HIV Singapore 2019

In June 2019, the Ministry of Health (MOH) released an update on the HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome) situation in Singapore 2018.
Here are the salient statistics and a short commentary for each.

  • There were 313 new cases of HIV infections reported among Singapore residents in 2018
    • There were 8,295 HIV-infected Singapore residents as of end 2018, of whom 2,034 had passed away.
    • The number of new HIV cases among Singapore residents has been between 400 to 500 per year from 2007 to 2017

The number of cases has dropped slightly – from 400-500 a year to 313 last year. In 2017 it was 434 new cases. In 2016 it was 408 new cases. While no reasons were provided as to why the numbers last year were lower, it is a step in the right direction for organisations like Action for AIDS, which is committed to ending HIV transmission and AIDS in Singapore by 2030. Safer sex practices such as the consistent and correct use of condoms and reducing high-risk sexual behaviour such as being faithful to one’s partner, avoiding casual sex and avoiding sex with commercial sex workers are some ways we can further reduce transmission of HIV. The usage of medications such as pre-exposure prophylaxis and post-exposure prophylaxis (PrEP and PEP) can also reduce the risk of contracting HIV.

  • The age and sex distribution of the 313 cases
    • 93% were male
    • 62% were between 20 to 49 years old

The majority of new cases are men, and usually in the age group of 20-49. Males of this age group might have a tendency to engage in high-risk sexual behaviour. Education about HIV transmission and prevention for everyone, especially for males aged 20-49 is crucial for the aim of reduction of new cases.

  • 95% acquired the infection through sexual intercourse
    • 43% were from heterosexual transmission
    • 42% were from homosexual transmission
    • 10% were from bisexual transmission.

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, which are
– Males who have sex with other males (210,000)
– Male clients of female sex workers (72,000)
– Female sex workers (4,200)
– Intravenous drug users (11,000)
These are the groups that are most at risk, and are the groups we need to increase screening rates and education about HIV and sexually transmitted infections (STIs) as well.

  • About 50% had late-stage HIV infection when they were diagnosed

HIV can be treated effectively – it is no longer the death sentence it was when HIV was first discovered. We know that the earlier we initiate treatment for HIV, the better the outcomes and life expectancy. All that is required to test for HIV is a small amount of blood and more importantly, ownership of your health. We highly advise everyone who engages in high-risk sexual behaviour regularly test for not just HIV, but other STIs as well.

  • Methods of detection
    • 57% were detected in the course of medical care provision
      • Such cases are typically at the late stage of HIV infection.
    • 22% were detected during routine programmatic HIV screening
    • 14% were detected from voluntary screening.
      • Such cases were more likely to be at an early stage of infection.

When someone presents at the late stage of HIV infection, outcomes and life expectancy are poorer. HIV ideally should never be discovered this way. HIV infection can be completely asymptomatic, especially in the early stages, and the only way to detect infection is to test for it.
The goal is to increase voluntary screening rates so that we can detect HIV early on, before the onset of AIDS. HIV infected people can lead normal, long, healthy lives with proper treatment. HIV testing is available at polyclinics, private clinics, and hospitals. There are also anonymous HIV test sites, where personal particulars are not required when signing up for an HIV test.
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. It is good to know that our government is taking steps to increase awareness and increase rates of HIV screening. We should do ours too by taking charge of our health by reducing high-risk sexual behaviour, and getting tested regularly should there be any high-risk sexual activity.

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