Know or don‘t know, it’s still illegal

First Published- 29 Sep 2007

Bottom line? Go for HIV test as ignorance is no longer an excuse

TAN HUI LENG

huileng@mediacorp.com.sg

THE Government doesn’t want to pry into your bedroom. But it does want you to be responsible if you engage in high-risk sexual behaviour, as what you do in your most private moments may have repercussions on public health here.

Health Minister Khaw Boon Wan went to some length to make this point as he announced an unprecedented move — possibly the world’s first — in the Government’s fight against Aids.

As the number of HIV-positive people continue to go up in Singapore, it will soon become an offence for HIV-positive people in high-risk groups to have sex, whether or not they know their HIV status, under certain conditions. And it doesn’t matter if the virus is passed on or not.

Adding this provision to the Infectious Diseases Act is the “right thing to do”, said Mr Khaw, so as to protect innocent victims and encourage those who engage in high-risk behaviour to take personal responsibility for their activities.

“My job is not to get into everybody’s bedroom,” said Mr Khaw on Friday on the sidelines of an event. “But I think it is to send a clear signal to those who engage in high-risk sexual activity what they need to do and it’s really regular testing and use of the condom.”

This legal responsibility thrust on the individual’s shoulders would apply in particular to those who have unprotected sex with multiple partners, share needles with others, or have reason to believe that they might have had sex with someone who has HIV.

As with the current Act, the individual would not be liable if he had — before sex — told his partner of the risk of contracting HIV infection, and if the partner voluntarily agreed to having sex with him.

He would also not be liable if had tested HIV-negative and had not — between the time of the test and sex — engaged in activities that may expose him to the risk, or if he takes “reasonable precautions” such as using a condom.

As with the current law, which makes it an offence for those who know they are HIVpositive to have sex without informing their partner, proving guilt would be difficult. Indeed, just two individuals have been found to run afoul of this law thus far (see box).

But the statistics are worrying the MOH enough to take such strong measures.

Last year, a record 357 Singaporeans were diagnosed with HIV. Men account for 91 per cent of the total, with 68 per cent contracting the virus through heterosexual sex. In the first eight months of this year, another 278 Singaporeans were diagnosed.

Mr Khaw does not think the amendments will further stigmatise HIV patients and pose a barrier to self-testing.

“Right now, they’d rather not test”, preferring to hide behind the mantle of ignorance, he said. The amendments will “make it clear it doesn’t matter if you know you are HIV-positive or not … (you will need to test regularly) as long as your sexual behaviour is high-risk”.

A person who breaches this law would be fined up to $50,000 and/or jailed for up to 10 years.

This latest move against HIV comes as the MOH steps up targeted strategies for different groups. In July, Senior Minister of State (Foreign Affairs and Information, Communications and the Arts) Balaji Sadasivan led a team of non-government volunteers and MOH officials to New South Wales, to study how the state dealt with HIV and Aids. The Government has pledged closer working ties with non-governmental organisations and academia.

Despite public education over the years, rates have continued to hit new highs, resulting in the proposed change to the Infectious Diseases Act. Enacted in 1976, it was last amended in 2003 to cope with the Sars crisis.

It’s not just HIV that is a concern now, as other proposed amendments include those to cope with an impending flu pandemic — as was first reported in this paper in July.

The Health Minister will be empowered to declare a public health emergency in the event of an outbreak or imminent outbreak of an infectious disease that “poses a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability in Singapore”.

Existing legislation allows the prohibition of specific meetings, gatherings and public entertainment. But “in a severe outbreak, a more extensive prohibition on gatherings needs to be quickly implemented across the island”, said the MOH.

The amendments would also empower the Director of Medical Services to close any premises that may be the source of an outbreak. Currently, this extends only to food establishments.

The first reading of the Bill is expected in January. The MOH is conducting a public consultation on the proposed amendments. Log onto www.moh.gov.sg for details. The exercise ends on Nov 9.