Angry Doctor

Tuesday, August 07, 2007

Sick, sick people 13


I guess it's too much to hope for that Dr Chin will pass up on an opportunity to give his professional opinion on how we should control 'this scourge of HIV', isn't it?



Law and public education should go hand in hand in dealing with HIV

I WRITE in response to the letter by Mr Paul Toh, ' 'Bug chasers' or 'gift givers' will not be let off lightly by the gay community' (ST, Aug 2),

His statement that because of our laws, especially Penal Code Section 377A, the message of 'safe sex' cannot be effectively communicated to those at risk is flawed.

Take the example of heroin drug abuse; laws prohibit its use. Using the same line of argument as Mr Toh's, it would then not be possible to effectively communicate the message 'Do not use drugs'.

However, the message against drug abuse has been effectively communicated to all segments of society. Everyone knows that it is wrong to use drugs and if you are caught you will be punished.

In the United States, 99 per cent of the population understands that you can get HIV through unprotected sex. In the United States' CDC Mortality and Morbidity Weekly Report, June 24, 2005, Issue, a study of 1,767 MSM men showed that one in four men had HIV. The number of MSM men getting HIV continues to rise despite all efforts.

This shows that education and awareness of HIV by itself cannot bring down the infection rates of HIV. If it were so, then data from the US should show falling rates of infection rather than rising rates.

An example of the inadequacy of public education and awareness alone is the phenomenon of 'bug chasing' and 'gift giving' at 'bug parties'.

This reckless behaviour is found among men who engage in anal penetrative coitus. Men, who knowing that they have HIV, yet still engage in unprotected anal penetrative coitus. This practice of having deliberate unprotected anal sex has the potential to cause widespread HIV infection. These men know that it is wrong and yet persist in doing it.

The number of MSM men having HIV in Singapore is about 1 in 20. It is still unacceptably high. However, compared to the US, we have a five times lower rate of infection.

It is our society's stance against such immoral and socially irresponsible behaviour and our laws, especially Penal Code Section 377A, that account for this difference.

Evidence in point:

1) Some time ago, the then Senior Minister of State for Health, Dr S. Balaji, stated that the relaxation of our laws against 'gay' events led to a spike in the number of HIV cases among MSM men from 2003 to 2004.

2) We have the lowest rate of heroin and drug abuse in the world because of our strict laws and tough stance against drug abusers.

Sometimes tough love is needed for those who, despite their being aware of their irresponsible and reckless behaviour, do not want to change.

The law and public education should go hand in hand in dealing with this scourge of HIV.

Dr Alan Chin Yew Liang


angry doc wonders if Dr Chin is trying to confuse the issue, or if he is just confused over the issues at hand.

The spread of HIV in Singapore is neither exclusively by men having sex with men (MSM), nor is it predominantly by men having sex with men.

We recognise the 'wrongness' of knowingly subjecting another person to the risk of a serious infectious disease like HIV, which is why it is an offence to do so under the Infectious Diseases Act, which states that:


Sexual intercourse by person with AIDS or HIV Infection
23. —(1) A person who knows that he has AIDS or HIV Infection shall not have sexual intercourse with another person unless, before the sexual intercourse takes place, the other person —

(a) has been informed of the risk of contracting AIDS or HIV Infection from him; and
(b) has voluntarily agreed to accept that risk.

(2) Any person who contravenes subsection (1) shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $10,000 or to imprisonment for a term not exceeding 2 years or to both.


The law does not discriminate between homosexual and heterosexual intercourse, and indeed if you go on the read the whole section, it does not discriminate based on age, and is in fact that it is meant to cover both heterosexual and homosexual sex (angry doc is just to shy to quote the sections here...).

So why does Dr Chin attribute our lower rate of HIV infection in MSM compared to that of the US to Section 377A, and not Section 23?

More importantly, if it is 'the HIV scourge' Dr Chin is so concerned about, shouldn't he be championing the enforcement of Section 23, which covers HIV-positive persons of all ages and orientation, rather than Section 377A, which covers even MSM who are HIV-negative?

Labels: ,

posted by angry doc at 6:00 pm

23 Comments:

  • A simple search on www.moh.gov.sg reveals Dr. Chin's background. Not a grand and almighty black tag! Well, at least now we know where not to go for intelligent advice.

    By Blogger blacktag, At August 07, 2007 10:02 pm  

  • Hi Blacktag,

    Do you mean that Dr. Chin is not a medical doctor?

    I can't find his name using MOH website search.

    By Blogger The Key Question, At August 08, 2007 12:07 pm  

  • This comment has been removed by a blog administrator.

    By Anonymous Anonymous, At August 08, 2007 1:14 pm  

  • Let's just look at Dr Chin's data and arguments, and not his background or qualifications, shall we?

    By Blogger angry doc, At August 08, 2007 2:24 pm  

  • Angry doc says, "The spread of HIV in Singapore is neither exclusively by men having sex with men (MSM)..."

