Angry Doctor

Tuesday, September 18, 2007

Them again

Why don't those people who are HIV-positive get themselves tested?

Could it be because of the stigma attached to being HIV-positive, or the fact that treatment is expensive and unsubsidised?

Or maybe we just aren't threatening them with enough punishment?

(emphasis mine)

Ignorance of HIV status no defence for high-risk behaviour soon

SINGAPORE: By year's end, all adult male patients admitted to hospitals will be asked if they would like to take a HIV-screening test.

Health Minister Khaw Boon Wan told Parliament on Tuesday he is also changing the Infectious Diseases Act soon so that no one will be able to claim ignorance of one's HIV-positive status as defence against charges of high-risk behaviour.

He said: "All individuals who engage in high-risk sexual behaviour must go for regular HIV-testing. The Infectious Diseases Act makes it an offence for someone who is HIV-positive to have sex without informing his sexual partner of his HIV status. I will soon come to this House to amend the Act to clarify that ignorance of one's HIV status will not be a defence for those who engage in high-risk sexual behaviour."

Currently, 3,338 Singaporeans are HIV-positive, with 278 infected in the first eight months of this year.

But what is worrying, Mr Khaw said, is the prevalence of undiagnosed HIV.

A Health Ministry study conducted early this year found this to be 1 in 350, or a prevalence of 0.28 percent.

In 2005, United Nations AIDS estimated that Singapore's total adult prevalence of diagnosed and undiagnosed HIV patients was at 0.3 percent - higher than the 0.1 percent for Australia, New Zealand, Japan and Korea.

Later this year, Singapore hospitals will start testing adult male inpatients on a voluntary basis.

Some MPs have asked if the screening could be made routine for the entire population, but Mr Khaw said this move may not be cost effective.

Dr Lim Wee Kiak, MP of Sembawang GRC, said: "Perhaps the Ministry could consider adding HIV-testing as part of the testing so the entire male cohort of Singaporeans can be screened regularly when they're doing their re-service or when they go back to NS (national service) at the age of 25, 30 or 35."

Replying, Mr Khaw said: "Population-wide screening or testing will, of course, have a trade-off that we have to make in terms of cost to the screening. And also you don't want to cause unnecessary inconvenience to the vast majority.

"That's why if you study the US CDC (Communicable Disease Centre) recommendation, they are careful in that even in hospital setting, they recommend voluntary but routine screening only if the prevalence is above a certain level.

"And in our case, our adult male prevalence rate has exceeded the threshold, but not for females. That is why we're doing (this) step by step.

"And I think the first step that we'll be doing before the end of this year is to start offering HIV-testing on adult males. With the benefit of those data, we can then plan our strategy, going forward."

Mr Khaw added that so far, no country has made HIV-screening compulsory.



  • Trust our "Opt-Out" Minister to come up with such an idea.

    What next?
    I predict in response to the headline "60-year-old woman is 8th person to die from dengue this year", he will say "Ignorance of dengue is no defence" and throw all her dengue-IgG positive neighbours in jail.

    And how about Hep B and Hep C? I'm sure that is killing more people that HIV. Throw anyone who is found to be Hep B positive in jail too.

    And while we're at it, let's do diabetes. How many legs and kidneys and strokes we could save if only for compulsory annual blood sugar testing! A $100,000 fine should be sufficient incentive if you are found to be diabetic but 'didn't know it'. After all, "Ignorance is no defence."

    On the bright side, if your kid goes to school and catches chickenpox and misses school and fails his PSLE and can't get a high-paying Health Ministerial job, don't worry! "Ignorance of chickenpox is no defence!!" Sue the pants off the other child's parents for letting him go to school!

    By Anonymous Poohbear, At September 19, 2007 1:31 pm  

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