I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
H
ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
1
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,
No
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1
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Ma
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20
2
5
,
p
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I
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ttp
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//
ijp
h
s
.
ia
esco
r
e.
co
m
Two
decades
of
H
IV/AI
DS mo
r
talit
y
t
rend ana
ly
sis
i
n t
he
Philippines
Ara
f
a
t
M
.
B
a
lt
,
Ro
s
nia
D.
M
a
ng
o
t
a
r
a
,
Niha
y
a
G
.
Sa
m
ba
wa
,
P
rincess
Alt
hey
a
M
a
e
P
.
Ala
m
a
da
,
Chin
-
chi
n
J
im
enea
Dem
a
y
o
,
Cesa
r
G
.
Dem
a
y
o
D
e
p
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B
i
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d
M
a
t
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m
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t
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c
s,
M
i
n
d
a
n
a
o
S
t
a
t
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U
n
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v
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r
si
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y
–
I
l
i
g
a
n
I
n
st
i
t
u
t
e
o
f
T
e
c
h
n
o
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o
g
y
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I
l
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a
n
C
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y
,
P
h
i
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i
p
p
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s
Art
icle
I
nfo
AB
S
T
RAC
T
A
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ticle
his
to
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y:
R
ec
eiv
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J
u
n
15
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2
0
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3
R
ev
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Ap
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2
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Acc
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ted
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u
n
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P
u
b
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h
e
a
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il
lan
c
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i
n
d
ica
tes
th
a
t
t
h
e
c
o
u
n
try
'
s
HIV
i
n
fe
c
ti
o
n
ra
te
is
risin
g
,
wit
h
t
h
e
Wes
ter
n
P
a
c
ifi
c
re
g
io
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e
x
p
e
rien
c
in
g
t
h
e
h
ig
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st
g
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o
wth
.
Du
e
to
t
h
e
sc
a
rc
it
y
o
f
stu
d
ies
o
n
HIV
in
t
h
e
n
a
t
io
n
,
th
e
p
re
se
n
t
sta
te
o
f
th
e
HIV
e
p
id
e
m
ic
m
u
st
b
e
a
sc
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rt
a
in
e
d
b
y
g
a
th
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ri
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g
d
a
ta
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m
p
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h
e
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lt
h
su
rv
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lan
c
e
a
n
d
HIV
m
o
rtali
ty
ti
m
e
tren
d
a
n
a
ly
sis.
Th
e
De
p
a
rtme
n
t
o
f
He
a
lt
h
'
s
P
h
il
i
p
p
i
n
e
He
a
lt
h
S
tatis
ti
c
s
(P
HS)
p
ro
v
i
d
e
d
t
h
e
i
n
fo
rm
a
ti
o
n
.
T
h
e
P
HS
-
re
c
o
m
m
e
n
d
e
d
a
lg
o
rit
h
m
s
fo
r
v
it
a
l
h
e
a
lt
h
i
n
d
ica
to
rs
we
re
u
se
d
to
c
a
lcu
late
m
o
rtalit
y
ra
tes
.
Ac
c
o
rd
in
g
t
o
th
e
stu
d
y
'
s
fin
d
in
g
s,
th
e
d
e
a
th
ra
te
in
th
e
n
a
ti
o
n
is
risi
n
g
,
n
e
c
e
ss
it
a
ti
n
g
ti
g
h
t
e
ffo
rts
to
sto
p
th
e
v
iru
s'
s
tran
sm
issio
n
a
n
d
p
ro
v
id
e
a
c
c
e
ss
to
a
n
t
i
-
r
e
tro
v
iral
th
e
ra
p
y
.
Al
th
o
u
g
h
t
h
e
re
is
a
c
o
n
sid
e
ra
b
le
d
iffere
n
c
e
b
e
t
we
e
n
th
e
two
se
x
e
s,
m
e
n
h
a
d
a
g
re
a
ter
m
o
rtalit
y
ra
te
th
a
n
wo
m
e
n
,
su
g
g
e
sti
n
g
t
h
a
t
m
e
n
we
re
m
o
re
v
u
ln
e
ra
b
le
to
HIV
/AIDS
m
o
rtalit
y
.
T
h
e
stu
d
y
a
lso
re
v
e
a
led
th
a
t
HIV
tes
ti
n
g
h
u
rd
les
we
re
to
b
lam
e
fo
r
m
a
k
in
g
y
o
u
n
g
to
m
id
d
le
-
a
g
e
d
in
d
iv
i
d
u
a
ls
t
h
e
p
o
p
u
latio
n
m
o
st
su
s
c
e
p
ti
b
le
to
m
o
rtalit
y
fro
m
t
h
is
il
ln
e
ss
.
