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5 Dec 2006

the challenge and the hope

The 5th Singapore AIDS Conference was themed "HIV in Singapore: The Challenge and the Hope." Fittingly, speakers seized this opportunity to challenge the government and the public to liberalise laws and attitudes towards MSMs and the HIV-positive community.

The 5th Singapore AIDS Conference, held on Saturday, 2 December 2006, was themed "HIV in Singapore: The Challenge and the Hope." Fittingly, speakers seized this opportunity to challenge the government and the public to liberalise laws and attitudes towards MSMs (men who have sex with men) and the HIV-positive community.

From left: Bryan Choong, Oogachaga; Paul Toh of Action for AIDS; Ho Lai Peng, a Medical Officer from Tan Tock Seng Hospital; Dr Stuart Koe, CEO of Fridae.com and gay activist Alex Au.
This began with the Welcome Address by Co-Chair of the Conference and President of AfA (Action for AIDS) Dr Roy Chan. In front of the crowd of 600, he condemned Article 377A of the Penal Code, which makes acts of "gross indecency" between men illegal.

"This legal barrier has made it impossible to target MSM (men having sex with men), and made us unable to address it within schools," said Dr Chan. "It is the main reason for stigma and pushes (the issue) into the closet. It is not surprising that more young gay men are getting infected."

Some believe these comments were directed at Guest-of-Honour Dr Balaji Sadasivan, Senior Minister of State for the Ministry of Foreign Affairs and Ministry of Information, Communication and the Arts. In his previous capacity as Senior Minister for Health, Dr Balaji has professed support for AfA and is a third-time Guest-of-Honour to the Singapore AIDS Conference. He has been criticised, however, for his failure to support subsidies for HIV medicines or acceptance of homosexuality.

In his speech as Guest-of-Honour, Dr Sadasivan gave a fairly formulaic response to Dr Chan, saying, "The committee will take this into consideration."

Yet the issue was not laid to rest. In the Keynote Address which followed, UNAIDS Regional Programme Advisor Dr Swarup Sarkar reiterated the position that "sodomy" laws should be repealed in both his native India and Singapore. These constituted "gaps in prevention," as they made it impossible to communicate a clear message from the government on safer sex. When interviewed, he elaborated that allowing such laws to remain nominally in the books was not an option, as future officials and governments would able to revive such laws as they pleased.

Such declarations of support for the repeal of sodomy laws were all the more remarkable considering the public nature of the biannual conference. Traditionally organised by the AfA and Tan Tock Seng Hospital, this year marked the first time the Health Promotion Board had joined as organiser. The event was held centrally in the Suntec Convention Centre with low registration fees, and the 600-strong audience was a varied group, consisting of activists, health workers, civil servants, volunteers and members of the concerned public, including several schoolchildren involved in the Red Cross.

Dr Chan also discussed the weight of social stigma associated with the disease, leading many HIV-positive individuals to only seek diagnosis and treatment when they had reached terminal stages of AIDS. The twin themes of challenges from institutions and challenges from public perceptions of HIV were to persist throughout the discussions of the day.

One symposium dwelt specifically on problems encountered promoting HIV-awareness amongst women. This was illustrated by Chommad Manopaiboon from the Global AIDS Programme in an earlier plenary, noting that many young Thai women were more afraid of the risk of pregnancy than the risk of contracting HIV. Another speech by Lionel Lee of AfA dwelt on the problems of heterosexual male clients of sex workers, many of whom remain unwilling to associate themselves with the thought of HIV risk and are consequently prone to unsafe sex.

Thankfully, "Hope," the second half of the conference's theme, also received significant attention. Dr Patrick French of the Mortimer Market Centre, London, shared with the audience information on the effectiveness of HAART (Highly Active Antiretroviral Therapy), which has radically increased life expectancies of HIV-positive individuals. Medical professionals appeared in force to discuss new advances and applications of HIV treatment. Many, however, noted the obstacle of convincing world governments that treatment programmes should receive government funding, making them affordable to all.

