Angry Doctor

Wednesday, April 23, 2008

Them 8

The proposed amendments to the Infectious Diseases Act were passed in parliament yesterday.


(emphasis mine)

Amended 'HIV' Act passed
New onus on personal responsibility, power of containment for ministry
Tan Hui Leng


HIV took the top spot in the minds of MPs yesterday when Health Minister Khaw Boon Wan read the amended Infectious Diseases Bill for the second time.

Will an HIV-positive man be charged if he showed up at a hospital's emergency department or if he infected healthcare workers? What about someone with multiple sex partners who practises safe sex? Will he be liable under the amended Act?

The Act was passed as the Minister revealed a new record: There were 422 newly-detected HIV cases last year, up from the 357 in 2006.

The Act now makes it an offence for any HIV-positive person to have sex — regardless of whether he knows of his status — as long as he has reason to believe he has been exposed to the risk of contracting the virus. He is not liable if he has informed his partner, who voluntarily agreed to the risk, or if he practises safe sex or tested negative before the act.

On the amendments to the Act, which stirred strong feelings when announced last year, Mr Khaw said the aim was not to persecute. "It is not our intention to go after every HIV-infected person," he told Parliament. "We will only act if there is a complaint from an aggrieved victim and only after a thorough investigation."

If an HIV-infected patient threatens healthcare staff, he may be charged with criminal intimidation under the Penal Code.

Questions posed by MPs included which types of people would have "reason to believe" they are practising high-risk behaviour.

Mr Khaw's answer: A man who has unprotected sex with prostitutes or other men; one who has unprotected sex with multiple partners; or one who shares injection needles with other drug addicts.

However, a "promiscuous" person who practises safe sex by using condoms every time he has sex is not considered a high risk.

On the latent nature in humans of the HIV virus — which causes Aids — that may affect test results, Mr Khaw said the standard practice is to have a second test after the three-month window. So as to be not liable for an offence, a person must have a negative result outside the window period.

The Health Ministry is setting aside $10 million more in the next two years for non-governmental organisations and healthcare institutions to be used for the care and support of people living with HIV.

The amended Act also expands the power of the Health Ministry to enforce social distancing measures soon after the first cases appear. It allows the selected or even blanket prohibition of gatherings or public entertainment or closure of premises islandwide.


angry doc notes that once again the minister thinks it necessary to make a distinction between "[a] man who has unprotected sex with prostitutes or other men" and "one who has unprotected sex with multiple partners". angry doc still fails to see the difference.

The new law does place the responsibility for testing and disclosure firmly onto the individual, which for a sexually-transmitted infection which may be largely asymptomatic in the early stage does not seem unfair to angry doc.

However, while this may serve to "[send] a strong message that no one has a right to put others at risk through his irresponsible behaviour", the minster already acknowledges that in practice, prosecuting a case will be difficult. Given that difficulty, will the amendments really make a difference in the way people behave, or reduce new cases of HIV/AIDS? angry doc awaits the ministry's next update on the HIV statistics in Singapore.

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2 Comments:

  • "angry doc notes that once again the minister thinks it necessary to make a distinction between "[a] man who has unprotected sex with prostitutes or other men" and "one who has unprotected sex with multiple partners". angry doc still fails to see the difference."

    I read this in the newspaper but failed to notice it.

    So subtle, yet glaring. Thanks for pointing it out.

    By Blogger Lim Leng Hiong, At April 24, 2008 12:15 pm  

  • Unfortunately none of the MPs in parliament seem to have noticed or bothered to point it out. I guess it shows that by and large the law-makers are still viewing HIV/AIDS as a moral issue.

    It might be interesting though to see what happens if someone wrote to the papers and asked MOH to clarify the difference between the two with respect to risk of HIV transmission.

    By Blogger angry doc, At April 24, 2008 4:45 pm  

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