Ad
d
it
i
o
n
a
ll
y
,
t
h
e
Na
ti
o
n
a
l
Ca
p
it
a
l
Re
g
i
o
n
h
a
s
t
h
e
m
o
st
sig
n
if
ica
n
t
m
o
rtalit
y
ra
te,
so
th
e
g
o
v
e
rn
m
e
n
t
sh
o
u
ld
fo
c
u
s
o
n
p
ro
m
o
ti
n
g
h
e
a
lt
h
in
th
is
a
re
a
a
s it
h
a
s th
e
h
ig
h
e
st mo
rtalit
y
ra
te.
K
ey
w
o
r
d
s
:
Ag
e
Mo
r
tality
Re
g
io
n
Sex
T
r
en
d
a
n
aly
s
is
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Ar
af
at
M.
B
alt
Dep
ar
tm
en
t o
f
B
io
lo
g
ical
Scien
ce
s
,
C
o
lleg
e
o
f
Scien
ce
an
d
Ma
th
em
atics,
Min
d
an
ao
State
Un
iv
er
s
ity
-
I
li
g
an
I
n
s
titu
te
o
f
T
ec
h
n
o
lo
g
y
I
lig
an
C
ity
,
Ph
ilip
p
in
es
E
m
ail: a
r
af
at.
b
alt@
g
.
m
s
u
iit.ed
u
.
p
h
1.
I
NT
RO
D
UCT
I
O
N
I
n
th
e
Ph
ilip
p
in
es,
th
e
f
ir
s
t
HI
V
in
f
ec
tio
n
was
d
o
cu
m
en
ted
in
1
9
8
4
[
1
]
.
Six
ty
-
two
th
o
u
s
an
d
twen
ty
-
n
in
e
(
6
2
,
0
2
9
)
HI
V
ca
s
es
h
ad
b
ee
n
r
ep
o
r
ted
in
2
0
1
8
[
2
]
.
Ac
co
r
d
in
g
to
d
ata
f
r
o
m
p
u
b
lic
h
ea
lth
s
u
r
v
eillan
ce
,
th
e
n
u
m
b
er
o
f
HI
V
in
f
ec
tio
n
ca
s
es
in
th
e
Ph
ilip
p
in
es
in
cr
ea
s
ed
alar
m
in
g
ly
o
v
er
th
e
p
as
t
ten
y
ea
r
s
,
f
r
o
m
3
1
1
ca
s
es
in
2
0
0
7
to
8
,
1
5
1
ca
s
es
i
n
2
0
1
6
[
3
]
.
T
h
e
co
u
n
t
r
y
'
s
in
f
ec
tio
n
r
ates
in
cr
ea
s
ed
b
y
1
7
4
%
b
etwe
en
2
0
1
0
a
n
d
2
0
1
7
,
th
e
f
astes
t
in
cr
ea
s
e
in
t
h
e
W
ester
n
Pacif
ic
R
eg
io
n
[
4
]
.
Me
n
wer
e
also
th
e
m
o
s
t
af
f
ec
ted
,
m
a
k
in
g
u
p
9
1
%
o
f
all
illn
ess
es
r
ep
o
r
ted
b
etwe
en
1
9
8
4
an
d
2
0
1
4
[
5
]
.
9
3
%
o
f
ca
s
es
th
at
wer
e
d
o
cu
m
en
ted
in
v
o
lv
ed
s
ex
u
al
co
n
tact
(
2
4
%
wer
e
h
et
er
o
s
ex
u
al,
4
7
%
wer
e
h
o
m
o
s
e
x
u
al,
an
d
3
0
%
wer
e
b
is
ex
u
al)
,
wh
ile
5
%
in
v
o
lv
ed
d
r
u
g
in
jecto
r
s
s
h
ar
in
g
n
ee
d
les.
T
h
e
r
em
ain
in
g
2
%
wer
e
s
p
r
ea
d
f
r
o
m
m
o
th
er
to
ch
i
ld
,
th
r
o
u
g
h
b
lo
o
d
tr
an
s
f
u
s
io
n
s
,
o
r
as a
r
esu
lt
o
f
n
ee
d
le
p
r
ick
in
j
u
r
ies.
Nin
ety
-
s
ev
en
th
o
u
s
an
d
(
9
7
,
0
0
0
)
p
eo
p
le
with
HI
V
wer
e
a
n
ticip
ated
to
b
e
liv
in
g
in
th
e
Ph
i
lip
p
in
es
in
2
0
1
9
;
7
3
%
wer
e
awa
r
e
o
f
th
eir
HI
V
s
tatu
s
,
an
d
4
4
%
wer
e
r
ec
eiv
in
g
an
ti
-
r
etr
o
v
ir
al
th
er
a
p
y
.
T
h
e
n
atio
n
r
is
k
s
an
em
er
g
en
t
HI
V
ep
id
em
ic
d
u
e
to
l
o
n
g
-
ter
m
s
o
cieta
l
a
n
d
b
eh
av
io
r
al
v
ar
ia
b
les
s
u
ch
as
p
o
o
r
co
n
d
o
m
u
s
e,
s
tig
m
a
ag
ain
s
t
s
ex
u
al
m
in
o
r
i
ty
co
m
m
u
n
ities
,
an
d
a
lack
o
f
s
ex
u
al
ed
u
c
atio
n
[
6
]
,
[
7
]
.
