Health + Wellness

A cautious optimism on the HIV situation in Singapore

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I was gratified when I read the latest update from the Singapore Ministry of Health (MOH) on the HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) situation in Singapore for the year 2018 – 313 total HIV/AIDS cases compared to 434 cases in 2017.

While we cannot pinpoint any particular reason why the total number of HIV/AIDS cases dropped, we are sanguine that it did. Perhaps advocacy groups such as Action for AIDS, or the rise in education on safe sex practices such as the right use of condoms, or reducing high-risk sexual behavior (such as being faithful to one’s partner, avoiding casual or commercial sex), are all possible cumulative contributors to this positive shift. The usage of medications such as pre and post exposure prophylaxis (PrEP and PEP) can also reduce the risk of contracting HIV, especially for those who engage in high-risk behaviour.

More educational outreach
While the total number of cases dipped, the MOH Update showed that the majority of new cases are men from the age group of 20 to 49, who may be more sexually active than others. Education about HIV transmission and prevention for everyone, especially for males aged 20 to 49 is crucial for the aim reduction of new cases.

For the first time, the rate of heterosexual transmission was greater than the rate of homosexual transmission for HIV. This could be due to increased awareness of HIV and its transmission in the homosexual population. 

A recent local study by researchers from the Saw Swee Hock School of Public Health at the National University of Singapore (NUS) has estimated that around 210,000 men have sexual intercourse with other men, which is more than twice an earlier estimate of 90,000. 

The researchers have identified four groups that have the highest risk of getting and transmitting HIV, namely: males who have sex with other males (210,000), males who have sex with female sex workers (72,000), female sex workers (4,200), and intravenous drug users (11,000). We would recommend increasing screening rates and educating people about HIV and sexually transmitted infections (STIs). 

No longer a death sentence
HIV is a stubborn medical problem, but is no longer as fearful as it once was. HIV can be treated effectively and patients can thereafter lead normal, long and healthy lives. The earlier we initiate HIV treatments, the better the outcomes and life expectancy. HIV tests are not onerous nor painful – all doctors need is a small amount of blood. We also recommend testing for both HIV and other STIs.

Late stage HIV infections are not favorable to patients in terms of outcomes and life expectancy. As HIV infections can be asymptomatic especially in the early stages, the only way to detect HIV is by voluntary testing. In Singapore, HIV testing is available at polyclinics, private clinics, and hospitals. There are also anonymous HIV testing sites where personal particulars are not required, giving concerned people yet another avenue to have clarity of health.

Collaborative community efforts
The Health Promotion Board (HPB) has been working with partner organisations to conduct educational programmes and campaigns to reach out to high-risk individuals to urge them to go for regular HIV testing. We can also chime in by taking charge of our own health with sexual hygiene and regular testing should there be a high-risk sexual activity. HIV is not the same mystical threat as it once was, and we will hope that HIV cases continue to deep dive for the years ahead.


Commentary attributed to Dr. Chester Lan, from DTAP Clinic

Dr Chester Lan is the resident doctor at DTAP Clinic Holland V, he believes in holistic care individualised to each patient. This patient-centric approach, along with his friendly persona, has earned him the trust of many of his patients. He sees patients from all age groups over a variety of sub-specialties and understands that building trust and rapport, along with good communication, is the key to a successful patient-doctor relationship.

Some background about DTAP clinic
Dr Tan & Partners clinic (DTAP Clinic) was established in 2005 at Robertson Walk (Singapore). A pioneer of GP plus, or “General Practice with Special Interest” model in Singapore, with an aim to provide quality healthcare for everyone.

DTAP clinic @ Robertson is an Anonymous HIV test site approved by Ministry of Health (Singapore and supported by Health Promotion Board. Locals and foreigners at risk of HIV can for HIV testing, without the need to provide their details, NRIC or passport, addresses and contacts numbers.

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