ZONE:

There was a significant increase in the number of homosexual and bisexual clients (men who have sex with men or MSM) seen at the Anonymous HIV Testing and Counselling Centre run by Action for AIDS in the first six months this year compared with the same period last year - a 48.7 percent jump from 347 in 2003 to 516 in 2004.

Jan-Jun 2003
� No. MSM Clients: 347
� % MSM Clients: 27.7

Jan-Jun 2004
� No. MSM Clients: 516
� % MSM Clients: 30.7

The proportion of MSM clients seen at the centre has, in fact, been gradually increasing over the past few years:
� 24.4 percent in 2002,
� 28.0 percent in 2003, and
� 30.7 percent in the first six months of 2004.

The bad news...
Twenty-two MSM tested positive from January to June 2004, accounting for 78.6 percent of all the positive results. That's almost two and a half times the number of MSM who tested positive during the same period last year. For the whole of 2003, 26 MSM tested positive, 68.4 percent of all the positive cases last year.

HIV prevalence among MSM clients from January to June this year was 4.41 percent, compared with 1.74 percent prevalence for the first six months last year and the 3.51 percent prevalence rate for the whole of 2003. Put another way, almost 1 in 20 MSM getting tested were HIV positive.

Jan-Jun 2003
� Total No. of HIV+ MSM Clients: 6
� % of HIV+ MSM among all HIV+ clients: 60.0
� HIV Prevalence (% of all MSM Clients): 1.74

2003 (whole year)
� Total No. of HIV+ MSM Clients: 26
� %. of HIV+ MSM among all HIV+ clients: 68.4
� HIV Prevalence (% of all MSM Clients): 3.51

Jan-June 2004
� Total No. of HIV+ MSM Clients: 22
� %. of HIV+ MSM among all HIV+ clients: 78.6
� HIV Prevalence (% of all MSM Clients): 4.41

Who tested positive this year?
They're relatively young - 11, or half of them, were below 30 years of age. Although there are fewer testing positive in the 40 to 59 age group, the prevalence rate for this group is also worryingly high.

No. of MSM tested
� under 30 years old: 244
� 30-39 years old: 192
� 40-59 years old: 51
� Unknown: 10

No. of HIV+ MSM
� under 30 years old: 11
� 30-39 years old: 7
� 40-59 years old: 4
� Unknown: 0

HIV Prevalence (%)
� under 30 years old: 4.5
� 30-39 years old: 3.6
� 40-59 years old: 7.8
� Unknown: 0

The prevalence of HIV infection among Singaporean MSM was higher than other nationals.

No. of MSM tested
� Singaporean / PR: 381
� Malaysian: 30
� Others: 76
� Unknown: 12

No. of HIV+ MSM
� Singaporean / PR: 18
� Malaysian: 1
� Others: 3
� Unknown: 0

HIV Prevalence (%)
� Singaporean / PR: 4.7
� Malaysian: 3.3
� Others: 3.9
� Unknown: 0

Four of the 22 HIV-infected persons had been infected very recently. (This was indicated by an initial indeterminate result for the confirmatory Western Blot test.)

Seven still had regular partners at the time they tested.

Four admitted to having participated in orgies and taking recreational drugs.

Two came for the test because a partner had tested HIV-positive.

Dangerous Testing Practices
There have been some reports of MSM in Singapore acquiring rapid testing kits to test themselves before having unprotected sex, which is silly and ill-advised. Such practices may lead to adverse consequences.

HIV testing should only be done in an appropriate setting, by trained individuals who offer pre- and post-test counselling and accurate information about HIV infection and AIDS and HIV testing.

This is especially crucial with respect to testing at the appropriate time and to understanding the meaning and implications of negative and positive results, including false negative and false positive results.

Final Note
Reliable sources indicate that the Communicable Disease Centre is also seeing a dramatic rise in the number of MSM testing HIV positive. They are seeing more HIV infections among younger MSM. Some are getting the infection from steady or regular partners (including boyfriends). Several have implicated getting infected at 'private sex parties' and at gay saunas where sex with multiple anonymous partners and the use of recreational drugs is frequently reported.

These data from the Anonymous HIV Testing and Counselling Centre together with other data clearly indicate an upward trend in HIV infections among MSM in Singapore.

These numbers are likely to rise even further unless MSM here are more conscientious about having safer sex, even with regular partners, and being extra cautious in situations involving the consumption of recreational drugs.

Details of the Anonymous HIV Testing and Counselling Service:

Venue: DSC Clinic, 31 Kelantan Lane (off Jalan Besar, near Bugis), #01-16, Singapore 200031
Day/Time: Wednesday 6.30 - 8pm/ Saturday 1 - 4pm (except on public holidays)
Cost: S$20.00

No personal particulars are recorded even if the result is positive. Trained volunteers offer pre- and post-test counselling. Test results are available within 20 minutes of doing the test.

Please call Roger at 96952144 or email MSM_Resources@yahoo.com.sg for more information.