WE APPLAUD the inclusion of new anonymous HIV test sites in Singapore. Demand for HIV testing is robust, with numbers more than doubling in the period from 2005 to last year.
The value of early testing cannot be overemphasised. Early identification with treatment leads to preservation of immune function and life, prevention of transmission to the spouse or newborn, and savings from avoiding costly hospitalisation.
It is not wishful thinking to believe that early identification and treatment are key to controlling the AIDS epidemic.
But identification without treatment negates the benefits. As infectious disease physicians actively looking after patients living with HIV, we have seen too many patients who refused treatment because of the attached stigma, and who went on to develop advanced disease.
Another group resorts to seeking medical care outside Singapore because of the baseless fear of detection by the Government or employers.
Despite having treated so many HIV patients, we can only imagine a tiny fraction of the pain they go through. It is time we closed the gap.
HIV must be de-stigmatised. Those with HIV can now enjoy lifespans equivalent to those of uninfected individuals, return to economic usefulness, and even experience parenthood with their own children. The impossible is now possible. Like diabetes mellitus and hypertension, having HIV is now a chronic condition that many individuals live with.
The HIV population in Singapore is growing as those infected are living longer and dying of “old age”, not opportunistic infections. We daresay everyone in Singapore knows at least someone living with HIV; it is just that the diagnosis was not revealed.
It is time the Government adopts “zero tolerance” for stigmatisation – that it is illegal to ask for an HIV test as pre-employment testing, that HIV individuals be allowed to work in all fields, and that it is illegal to dismiss an employee strictly on the grounds of HIV.
Wherever possible, these should be extended to foreigners. Foreigners with HIV course through our porous immigration gates without having to declare their condition. They are barred subsequently from entering only if a HIV test is done and turns out positive.
The image of HIV is changing rapidly. Patients with HIV now live longer, contribute positively to society and have children. Even the cure for HIV is no longer a pipe dream. It is not for us to imprison patients in a cage of stigma or irrational fear.
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