13-6-2023 (SINGAPORE) In June 2023, the Ministry of Health (MOH) released data revealing that Singapore had recorded a total of 202 new cases of human immunodeficiency virus (HIV) among its residents in the previous year.
This marks the third consecutive year of decline in new HIV infections and represents the lowest number reported since 1998, when there were 199 cases.
Comparing the figures to previous years, there were 250 new cases in 2021, 261 in 2020, and 323 in 2019.
Of the cases reported in 2022, slightly over half of them were diagnosed at a late stage of HIV infection.
The MOH stated that 18 percent of the cases were detected during routine HIV screening, while 17 percent were identified through self-initiated screening, which tended to occur at the early stage of infection.
Most of the cases reported in 2022 involved men, with 187 individuals diagnosed with HIV. Among men, those who have sex with men, including bisexual males, were more likely to discover their HIV infection through self-initiated screening compared to men who have sex with women.
Sexual intercourse remained the primary mode of transmission, accounting for approximately 93 percent of the cases in 2022.
Men who have sex with men constituted around half of the cases, while men who have sex with women accounted for approximately 37 percent. Bisexual transmission was responsible for about 4 percent of the cases. Additionally, three cases were attributed to intravenous drug use.
As of the end of 2022, the total number of HIV-infected Singapore residents stood at 9,331, with 2,362 deaths recorded.
Between 2007 and 2017, the annual number of new cases ranged from 400 to 500 before gradually decreasing to fewer than 300 cases in the past three years.
MOH Urges Regular HIV Testing and Awareness
In a public advisory, the MOH and the Health Promotion Board emphasized the importance of regular HIV testing for individuals engaged in high-risk sexual behavior. They recommended testing every three to six months.
The MOH emphasized that it is crucial for everyone to be aware of their HIV status and get tested at least once. Early diagnosis enables individuals living with HIV to achieve better treatment outcomes. Furthermore, it provides an opportunity to protect sexual partners from infection since individuals with HIV who receive treatment and maintain an undetectable viral load have an extremely low risk of transmitting the virus.
The MOH stated, “With early and effective treatment, people living with HIV can lead lives no different from others.”
The ministry highlighted that the most effective means of preventing HIV infection is to remain faithful to one’s spouse or partner and to avoid engaging in casual sex or sexual activities with sex workers.
Recommendations by the National HIV Programme
A team of doctors from the National HIV Programme recently developed a set of recommendations aimed at encouraging more people to undergo voluntary HIV testing and to detect infections at an earlier stage. These recommendations were published in the Singapore Medical Journal last month.
The National HIV Programme is operated by the respective clinical HIV programs under the National Centre for Infectious Diseases, National University Hospital, Singapore General Hospital, and Changi General Hospital.
The doctors recommended that individuals aged above 21, except females above 65, should be offered HIV screening at least once in their lifetime unless they have risk factors that warrant repeated screening.
Those engaged in high-risk behavior, such as individuals with a history of injection drug use or those with multiple sex partners, should undergo HIV screening at least once a year.
For individuals being tested for the first time or those lacking sufficient education on the implications of an HIV test, the doctors strongly encouraged pre-test counseling.
HIV testing is traditionally conducted at hospitals, clinics, and through services provided by community-based organizations. Some organizations, such as the local non-profit organization Action for AIDS, offer anonymous testing.
The doctors also recommended that healthcare providers and HIV testing service providers encourage individuals to disclose their HIV status to their spouse, current sex partners, and previous sex partners. They should also promote testing among these individuals.
The doctors emphasized that positive HIV results should be communicated confidentially and in person by physicians or other trained staff due to the risk of discrimination and stigma.
In their article, the doctors referred to the “95-95-95” targets set by the Joint United Nations Programme on HIV/AIDS in an effort to end the epidemic. These targets aim to ensure that, by 2030, 95 percent of all people living with HIV are aware of their diagnosis, 95 percent of those diagnosed receive sustained antiretroviral therapy, and 95 percent of those receiving therapy achieve viral suppression.
According to estimates based on 2020 data, 82 percent of people in Singapore who have HIV infection know their status, 93 percent of those aware of their status are on antiretroviral therapy, and 94 percent of those on therapy have sustained viral suppression.
The doctors emphasized the need to increase the uptake of voluntary HIV testing to reduce the number of late-stage infections at diagnosis. Early detection allows for earlier initiation of antiretroviral therapy, which reduces the risk of developing serious AIDS-related events, serious non-AIDS deaths, or deaths by at least 50 percent.
Understanding HIV and Prevention
HIV attacks the body’s immune system, particularly its white blood cells. While there is no cure, individuals who receive treatment for HIV can maintain an undetectable viral load.
This means that there is effectively no risk of transmitting HIV to their sexual partners, even without using condoms during penetrative sex.
Untreated HIV can progress to AIDS (acquired immunodeficiency syndrome), which is potentially fatal and typically takes five to 10 years to develop.
Apart from unprotected sex, HIV can be contracted through sharing injection equipment, contaminated blood transfusions, organ or tissue transplants, and from a mother to her unborn child.
