CNA: Number of new HIV cases hit record high of 422 in 2007 (April 29)

Number of new HIV cases hit record high of 422 in 2007
By Dominique Loh, Channel NewsAsia | Posted: 29 April 2008 1839 hrs

SINGAPORE: Latest figures from the Ministry of Health (MOH) showed 422 new cases of HIV infection were detected in Singapore in 2007, the highest in a single year since 1985. MOH added that 93 per cent of the cases were men.

This brings the total number of reported cases as of end-2007 to 3,482. Out of these cases, 1,534 are carriers showing no symptoms, while 804 have AIDS-related illnesses and 1,144 have died.

MOH said sexual transmission remains the main mode of HIV infection resulting in 95 per cent of the new cases. Out of the 422 new cases, 255 were infected during heterosexual sex. Meanwhile, 130 of them caught HIV through homosexual activity, a 38 per cent rise compared to 2006.

One reason for the increase in this group could be due to more screening.

29 per cent of homosexuals had their HIV detected during voluntary screening compared to just 5 per cent of heterosexuals. Action for Aids said this is a result of greater awareness arising from more intensive and targeted campaigns for men who have sex with men.

Meanwhile, infection via intravenous drug use halved from 14 cases in 2006 to seven last year.

One case saw HIV being contracted through blood transfusion overseas and is the first such reported case in the past six years.

57 per cent of all new cases reported in 2007 were Singapore citizens and permanent residents between 30 and 49 years of age. About one-eighth of the cases were between 20 and 29 years of age.

Ten people aged under 20 were diagnosed HIV positive. Of these, one was a baby infected by his mother during pregnancy.

Action for Aids said: "More young persons are having sex and at a younger age. Programmes meant for young people must address all aspects of sexual behaviour, including homosexuality and condom use, otherwise those most at risk will not be helped."

According to the ministry, 53 per cent of the new cases already had late stage HIV infection when they were diagnosed.

Only 13 per cent of new cases were detected through voluntary screening, while most had their HIV status detected while they were undergoing some form of medical care.

In its annual HIV/AIDS update, the health ministry urged those engaging in high-risk sexual behaviour to use condoms properly and go for HIV testing regularly. - CNA/vm

ST Online Forum: HIV: Laws can bring about marked behavioural change (Oct 16)

Oct 16, 2007

HIV: Laws can bring about marked behavioural change

MS KAREN Tan of the Ministry of Health in her letter, 'HIV law aims to deter irresponsible sex conduct' (ST, Oct 11), admitted that 'public education and prevention must be the mainstay but legislation by itself is inadequate to tackle the problem of HIV/Aids'. It is always not easy to coax people to change their social behaviour but legislation is still the last bastion to drive home the message that the HIV/Aids epidemic can be contained. As early as 2003, the governor of California had been lobbying for the promulgation of HIV laws in his state and a year later California's HIV/Aids laws were accepted by the legislature. Under the Health and Safety Code, the following provisions are enacted: a) All licensed physicians and surgeons or other persons engaged in the prenatal care of a pregnant woman or attending the woman at the time of delivery are to inform the woman of the intent to perform a test for HIV infection; the routine nature of the test; the purpose, risks and benefits of the test; the risks of perinatal transmission of HIV and that treatments are known to decrease the risks of perinatal transmission. b) A three-year sentence enhancement is mandatory for a conviction of rape (including statutory and spousal rape), or unlawful sodomy or oral copulation, if the defendant knew that he was HIV positive at the time of the commission of the offence. c) At the request of the crime victim, the court may order HIV testing of any person charged with a crime. Before issuing a search warrant for the defendant's blood, the court must find that there is a probable cause to believe that blood, semen or other bodily fluids have been transferred from the defendant to the victim and that there is probable cause to believe the defendant committed the alleged offence. A victim may also request HIV testing of the accused in the case of certain alleged sex crimes that are the subject of a police report. d) Any person who exposes another to HIV by engaging in unprotected sexual activity is guilty of a felony when the infected person: i) knows he is infected ii) has not disclosed his HIV-positive status iii) acts with the intent to infect the other person with HIV. The felony charge is punishable in the state prison for a period not exceeding eight years. What are the principles that should guide legal policy on HIV? The law must be used to establish a protective and supportive framework for people affected by the epidemic and not a punitive one. Informed ethical debate can guide the direction of the evolution of the law in this area. The law can be used as an instrument to bring about change in personal behaviour and only by having an informed group of lawyers will the legal and human rights issues associated with the epidemic be properly tackled. The people who remain vulnerable to HIV are those who are denied the means of protecting themselves against the disease because of economic need, for example, or powerlessness to control the basis upon which their sexual relationships take place. Many factors come into play here such as poverty, inadequate health care and health education and cultural values that compel certain practices that expose women to the risk of HIV transmission. Women are often not free to make their own decisions about their sexual relationships or to insist upon measures, such as the use of condoms or fidelity on the part of their partner, that would reduce the risk of exposure to HIV. The HIV policy debate is usually characterised as an inevitable conflict between public health and individual rights. Policies that infringe individual rights such as forcible HIV testing are defended on the basis of an overriding need to protect public health. On a practical level, HIV laws are not easy to enforce. However, there is some evidence that such laws can assist in encouraging condom use, if only because it makes it easier for prostitutes to nsist upon condom use by their clients. The legislation can be an instrument to bring about a marked behavioural change in this way. Law is a product of social and cultural values within a community. It can also be instrumental in defining, reinforcing and actively promoting certain values and practices. By either condoning or outlawing certain forms of behaviour or expressions of cultural values, the law can be a very powerful instrument for shaping and reinforcing these values. The law can and ought to play a proactive role not merely in mediating rights and obligations as between individuals but also in seeking to change underlying values and patterns of social interaction that create vulnerability to the threat of HIV infection. Heng Cho Choon

