Billy Santo recently spent two sleepless nights looking after a friend who had just found out that he’s reactive to the human immunodeficiency virus (HIV). HIV antibodies have been found in the friend’s blood and he must take another set of tests to confirm if he is HIV positive.

Santo is HIV-positive himself. A peer counselor to those who have contracted the virus, he is one of a growing epidemic that numbers 35,000 cases since 1984 and shows little sign of abating. While the Philippines has one of the world’s lowest rates of infection, it has one of the fastest-growing number of cases worldwide.

Ominously, although President Rodrigo Duterte has reacted positively to the menace, the country faces roadblocks put in the government’s way by lawmakers and the Catholic Church to block distribution of condoms and because of a government decision to concentrate its prevention and treatment efforts on female sex workers and not on males having sex with males (MSM), who account for 81 percent of the AIDS population.

The Philippine government “has not tailored HIV prevention policies to address the needs of populations most at risk of HIV infection, a failure that has facilitated HIV transmission among MSM populations,” according to a new report by Human Rights Watch released this month.

Santo says he knows how difficult it is to suffer alone, with no family or friend to tend to his needs. He found out he had contracted HIV in 2015.

“I reached out to a lot of people, but a lot of people do not also understand my situation,” he said. He initially tried to keep it a secret from his family, but the days of desolation spent in the hospital drove him to finally tell the truth “They could not accept me. Hence, I have to look for other people who will – those also living with HIV.”

Human Rights Watch said in its 2017 report “Fueling the Philippines’ HIV epidemic: Government Barriers to Condom Use by Men Who Have Sex With Men” said President Rodrigo Duterte must improve preventive measures for HIV transmission among MSM populations.

“The number of people living with HIV notably increased from 2009 to 2010 – it doubled to 1,591 following reports of transmission among men who had sex with men. Since 2010, however, the government has yet to craft a response addressing the MSM population infected with HIV as well as other groups which also find it difficult to access condoms and sex education.

Existing government actions against HIV infection have been designed to target female sex workers, the World Health Organization said in 2013. “Most [government anti-HIV] program activities remained focused on FSWs [female sex workers], mostly through the vast and busy network of SHCs [social hygiene clinics], while HIV continues to spread, unabated, among other key populations that have little or no access to services suited to their needs.”

As an indication of the cultural antipathy to dealing with the situation, in 2015, the Philippine Senate slashed US$21 million from the budget of the Department of Health, an amount which was initially allotted for the implementation of the Reproductive Health Law. As a consequence, doctors said government clinics may have inadequate condom supplies.

What remains the biggest obstacle to strengthening HIV preventative measures in the country, however, is the social stigma that comes with using condoms, a sentiment driven by the conservative position of the Catholic Church.

“These restrictions reflect the influence of conservative forces in government at both national and local levels, driven by the underlying authority of the Catholic Church. An estimated 80 percent of Filipinos are Roman Catholics, and the Catholic Bishops Conference of the Philippines, which stated in 2015 that Filipinos who contract HIV are products of “broken, dysfunctional families,” has had a longstanding obstructive influence on government health and education policies,” the HRW said.

The Duterte Administration finds itself battling this same obstruction. The president has expressed his support for the implementation of the RH law. Health secretary Paulyn Ubial have also announced that the DOH will begin distributing condoms in schools. Despite the president’s pronouncement however, some officials such as Sen. Vicente Sotto III have already blocked the initiative to distribute condoms in schools. He said doing this is akin to promoting underage sex.

That viewpoint has been held by other LGUs which have earlier refused to implement the RH law. Balanga City and Sorsogon City have issued local ordinances or directives stopping government clinics from procuring and distributing condoms and contraceptives.

As a person living with HIV, however, Santo said this opposition to the action of the DOH smacks of hypocrisy. “This conservative attitude, it’s not working. We should wake up. There’s an epidemic already.”

Amid these setbacks, the DOH has not yet backtracked from its decision to distribute condoms to schools and said that it is also looking at distributing HIV self-testing kits. The HRW lauded these initiatives, but said they should be done through measures that are “non-stigmatizing” to children.

This stigma has discouraged teenagers from buying condoms or accessing them for free from public social hygiene clinics (SHCs). “Many Filipinos will not visit SHCs because they carry a social stigma related to their outreach activities for commercial sex workers.”

Human Rights Watch said then that the health department must push for a comprehensive sex education in Philippine schools. Schools, both public and private, do not currently discuss safe sex in the classrooms.

Educating the youth and the public in general about safe sex must also be more inclusive and must be done through different venues. It must cascade to the promotion and commercial marketing of condoms which as of now, only speak to heterosexual couples and do not target the lesbian, gay, bisexual, or transgender (LGBT) people. Human Rights Watch, in its report, said it hopes these changes can be done as Duterte, during the presidential campaign in 2016, vowed to do more for the rights of LGBT people.

“The Duterte government has a golden opportunity to remedy the legal and policy errors of previous administrations by implementing proven low-tech and low-cost interventions that can help stop in its tracks the country’s HIV epidemic among men who have sex with men,” said Carlos Conde, an HRW researcher. “Failure to do so will only ensure that the already alarming number of new HIV infections among men who have sex with men will continue to rise.”