    That is true, but even angrydoc must concede that if gays constitute just 2.5% of the population but account for 30% of the HIV cases, that indicates a serious problem in the homosexual lifestyle. The gay community should first look into why they carry a much higher risk of HIV compared to the rest of the population.

    By Anonymous Anonymous, At August 08, 2007 2:35 pm  

  • No, we should look into what is common between people who have HIV, be they homosexual, heterosexual, or bisexual, and work on educating people on the risks and how to reduce them.

    By Blogger angry doc, At August 08, 2007 3:10 pm  

  • Let's just look at Dr Chin's data and arguments, and not his background or qualifications, shall we?

    Of course. I asked about it because I'm not familiar with the term "grand and almighty black tag". Just to clarify.

    By Blogger The Key Question, At August 08, 2007 6:29 pm  

  • I wasn't referring to you, leng hiong, but the deleted comment.

    Traditionally, a specialist doctor wears a black name-tag (like Dr Mahatir); Dr Chin is, as far as I know, a practising doctor.

    By Blogger angry doc, At August 08, 2007 7:04 pm  

  • This comment has been removed by a blog administrator.

    By Blogger The Key Question, At August 08, 2007 7:47 pm  

  • Er... the link to that article *was* the reason why I deleted that comment...

    By Blogger angry doc, At August 08, 2007 7:49 pm  

  • Er... the link to that article *was* the reason why I deleted that comment...

    I understand.

    By Blogger The Key Question, At August 08, 2007 7:52 pm  

  • Thanks.

    Think you can get your hands on the new Dawkins documentary?

    By Blogger angry doc, At August 08, 2007 7:53 pm  

  • Of course Dr Chin's background is entirely relevant, considering he misses no opportunity to declare his own profession to the adoring world. Strangely enough, most loc-tors seem to share the same affliction, extending all the way to the obituary pages.

    Sick people are sick, as is declared in the title of the post. To what else would the title be referring to, really?

    By Blogger blacktag, At August 08, 2007 9:09 pm  

  • Think you can get your hands on the new Dawkins documentary?

    I'll just wait for it to appear on Google Video, like his previous documentary.

    By Blogger The Key Question, At August 09, 2007 11:11 am  

  • angry doc said...

    No, we should look into what is common between people who have HIV, be they homosexual, heterosexual, or bisexual, and work on educating people on the risks and how to reduce them.

    No, we should apply the same logic as Dr. Chin and point to the horrendous HIV affliction in Africa where it is spread mostly by heterosexual men and accordingly vote to criminalise heterosexual sex.

    These heteros who patronise prostitutes at Geylang and Orchard Towers are thoroughly disgusting.

    The hetero lifestyle is so uncool.

    PZ

    By Anonymous Anonymous, At August 10, 2007 10:31 am  

  • No, we should look into what is common between people who have HIV, be they homosexual, heterosexual, or bisexual, and work on educating people on the risks and how to reduce them.

    The prevalence of HIV in the MSM population is higher than the general hetero population in singapore. IT should be investigated. It is not about discrimation. It is about facts and figures on why there is higher risk in the MSM population. Whether gay community like it or not the percentages are higher in singapore. I think ignoring the stats is not doing justice to acknowledge the problem.

    I have no idea why should we just look at the similiarities and not the differences. I think we should look at both similiarities and difference to get a better idea of how the disease is spread.


    Your objectivity is tampered by your crusade against homophobia.

    palmist

    By Anonymous Anonymous, At August 11, 2007 1:14 pm  

  • palmist,

    HIV transmission is a function of behaviour, not sexual orientation.

    By all means look at the difference in behaviour between people with HIV (homo- or heterosexual), and those without HIV (homo- or heterosexual); but to single out homosexuals as the people who need attention more than heterosexual is to confuse the epidemiology of the disease for its mode of transmission and therefore prevention.

    I'll draw an analogy (which is of course imperfect because all analogies are imperfect...):

    Every year the Ministry of Education releases figures on how well children do in their exams, and they break the figures down by race.

    Supposing you notice that Malay children tend to do worse than Chinese children.

    Do you then try to find out how the 'Malayness' of the children predispose them to doing worse?

    Or do you try to look at why the Malay children who don't do well don't do well, and why the Chinese children who don't do well don't do well, and see what the common underlying factor is (like family make-up or family income)?

    As I wrote time and again, every piece of information that is presented to you is there because someone wants to influence the way you think and act.

    By Blogger angry doc, At August 11, 2007 2:47 pm  

  • HIV transmission is a function of behaviour, not sexual orientation

    And that is why I use MSM instead of homosexuals. However you must agree that there is a correlation between sexual orientation and sexual habits/behaviours.

    but to single out homosexuals as the people who need attention more than heterosexual is to confuse the epidemiology of the disease for its mode of transmission and therefore prevention.

    the only reason why more attention is paid to them is because their prevalance in terms of percentage is higher compared to that of the heterosexuals counterparts. That is something worth looking at. Why they should have a higher infection rates. You can never find the answer by just looking at what is common. For eg if malays have a higher incidence of diabetes you will never find your answer if you just look at what is common with the chinese population.

