SINGAPORE: He had gone for human immunodeficiency virus (HIV) screening when he was doing his National Service, but 29-year-old Daniel (not his real name) did not think he needed to get tested again.
Seven years later, his current partner urged him to go for a test, and so Daniel decided to take the plunge. Little did he know that his life would change forever - Daniel was diagnosed with HIV in August last year.
"I was in disbelief," he said. "I'm not the kind of person who sleeps around."
Daniel was one of the 455 new cases of HIV infections reported among Singapore citizens and permanent residents in 2015. In an update on the HIV situation in Singapore, the Ministry of Health (MOH) said 18 per cent of the new cases were detected as a result of voluntary HIV screening.
One activist group described the voluntary screening rate as "extremely worrying".
"Eighteen per cent is very low and it is very important to go for testing (and) get diagnosed early. When a person is diagnosed early, and has gone on treatment early, it will improve the treatment results," said Sumita Banerjee, general manager for Action for Aids (AFA).
"When a person is diagnosed later, there are challenges related to treatment, success," she added.
The importance of going for voluntary screening to increase the chance of diagnosing the infection at an early stage was supported by statistics from MOH. Around 66 per cent of the newly-reported cases detected by HIV tests done in the course of medical care provision were already suffering from late-stage HIV when they were diagnosed. On the other hand, of those who were diagnosed through voluntary testing, only around 20 per cent of the new cases were suffering from late-stage HIV.
IGNORANCE, FEAR OF STIGMATISATION CITED AS REASONS FOR LOW VOLUNTARY SCREENING RATE
Many reasons have been cited as barriers to voluntary HIV testing but Ms Banerjee said one main reason is stigmatisation.
"People are worried that if they get tested, if they come out as being positive they would be subject to discriminatory behaviours and attitudes within their social spaces and their social networks," she added.
Leow Yangfa, the executive director of Oogachaga - a counselling group for the lesbian, gay, bisexual, and transgender community - agreed with that perspective. He said fear is also a contributing factor. "What happens after one is tested HIV-positive? For example, will my employer know? Will I lose my job? Can I get another job? What do I tell my family? How much will it cost?"
But there is still a lack of awareness among the general population that has to be addressed. "People don't know the difference between getting tested early and getting tested late," said Ms Banerjee.
A COMMONPLACE FOR HIV TESTING TO INCREASE VOLUNTARY SCREENING RATE
At AFA, the number of people going for HIV testing in 2015 decreased by about 12 per cent to 8,469 from 2014. While efforts such as having talks and seminars could be scaled up to get more people to go for HIV testing, Ms Banerjee suggested working with private-sector companies.
"We need inputs from the private sector where we could maybe have a day when we can go into some places and get people run a HIV testing at a workplace," she said. "We have limited resources as well. So I think there is scope to expand but I think it requires engagement by other players."
Mr Leow said much more could be done to normalise HIV testing and to remove the stigma attached to going for an HIV test. "Perhaps make it as commonplace as going for a cholesterol test or dental check up," he suggested.
In a statement to Channel NewsAsia, a spokesperson from the Health Promotion Board (HPB) said its public education programmes are aimed at raising awareness on HIV or AIDS and its prevention.
HPB has also worked with partner organisations to put in place programmes and campaigns, urging high-risk individuals to go for early and regular HIV testing.
"Persons engaging in high-risk sexual behaviour, such as having multiple sexual partners or engaging in casual or commercial sex, are strongly advised to use condoms to reduce their risk of HIV infection," the spokesperson added.
Daniel's condition was detected while he is still in the early stage of infection. For those who are engaging in high-risk sexual behaviour, he strongly encouraged them to go for early testing.
"You never know until you know. It's always good to know your status because you are not actually saving yourself, you are saving everyone else," he said, adding that the screening process is anonymous.
"You just have to fill in some forms, get a prick on the finger, then wait for another 20 minutes, they will tell you the results straightaway. It was that fast."