DANIEL ESTRIN, BYLINE: Sub-Saharan Africa has been the epicenter of the HIV crisis for decades, but it's made real progress thanks to an extraordinary international campaign and new medications. Now in other parts of the world, new hot spots are emerging, and the Philippines is one of them. NPR's Gabrielle Emanuel reports.
GABRIELLE EMANUEL, BYLINE: In the Philippines, the HIV epidemic is known for being highly concentrated in the young LGBT community and relatively small. But lately, new HIV infections per year have jumped by 500%, going from a few thousand cases in 2010 to tens of thousands of cases in recent years. Doctors are describing the epidemic as having gone from slow and growing to fast and furious. But, they say, the country has all the knowledge and tools needed to combat this virus. Rossana Ditangco oversees HIV at the Research Institute for Tropical Medicine in the Philippines.
ROSSANA DITANGCO: The availability of the test is not an issue, but it's the question of, would they go to these testing centers? Would they need to go there?
EMANUEL: The answer is no. Many aren't going to get tested. Why? One man has a theory.
DARWIN TENORIA: My name is Darwin.
EMANUEL: Darwin Tenoria - He's an HIV educator, and I met him at a health clinic in Metro Manila called Project 7. He told me one issue is that when it comes to sex, people just don't discuss it here.
TENORIA: They never talk about it inside their homes. They never talk about it inside of schools.
EMANUEL: That was true for him. Tenoria is gay and says he never learned about sexual health. That changed at age 27 when he got really sick - so sick, in fact, he was on his deathbed.
TENORIA: I died for 2 minutes, and I was revived in the hospital.
EMANUEL: He weighed just 70 pounds.
TENORIA: My doctor asked me, did you undergo HIV tests before? So what HIV? What's that?
EMANUEL: It was the first time he'd heard of HIV or AIDS. This all happened 10 years ago. So fortunately, he was able to get on treatment. But the whole experience - it left him determined to do something.
TENORIA: I don't want that to happen to other people as well.
EMANUEL: So he quit his corporate office job and became an HIV educator. Since new infections are highest in young people, he focused on getting HIV information into schools, but it hasn't been easy.
TENORIA: We're constantly invited by the schools, and the first thing that they will - told us, please don't discuss condoms.
EMANUEL: He says, some schools do allow discussion of condoms, but many don't. Tenoria says this resistance to a full discussion of safe sex is leaving young people without the information they need to protect themselves. Elsewhere in Metro Manila, health authorities are trying to reach those who may already be infected. They realized many people didn't want to go into testing sites for fear of being seen, so they found a workaround.
WILSON ATILANO: We can park over here, and we can do the testing.
EMANUEL: Wilson Atilano helped open the country's first park-and-test HIV clinic. It's deep inside an echoey parking garage.
ATILANO: We can do the rapid test, then they can wait 15 to 20 minutes. Then after that, if there is a negative, they can already exit.
EMANUEL: He says they picked this garage carefully. It serves a number of call centers. Atilano says they wanted to reach those employees.
ATILANO: A lot of them is an LGBT, so the lesbian, gay, bisexual, transgender.
EMANUEL: Many of these call centers serve U.S. companies, and they are known for being more willing to hire LGBT employees. Reaching them matters because 90% of new infections are in this community. The clinic is off to a good start. Dozens of people came in the first week. Experts say it's this kind of creative approach that will be necessary if the Philippines and other emerging hot spots, like Egypt and Venezuela, are going to get a handle on their surge in HIV cases. Gabrielle Emanuel, NPR News.
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