HI
V
s
tig
m
a
was
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
1
,
Ma
r
ch
20
2
5
:
1
-
9
2
p
er
v
asiv
e
in
th
e
Ph
ilip
p
in
es,
wh
er
e
it
was
b
eliev
e
d
th
at
h
a
v
in
g
HI
V
was
a
s
ig
n
o
f
v
ice
an
d
im
m
o
r
ality
[
4
]
,
an
d
th
er
e
is
g
r
o
win
g
ev
i
d
en
ce
th
at
HI
V
-
r
elate
d
s
tig
m
a
a
n
d
p
r
eju
d
ice
h
am
p
er
HI
V
te
s
tin
g
,
d
is
clo
s
u
r
e
o
f
s
er
o
s
tatu
s
,
r
eten
tio
n
in
ca
r
e,
a
n
d
u
p
tak
e
a
n
d
ad
h
e
r
en
ce
t
o
a
n
ti
-
r
etr
o
v
ir
al
t
h
er
ap
y
[
8
]
–
[
1
2
]
.
Seco
n
d
,
ac
ce
s
s
to
HI
V
p
r
ev
en
tio
n
an
d
tr
ea
tm
en
t
m
ed
icatio
n
s
was lim
ited
[
1
3
]
.
Fu
r
th
er
m
o
r
e
,
HI
V/AI
DS
is
a
n
ewly
em
e
r
g
in
g
in
f
ec
ti
o
u
s
d
is
ea
s
e,
an
d
th
e
co
u
n
tr
y
'
s
HI
V/AI
DS
ep
id
em
ic
h
as
r
ec
eiv
e
d
litt
le
r
e
s
ea
r
ch
,
m
a
k
in
g
g
o
v
er
n
m
e
n
t
e
f
f
o
r
ts
in
ef
f
ec
t
u
al.
Stu
d
ies
o
n
H
I
V
co
u
l
d
p
in
p
o
i
n
t
th
e
d
em
o
g
r
a
p
h
ics
an
d
g
r
o
u
p
s
m
o
s
t
at
r
is
k
,
h
elp
in
g
to
p
r
io
r
itize
th
e
ap
p
r
o
p
r
iate
h
ea
lth
p
o
li
cies
an
d
m
ea
s
u
r
es.
T
h
e
cu
r
r
e
n
t
s
tu
d
y
u
s
ed
tim
e
-
tr
en
d
an
al
y
s
is
to
co
m
p
ar
e
g
r
o
u
p
s
an
d
d
r
aw
c
o
n
clu
s
io
n
s
a
b
o
u
t
h
o
w
ex
p
o
s
u
r
e
im
p
ac
ts
d
i
f
f
er
en
t
p
o
p
u
latio
n
s
.
Fo
r
ea
ch
g
r
o
u
p
,
eq
u
ally
s
p
ac
ed
o
b
s
er
v
atio
n
s
ar
e
m
ad
e
r
eg
ar
d
in
g
illn
ess
es
'
f
r
eq
u
e
n
cy
,
s
ev
er
ity
,
an
d
p
r
e
v
alen
ce
[
1
4
]
.
T
h
is
s
tu
d
y
e
v
a
lu
ated
m
o
r
tality
r
ates
f
o
r
a
s
p
ec
if
ic
p
er
io
d
an
d
d
eter
m
in
ed
wh
eth
er
th
er
e
is
a
n
o
tab
le
m
o
v
em
en
t,
s
u
ch
as
an
in
cr
ea
s
e,
d
ec
r
ea
s
e,
o
r
c
o
n
s
is
ten
cy
o
v
er
th
e
p
er
io
d
;
tim
e
-
tr
en
d
an
aly
s
is
ca
n
b
e
em
p
lo
y
ed
.
T
h
is
s
tu
d
y
u
s
es
th
e
Ph
ilip
p
i
n
e
Hea
lt
h
Statis
tics
(
PHS
)
in
f
o
r
m
atio
n
to
p
r
o
v
id
e
a
tim
e
-
tr
en
d
an
al
y
s
is
o
f
HI
V/AI
DS
m
o
r
tality
in
th
e
Ph
ilip
p
i
n
es
f
r
o
m
1
9
9
9
to
2
0
2
0
.
T
h
e
d
is
tr
ib
u
tio
n
o
f
HI
V/AI
D
S
m
o
r
tality
ac
r
o
s
s
th
e
co
u
n
t
r
y
'
s
s
ex
es,
ag
e
r
an
g
es,
an
d
r
eg
io
n
s
h
asn
'
t
b
ee
n
ex
p
licitly
s
tu
d
ied
,
s
o
th
is
s
tu
d
y
will u
s
e
d
ea
th
tr
en
d
s
b
y
co
u
n
tr
y
,
s
ex
,
a
g
e,
an
d
lo
ca
tio
n
to
v
is
u
alize
th
e
d
ata.
