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HAW NJ, Lesko CR, Ng DK, Lam JO, Gebo K, Sterling TR, Rabkin CS, Li J, Buchacz K, Agwu A, Althoff KN. Incidence of AIDS-defining Conditions among Adults with Perinatally Acquired HIV after Transition to Adult HIV Care in the United States and Canada, 2000-2022. Clinical Infectious Diseases 2025. (Available upon request)
Among people with perinatally acquired HIV, the mean cumulative count of AIDS defining conditions by three years in adult HIV care was 26 per 100 persons in 2000-2011 and 16 per 100 persons in 2012-2022. People with perinatally acquired HIV did not experience a greater incidence of AIDS defining conditions in adult HIV care than people with non-perinatally acquired HIV. Continued engagement in HIV care among adults with perinatally acquired HIV provides opportunities for ADC prevention.
HAW NJ, Banegas M, Lujintanon S, Fairlie L, Bwakura-Dangarembizi M, Agwu A, Ng DK, Lesko CR. Characterizing the HIV Care Continuum among Children and Adolescents with HIV in eastern and southern Africa in the Era of “Universal Test and Treat”: A systematic review and meta-analysis. Journal of the International AIDS Society 2025; 28(6). (Open access)
Consistent with “Universal Test and Treat” expectations, most children and adolescents with HIV in eastern and southern Africa have initiated antiretroviral therapy, but challenges remain on other HIV care continuum indicators. Future planning for HIV programs should consider locally informed, community-supported approaches to consistently support children and adolescents with HIV throughout the HIV care continuum.
HAW NJ, Lesko CR, Ng D, Lam J, Lang R, Kitahata M, Crane H, Eron J, Gill MJ, Horberg MA, Karris M, Loutfy M, Mcginnis K, Moore RD, Althoff K, Agwu A, NA-ACCORD. Incidence of non-AIDS defining comorbidities among young adults with perinatally acquired HIV in North America, 2000-2019. AIDS 38(9): 1366-1374. (Free text via PubMed)
There was a high incidence of five chronic comorbidities among people with perinatally acquired HIV. Cumulative incidence by age 30 and incidence rates from age 18 to 30 (per 100 person-years) were: Type 2 diabetes mellitus: 19%, 2.9; hypercholesterolemia: 40%, 4.6; hypertriglyceridemia: 50%, 5.6; hypertension: 22%, 2.0; and chronic kidney disease: 25%, 3.3. Earlier screening at younger ages might be considered for this unique population to strengthen prevention strategies and initiate treatment in a timely way.
HAW NJ. Inequalities and impacts on poverty incidence of tobacco, alcohol, and health out-of-pocket expenditures in the Philippines, 2012-2018. Social Sciences and Humanities Open 8(1): 100595. (Open access)
Between 2012 and 2018, fewer Filipino households reported spending on tobacco and alcohol, and the amount decreased among poor households, resulting in a decrease in impoverishment. The regressivity of tobacco and alcohol spending decreased between 2015 and 2018. Health out of pocket expenditures decreased between 2015 and 2018. The Philippines may have made some gains in reducing the inequitable effects of tobacco and alcohol spending on poorer households because of policy reforms that increased taxes for tobacco and alcohol products and expanded population coverage under the national social health insurance scheme (colloquially known as PhilHealth).
HAW NJ, Cañal EM, Zuasula J, Loreche MJ, Bernadas J. Epidemiological characteristics of the SARS-CoV-2 Theta variant (P.3) in the Central Visayas region, Philippines. Western Pacific Surveillance and Response 13(1). (Open access)
Based on epidemiologic surveillance data from Region 7, Philippines, the Theta variant of SARS-CoV-2 was not associated with more severe disease as compared to non-Theta variants. The overall secondary attack rate for
cases infected with the Theta variant was 44.5%.
Sy KTL, HAW NJ, Uy J. Previous and active tuberculosis increases risk of death and prolongs recovery in patients with COVID-19. Infectious Diseases 52(12): 902–907. (Open access)
The risk of death in COVID-19 patients with tuberculosis was 2.17 times higher than in those without. The risk of recovery in COVID-19 patients with tuberculosis was 25% lower than in those without. Similarly, time-to-death was significantly shorter and time-to-recovery significantly longer in patients with tuberculosis.
There is a need to prioritize routine and testing services for tuberculosis, although health systems were disrupted by the heavy burden of the SARS-CoV-2 pandemic.
HAW NJ, Uy J, Sy KTL. Epidemiological Profile and Transmission Dynamics of COVID-19 in the Philippines. Epidemiology and Infection 148(e204): 1-8. (Open access)
Based on data from the first 8,212 COVID-19 cases in the Philippines, the median age at infection was 46 years. The mean length of hospitalization for those who were discharged was 16 days and died was 7.27 days. Mean duration of illness was 26.66 days for those who recovered and 12.61 days for those who died. Mean serial interval was 6.90 days.
