Review of HIV disclosure law to take 'latest scientific evidence' into account: MOH

SINGAPORE: The Ministry of Health (MOH) is conducting a review of the human immunodeficiency virus (HIV) disclosure law and will take the “latest scientific evidence into account”.

This is to ensure continued relevance and alignment with public health policy goals, the ministry said in response to CNA’s queries on Wednesday (Dec 27).

MOH said that it is conducting a review of the Infectious Diseases Act following the White Paper on Singapore's Response to COVID-19 and will take the latest scientific evidence into account when reviewing the sections on HIV.

The ministry has been monitoring medical and scientific advances on the effectiveness of HIV treatment in suppressing the virus.

“Studies show that people living with HIV who have been compliant with treatment and have maintained a stable undetectable viral load have practically no risk of transmitting HIV to their sexual partners,” MOH said.

Singapore currently requires a person living with HIV to inform their partner of the risk of contracting HIV infection before sexual activity takes place.

This current requirement accords “choice and protection” to the partner, who can decide whether to engage in sexual activity and to take precautions if so, such as through the use of condoms, thereby reducing the risk of spreading HIV, the ministry said.

Information relating to the identities of those living with HIV continues to be protected under the Infectious Diseases Act, MOH added.  

However, their identities can be disclosed if they are charged in court, as long as it does not lead to the identification of any victims or witnesses. 

Six people have been convicted for offences under the Infectious Diseases Act since 2019, said the ministry. 

In an update on the HIV and AIDS situation in the country earlier this month, MOH noted that 94 per cent of Singapore’s residents who are living with HIV and undergoing treatment have achieved an undetectable viral load.

Singapore saw 10 per cent more newly diagnosed HIV cases among residents in the first 10 months of 2023 than it did during the same period last year. A total of 188 cases were reported between January and October, MOH said.

This comes after three consecutive years of declining cases, with last year’s number – 202 cases – being the lowest since 1998. There were 250 new HIV infections in 2021, 261 in 2020, and 323 in 2019.

Sexual intercourse remained the main mode of HIV transmission, accounting for 96 per cent of the cases reported in the first half of the year, MOH said.

It added that the most effective way to avoid contracting HIV is to remain faithful to one’s spouse or partner and to avoid casual sex, or sex with sex workers.

The ministry also strongly advised those who have multiple sexual partners or engage in casual or commercial sex to use condoms consistently and correctly to reduce their risk of contracting HIV and other sexually transmitted infections.

“In addition, preventive measures like HIV pre-exposure prophylaxis are highly effective when used as part of a comprehensive HIV prevention strategy,” MOH said.

CHANGE IN LAW WILL ENCOURAGE MORE TO GET TESTED: NON-PROFIT

Professor Roy Chan, the president of Action for AIDS Singapore (AfA), told CNA that the non-profit organisation “would strongly urge and call for laws that specifically mention HIV (to) be fully repealed as they no longer serve their intended purpose”.

“By amending or repealing the law, we hope to reduce the stigma surrounding HIV,” he said. “This will encourage more of those at risk to voluntarily come forward to test.”

Prof Chan said that the Infectious Diseases Act as it stands is “likely to have the effect of increasing HIV-related stigma and discrimination”.

This will lead to poorer prevention and control, instead of reducing HIV transmission, he said, noting that the law also places an “unfair responsibility of HIV prevention on persons living with HIV” and that AfA has “always maintained that sexual health should be a shared responsibility between partners”.

“The law should minimally be amended or repealed such that those who have been compliant with treatment and have an undetectable viral load are not unjustly penalised,” he added.

Prof Chan said that people living with HIV “would be more empowered to develop more meaningful relationships and live their lives to their fullest” if they did not have “the stigmatisation of the persecutory law hanging above them”.

He pointed out that some people living with HIV live with the fear that their sexual partners can report them to the police at any point in time, putting them at risk of being charged if they do not have definitive proof that they disclosed their status.

The decriminalisation of HIV non-disclosure would change this.

“(It) will remove one of the main causes of fear and marginalisation that they are burdened with and will give them more assurance that the law cannot be unfairly used against them,” he said.