2.
M
E
T
H
O
D
2
.
1
.
Co
llect
io
n o
f
da
t
a
T
h
e
H
I
V
m
o
r
t
a
l
i
t
y
s
ta
t
is
t
ic
s
we
r
e
c
o
l
l
e
c
t
e
d
t
h
r
o
u
g
h
t
h
e
a
n
n
u
a
l
p
u
b
l
i
c
a
t
i
o
n
o
f
t
h
e
D
e
p
a
r
t
m
e
n
t
o
f
H
e
a
l
t
h
P
h
i
l
i
p
p
i
n
es
,
t
h
e
P
HS
s
e
r
i
es
.
T
h
e
p
u
b
l
i
c
a
t
i
o
n
t
h
o
r
o
u
g
h
l
y
s
u
m
m
a
r
i
z
e
s
t
h
e
'
c
o
u
n
t
r
y
'
s
c
u
r
r
e
n
t
s
t
a
t
is
t
ic
s
o
n
Na
t
a
li
t
y
,
M
o
r
b
i
d
i
t
y
,
a
n
d
M
o
r
t
al
i
t
y
.
T
h
e
P
HS
r
e
s
u
l
ts
f
r
o
m
t
h
e
j
o
i
n
t
an
d
c
o
l
l
a
b
o
r
a
t
i
v
e
e
f
f
o
r
t
s
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
S
t
at
is
t
ic
s
A
u
t
h
o
r
i
t
y
(
PS
A
)
,
D
e
p
a
r
t
m
e
n
t
o
f
H
e
a
l
t
h
(
DO
H
)
,
a
n
d
t
h
e
l
o
c
al
h
e
a
l
t
h
u
n
i
ts
.
2
.
2
.
M
is
s
ing
da
t
a
F
o
r
t
h
e
y
e
a
r
2
0
0
0
,
t
h
e
r
e
is
i
n
s
u
f
f
i
c
i
e
n
t
m
o
r
ta
l
i
t
y
d
a
t
a
.
T
h
e
s
e
d
a
t
a
a
r
e
r
e
g
a
r
d
e
d
a
s
"
i
r
r
es
o
l
v
a
b
le
,
"
w
h
i
ch
i
n
d
i
c
a
t
es
t
h
a
t
i
t
is
n
o
t
p
o
s
s
ib
l
e
t
o
d
e
t
e
r
m
i
n
e
o
r
a
p
p
l
y
t
h
e
s
o
u
r
c
e
o
f
t
h
e
a
d
j
u
s
t
m
e
n
t
to
t
h
e
d
i
s
a
g
r
e
e
m
e
n
t
.
N
e
v
e
r
t
h
e
l
es
s
,
w
e
t
o
o
k
t
h
e
l
i
b
e
r
t
y
t
o
g
e
t
t
h
e
a
v
e
r
a
g
e
v
a
l
u
e
f
r
o
m
t
h
e
p
r
e
c
e
d
i
n
g
a
n
d
s
u
c
c
ee
d
i
n
g
y
e
a
r
u
s
e
d
t
o
s
u
p
p
l
e
m
e
n
t
m
is
s
i
n
g
d
a
t
a
[
1
5
]
.
2
.
3
.
Co
m
pu
t
a
t
io
n o
f
m
o
r
t
a
lity
r
a
t
es
T
h
e
HI
V
m
o
r
tality
s
tatis
tics
t
h
at
wer
e
co
llected
in
th
e
Ph
ili
p
p
in
e
Hea
lth
Statis
tics
(
PH
S)
wer
e
u
s
ed
to
co
m
p
u
te
m
o
r
tality
r
ates.
T
h
e
co
m
p
u
tatio
n
s
s
y
s
tem
was
b
ased
o
n
th
e
f
o
r
m
u
la
f
o
r
v
ital
h
ea
lth
i
n
d
icato
r
s
r
ec
o
m
m
en
d
ed
in
t
h
e
PHS,
in
wh
ich
th
e
r
ates w
er
e
ca
lcu
late
d
p
er
1
0
0
,
0
0
0
p
o
p
u
latio
n
s.
S
p
e
c
i
f
i
c
D
e
a
t
h
R
a
t
e
=
(
D
e
a
t
hs
in
spe
c
i
f
i
c
c
las
s
or
gr
o
u
p
r
e
gi
s
t
e
r
e
d
in
a
gi
v
e
n
c
a
le
n
dar
y
e
a
r
E
st
i
m
a
t
e
d
p
o
p
ulat
i
o
n
as
of
J
uly
1
in
sa
m
e
spe
c
i
f
i
e
d
c
las
s
or
gro
up
of
s
a
i
d
y
e
a
r
)
×
100
,
000
2
.
4
.
