Posts

WORLD AIDS DAY 2020

On December 1st, the global community unites to commemorate World AIDS Day, showing support for those living with and affected by HIV, and to remember those who have lost their lives to AIDS. This year in particular, the COVID-19 pandemic has laid bare how critically interlinked our health is with issues such as social inequality, human rights, stigma and discrimination, economic security, and political will and stability.

The theme of World AIDS Day this year is “Global solidarity, shared responsibility”. The COVID-19 crisis has demonstrated that, during a pandemic, no one is safe until everyone is safe. We all have a part to play in addressing the dual pandemics of COVID-19 and HIV/AIDS, in order to successfully eliminate them both as a public health threat.

There were approximately 38 million people living with HIV/AIDS in 2019, with an estimated 1.7 million people acquiring HIV in the year, marking a 23% decrease in new HIV infections since 2010. In Singapore, latest figures released in June this year showed 323 new cases of HIV infection reported among residents in 2019, bringing the total number of HIV-infected residents to 8,618 as of end of 2019, of whom 2,097 had passed away. The annual incidence of new infections locally has decreased overall by about 25% when compared to 2007 to 2017.

This decrease of new HIV infections is a result of the concerted and coordinated efforts of both government and community-led initiatives, but there is still much that can be done. In 2014, UNAIDS set an ambitious goal of eradicating the HIV epidemic by 2030. This involved a set of targets called the “90-90-90” vision, which stated that by 2020:

  • 90% of people living with HIV would know their diagnosis
  • 90% of those diagnosed with HIV would be on antiretroviral therapy (ART)
  • 90% of those on treatment would have achieved viral suppression

Singapore has made significant improvements towards the last two goals, with approximately 89% of people diagnosed with HIV on treatment and 94% of those achieving viral suppression; however, we are still relatively lacking in our progress towards the first target, with only an estimated 72% of people living with HIV who have been diagnosed. 

We know that early diagnosis leads to early treatment and better outcomes. Knowing their HIV status early will also help to prevent the spread of infection to others. Providing access to better information and testing for HIV, increasing awareness and uptake of Pre-Exposure Prophylaxis (PrEP), and ensuring long term compliance to antiretroviral therapy (ART) by people living with HIV are some of the primary facets of eradicating the HIV epidemic.

As we approach the end of a tumultuous year, the impact of COVID-19 has forced us to view our global health responses, including the HIV/AIDS response, in a different way. We must now be more committed than ever to ensure no individual or community is left behind – healthcare must be funded and accessible to all, stigma must be eliminated and vulnerable populations offered social protections, and public health systems must be strengthened through investment and sound government policy.

As the WHO has so accurately and succinctly captured:

“Now is the moment for bold leadership for equal societies, the right to health for all and a robust and equitable global recovery. This World AIDS Day, join us in calling on countries to step up their efforts to achieve healthier societies. This World AIDS Day let us demand global solidarity and shared responsibility.”

Tags: HIV Test Singapore, HIV Test, Anonymous HIV Testing

World AIDS Day 2019 Press Statement

World AIDS Day is a day to remember all those who have lost their lives to the illness. At the end of 2018, it is estimated that 32 million lives were lost worldwide to the disease. WHO had previously set the 90-90-90 target for countries in the world to achieve by 2020, 90% of those living with HIV will know their status, 90% of those who are positive are on ART treatment and 90% of those who are on treatment have undetectable levels of the virus. Let us take stock of what we have been able to achieve thus far.


Since then Singapore has risen to the challenge to achieve those goals.
 Singapore has done well with 2 of the goals – 89% of those who are positive are on ART treatment and 94% of those who are on treatment achieved undetectable viral loads. However, much has to be done to improve on getting those living with HIV to know their status as only about 72% are aware they are positive for HIV.
Thus we need to encourage more people who are at risk of HIV infection to get tested. At Dr Tan and Partners we have been strong advocates of screening of HIV and STIs for at risk persons and provide a non-judgmental and LGBT-friendly environment to discuss your concerns. This is to help to protect their families and their loved ones. It is not uncommon for people that I see in my practice to tell me one of the reasons why they are reluctant to get tested is because they are afraid of what will happen if their families or their loved ones find out.
The other common concern is that they will lose their jobs. Finally there are still many misconceptions about how HIV is transmitted. I have patients who are concerned that because they share food with their families they can transmit HIV to their family which is of course not true. HIV is NOT transmitted via casual contact like sharing of food and drinks or shaking hands.


Of note in Singapore as of 2018, of all those who were tested positive more LGBTs are stepping up to get voluntary testing for HIV (20%) compared to heterosexuals (9%). Also importantly, in all newly diagnosed HIV persons in Singapore both homosexuals (42%) and heterosexuals (43%) contribute equally to number of cases. What this shows is that contrary to what some believe, HIV is NOT a homosexual disease but it is a disease that affects all sexual orientation.
Finally, there is strong evidence from large studies involving thousands of sero-discordant couples (that is one partner is HIV positive and the other partner is HIV negative) who have sexual acts between 2007-2016 showed that there was not a single case of HIV transmission to the HIV negative partner if the HIV positive treated partner has undetectable levels of HIV virus. This highlights the importance of treatment of HIV, that treatment of HIV can be successful in achieving undetectable levels of virus and that transmission of HIV is effectively blocked when levels of the virus is undetectable.


We are proud that our Doctors at DTAP have been actively involved in the fight against the HIV epidemic. Our Anonymous HIV Testing site at Robertson Walk has provided a safe space for thousands of people seeking confidential HIV testing since 2005. Our Doctors were the lead and co-lead authors of the Community Workforce section in the Blueprint to end HIV transmission and AIDS in Singapore by 2030. Our Doctors were also part of the Singapore HIV PrEP Taskforce and helped write the first ever local Singapore guidelines for the clinical management of HIV PrEP.
We will continue this fight until we see a world free of stigma, free of discrimination and hopefully free of HIV.


Dr. Julian Ng

Dr Julian Ng has 10 years of medical practice experience. He currently serves as the Chief Medical Officer of the DTAP Group of clinics in Singapore and Malaysia. He is also a member of the Singapore Men’s Health Society. His special interests are in the field Andrology, especially sexual health. He is currently practising at Dr Tan and Partners (DTAP) clinic at Novena Medical Centre.