Decline in new HIV cases, even as more go for voluntary screening

A man using a do-it-yourself kit that tests for the human immunodeficiency virus (HIV) which causes Aids.
A man using a do-it-yourself kit that tests for the human immunodeficiency virus (HIV) which causes Aids.PHOTO: ST FILE

SINGAPORE - The number of new human immunodeficiency virus (HIV) cases reported among Singaporeans and permanent residents has gone down in recent years, even as more people are going for voluntary screenings.

In line with World Aids Day on Sunday (Dec 1), the Ministry of Health (MOH) and the Health Promotion Board (HPB) released figures that showed a downward trend of HIV incidences here in the last four years - 275 cases were detected between January and October while 265 were diagnosed in the same period last year.

The corresponding figures for 2017 and 2016 were 361 and 319 respectively.

The full-year figures were 313 last year, 434 in 2017 and 408 in 2016.

Doctors The Straits Times spoke to said they have noticed a greater awareness among the young here, especially those within the homosexual community.

They said having HIV talked about more has reduced the stigma of the disease, with many now more willing to treat its diagnosis, whether in themselves or their friends, with a more open mind.

"Young people are more aware that a diagnosis does not mean their lives are over. Some of them know others who have HIV who are living good, happy lives," said Dr Leong Hoe Nam, an infectious disease specialist at Mount Elizabeth Novena Hospital.

The 49-year-old noted that those who have their infections detected early can receive treatment with "practically no side effects" and "no changes to their projected life span".

It is actually the older demography that is more concerning, Dr Leong said. "They tend to think of themselves as more invincible, or smarter about their choice of sexual partners.

 
 
 

"But HIV has a really long incubation period. Not only do they not get treatment when they are not diagnosed, they could pass it on to their partners too."

Dr Piotr Chlebicki, an infectious disease specialist at Mount Alvernia Hospital, said those who receive treatment early could have their HIV status reduced to "undetectable".

The 52-year-old said: "Recent studies have shown quite clearly that if treated early, patients can have their HIV become 'undetectable', which means it cannot be transmitted to others. That is much better than treating it later on when the immune system could already have suffered irreversible damage."

Of the newly reported cases, 19 per cent were detected through voluntary screening, a 2 percentage point improvement from last year. The vast majority - 55 per cent - were detected by tests done in the course of medical care the patient was already undergoing, while another 20 per cent were found through routine programmes of HIV screening.

About 49 per cent were diagnosed at a late stage, down from 53 per cent for the same period in 2018.

The authorities analysed 154 of the new cases, and found that those aged between 20 and 39 accounted for 41 per cent of them, while those between 40 and 59 years made up 40 per cent.

All were exposed to the virus through sexual intercourse.

HIV, the virus that causes Acquired Immune Deficiency Syndrome (AIDS), can be transmitted through unprotected sex acts or through sharing needles, syringes, or other injection equipment.

In some cases, it can also be passed on to a child by his mother during pregnancy, or through breastfeeding.

 
 

Professor Roy Chan, president of Action for Aids, a non-governmental organisation dedicated to fighting HIV infection in Singapore, said he thinks more people went for voluntary screenings than the 19 per cent indicates.

"My feeling is that this is an underestimation. We need to review how we classify modes of detection," he said.

Commenting on the significant difference between the proportion of homosexual or bisexual transmissions (30 per cent) detected through voluntary screening, and the corresponding figure for heterosexuals (4 per cent), he said: "This has been the pattern for many years."

"Gay and bisexual men are more aware of their risk factors and are therefore more willing to seek testing and treatment."

The cost of HIV tests depends on the type of test used, with clinics usually charging between $25 and $30 for them.

MOH and HPB also urged individuals at risk of HIV infection to go for regular HIV testings available at polyclinics, private clinics and hospitals.

"With early and effective treatment, persons living with HIV can delay the onset of Aids for many years, continue to lead an active and productive life, and also help reduce the spread of HIV in the community," the authorities said.