HAW NJ, Uy J, Ho BL. Association of social health insurance coverage and level of healthcare utilization and costs in the Philippines: A 10-year pooled analysis. Journal of Public Health 42(4): e496-e505. (Available upon request)
The national health insurance program (colloquially known as PhilHealth) has likely decreased barriers to health care utilization but may have inadvertently driven up health care costs in the country. PhilHealth membership was associated with 42% greater odds of outpatient utilization and 47–100% greater odds inpatient utilization depending on survey year (2008, 2013, 2017). Depending on facility type, use of PhilHealth to pay for care was associated with higher average health care costs of 244–865% for outpatient care and 135–206% for inpatient care than without using PhilHealth.
HAW NJ. Utilization of the Ghana National Health Insurance Scheme and Its Association with Patient Perceptions on Health Care Quality. International Journal for Quality in Health Care 31(6): 485-491. (Available upon request)
In general, utilization of the Ghana National Health Insurance Scheme (NHIS) was negatively associated with overall perception on health care quality, and the difference across utilization categories was higher among private facility users than public facility users. Among private facilities, those who paid fully with NHIS reported 5 points lower than those who paid fully out of pocket. Among public facilities, the difference is only 1.7.
HAW NJ, Cabaluna IT, Kaw GE, Cortez JF, Chua MP, Guce K. A cross-sectional study on the burden and impact of migraine on work productivity and quality of life in selected workplaces in the Philippines. The Journal of Headache and Pain 21(125). (Open access)
Migraine poses a significant threat to work productivity in the Philippines. Stress and looking at computer screens were cited as the top trigger for migraine, while sleeping enough hours and getting a massage were cited as top coping mechanisms. Three in four (77%) visited their company clinic within the past 3 months, which meant that most doctors seen for migraine-related symptoms were general practitioners. Five in six (85%) took medication for migraine, almost all of which were over-the-counter medications. Mean annual productivity costs lost due to migraine disability were PHP27 794 (USD556) per person. Many opportunities, such as disease management and introduction of alternative options for migraine treatment, may be introduced to help address these issues.
HAW NJ. Consistency of Ever Reported Risky and Sensitive Behaviors Among Early Adolescents in a Nationally Representative Longitudinal Study: Results From the First 2 Waves of the Longitudinal Cohort Study of the Filipino Child, 2016 to 2018. Global Pediatric Health 7: 1-6. (Open access)
Majority of Filipino adolescents were inconsistent with their responses on a wide range of 17 risky and sexual behaviors. Eight of 17 behaviors reported lower prevalence rates between waves, most notably on watching pornographic movies (−7.7 percentage points [pp]), witnessing physical violence at home (−5.4 pp), and asking their mother about sex (−4.7 pp). The decreases are accounted for by higher retraction (changing answers from yes to no between waves) than apparent initiation rates (changing answers from no to yes between waves).
HAW NJ, Yang J, Li H, Duo L, Wang Z, Bouey J. Challenges and value of peer outreach workers in needle and syringe exchange programs: Evidence from an HIV prevention program in Yunnan province, China. Journal of Ethnicity in Substance Abuse 19(3):403-416. (Available upon request)
In a needle and syringe exchange program in Yunnan, China, peer outreach workers seem to be more effective than non-peer outreach workers in conducting outreach to people who inject drugs, though peer outreach workers face unique challenges. Commonly cited concerns from peer outreach workers were low wages and frustration with client follow-up. Managers expressed the most concern on high turnover rates and low education levels.
Wong J, Uy J, HAW NJ, Valdes JX, Bayani DB, Bautista CA, Haasis MA, Bermejo R, Zeck W. Priority-Setting for a Health Benefits Package: Experience from the Philippines. Health Systems and Reform 4(1): 19-29. (Open access)
The top 48 (or 22%) of diseases account for 80% of total disability-adjusted life years (DALYs), reflecting a well-known concept in management, the Pareto principle. Due to its simplicity and widespread applicability, the Pareto principle facilitated interest in rational priority setting among high-level officials in the Philippine health sector. Priority setting must not be limited to disease burden and cost-effectiveness criteria. This list can be used after further deliberation and stakeholder consultation. Priority setting is a complex, value-laden process, and a purely utilitarian approach to prioritization may lead to further deterioration in the health status of vulnerable populations.
HAW NJ, Pecache NE, Albiola N, Chan KF, Dela Cruz KG, Gotianse CS, Uy SS. Factors Affecting Family Planning Service Delivery by Community Health Workers in District 2, Quezon City, Philippines: A Cross Sectional Study. Social Medicine 10(1): 22-29.
The factors affecting community health workers in Quezon City that have moderate impact on family planning service delivery are family planning training, allowances, satisfaction with incentives, and age. We recommend that the local health department increase training sessions, increase allowances and other benefits, and encourage younger people to become community health workers.
Jason Haw, PhD 