoming more and more needed given that in the Philippines, more and more Filipinos are engaging in sex at a younger age, and children as young as 12 are getting pregnant.
Gamido concurred. “Many Filipinos are getting HIV and don’t know it. Because they don’t get tested for HIV, their illnesses are being written down as tuberculosis, pneumonia, or any other generalized infection.
“Given this, it’s crucial to teach about HIV awareness to the public. For us, our focus is teaching seafarers, students attending maritime schools, and the staff of manning agencies and diagnostic centers. Correct knowledge about HIV and how it can be contracted, and how it can now be managed through retroviral drugs, will greatly help seafarers protect their employability.
“The stigma associated with HIV and AIDS is still quite considerable. Much still has to be done to inform and educate the public on HIV and the many leaps and bounds science has made to make HIV preventable and, for those who have it, manageable. There is still so much misinformation out there, and this is often what forms the foundation for discrimination against PLHIV.”
Laws against discrimination of HIV-positive seafarers
“The PMPI and our partners are not directly involved in the employment of seafarers, but we do consider it our responsibility to inform crewmembers of their rights and shipping agencies and clinics of their responsibilities under the law,” Gamido said.
In many countries, selection for employment based on HIV status is unacceptable and is illegal. If a seafarer is denied employment because of his/her HIV status, unions can challenge the management on the matter.
As long as the seafarer is declared medically fit, is competent and qualified, and has informed the management of a pre-existing medical condition, then there is no reason to deny the seafarer the right to work.
The Philippines is a signatory to the International Labor Organization (ILO) Maritime Labor Convention 2006 which states under Article III (d) that Members shall respect the fundamental right to elimination of discrimination in respect of employment and occupation, and under Article IV (4) states that every seafarer has a right to health.
The Convention also requires that Member States follow the Guidelines on the Medical Examinations of Seafarers. In the said guidelines (ILO 2013), it is stated that if a seafarer has a CD4 of <350 and is not stabilized on treatment, then he/she is temporarily “incompatible with reliable performance of routine and emergency duties safely and effectively.”
However, if a HIV-positive seafarer has a CD4 of >350 and a very low likelihood of disease progression, is stabilized on medication, and has no requirements for frequent surveillance, he/she is then considered to be “able to perform all duties worldwide within the designated department and may participate in long voyages.”
There are also Philippines laws that support HIV-positive workers. In the Philippine AIDS Prevention and Control Act 1998 (R.A. 8504), it is illegal to decline a medical certificate to a seafarer solely on the grounds of the HIV status. Section 53, IRR of R.A. 8504 “Penalties for Discriminatory Acts and Policies” states that licenses or permits of schools, hospitals, and other institutions found guilty of committing said discriminatory acts and policies shall be revoked.
The International Group of P&I Clubs, Pre-Employment Medical Examinations (PEME) Programs, Guidance for Clubs, states that the PEME shall not contravene the shipowner employer’s legal obligations concerning the prohibition of discrimination in the employment selection process.
Campaigning for HIV awareness
The Philippines currently has one of the fastest-growing HIV epidemics in the world. In 2020, around 75,000 Filipinos tested positive. Reports from the health department pointed out that these Filipinos did not have the right information on HIV transmission and prevention before they contracted HIV.
In the meantime, even before Covid-19 happened, seafarers often had difficulties getting HIV medications. The problem worsened in 2020 when many governments closed the borders of their respective countries even against seafarers working aboard ships transporting crucial goods. Groups like PMPI work hard to ensure that seafarers with HIV get access to their medication.
Gamido said: “We know that political will is indispensable in the fight for a HIV-free future, and we work hard to promote awareness about HIV prevention and to help those affected. Seafarers contribute much to the Philippine economy, and those who have HIV need support so that they can continue to work and live productive lives.”
Gamido’s group has a small staff, but they are active on social media, and Gamido himself and the other executives of PMPI are always actively engaging with other groups advocating AIDS awareness and migrant worker rights. They receive one to four messages on their Facebook accounts every day, and most of the queries are about the employability of HIV-positive seafarers.
He said: “We’ve had a few success stories – helping seafarers with HIV status to get on board, and each one is really a victory considering how many get turned away despite our efforts. We write to companies about the seafarers and ask them to reconsider their decision against hiring said seafarers.
“We explain that HIV is no longer the crippling disease that it used to be, that the survival rate has greatly improved compared to what it was back in the 80s or 90s, that’s now manageable. Having HIV does not make the individuals unqualified to work as seafarers if they have trained for it and are strictly taking their medications and observing health precautions.”
Gamido is also very passionate about education. “We’ve given talks in person and online to many members of the maritime community – students, training school administrators, seafarers associations, and their families – to explain about HIV and the rights of PLHIV to continued employment. Raising awareness is a key element to end the HIV pandemic and to fight discrimination.”
The PMPI supports the expansion of free HIV treatment including Post-Exposure Prophylaxis PreP and prevention services by community-led organizations which have built partnerships with the government health department.
Gamido said: “We also want to have the Undetectable and Untransmittable or the UequalsU program to be integrated into the national health guidelines. It’s still a public misconception that U=U does not benefit PLHIV who struggle with the many different social and legal barriers to treatment and care.
“We believe all people with HIV who are on treatment have the right to accurate and meaningful information about their social, sexual, and reproductive health, and this includes seafarers.”
Working towards a more enlightened maritime industry
Gamido emphasized the importance of having all stakeholders and players in the maritime industry in the country work together to ensure that the rights of seafarers are not violated because of their HIV status.
“Because of their work conditions, seafarers are particularly vulnerable to HIV. They are away from their families and loved ones for months at a stretch; they stay within the isolated environments of ships. These can cause stress, and to relieve this stress they become prone to risky behavior like unprotected sex,” he said.
To battle HIV stigma and discrimination where it happens in the Philippine maritime industry, Gamido said that it is crucial to build ties with similar-minded institutions.
“Take the Magsaysay Shipping company, for instance. It’s been a consistent ally in this campaign, allowing us to teach their seafarers about HIV awareness. There are also diagnostic clinics and manning agencies which, after we have given talks to their staff, have been more tolerant about HIV. They’ve become more discreet about test results instead of making it the topic of gossip in their offices,” he said.
The group is also committed to the United Nations’ goal of #Zeroat2030 which aims to have zero new cases, zero discrimination, and zero HIV-related deaths in the world by the year 2030. It also implements the UNAIDS livelihood project in the Philippines for the PLHIV community affected by Covid-19.
At the end of the day, Gamido said that helping, empowering, and assisting displaced seafarers with HIV/AIDS so they can have normal and productive lives through continuous employment on board merchant ships or other maritime-related endeavors are what inspire their group.
“We want to see a more sex-positive and inclusive maritime industry that is free from stigma and discrimination regardless of HIV status and sexual orientation and gender identity expression, and sex characteristics. We are all for the advancement of the rights of all seafarers living with HIV,” he said.