The 5th Singapore AIDS Conference also featured, for the third time, a symposium on men who have sex with men (MSM). A summary of papers presented at this symposium may be viewed on the next page.
The 5th Singapore AIDS Conference included a symposium on the MSM community. It focused on the MSM community with theme on Stigma and Discrimination, and was chaired by President of Singapore Psychological Society Clarence Singam and Associate Professor Khoo Hoon Eng.

2006 MSM KABP (Knowledge, Attitude, Behaviour and Practices) Survey Results
Dr Stuart Koe, CEO of Fridae.com, began by presenting the results of his 2006 MSM KABP survey. The survey, conducted among Internet-savvy MSMs from Singapore, indicated extremely high awareness of HIV services in Singapore, as well as a very high proportion - 81% - of men having undergone HIV tests.

Condom usage is increasing, yet it remains inconsistent. Moreover, no correlation was shown between having had an HIV test and displaying consistent condom use; HIV+ individuals even displayed higher tendencies to practise unsafe sex. This counters the conventional wisdom that promoting HIV tests will also encourage safer sex practices. Dr Koe recommended a more focussed message on condom use and HIV prevention in public programmes.

AfA MSM Programme
Paul Toh of Action for AIDS summarised the work of the MSM Prevention Programmes. This includes outreach to saunas and bars, an MSM drop-in centre, interactive theatre, hotlines, campaigns and meetings and seminars with MSMs in English and Mandarin. New initiatives included Internet outreach, through the infiltration of gay chatrooms by MSM volunteers who explain safe sex queries online.

Counseling and Support for MSMs in Singapore
Bryan Choong, who oversees the Oogachaga MSM Hotline service, presented on the theme of counselling and supporting MSMs in Singapore. He noted the relevance of this theme to HIV as non-acceptance of sexual identity and low self-esteem is often correlated with unprotected sex behaviour in MSMs. Oogachaga's new phone counselling service now provides support for MSMs who desire to remain faceless. However, challenges to counselling remain, including difficulties in outreach to non-gay identified and less educated MSMs and distrust from the closeted gay community.

AIDS Related Stigma/Discrimination
Ho Lai Peng, a Medical Officer from Tan Tock Seng Hospital, spoke on HIV-related stigma and discrimination. She emphasised the problem of HIV existing as a social phenomenon as well as a physical disease, turning HIV+ individuals into social outcasts and discouraging them to lead healthy lives and seek treatment. Even educated professionals show high levels of misconceptions and irrational fear towards the HIV+. She noted that in order for HIV+ people to be accepted and gain equal rights in employment, more must go public, refusing to remain a faceless community.

Overcoming Barriers to HIV Prevention for MSM
Gay activist Alex Au shared the results on his online study amidst politically aware young people. Worryingly, the majority did not regard HIV as a serious issue for Singapore. HIV infection was also associated as stemming from the actions of others, not as the consequence of one's own behaviour. Heterosexuals also found it harder than gay men and women to understand how laws against homosexual acts have a direct bearing on HIV infection rates.

In a question-and-answer session, Alex Au and Dr Koe expressed concerns that the National AIDS Council includes no grassroots representation from at-risk communities like MSMs. They urged audience members to write in to schools and newspapers to correct misinformation on HIV prevention, such as misreported statistics on condom effectiveness. They concluded by asking those present to extend their acceptance to the HIV+ and to spread awareness of the issues by all means possible.

Reader's Comments

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10. 2006-12-16 11:24  
In response to Post #5 stan says (Posted : 11 December 2006 19:59), yes I am suggesting that the official are wrong. It is just the tip of the iceberg. I have lived long enough to make this comment as the people I know ranges from 19 to 71 and from all walks of life
- less than 3 % are comfortable to talk about STD.
- less than 10% has knowledge of STD.
- more than 90% are too embarassed to be seen at Kelantan Lane.
- More than 90% lie through their teeth to stay competitive in this look orientated lifestyle.
- More than 90% think that the survey can be tracked in one way or another.

Talked to all your friends about serious issues like HIV. Note their reactions. Then make your own conclusion. It will be a revelation.
9. 2006-12-11 19:59  
gymhotbod, I'm guessing that people would be more inclined to admit that they are HIV+ in an anonymous survey than in a public profile with photos for everyone to see. Same reason as official stats that say 2000 or so people in spore have HIV/AIDS but only the late Paddy Chew has come out so far. surely you're not going to suggest that the official stats are wrong because the straits times has not recorded that anyone (besides Paddy) is HIV+.