Da
t
a
a
na
ly
s
is
A
l
l
o
f
t
h
e
c
o
m
p
u
t
e
d
m
o
r
t
a
l
i
t
y
r
a
t
e
s
w
e
r
e
u
s
e
d
t
o
c
o
n
s
t
r
u
c
t
t
r
en
d
s
f
o
r
e
a
c
h
n
a
t
i
o
n
w
i
d
e
a
n
n
u
a
l
m
o
r
t
a
l
i
t
y
,
S
e
x
,
a
n
d
a
g
e
-
s
p
e
c
i
f
i
c
g
r
o
u
p
a
n
d
r
e
g
i
o
n
u
s
i
n
g
M
i
c
r
o
s
o
f
t
E
x
c
e
l
2
0
1
9
.
A
g
e
-
s
p
e
c
i
f
i
c
s
t
an
d
a
r
d
i
z
e
d
r
a
t
e
s
w
e
r
e
c
o
m
p
u
t
e
d
b
a
s
e
d
o
n
t
h
e
W
o
r
ld
H
e
a
lt
h
O
r
g
a
n
i
z
at
i
o
n
(
W
HO
)
W
o
r
l
d
St
a
n
d
a
r
d
P
o
p
u
l
at
i
o
n
D
i
s
t
r
i
b
u
t
i
o
n
[
1
6
]
.
A
d
d
i
t
i
o
n
a
l
l
y
,
SP
S
S
S
o
f
tw
a
r
e
w
a
s
u
t
il
i
z
e
d
t
o
a
n
a
l
y
s
e
t
h
e
d
a
ta
a
t
a
9
5
%
c
o
n
f
i
d
e
n
c
e
l
e
v
e
l
i
n
o
r
d
e
r
t
o
c
o
m
p
u
t
e
f
o
r
i
n
d
e
p
e
n
d
e
n
t
s
a
m
p
l
e
t
-
t
e
s
t
s
;
i
f
th
e
p
-
v
a
l
u
e
i
s
l
ess
t
h
a
n
0
.
0
5
,
t
h
e
n
u
l
l
h
y
p
o
t
h
e
s
i
s
m
u
s
t
b
e
r
ej
e
c
te
d
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
Annu
a
l H
I
V/AIDS
m
o
rt
a
lity
ra
t
e
in t
he
P
hil
ipp
i
ne
s
in
1999
-
2
0
2
0
F
r
o
m
1
9
9
9
t
o
2
0
1
0
,
n
o
s
u
b
s
t
an
t
i
a
l
c
h
a
n
g
e
s
w
e
r
e
f
o
u
n
d
,
as
in
d
i
c
a
t
e
d
i
n
Fi
g
u
r
e
1
.
H
o
w
e
v
e
r
,
b
e
g
i
n
n
i
n
g
i
n
2
0
1
1
,
H
I
V
/A
I
DS
m
o
r
t
al
i
t
y
g
r
e
w
c
o
n
s
i
d
e
r
a
b
l
y
.
T
h
e
h
i
g
h
e
s
t
m
o
r
t
a
li
t
y
r
at
e
(
0
.
8
8
p
e
r
1
0
0
,
0
0
0
)
w
a
s
r
e
c
o
r
d
e
d
i
n
2
0
2
0
,
w
h
i
l
e
t
h
e
l
o
w
e
s
t
w
as
r
ec
o
r
d
e
d
i
n
2
0
0
0
a
n
d
2
0
0
7
(
0
.
0
2
p
e
r
1
0
0
,
0
0
0
,
r
e
s
p
e
c
t
i
v
e
l
y
)
.
T
h
e
S
o
u
t
h
E
as
t
As
i
a
r
e
g
i
o
n
a
r
e
p
o
p
u
l
a
r
t
r
a
v
e
l
d
e
s
t
i
n
a
t
i
o
n
s
f
o
r
s
e
x
t
o
u
r
i
s
m
,
w
h
i
c
h
i
s
o
n
e
o
f
t
h
e
p
r
i
m
a
r
y
c
a
u
s
e
s
o
f
t
h
e
h
i
g
h
m
o
r
t
a
l
i
t
y
r
a
t
e
s
i
n
t
h
e
P
h
i
li
p
p
n
e
s
[
1
7
]
.
I
n
a
d
d
i
t
i
o
n
,
t
h
i
s
r
e
g
i
o
n
h
as
a
n
u
n
a
c
c
e
p
t
a
b
l
el
y
h
i
g
h
r
a
t
e
o
f
S
T
Ds,
e
s
p
e
c
i
al
l
y
a
m
o
n
g
m
e
n
w
h
o
h
a
v
e
s
e
x
w
i
t
h
m
e
n
an
d
t
r
a
n
s
g
e
n
d
e
r
i
n
d
i
v
i
d
u
a
l
s
[
1
8
]
.
