An interesting article from Bloomberg (which is usually more associated with business news than with HIV policy) on Singapore's worrying plans to criminalise people who do not disclose they have previously had "unsafe" sex, and have "reason to believe" they may be HIV-positive, previously reported here last September.
Offenders would face as much as 10 years in prison and a S$50,000 fine. Penalties for those who know they're HIV-positive and don't inform their partners, already a crime under legislation that took effect in 1992, would be increased to the same level. No one has been prosecuted under the existing law.
Enforcement would depend on an aggrieved partner filing a complaint and prosecutors proving that a defendant had a history of high-risk sexual behavior.
HIV Ignorance Is No Defense in Singapore Plan to Curb Risky Sex
By Simeon Bennett
Feb. 12 (Bloomberg) -- Every weekend, men from Singapore take a one-hour ferry ride to Indonesia's Batam Island for cheap golf, beer and sex.
About S$70 ($49) hires an island prostitute for the day, compared to just an hour with a Singapore hooker. The trade has contributed to a doubling of Singapore's HIV infection rate in the past 10 years, the government says.
The city-state proposes to curb infections by making it a crime for those who engage in such unsafe practices, and thus have "reason to believe" they may be HIV-positive, to have sex without informing their partners of the risks. United Nations groups and AIDS activists say that would violate human rights and increase infection rates by encouraging anonymous sex.
"Stigma and discrimination are major drivers of the HIV epidemic," Dr. Roy Chan, president of the Singapore advocacy group Action for AIDS, said in written comments on the legislation, which may be considered by parliament this month. "The net effect will be poorer control of HIV infection."
The government disagrees, saying the bill would encourage people to get tested and avoid risky behavior such as having unprotected gay sex or frequenting prostitutes. Violators may be prosecuted even if they don't test positive for HIV.
"We're trying to find a way essentially to ask them to be responsible for their own actions," said Koh Peng Keng, the Health Ministry's senior director of operations. "There is a greater impetus to get more people to come forward for testing.''
No 'Witch Hunt'
Offenders would face as much as 10 years in prison and a S$50,000 fine. Penalties for those who know they're HIV-positive and don't inform their partners, already a crime under legislation that took effect in 1992, would be increased to the same level. No one has been prosecuted under the existing law.
Enforcement would depend on an aggrieved partner filing a complaint and prosecutors proving that a defendant had a history of high-risk sexual behavior.
"It's never the intention to go on a witch hunt," Koh said. "It's going to help in public education."
The government also plans to double spending on AIDS prevention programs to S$8 million annually for the next three years, he said.
Zack, a self-employed electrical engineer who suspects he contracted HIV from a prostitute, isn't convinced of the government's motives, especially considering that gay sex is illegal in Singapore.
"People are going to hide," said Zack, 36, who spoke on condition his real name not be used for fear of losing his business.
Infected for Years
Singapore's HIV infection rate has doubled in the past 10 years. About 1 in 10,000 people were newly infected in 2006, compared with fewer than 0.5 in 1996, according to government statistics. More than half of those diagnosed in 2006 also had AIDS, indicating they'd been infected for years without knowing it, Koh said.
In total, about 7 of every 10,000 people in Singapore have HIV, the government says.
UNAIDS estimates the rate may be as high as 30 once undiagnosed cases are included. That's higher than estimated infection rates in other developed Asian nations such as Japan and South Korea. Singapore's rate is lower than in neighboring nations, including Malaysia and Thailand.
The UN agency calculated its figure from government data for high-risk groups -- including prostitutes and their customers, gay and bisexual men, and intravenous drug users -- and statistics provided by HIV and pregnancy clinics.
UN Opposition
Seema Paul, chief policy coordinator for Geneva-based UNAIDS, said the Singapore bill would force people to get HIV tests, putting them at risk of discrimination and violence if others learned they were HIV-positive.
"We have consistently advocated that HIV testing should be voluntary," she said in an e-mail.
Stuart Koe, chief executive officer of media company Fridae Ltd., said those who contract HIV won't disclose the names of their partners to doctors for fear of being prosecuted, and that will contribute to spreading the disease.
"There'll be a lot of unexpected negative effects," said Koe, who works with AIDS support groups in Singapore and whose company runs a gay Web site.
The groups primarily responsible for spreading HIV in Singapore are men who visit prostitutes, and gay and bisexual men, the government says.
Refusing Condoms
In Batam, brothels occupy storefronts scattered among homes, shops and bars like the PP Banana Laptop Lounge. Pimps ply their trade wherever foreigners are found.
The AIDS rate in the province including Batam is the third- highest in Indonesia after Papua and Jakarta, the national AIDS commission said on its Web site.
Ayu, a 28-year-old prostitute, said most of her clients are married Singaporean men and not all practice safe sex.
"Sometimes the customer does not want a condom," she said, her purple eye shadow sparkling under neon lights. "I cannot force."
Like many Indonesians, Ayu uses only one name.
Koh said the government works with activist groups to educate men before they get on the Batam ferry. Those efforts include handing out condoms and HIV prevention information.
"There's this huge reservoir of people who are HIV-positive and may not know," he said. "Once someone knows they're positive, typically they change behavior."
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