17 Nov 2004

Singapore Will Not Promote Condoms To Fight AIDS

Medical News
17 Nov 2004

Singapore will not sponsor a "publicity blitz" to promote condom use in order to prevent HIV transmission "out of respect" for residents who hold "conservative views" on sexual behavior, a senior health minister said on Sunday, AFP/Yahoo! News reports (AFP/Yahoo! News, 11/14).

Balaji Sadasivan, senior minister of state for the country's Ministry of Health, said that an "in-your-face" approach is not the best option to educate people about condom use and HIV/AIDS in the country, Singapore's Straits Times reports (Quek, Straits Times, 11/14).

Sadasivan last week announced that Singapore is facing an alarming AIDS epidemic and that if efforts to fight the disease are not implemented, the number of HIV cases in the country would reach more than 15,000 by 2010 (Kaiser Daily HIV/AIDS Report, 11/12).

"Sexual behavior is a private thing, it's something people don't want to talk about. It's not discussed in polite society," Sadasivan said (Straits Times, 11/14).

He added, "To educate people, you don't have to be offensive" (Channel News Asia, 11/13).

However, Sadasivan did not rule out a public campaign promoting sexual abstinence and proper condom use, the Khaleej Times reports (Khaleej Times, 11/14).

Action For AIDS criticized the government for not publicly promoting condoms despite the success of such campaigns in Thailand and Cambodia, the Straits Times reports.

"We need a massive campaign to let people know that it is all right to use condoms. We need to de-link condom use from promiscuity," AFA Vice President Brenton Wong said (Khalik, Straits Times, 11/13).

Action for AIDS Dispute

Sadasivan last week criticized AFA for not taking a tougher approach to HIV/AIDS education in the country and for using "misleading information" about HIV/AIDS on its Web site, according to the Straits Times (Straits Times, 11/14).

Wong defended the group, saying, "Over the last 16 years, AFA has tried to address the multitude of issues surrounding AIDS as comprehensively as possible" (Khaleej Times, 11/14).

Wong said that AFA had been limited by a lack of resources, adding, "We're all not doing a good enough job in tackling the AIDS problem in Singapore." Wong said that AFA would "welcome more partners and the chance to sit and talk to the health ministry on expanding our role." The statement on AFA's Web site -- which says, "Not everyone who has sex contact with an infected person will get infected" -- could "actually make things worse by promoting unsafe sex," Sadasivan said last week (Straits Times, 11/13).

AFA said that although the statement was supported by medical and scientific research, the group will review the wording because of Sadasivan's concern (Straits Times, 11/14).

Government Subsidies

Wong recommended that the government provide subsidies for antiretroviral medications to reduce the cost burden of proper treatment for HIV-positive people, according to the Straits Times.

Wong added that subsidies also could help with HIV/AIDS prevention efforts, as many people refuse to undergo HIV testing because they cannot afford treatment, the Straits Times reports.

"People will be more ready to step forward to get screened if they can get help," Wong said (Straits Times, 11/13).

However, Sadasivan said that HIV/AIDS is not a "privileged disease" and that HIV-positive patients are entitled to the same subsidies as patients with other diseases. "There is no reason why an AIDS patient should be more special than a heart or kidney patient," he said, adding, "We treat all equally" (Khaleej Times, 11/14).

Lack of Experts

There are only 11 infectious disease specialists in Singapore, which doctors say is "not enough" to adequately address the growing HIV/AIDS problem in the country, the Straits Times reports.

More money, research and expertise is needed to tackle threats from HIV/AIDS and other infectious diseases that are "becoming rampant," Dr. Leo Yee Sin, the clinical director of the country's Communicable Disease Center, said. Sadasivan last week called for the country's CDC to become more involved in HIV/AIDS prevention to tackle the epidemic, but Leo said that the agency does not have the "expertise to do the job right now," according to the Straits Times (Basu, Straits Times, 11/15).

Infectious disease public health has been a "neglected field" for years, Leo said, adding that the center needs "many more" specialists to continue its work, Agence France-Presse reports.

In order to step up prevention efforts, the center also would have to review its current strategy, which focuses only on treatment (Agence France-Presse, 11/14).

"Treatment has been our forte. What we've been trained for is patient care and that will remain our focus," Leo said. To expand into prevention and "draw up and implement strategies," the group would need additional resources and would not focus only on HIV/AIDS, Leo said, according to the Straits Times (Straits Times, 11/15).


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