T
h
e
r
e
is
s
ti
l
l
n
o
c
u
r
e
o
r
v
a
c
ci
n
e
f
o
r
H
I
V
/
A
I
D
S,
b
u
t
p
e
o
p
l
e
wi
t
h
H
I
V
h
a
v
e
a
c
c
es
s
t
o
li
f
e
-
s
a
v
i
n
g
a
n
t
i
-
r
et
r
o
v
i
r
a
l
t
h
e
r
a
p
y
.
T
h
e
f
i
r
s
t
e
f
f
ec
t
i
v
e
d
r
u
g
f
o
r
H
I
V
t
r
e
a
t
m
e
n
t
i
s
zi
d
o
v
u
d
i
n
e
,
w
h
i
c
h
t
h
e
FD
A
a
p
p
r
o
v
e
d
i
n
1
9
8
8
.
I
n
a
d
d
i
t
i
o
n
,
p
r
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r
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w
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d
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1
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,
w
h
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h
p
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d
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w
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f
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o
f
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t
i
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r
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v
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al
d
r
u
g
s
[
1
9
]
.
A
l
t
h
o
u
g
h
a
n
t
i
-
r
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r
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v
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ti
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[
2
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.
D
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s
p
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te
t
h
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p
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v
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D
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m
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n
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f
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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t J Pu
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Hea
lth
Sci
I
SS
N:
2252
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8
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Tw
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es o
f H
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mo
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lity tren
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A
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3
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s
p
r
e
v
e
n
t
i
v
e
(
T
a
s
P
)
a
lt
h
o
u
g
h
t
h
e
s
e
t
r
e
a
t
m
e
n
ts
a
r
e
u
n
d
e
r
u
t
i
l
i
z
e
d
d
u
e
t
o
s
t
r
u
c
t
u
r
a
l
o
b
s
t
a
cl
e
s
a
n
d
s
o
c
i
et
al
f
a
c
t
o
r
s
t
h
a
t
h
a
v
e
a
n
i
m
p
a
ct
o
n
h
e
a
l
t
h
[
4
5
]
–
[4
7
].
I
n
t
e
r
v
e
n
t
i
o
n
s
at
t
h
e
s
t
r
u
c
t
u
r
al
a
n
d
c
o
m
m
u
n
i
t
y
l
e
v
e
ls
s
h
o
u
l
d
a
l
s
o
b
e
t
a
k
e
n
i
n
t
o
a
c
c
o
u
n
t
.
T
h
e
c
o
n
t
e
x
t
-
r
e
l
a
t
e
d
as
p
e
c
ts
(
e
.
g
.
,
s
o
ci
a
l
,
p
o
l
i
t
i
c
al
-
e
c
o
n
o
m
i
c
,
p
o
l
ic
y
-
l
e
g
a
l
,
a
n
d
c
u
lt
u
r
a
l
)
t
h
at
a
f
f
e
ct
H
I
V
i
n
f
e
ct
i
o
n
a
n
d
t
r
a
n
s
m
is
s
i
o
n
a
r
e
t
h
e
m
a
i
n
f
o
cu
s
o
f
t
h
es
e
H
I
V
p
r
e
v
e
n
t
i
o
n
a
ct
i
v
i
t
ie
s
,
w
i
t
h
a
n
e
f
f
e
ct
t
h
a
t
e
x
te
n
d
s
t
o
m
e
m
b
e
r
s
o
f
s
i
g
n
i
f
i
c
a
n
t
p
o
p
u
l
a
t
i
o
n
s
[
4
8
]
.
C
o
m
m
u
n
i
t
y
-
l
e
v
e
l
t
r
e
at
m
e
n
t
s
a
i
m
t
o
a
f
f
e
ct
t
h
e
s
o
c
ia
l
e
n
v
i
r
o
n
m
e
n
t
(
s
u
c
h
as
c
o
m
m
u
n
i
t
y
-
l
e
v
e
l
n
o
r
m
s
a
n
d
c
o
l
l
e
c
ti
v
e
s
e
l
f
-
e
f
f
ic
a
c
y
)
a
n
d
b
e
h
a
v
i
o
r
a
l
p
a
t
t
e
r
n
s
o
f
e
n
t
i
r
e
p
o
p
u
l
a
t
i
o
n
s
,
i
n
c
o
n
t
r
a
s
t
t
o
i
n
d
i
v
i
d
u
a
l
-
l
e
v
e
l
i
n
t
e
r
v
e
n
t
i
o
n
s
,
w
h
i
c
h
a
i
m
t
o
c
h
a
n
g
e
i
n
d
i
v
i
d
u
a
l
b
e
l
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e
f
s
,
s
t
a
n
d
a
r
d
s
,
a
n
d
b
e
h
a
v
io
r
s
[
49
].
4.
CO
NC
L
U
SI
O
N
T
h
e
s
t
u
d
y
r
e
v
e
a
l
e
d
t
h
a
t
H
I
V
/A
I
D
S
m
o
r
t
al
i
t
y
i
n
t
h
e
P
h
i
l
i
p
p
i
n
e
s
i
n
c
r
ea
s
e
d
s
i
g
n
i
f
i
ca
n
t
l
y
f
r
o
m
1
9
9
9
t
o
2
0
2
0
.
