Update on the HIV/AIDS situation in Singapore 2013

2 June 2015

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Characteristics of new cases of HIV infection reported in 2013

1. In 2013, 454 new cases of human immunodeficiency virus (HIV) infections were reported among Singapore residents[1]. This brings the total number of HIV infected Singapore residents to 6,229 as of end 2013, of whom 1,671 had died.

2. Sexual transmission remains the main mode of HIV transmission among Singapore residents. Of the 454 cases reported in 2013, 428 cases acquired the infection through the sexual route, with heterosexual transmission accounting for 40% of infections, homosexual transmission 46% and bisexual transmission 8%. Intravenous drug use (4 cases) accounted for 1% of infections.

3. Almost half of the new cases reported in 2013 were between 30 and 49 years of age.

4. About 94% of the new cases were males. Approximately 66% of all new reported cases were single, 23% were married and 9% were divorced or separated. 68% of the males were single, compared to 31% among the females.

5. In 2013, 41% of the new cases already had late-stage HIV infection[2] when they were diagnosed.

6. About 46% of the new cases in 2013 had their HIV infection detected when testing was performed in the course of medical care provision[3]. Another 25% were detected during routine programmatic HIV screening[4] while another 20% were detected as a result of voluntary HIV screening. The rest were detected as through other types of screenings. When differentiated by sexual transmission, a higher proportion of homosexuals/bisexuals (30%) had their HIV infection detected via voluntary screening compared to heterosexuals (9%). Annex A provides detailed data on the cases reported in 2013.

Public advisory

7. The most effective way to prevent HIV infection is to remain faithful to one’s spouse/partner and to avoid casual sex, or sex with sex workers. 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. Condoms should be used consistently and correctly during every sexual encounter.

8. MOH and the Health Promotion Board (HPB) urge individuals at risk of HIV infection to go for regular HIV testing. Regular HIV testing can help an infected person to be diagnosed at an earlier stage of infection. With early diagnosis, a HIV positive person can access care and treatment earlier, and also receive counseling on how to protect their partners from infection.

9. HPB has been working with partner organisations to conduct programmes and campaigns targeted at high-risk individuals to urge them to go for early and regular HIV testing. HPB’s partners conduct various educational outreach programmes on HIV prevention and management by adopting a strategy that appeals to the target audience. This approach uses elements of edutainment infused with public health messages. This assists in making the messages relevant to the target audience. These programmes reach out to at-risk individuals through social settings to encourage them to take personal proactive measures and have regular HIV testing, so as to allow for early detection and treatment, delay the onset of Acquired Immune Deficiency Syndrome (AIDS) and ensure an active and productive life.

10. More information about HIV and AIDS can be found at the HPB website at http://www.hpb.gov.sg.

MINISTRY OF HEALTH

[1] Singapore citizens and permanent residents

[2] CD4+ cell count of less than 200 per cu mm or AIDS-defining opportunistic infections or both.

[3] Includes cases that presented with HIV-specific symptoms and cases with non-HIV related medical conditions

[4] Includes screening programmes for individuals with sexually transmitted infections, hospital inpatients and those identified through contact tracing

ANNEX A

Table 1

Number of Singapore residents reported with HIV/AIDS (1985 - 2013)

Number of Singapore residents reported with HIV/AIDS (1985 - 2013)

Year	HIV/AIDS
Year	Male	Female	Total	Rate*
1985	2	0	2	0.8
1986	6	1	7	2.8
1987	10	0	10	3.9
1988	15	0	15	5.8
1989	9	1	10	3.8
1990	17	0	17	6.2
1991	39	3	42	15.0
1992	49	6	55	19.3
1993	58	6	64	22.0
1994	76	10	86	29.1
1995	102	9	111	36.8
1996	123	16	139	45.3
1997	157	16	173	55.4
1998	167	32	199	62.6
1999	171	35	206	63.8
2000	193	33	226	69.0
2001	204	33	237	71.3
2002	206	28	234	69.2
2003	212	30	242	71.9
2004	290	21	311	91.1
2005	287	30	317	91.4
2006	327	32	359	101.8
2007	392	31	423	118.1
2008 2009 2010 2011	426 418 403 430	30 45 38 31	456 463 441 461	125.2 124.0 116.9 121.7
2012	437	32	469	122.8
2013	428	26	454	118.1
Total	5654	575	6229	-

* per million resident population.

