In November 2019, AfA launched the Community Blueprint Towards Ending HIV and AIDS in Singapore by 2030.
The Blueprint focuses on the following themes:
Populations affected by HIV:
Key populations in Singapore: This includes the two main groups that are almost equally affected by HIV (based on MoH data over the last five years) and are:
- heterosexual males with multiple sexual partners
- men who have sex with men (MSM)
- Hidden populations: This encompasses populations with low uptake of HIV programmes and services due to socio-structural barriers and include:
- unregulated female sex workers: In Singapore regulated (or licensed) sex workers are at low risk of HIV due to regular testing and services that are offered. The group that the blueprint addresses are mainly unregulated female sex workers who remain underground and are at a higher risk of HIV.
- transgender persons,
- persons who use drugs (PUD)
- late presenters (all those diagnosed at later stages of infection across all population groups)
Cross Cutting Themes:
- Tackling HIV Related Stigma and Discrimination including review of policies that perpetuate stigma
- The Community Workforce: General Practitioners and Community Groups Providing HIV Services to Affected Populations
- Normalising and Scaling up the use of PrEP (HIV Pre-exposure Prophylaxis)
- Monitoring & Evaluation of HIV Prevention Programmes
The blueprint examines the current state of the HIV epidemic in detail and the populations most affected by it. It reviews the estimated size of each of the population segments at risk of HIV infection and the reach of current services. It further assesses existing programmes, estimates the gaps including other strategies and programmes required to broaden reach and the additional resources that will be needed to close the gap. It also examines the group of late presenters (those diagnosed at later stages of HIV infection) to understand more deeply why they presented late and recommend ways to increase reach and effectiveness of educational and testing programmes. These strategies were developed by working groups representing communities they serve.
The second section of the Blueprint explores themes that cut across the different population segments affected by HIV and tackling of which are imperative to end HIV.
Recommendations:
Some of the key recommendations from the blueprint include:
- Incrementally scale up the reach of HIV prevention and testing programmes for key populations focusing on proven and evidence-based interventions.
- Focus on late presenters; identify trends and improve reach.
- Roll out robust self-testing programmes, particularly for hard-to-reach persons, working with community organisations.
- Strengthen the community workforce and develop appropriate training and educational programmes to bolster prevention and testing.
- Scale up PrEP awareness and use for most at-risk persons with appropriate guidelines.
- Address stigma and discrimination through up to date research, sensitisation programmes and structural changes including laws and policies.
- Roll out communication strategies to promote safe sex and testing among travellers and through national campaigns increasing awareness and knowledge of advances in HIV treatment.
- Improve M&E to track outcomes and impact of community-based programmes.