M
a
l
e
s
w
e
r
e
t
h
e
m
o
s
t
s
u
s
c
e
p
t
i
b
le
S
e
x
t
o
H
I
V
/
A
I
D
S
m
o
r
t
a
l
i
t
y
,
a
n
d
MS
M
s
i
g
n
i
f
i
c
an
t
l
y
c
o
n
t
r
i
b
u
t
e
d
t
o
H
I
V
/
A
I
D
S
m
o
r
t
al
i
ti
e
s
.
I
n
a
d
d
i
t
i
o
n
,
a
g
e
-
s
p
e
ci
f
i
c
m
o
r
t
al
i
t
y
r
a
t
e
s
s
h
o
w
t
h
at
e
v
e
r
y
a
g
e
g
r
o
u
p
i
s
a
f
f
e
c
t
e
d
b
y
H
I
V
/
A
I
D
S
.
W
h
e
r
ei
n
t
h
e
2
5
–
2
9
a
g
e
g
r
o
u
p
w
a
s
t
h
e
m
o
s
t
a
f
f
e
c
t
e
d
.
I
m
p
l
y
i
n
g
t
h
a
t
t
h
i
s
a
g
e
g
r
o
u
p
w
a
s
t
h
e
m
o
s
t
a
f
f
e
c
t
e
d
b
y
t
h
e
H
I
V
e
p
i
d
e
m
i
c
i
n
t
h
e
c
o
u
n
t
r
y
.
F
u
r
t
h
e
r
m
o
r
e
,
t
h
e
N
at
i
o
n
a
l
C
a
p
it
a
l
R
e
g
i
o
n
(
N
C
R
)
is
t
h
e
m
o
s
t
a
f
f
e
c
t
e
d
r
e
g
i
o
n
i
n
t
h
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c
o
u
n
t
r
y
,
d
e
s
p
i
t
e
a
h
i
g
h
e
r
n
u
m
b
e
r
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t
e
s
t
i
n
g
a
n
d
t
r
e
a
t
m
e
n
t
c
e
n
ter
s
.
M
ea
n
w
h
i
l
e
,
t
h
e
B
AR
M
M
r
ec
o
r
d
e
d
t
h
e
l
o
w
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t
m
o
r
t
a
l
i
t
y
r
a
t
e
t
h
r
o
u
g
h
o
u
t
t
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e
s
t
u
d
y
p
e
r
i
o
d
.
T
h
i
s
c
a
n
b
e
a
tt
r
i
b
u
t
e
d
t
o
b
e
i
n
g
a
M
u
s
l
i
m
-
d
o
m
i
n
at
e
d
r
e
g
i
o
n
w
i
th
l
i
m
i
t
e
d
H
I
V
c
as
e
s
r
e
c
o
r
d
e
d
.
T
o
c
o
n
c
l
u
d
e
,
t
h
e
r
i
s
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n
g
n
u
m
b
e
r
o
f
A
I
D
S
-
r
e
l
a
t
e
d
d
e
a
t
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s
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n
t
h
e
n
a
t
i
o
n
is
a
s
i
g
n
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f
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c
a
n
t
h
e
a
lt
h
b
u
r
d
e
n
.
T
h
e
m
a
i
n
c
a
u
s
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o
f
t
h
is
e
p
i
d
e
m
i
c
w
e
r
e
w
i
d
e
s
p
r
e
a
d
s
t
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g
m
a
a
n
d
d
i
s
c
r
i
m
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n
a
t
i
o
n
.
E
l
i
m
i
n
at
i
n
g
t
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t
w
o
f
a
c
t
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s
s
h
o
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l
d
b
e
th
e
p
r
i
m
a
r
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s
t
e
p
i
n
a
d
d
r
e
s
s
i
n
g
t
h
i
s
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p
i
d
e
m
i
c
.
L
e
s
s
s
t
i
g
m
a
a
n
d
d
is
c
r
i
m
i
n
at
i
o
n
w
il
l
l
e
a
d
t
o
h
i
g
h
e
r
n
u
m
b
e
r
s
o
f
H
I
V
t
e
s
t
s
a
n
d
s
t
a
t
u
s
a
wa
r
e
n
e
s
s
,
e
v
e
n
t
u
a
l
l
y
r
e
d
u
c
i
n
g
r
i
s
k
b
e
h
a
v
i
o
r
s
a
n
d
t
r
a
n
s
m
is
s
i
o
n
.
