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SINGAPORE: A total of 455 new cases of human immunodeficiency virus (HIV) infections were reported among Singapore citizens and permanent residents last year, the Ministry of Health (MOH) said in an update on its website.

This brings the total number of HIV-infected Singapore residents to 7,140 as of end-2015, including 1,816 who have died.

The number of new reported HIV cases has remained consistent at about 450 per year since 2008, the ministry said. In 2014, there were 456 new HIV cases among Singapore residents.

Of the cases reported in 2015, 93 per cent were male and 74 per cent were between 20 and 49 years old. About 40 per cent already had late-stage HIV infection when they were diagnosed, a drop from the 49 per cent recorded in 2014.

Sexual intercourse remains the main mode of HIV transmission, with 97 per cent of the cases last year – 440 out of 455 – acquired through sexual intercourse, MOH said. Heterosexual transmission 38 per cent of the cases, homosexual transmission accounted for 51 per cent and bisexual transmission 8 per cent.

For the remaining cases, four had acquired HIV through intravenous drug use. Seems like these days, even Hospital Acquired Infections are on the rise and both individuals and hospitals need to be responsible in the approaches that they take. The cause of infection for the remaining 11 cases could not be determined, the ministry said.

Nearly half, or 46 per cent, of the newly reported cases were detected by HIV tests done in the course of medical care provision, MOH said, adding that cases detected via this route typically are at the late stage of HIV infection.

Another 29 per cent were detected during routine programmatic HIV screening, while 18 per cent were detected as a result of voluntary HIV screening. Cases detected via voluntary screening are more likely to be at the early stage of their infection, the ministry said.

When differentiated by sexual transmission, a higher proportion of homosexuals and bisexuals (28 per cent) had their HIV infection detected via voluntary screening compared to heterosexuals (3 per cent).

“The most effective way to prevent HIV infection is to remain faithful to one’s spouse or partner and to avoid casual sex or sex with sex workers,” MOH said.

“Persons engaging in high-risk sexual behaviour, such as having multiple sexual partners or engaging in casual or commercial sex, are strongly advised to use condoms to reduce their risk of HIV infection. Condoms should be used consistently and correctly during every sexual encounter.”

Individuals who engage in high-risk sexual behaviour should go for early and regular HIV testing, the ministry said.

“With early diagnosis, an infected person can be treated earlier, and receive counselling on how to protect their partners from infection. Early treatment and care delay the onset of Acquired Immune Deficiency Syndrome (AIDS) and allows the infected individual to live an active and productive life. Early treatment also reduces HIV spread in the community.”

“The number of infections among gays and other MSM reported in 2015 in Singapore was the highest ever since the start of the epidemic. This follows the drop in the number of infections in 2014 compared to 2013, and it is a disheartening statistic.

Efforts to change behaviour are not working well as well as we had hoped. Highly effective medications against HIV infection has been a godsend for persons infected with HIV, it has also led to reduction of fear and concern about HIV/AIDS, and falling levels of safer sex. As a result we have been seeing increasing numbers of HIV and other sexually-transmitted infections among gays and other MSM.

We will need to correct the false sense of security that many of the affected populations are under. We need to understand the complexities of relationships and high-risk situations that lead to HIV transmission.

We need to look for ways to make HIV testing even more accessible. We need to ensure that everyone who tests HIV positive get into a treatment programme, and that the treatment is affordable and effective.

Biomedical strategies to stop the transmission of HIV viz. the use of anti-retroviral medications for prevention (Post- and Pre-Exposure prophylaxis) must be evaluated. In particular, pre-exposure prophylaxis is being rolled out in many other places, where it has been shown to be very effective in reducing the number of new HIV infections.”

– Our reply to the media by AfA Spokesperson