ST: Budget for Aids education hits $4m

Budget for Aids education hits $4m
The Straits Times, Aug 30, 2007

The Health Promotion Board (HPB) will spend $4 million on Aids education this year, an increase on the $3.3 million spent for the year end in March.

This is more than triple the $1.3 million budget it had in 2005.

The spending on Aids education was increased after the Ministry of Health (MOH) corrected a mistake in its 2005 report on the number of new Aids/HIV patients.

The reason for the spike?

The HPB had originally reported 255 new patients. But last September, this number was revised to 317.

With the new figure, the Aids education budget grew as well.

Responding to a Straits Times query, an MOH spokesman explained: 'The additional 62 cases were diagnosed in late 2005 and were retrospectively added to complete the picture.'

The correct number showed that there had been no fall in the number of human immunodeficiency virus (HIV) infections here and, in fact, the upward trend continued unchecked.

Last year, it rose again to 357 new cases, a 13 per cent increase from the previous year. Three in four people infected are heterosexual.

The HPB's stepped-up education efforts include placing advertisements targeted at specific groups, such as the one in The Straits Times last week aimed at young women who indulge in casual sex.

The HPB is also working with the Textile and Fashion Federation to promote more than 50 T-shirts designed by prominent personalities, such as TV actor Adrian Pang and MP Fatimah Lateef, to raise Aids awareness. The T-shirts will be on display at VivoCity from Oct 12 to 21.

Dr Roy Chan, president of the non-governmental association Action For Aids, was not impressed by the new tack: 'Giving information alone is not enough. Many people don't take it seriously because they don't think it applies to them.'

He said this is 'true for any medical condition, and is particularly true for HIV infection'.

People need to be encouraged to take control of their health. The stigma and discrimination against people with the disease also need to change, he added.

Prevention is much more cost-effective than treatment, as the cost of medicine alone comes to about $1,300 a month for each patient. This is on top of any other medical treatment patients may need due to their compromised immune system.

The HPB is focusing its campaign on three groups - teenagers, workers, and men who have sex with other men and illegal prostitutes.

In schools, the HPB runs Aids/HIV education classes for Secondary 3 and JC1 students.

MOH: Update on the HIV/AIDS Situation in Singapore (Dec 99)

Update On The HIV/AIDS Situation In Singapore

01 Dec 1999

For the first nine months of this year, another 150 Singaporeans were found to be HIV infected. This brings the total number of HIV infected Singaporeans to 1,080 as at 30 September 1999. Among them, there were 468 asymptomatic carriers, 251 with full-blown AIDS and 361 have died.

Mode Of Transmission Of HIV Infection Among Singaporeans

Sexual transmission remained the main mode of transmission among Singaporeans accounting for 96% of all reported cases (1,040 out of 1,080 cases). The remaining HIV infected Singaporeans contracted the infection through intravenous drug use (21), the perinatal route (11), renal transplant overseas (5), and blood transfusion (3).

Heterosexual transmission was the most common mode of HIV transmission among Singaporeans since 1991, accounting for 72% of all reported HIV infected Singaporeans. Most of these cases contracted the infection through unprotected casual sex and sex with prostitutes in Singapore and overseas.

Profile of HIV infected Singaporeans

The majority (954 cases) of the HIV infected Singaporeans were males and 126 were females giving a male to female ratio of about 8 : 1. Two-thirds (65%) of the cases were between the ages of 20 - 39 years at the time of diagnosis. About 83% were Chinese, 7% were Malays, 6% were Indians and 4% Others.

60% of the reported cases were single. Among the males, 65% were single while among the females majority (70%) were married (Table 5). Since 1991, there has been an increase in the number of married persons among HIV infected Singaporeans from 14% in 1991 to 38% in 1998. For the first nine months of this year, 39% of the reported cases were married.

Ministry's Advice

The Ministry would like to emphasise that the only way to avoid AIDS is to remain faithful to one's spouse and to avoid casual sex and sex with prostitutes. A HIV infected person looks and feels normal during the early stage of the infection. It is therefore not possible to tell if a person is infected by looking at his/her appearance.

The Ministry would also like to remind those who are at risk of being infected with the HIV virus not to donate blood. They should see their doctors for HIV screening. All women who are pregnant are encouraged to be screened for HIV infection so that measures to prevent transmission from mother to infant could be taken early. The Ministry would like to assure that the identities of persons who come forward for testing and those who are found to be HIV positive will be kept strictly confidential.

Please visit http://www.gov.sg/moh/releases/update_aids.html to know more about the issue.