8. 2006-12-07 08:44  
I personally suspect that the Singapores Gvernment's policy, of not subsidising the precious live saving antiretroviral drugs and Article 377A of the Penal Code, is their way of exterminating the gay population in Singapore, or at least curb the "immoral" gay activities in Singapore. Maybe by "promoting" the spread of HIV among "undesirable" elements, Singapore can be the "perfect" society in 10 years as what Dr Balaji Sadasivan states about his vision for his programe.

By the their very actions or inactions, they have already passed a death sentence on the gay population. Many now do not want to know if they are HIV+, and live in a life of denial and lies.

The survey presesented by Fridae.com is highly flawed as everyone in that survey tell ties. I have yet to see anyone in Trevvy.com or Fridae.com openly stating that they are HIV+. So what can we say of the people who contributed to this statistic ???

On the AFA statistic, the contribution are only from those who are highly ware of HIV or those who suffers from Obsessive Compulsive Disorder and get themselves tested 2-4 times a year. Some even go there for test so that they can engage in unsafe sex later knowing that they a HIV-.

Food for thought

7. 2006-12-06 21:34  
On the matter of explicit education, given the choice between being prudish and saving a life (and more especially thousands of lives) any reasonable person would choose the latter. That is why even in Thatcherite "Victorian Values" Britain, the government was persuaded by NGOs to take a practical and non squeamish approach to education on the subject. And Princess Diana's stance of meeting and hugging gay people with AIDS did a lot to dispel the stigma.

All the Singaporeans I've met (which is a lot) are good, decent, caring people, whatever their beliefs, and I believe Singapore has led the way in the region in many respects in trying to reduce prejudice, for example, against disabled people, or ethnic /religious difference.

Surely most Singaporeans are prepared to cope with a little embarrassment if it saves lives and suffering, once they know the facts.
6. 2006-12-06 10:51  
The whole process unfolding now is a conundrum. Perhaps the government sees it but chooses not to for ease of policy.

Sexual diseases is a human affectation that affect anyone who has sex, morally or immorally. It's not a simple black and white issue that can be addressed with simplistic measures.

Condoms are fine with casuals but how does one introduce protection with one's life partner and spouse without inciting suspicion and offence? When do u start?
And if couples intend to start a family, then the risk surface again. The deal here lies in faith that both parties have been faithful and safe before going into the naturale. All it takes is one time of error. How then will they be judged? Together with the rest of the sinful outcasts?

This simply illustrates that anyone can get HIV on the right and wrong reason and circumstance. It's not a case of simply advocating safe sex. It's much more than lip service. Whilst health campaigns around the world are crusading against unsafe sex, people are still getting infected and living and dying of Aids. So while the campaigns are all well and good, something more urgent and necessary must be addressed. What significant support structures are set up to help those already infected? How can the authorities work with the already traumatised and depressed infected individuals to elevate their already diminished self worth?

How can any self respecting government truly be of true conscience when in the absence of subsidies and support groups, its own infected citizens need to travel to another country for cheaper drugs and medical care. It's a national joke. There lies in itself discrimination and stigma already created by the laws that govern the country.

An inclusive society means it includes all its citizens, for better or for worse. You do not abandon the sons and daughters of the country who has contributed to its progress and prosperity, one way or another.
Hmmm...or does that promise only hold true on Animal Farm? Damn...they're just pigs I tell you...just pigs!!!
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1. 2006-12-06 01:46  
There hv few words & who can get HIV.?

1.. Str8 guy or Marry man go looking Chicken or Dick & by Black-Line & Make sure can something wrong with HIV too.. ( coz so many ppl=pep[le f**K a nite in back-line )

2.. Gay w gay ( M4M ) ...

3.. Lady w lady or Girl w girl ( L4L or G4G ) ...

This all could carefully & play with safe points.

wish u all play safe in all time & also care other people are you friends tooo...

My id: ian88. / ian_sg. / s1168.
If any my mistake & pls 4get me a words wrong 2 me.... Thz all reading.


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