Table 2

Distribution of HIV/AIDS - Infected Singapore residents by modes of transmission (1985 - 2013)

Distribution of HIV/AIDS - Infected Singapore residents by modes of transmission (1985 - 2013)

Mode of Transmission	1985 – 2006	2007	2008	2009	2010	2011	2012	2013	Total
Sexual Transmission
Heterosexual	2115	255	248	284	228	210	220	181	3741
Homosexual	515	130	151	139	163	195	210	209	1712
Bisexual	222	15	34	27	41	42	27	38	446
Intravenous drug use	67	7	20	7	4	4	2	4	115
Blood Transfusion	2	1	0	0	0	0	0	0	3
Renal Transplant overseas	5	0	0	0	0	0	0	0	5
Perinatal (mother to child)	27	2	0	0	2	0	0	0	31
Others/Uncertain	109	13	3	6	3	10	10	22	176
Total	3062	423	456	463	441	461	469	454	6229

Table 3

HIV/AIDS - Infected Singapore residents by marital status and sex (1985 - 2013)

HIV/AIDS - Infected Singapore residents by marital status and sex (1985 - 2013)

Marital status		1985 – 2006	2007	2008	2009	2010	2011	2012	2013	Total
Male
	Single	1642	230	280	255	265	300	295	292	3559
	Married	760	114	105	116	108	101	102	92	1498
	Divorced/Separated	254	42	37	40	26	26	31	38	494
	Widowed	64	6	4	7	4	3	9	6	103
	Total	2720	392	426	418	403	430	437	428	5654
Female		0
	Single	71	6	1	8	8	8	7	8	117
	Married	208	17	17	26	20	14	13	14	329
	Divorced/Separated	38	7	7	9	6	6	10	3	86
	Widowed	25	1	5	2	4	3	2	1	43
	Total	342	31	30	45	38	31	32	26	575
Total
	Single	1713	236	281	263	273	308	302	300	3676
	Married	968	131	122	142	128	115	115	106	1827
	Divorced/Separated	292	49	44	49	32	32	41	41	580
	Widowed	89	7	9	9	8	6	11	7	146
	Total	3062	423	456	463	441	461	469	454	6229

Table 4

HIV/AIDS - Infected Singapore residents by ethnic group (1985 - 2013)

HIV/AIDS - Infected Singapore residents by ethnic group (1985 - 2013)

Ethnic Group	1985 - 2006	2007	2008	2009	2010	2011	2012	2013	Total
Chinese	2547	355	363	341	329	355	356	323	4969
Malay	288	47	71	76	69	77	80	94	801
Indian	135	11	15	28	27	24	22	22	285
Others	92	10	7	18	16	5	11	15	174
Total	3062	423	456	463	441	461	469	454	6229

Table 5

HIV/AIDS - Infected male Singapore residents by age and modes of transmission (1985 – 2013)

HIV/AIDS - Infected male Singapore residents by age and modes of transmission (1985 – 2013)

Age group			1985 - 2006	2007	2008	2009	2010	2011	2012	2013	Total
Male	Heterosexual
		15 – 19	2	1	2	1	0	0	0	0	6
		20 – 29	206	15	11	10	16	12	15	14	299
		30 – 39	554	33	37	42	30	28	25	23	772
		40 – 49	515	82	73	72	58	48	42	32	922
		50 – 59	299	66	59	64	47	48	68	51	702
		60 & above	236	28	37	52	41	45	39	37	515
		Total	1812	225	219	241	192	181	189	157	3216
	Homosexual/Bisexual
		15 – 19	14	4	4	2	4	3	9	1	41
		20 – 29	192	38	52	44	50	73	72	70	591
		30 – 39	327	61	73	62	77	86	81	77	844
		40 – 49	158	33	39	45	58	52	58	65	508
		50 – 59	33	8	15	11	12	18	12	31	140
		60 & above	6	1	2	2	2	5	4	3	25
		Total	730	145	185	166	203	237	236	247	2149
	Others
		0 – 14	14	1	0	0	2	0	0	0	17
		15 –19	2	1	1	0	1	1	1	1	8
		20 –29	23	1	3	2	0	1	2	2	34
		30 –39	59	5	10	5	2	2	2	2	87
		40 –49	52	6	4	3	3	1	3	11	83
		50 –59	18	7	4	1	0	7	2	4	43
		60 & above	10	1	0	0	0	0	2	4	17
		Total	178	22	22	11	8	12	12	24	289
	Total
		0 – 14	14	1	0	0	2	0	0	0	17