SINGAPORE CONSIDERS TOUGHER HIV LEGISLATION

UNCLAS SECTION 01 OF 02 SINGAPORE 002584 SIPDIS SENSITIVE E.O. 12958: N/A TAGS: KHIV TBIO PHUM ECON SN SUBJECT: SINGAPORE CONSIDERS TOUGHER HIV LEGISLATION REF: A. 04 SINGAPORE 395 ¶B. SINGAPORE 1839 ¶1. (U) SUMMARY: Singapore is considering legislative changes that put the onus on individuals to be aware of their HIV status and responsible for protecting others from infection. This comes on the heels of Singapore's increase in HIV cases in 2004 from 1,192 to 1,503 infections among the country's 4.2 million people. Most experts here believe that another 2,000-3,000 HIV cases remain undiagnosed. END SUMMARY. New HIV Infections are Few, but the Number is Increasing -------------- -------------- ¶2. (U) Singapore reported a 28% increase in newly diagnosed HIV infections with 311 cases in 2004, compared to 242 new cases diagnosed in 2003, bringing the official total of HIV- positive individuals in Singapore to 1,503. Experts estimate the actual number of HIV cases is between 3,000 and 5,000. Even using unofficial estimates, less than 0.12% of Singapore's population has HIV; however, if this trend continues, there could be more than 15,000 HIV-infected individuals in Singapore by 2010. ¶3. (U) The most at-risk population group for HIV is heterosexual, single males, aged 30-49, (206, or 66%, of last year's new cases). Among these, 171 individuals had sex with prostitutes or engaged in casual sex. Further analysis of Singapore's HIV statistics is available on the Ministry of Health website at www.moh.gov.sg. GOS Considers Tougher Legislation -------------- ¶4. (SBU) The Government of Singapore (GOS) is considering legislation to put the onus on HIV-positive individuals to not spread the disease to others. Key proposals include: -- Mandatory Pre-Natal Testing: Since November 2004, doctors must offer optional HIV tests to pregnant women; 98% opt to have the test. New legislation would make the pre-natal HIV test mandatory. -- Mandatory Pre-Marital Testing: Over half of HIV-positive women are married and experts here believe most contracted the disease from their husbands. New legislation would require an HIV test before marriage. -- Relaxation of Doctor-Patient Confidentiality: As of July 2005, Health workers must inform the spouses of patients with HIV regardless of whether the infected person agrees. The GOS is considering legislation to compel patients to disclose further information on sexual history so that doctors can inform other sexual partners. -- Criminalizing "Reckless Transmission": It is illegal for diagnosed HIV-positive individuals to have sex with a person who is unaware their status. MOH is considering legislation to make individuals criminally liable even if they unknowingly transmit the virus. MOH Deputy Director of Epidemiology and Disease Control Dr. Jeffrey Cutter told EconOff that strong public opposition has made this legislation highly unlikely. Educational Efforts Expanding -------------- ¶5. (U) The MOH collaborates with outside organizations, including the American Chamber of Commerce, to educate on HIV prevention through its statutory arm the Health Promotion Board (HPB). HPB is the main driver for national health promotion and disease prevention programs. ¶6. (SBU) Senior Minister of State for Health Balaji Sadasivan announced formation of a Singapore "AIDS Alliance" at an American Chamber of Commerce meeting on August 25. The AIDS Alliance will coordinate the efforts of government, business, health workers, and community organizations to promote AIDS education and end discrimination against HIV- positive individuals. ¶7. (SBU) The vast majority of Singaporeans contract HIV through sexual means. Still, concerns about negative public reaction prevent MOH from undertaking safe sex education promoting condom use; MOH opts instead to promote abstinence and monogamous sexual activity as prevention methods. Some activists here argue that educational programs directed at condom usage could decrease the infection rate more effectively than this or legislation aimed at already infected individuals. -- HIV infections are not high among youths (age 10-19) but incidence of other sexually transmitted infections (including gonorrhea and syphilis) has upsurged, a sign of increased unsafe sexual activity. -- A 2004 National University of Singapore study found that while "almost all" Singapore men use a condom when engaging in casual sex in Singapore, only about half will use a condom when abroad. Singaporean men do engage in sex tourism; the nearby Indonesian island of Batam, for example, is a popular destination for Singapore men seeking inexpensive prostitutes, and has a higher rate of HIV infections than Singapore. Singapore Actions to Stem Spread Have Economic Impact -------------- -------------- ¶8. (U) The Singapore economy has benefited from homosexual- oriented consumerism, despite the illegality of homosexual acts. However, the GOS has recently cancelled gay parties and concerts on the grounds that reported sexual activity at earlier homosexual gatherings contributed to the HIV infection rate. (NOTE: The Nation Party, a popular gay and lesbian festival held annually in Singapore since 2000, hosted 8,000 people and generated an estimated S$6 million (US$3.63 million) in tourism revenue in 2003. END NOTE.) ¶9. (SBU) COMMENT: Authorities are worried about the increased rate of HIV, and are responding by trying to legislate responsible behavior, even if some civil liberties like personal privacy are encroached upon in the process. While it is too early to speculate whether new infections in 2005 will be higher or lower than 2004 numbers, more individuals are taking HIV tests, an indication that government efforts to increase HIV awareness among the population is working. END COMMENT. Lavin