How to stop HIV and Aids

Published: May 1, 2012

For more than three decades, we have tried and have been relatively successful in controlling the
spread of HIV infection in Singapore. It has taken the perseverance and ingenuity of individuals and
groups, the support and collaboration with government organisations and agencies to bring us to where
we are today.

The cumulative number of Singaporeans and residents diagnosed with HIV/Aids was 5,306 last year.
Females have been less affected by infection, accounting for 7per cent of newly diagnosed infections
last year.

There are, however, two troubling trends:

More than half of newly diagnosed HIV infections were made in persons with late stage of infection;
HIV infection is increasing rapidly among the group referred to as "men who have sex with men"
(MSM), who include homosexuals as well as men who have sex with both men and women. Last year,
newly-diagnosed infections among MSM outnumbered those in heterosexuals by 49 per cent to 43
per cent for the first time in two decades.

To date, we have relied on the "traditional" approach to prevention – disseminating Aids education and
information to warn the public of the dangers of casual sex and sex with sex workers.
Where permitted, we have expounded safer sex messages that include the consistent and correct use
of condoms and lubricants for sex with casual partners.

For those who may have been exposed to HIV or who have casual sex partners, we have been advising
regular HIV testing. Over the years, the number of anonymous test sites has increased to eight.
Targeted and intensive 100 per cent condom use programmes have succeeded outstandingly in
reducing to zero the incidence of HIV infection among regulated brothel-based sex workers.
Unfortunately, such programmes cannot be replicated for transient street- and nightclub-based
freelance sex workers.
No longer a death sentence

HIV infection in the 21st century is no longer the death sentence it was in the 1980s and 1990s. While
complete eradication of HIV in the body is still elusive, modern antiretroviral (ARV) drugs can effectively
suppress HIV to the point that those with HIV/Aids are able to lead relatively normal lives, free from the
physical stigma and opportunistic infections that used to plague patients in the past.
I use the term "relatively normal" because living with HIV infection has significant challenges. For
example, the ARV medications have to be taken regularly, a high level of adherence is necessary to
achieve a satisfactory result, treatment is life-long, costly, and there are enormous psychological,
emotional, social and financial consequences on those with HIV/Aids.

Furthermore ARV treatment is not without side effects, and HIV infection by itself is also known to have
long-term complications and may affect the cardiovascular, metabolic and nervous systems that could
lead to serious consequences.

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