ACK
NO
WL
E
DG
E
M
E
NT
S
T
h
e
a
u
t
h
o
r
s
w
o
u
l
d
l
i
k
e
t
o
t
h
a
n
k
t
h
e
D
e
p
a
r
t
m
e
n
t
o
f
S
ci
e
n
c
e
an
d
T
e
c
h
n
o
l
o
g
y
'
s
Ac
c
e
l
e
r
at
e
d
Sc
i
e
n
c
e
a
n
d
T
e
c
h
n
o
l
o
g
y
H
u
m
a
n
R
es
o
u
r
c
e
D
e
v
e
l
o
p
m
e
n
t
P
r
o
g
r
a
m
(
DO
S
T
-
A
S
T
HR
DP
)
a
n
d
C
l
i
m
at
e
C
h
an
g
e
L
a
b
o
r
a
t
o
r
y
,
t
h
e
P
r
e
m
i
e
r
R
es
e
a
r
c
h
I
n
s
t
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t
u
te
o
f
S
c
i
e
n
c
e
a
n
d
M
a
t
h
e
m
at
i
cs
(
PR
I
S
M
)
,
a
n
d
M
i
n
d
a
n
a
o
St
a
t
e
U
n
i
v
e
r
s
it
y
'
s
I
l
i
g
an
I
n
s
t
i
t
u
te
o
f
T
e
c
h
n
o
l
o
g
y
,
w
h
i
c
h
s
e
r
v
e
s
as
r
es
e
a
r
c
h
e
r
s
'
w
o
r
k
p
l
a
ce
.
RE
F
E
R
E
NC
E
S
[
1
]
D
e
p
a
r
t
me
n
t
o
f
H
e
a
l
t
h
(
D
O
H
)
,
“
H
I
V
/
A
I
D
S
a
n
d
a
r
t
r
e
g
i
st
r
y
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s:
S
e
p
t
e
m
b
e
r
2
0
2
1
,
”
H
I
V
/
A
I
D
S
D
a
t
a
H
u
b
f
o
r
t
h
e
A
si
a
P
a
c
i
f
i
c
.
A
c
c
e
ss
e
d
:
Ja
n
.
1
6
,
2
0
2
3
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
w
w
w
.
a
i
d
s
d
a
t
a
h
u
b
.
o
r
g
/
r
e
s
o
u
r
c
e
/
h
i
v
-
a
i
d
s
-
a
n
d
-
a
r
t
-
r
e
g
i
st
r
y
-
p
h
i
l
i
p
p
i
n
e
s
-
sep
t
e
m
b
e
r
-
2
0
2
1
[
2
]
G
l
o
b
a
l
A
I
D
S
M
o
n
i
t
o
r
i
n
g
,
“
C
o
u
n
t
r
y
p
r
o
g
r
e
ss
r
e
p
o
r
t
-
P
h
i
l
i
p
p
i
n
e
s,”
G
l
o
b
a
l
A
I
D
S
M
o
n
i
t
o
r
i
n
g
2
0
1
9
.
A
c
c
e
ss
e
d
:
J
a
n
.
1
6
,
2
0
2
3
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s:
/
/
w
w
w
.
u
n
a
i
d
s.
o
r
g
/
si
t
e
s
/
d
e
f
a
u
l
t
/
f
i
l
e
s
/
c
o
u
n
t
r
y
/
d
o
c
u
men
t
s/
P
H
L
_
2
0
1
9
_
c
o
u
n
t
r
y
r
e
p
o
r
t
.
p
d
f
[
3
]
D
e
p
a
r
t
me
n
t
o
f
H
e
a
l
t
h
(
D
O
H
)
,
“
H
I
V
/
A
I
D
S
a
n
d
A
R
T
r
e
g
i
s
t
r
y
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s
:
N
o
v
e
m
b
e
r
2
0
2
2
.
”
A
c
c
e
sse
d
:
N
o
v
.
2
5
,
2
0
2
2
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s:
/
/
w
w
w
.
a
i
d
s
d
a
t
a
h
u
b
.
o
r
g
/
r
e
s
o
u
r
c
e
/
h
i
v
-
a
i
d
s
-
a
n
d
-
a
r
t
-
r
e
g
i
s
t
r
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p
h
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l
i
p
p
i
n
e
s
-
n
o
v
e
m
b
e
r
-
2
0
2
2
[
4
]
L.
M
.
A
.
G
a
n
g
c
u
a
n
g
c
o
,
“
H
I
V
c
r
i
s
i
s
i
n
t
h
e
P
h
i
l
i
p
p
i
n
e
s:
u
r
g
e
n
t
a
c
t
i
o
n
s
n
e
e
d
e
d
,
”
Th
e
L
a
n
c
e
t
Pu
b
l
i
c
H
e
a
l
t
h
,
v
o
l
.
4
,
n
o
.
2
,
p
.
e
8
4
,
F
e
b
.
2
0
1
9
,
d
o
i
:
1
0
.
1
0
1
6
/
S
2
4
6
8
-
2
6
6
7
(
1
8
)
3
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He
c
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o
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tac
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a
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m
a
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:
c
g
d
e
m
a
y
o
@g
m
a
il
.
c
o
m
.
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