    Beside there is no confusion of the epidemiology. MSM most common form of sex is anal sex and heterosexual is vaginal sex. There is already a difference and this should be taken into account.

    Do you then try to find out how the 'Malayness' of the children predispose them to doing worse?

    The reason to find the difference is to solve the problem not to box them into stereotype of 'malayness'. If for the sake of political correctness we sacrifice the truth then we are avoiding the problem. We can never move on if we fear we might open a can of worms. How to solve a problem without first understanding it and acknowledging it?

    Or do you try to look at why the Malay children who don't do well don't do well, and why the Chinese children who don't do well don't do well, and see what the common underlying factor is (like family make-up or family income)?

    If you look at what is common only you may miss out other factors which contributes to the difference. Like I say do both look at what is different and what is common to get a complete picture.

    As I wrote time and again, every piece of information that is presented to you is there because someone wants to influence the way you think and act.

    If the stats are true then I think it would be more helpful to look at both the similiarities and differences. You wrote out of political correctness to prevent discrimination. However I feel that there are other better ways to prevent discrimination. It is how we handle the data and finding that leads to discrimination and not the data themselves.

    palmist

    By Anonymous Anonymous, At August 13, 2007 8:54 am  

  • "you must agree that there is a correlation between sexual orientation and sexual habits/behaviours."

    "MSM most common form of sex is anal sex and heterosexual is vaginal sex. There is already a difference and this should be taken into account."

    Yes, orientation correlates with behaviour, but how is unprotected anal sex between a man and a woman different from unprotected anal sex between two men?

    If it is the sex act itself which carries a higher risk, why focus on the orientation or gender of the participants?

    Like I wrote earlier by all means look at the different and common factors between those who have HIV and those who do not, but by drawing the line at orientation, you are already saying that it is this difference in orientation that accounts for the difference.

    Look at the MOH HIV Statistics again. It also lists prevalence by age, gender, race, and marital status. Why aren't any of these used as the dividing line in the current debate?

    What about other factors which may account for the differences, like number of partners, frequency of condom use, age of first intercourse, etc.?

    The fact is if you view the prevalence as a function of each of the factors above, at least a few will give you significant difference in HIV prevalence, so like you said, the key is finding the differences which we can change to help curb the spread of HIV.

    Currently our knowledge points to multiple partners and unsafe sex practices as the factors which are the main factors, and these things cut across orientation divide.

    To continue with my analogy, to continue to look at the statistics with orientation as a divide is to continue to look at race as a divide even after we found out that among the Chinese and Malay children, it is those who come from lower-income families who do worse.

    By Blogger angry doc, At August 13, 2007 10:25 am  

  • Yes, orientation correlates with behaviour, but how is unprotected anal sex between a man and a woman different from unprotected anal sex between two men?

    There is no difference but it not all heterosexual engagae in anal sex.

    The analysis now is sexual behaviour. I think sexual behaviour of MSM and heterosexual are good data to have. I don't see why we should exclude this data.

    If it is the sex act itself which carries a higher risk, why focus on the orientation or gender of the participants?

    just another way of analysis. The more way of analysis the better you understand by looking at the problem with different angles.

    Like I wrote earlier by all means look at the different and common factors between those who have HIV and those who do not, but by drawing the line at orientation, you are already saying that it is this difference in orientation that accounts for the difference.

    No it is not the orientation but a characteristic of the orientation that might lead to the difference.

    If you want to find out why cantonese has a higher incidence of nasal pharnygeal carcinoma would you not want to do a comparative study between cantonese and the other dialect groups to find out why it is so? In the same way if the homosexual population has a higher percentage of HIV carriers would you not want to find out why so you can effective prevent the high percentage? So why not?

    Look at the MOH HIV Statistics again. It also lists prevalence by age, gender, race, and marital status. Why aren't any of these used as the dividing line in the current debate?

    Well because the topic began with your post of homosexuality. I think should analyse all the data.

    Currently our knowledge points to multiple partners and unsafe sex practices as the factors which are the main factors, and these things cut across orientation divide.

    yes but what about psychological aspects? I believe understanding how a heterosexual thinks and how a homosexual thinks would give more stratgies to encourage safe sexual practices.

    To continue with my analogy, to continue to look at the statistics with orientation as a divide is to continue to look at race as a divide even after we found out that among the Chinese and Malay children, it is those who come from lower-income families who do worse.

    again it depends of what you do with the data you find out. HOw people want to use the data. It is a double edge sword. People can use it for good or discrimination.

    palmist

    By Anonymous Anonymous, At August 15, 2007 12:48 am  

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