In the vibrant heart of Central Visayas, a public health crisis is escalating with a speed that has alarmed officials. Cebu City has been identified as a significant hotspot for new HIV cases, with the region accounting for a troubling portion of nationwide infections. This epidemic is not just a statistic; it's reshaping the lives of young Cebuanos in profound ways, including in an area many wouldn't immediately connect: the health of their smiles.

The Cebu Context: A Generation at Risk

Recent reports highlight Central Visayas as a critical area in the Philippines' HIV landscape. The data paints a clear picture: a significant number of new infections are among sexually active young adults. This isn't a distant issue—it's happening in our barangays, schools, and workplaces. For many young people, the focus is on prevention and testing, but there's another chapter to this story that unfolds after a diagnosis, one that affects daily life and well-being: the impact on oral health.

Two Paths: The Stories of Thomas and James

Thomas, 24, HIV-negative, lives a life where dental care is routine. He visits his dentist in Mandaue for cleanings, and any minor cavity is a simple, straightforward fix. His strong immune system acts as a constant defense, keeping common oral bacteria in check and ensuring his gums stay healthy and his teeth strong.

James, 23, living with HIV, walks a different path. After his diagnosis, he learned that HIV attacks the body's immune system, specifically the CD4 cells that fight infection. While antiretroviral therapy (ART) is crucial for managing the virus, a weakened immune system opens the door to opportunistic infections—illnesses that take advantage of the body's reduced defenses. The mouth is often the first place these problems appear.

James started noticing changes. His gums bled more easily and seemed to pull away from his teeth. He developed persistent, painful white patches on his tongue that wouldn't scrub off. Most concerning to him, his teeth began to feel loose and weak, and a previously minor cavity rapidly turned into a severe toothache.

Why HIV Affects the Mouth: The Oral-Systemic Link

James's experience is, unfortunately, common. The mouth is a mirror of systemic health. When the immune system is compromised by HIV, several oral conditions can arise and directly threaten dental integrity:

1. Severe and Rapid Periodontal Disease: This is not just "gingivitis." HIV-associated periodontitis can cause rapid, painful destruction of the gums and bone that hold teeth in place, leading to loosening and tooth loss.

2. Oral Candidiasis (Thrush): A fungal infection causing creamy white lesions. It can be painful, affect taste, and is a clear clinical sign of immune suppression.

3. Oral Hairy Leukoplakia: Caused by the Epstein-Barr virus, it presents as white, corrugated patches on the sides of the tongue. It is almost exclusively seen in people with weakened immunity.

4. Dry Mouth (Xerostomia): HIV and some medications can reduce saliva flow. Saliva is essential for neutralizing acids and remineralizing teeth. Without it, the risk of rampant, aggressive tooth decay skyrockets.

5. Delayed Healing: Simple dental procedures or ulcers may take much longer to heal, increasing the risk of secondary infections.

For James, the "weak teeth" were a symptom. The real cause was the unchecked bacterial and fungal growth in his mouth, which his body could no longer manage effectively.

A Call to Action: Prevention, Testing, and Integrated Care

The intertwined stories of Cebu's HIV surge and oral health underscore a need for a dual approach:

• For Prevention (Like Thomas's Path): Education on safe sexual practices and access to prevention tools (like PrEP) remain paramount. Regular health check-ups should include discussions about sexual health.

• For Early Intervention: Getting tested is an act of self-care. Free and confidential HIV testing is available at Social Hygiene Clinics and health centers across Cebu City. Knowing your status early allows for immediate ART initiation, which can preserve immune function and prevent the severe oral complications James faced.

• For Holistic Management (Like James's Path): Medical care for HIV must include dental care. A dentist experienced in managing HIV-related conditions is a vital part of the healthcare team. They can provide:

  • Aggressive preventive care (professional cleanings, fluoride treatments).

  • Prompt treatment of infections.

  • Guidance on managing dry mouth.

  • Restoration of damaged teeth to maintain function and nutrition.

The rapid scaling of HIV in Central Visayas is more than a number; it's a threat to the overall health of a generation, starting with their smiles. Oral health problems are often early, visible signs of a struggling immune system. Protecting the community means promoting prevention, normalizing testing, and ensuring that healthcare—including dedicated dental care—is integrated and accessible for everyone living with HIV.

By addressing the outbreak with compassion and comprehensive care, Cebu can work towards not only slowing the infection rate but also safeguarding the quality of life and health of all its residents, from their systemic immunity down to the strength of their teeth.

Addon sources: https://www.philstar.com/cebu-news/2025/12/03/2491589/fourth-new-cases-n...

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