TNP: I may have HIV. Will you still sleep with me? (Sept 30)

I may have HIV. Will you still sleep with me?
Under proposed changes to law, those at risk must disclose sex history to partner
By Ng Wan Ching
September 30, 2007

Tell the truth, says a new legal proposal that seeks to put the onus on those who lead risky sexual lifestyles to come clean with their partners.

Deceive - if there is a possibility that you have been exposed to the Aids virus - and you face up to 10 years in jail and a fine of up to $50,000.

Will such a law be effective in stemming the spread of Aids? Or could it drive people further into secrecy?

Imagine saying before sex: 'I may have been exposed to HIV. If you have sex with me, you should accept the risk of infection.'

Under the Infectious Diseases Act now, a person who knows that he is HIV-infected must inform his partner before having sexual intercourse. His partner must agree to accept the risk of infection.

If he doesn't warn his partner, he's breaking the law.

The Ministry of Health (MOH) is proposing to expand the act to include those who, although unaware that they are HIV-positive, have reason to believe that they have been exposed to the risk of contracting HIV or Aids.

This could be from having unprotected casual sex with multiple partners and prostitutes or sharing needles.

Another condition is that he must have had tested negative for HIV and not had sex or engaged in any risky activity since then.

Finally he must take reasonable precautions during sex, such as by wearing a condom.

Said Mr Benedict Jacob-Thambiah, an HIV/Aids educator: 'Who can be bothered? I think this will drive such people underground even more. Because now you are saying they are potential criminals.'

BLAME GAME?

The proposed laws appear to be more intent on ascribing blame rather than to treat HIV/Aids as a public health concern, said Mr Jacob-Thambiah.

Said Mr Brenton Wong, former vice-president of Action for Aids: 'This is putting the law in the bedroom, but how are the authorities actually going to police it?

'This is saying that if you are morally questionable, then you will get HIV. Only if you remove the stigma and make treatment available and affordable will people come forward.'

Dr Stuart Koe, chief executive officer of Fridae.com and a trained pharmacist specialising in HIV medicines, predicts that the new law will rarely be used.

'It will have minimum impact on HIV in Singapore. I think we could use our resources better,' he said. He thinks that to accuse someone of infecting another person with HIV is a
difficult thing to prove in court.

Said Dr Koe: 'Firstly, the chain of transmission is fairly difficult to ascertain.

'Secondly, if it's between a married couple, usually the wife will not want to prosecute the husband for fear of breaking up the family.'

If the Government is willing to go to the extent of changing the law, he thinks it would be much more helpful to change it to protect HIV individuals from workplace and insurance discrimination.

'We should improve their access to treatment and care rather than further alienating them,' said Dr Koe.

Already, there are fears that there is a hidden HIV epidemic.

A study of more than 3,000 leftover blood samples from public hospital patients early this year showed that one in 350 was infected with HIV.

If accurate, this would mean that Singapore has about 9,000 infected adults, much more than the official figures.

Neither the patients in the study nor their doctors were aware of their HIV status. Also, HIV is now a treatable disease like any other chronic disease.

'With treatment, people have stopped dying from HIV. But that message has not gone out. Instead when people find out they are positive, they go underground and they feel helpless,' said Dr Koe.

But Health Minister Khaw Boon Wan points out he has good reasons for the proposed changes.

Every year, 10 per cent of those newly infected with HIV are women. About half of them are married women whose husbands are HIV positive.

Said Mr Khaw: 'I draw the conclusion that they got it from their husbands.'

These are among the people he wants to protect. The new laws will help the Ministry deal with the minority of people who are sexually irresponsible.

For the majority of people, ABC - abstain, be loyal or use a condom - is good enough.

The minority may need CRT - condom and regular testing.

'If you insist on harming yourself by visiting prostitutes and so forth, then do CRT and inform your sexual partner,' said Mr Khaw.

Three cases have been dealt with under the existing laws.

In 2005, investigations unearthed the case of an HIV-positive foreigner from Nigeria who had unprotected sex with several women in Singapore.

He did not inform them of his status before they had sex. He left Singapore before he could be charged.

Earlier this year, an HIV-positive man did not inform his wife of his status before engaging in sex, using a condom.

His wife, who was a foreigner and unwilling to testify against her husband, tested negative for HIV.

He was fined.

An HIV-positive individual who may have had sexual intercourse without informing his partner of his HIV status is also being investigated.

Will the amendments take it a step further in preventing the spread of Aids?

Yes - but only if honesty is a policy that is practised in bed.

HIV+

2,852 people in S'pore HIV-positive, 25 are kids

HIV+

1,547 people in S'pore have Aids