ST Forum: Community-based anonymous STI testing will improve access to sexual healthcare
We welcome The Straits Times’ recent spotlight on sexual health in Singapore (Fear and shame surrounding sexual health means many suffer in silence, say experts, 24 Feb).
In our experience, while there has been significant attention paid to HIV, many are less aware of the more common bacterial STIs such as chlamydia, gonorrhoea, syphilis. These infections are easily missed as they are often asymptomatic, but if left untreated can lead to serious complications, including infertility and increased HIV susceptibility. However, they are treatable and curable when diagnosed early.
AfA had been providing anonymous, community-based HIV testing for over 30 years. For a period of time, we provided anonymous, community-based syphilis testing from 2006 and gonorrhoea and chlamydia from 2020. Unfortunately, in 2023, these services were discontinued due to changes in regulations. While notifications for STIs other than HIV do not require personal identifiers, accessing sexual healthcare can be daunting for many.
This fear is not driven only by statutory reporting requirements. Many of our clients report stigmatising experiences when seeking sexual healthcare from mainstream healthcare providers, especially when discussing sex outside of heterosexual marriage. Others simply feel more comfortable talking to trained peer counsellors in the community setting.
Cost is another significant barrier. Private STI testing can run into hundreds of dollars. Public testing, while subsidised often involves time off work, long waits and increasingly higher costs. For example, the price of a PCR test for gonorrhoea/chlamydia doubled between 2023 and 2025. When affordability, accessibility and privacy concerns intersect, the result is delayed or deferred testing and continued transmission.
We feel that AfA’s community-based service model can address some of these issues. We used to be able to provide STI tests in the evenings and on weekends, and in accessible locations like the heartlands and nightlife hotspots. For many, these were the only settings where they felt safe enough to test. In order to improve sexual health services, we must remove structural and psychological barriers to seeking care.
We urge the Ministry of Health to work with community partners to expand anonymous, community-based STI testing as part of a comprehensive and effective public health strategy.
Fikri Alkhatib
Senior Manager, Clinical Services and Community Research
Action for AIDS Singapore (AfA)