Forum: Community-based anonymous STI testing will improve access to sexual healthcare
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We welcome The Straits Times’ recent spotlight on sexual health in Singapore ( Fear and shame surrounding sexual health means many suffer in silence, say experts
In our experience, while there has been significant attention paid to the human immunodeficiency virus (HIV), many are less aware of the more common bacterial sexually transmitted infections (STIs) such as chlamydia, gonorrhoea and syphilis.
These infections are easily missed as they are often asymptomatic, but if left untreated they can lead to serious complications, including infertility and increased HIV susceptibility. However, they are treatable and curable when diagnosed early.
Action for AIDS Singapore (AfA) had been providing anonymous, community-based HIV testing for over 30 years. We provided anonymous, community-based testing for syphilis from 2006 and for gonorrhoea and chlamydia from 2020. But in 2023, these were discontinued because of changes in regulations. While notifications for STIs other than HIV do not require personal identifiers, accessing sexual healthcare can be daunting for many.
This fear is not driven only by statutory reporting requirements. Many of our clients report stigmatising experiences when seeking sexual healthcare from mainstream healthcare providers, especially when discussing sex outside of heterosexual marriage. Others simply feel more comfortable talking to trained peer counsellors in the community setting.
Cost is another significant barrier. Private STI testing can run into hundreds of dollars. Public testing, while subsidised, often involves time off work, long waits and increasingly higher costs. For example, the price of a polymerase chain reaction test for gonorrhoea/chlamydia doubled between 2023 and 2025. When affordability, accessibility and privacy concerns intersect, the result is delayed or deferred testing and continued transmission.
We feel that AfA’s community-based service model can address some of these issues. We used to be able to provide STI tests in the evenings and on weekends, and in accessible locations like the heartland and nightlife hot spots. For many, these were the only settings where they felt safe enough to have the test. To improve sexual health services, we must remove structural and psychological barriers to seeking care.
We urge the Ministry of Health to work with community partners to expand anonymous, community-based STI testing as part of a comprehensive and effective public health strategy.
Fikri Alkhatib
Senior Manager, Clinical Services and Community Research
Action for AIDS Singapore (AfA)
