<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR>Surge in HIV cases among gay men
</TR><!-- headline one : end --><TR>Reduced fear of the virus, drug use and rebellion among reasons for uptrend </TR><!-- Author --><TR><TD class="padlrt8 georgia11 darkgrey bold" colSpan=2>By Wong Kim Hoh
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Mark (not his real name) found out seven years ago that he is HIV-positive. Experts say that advances in HIV medication may have bred complacency and fuelled risky behaviour among homosexuals. -- ST PHOTO: STEPHANIE YEOW
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<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->The number of human immunodeficiency virus (HIV) infections in the gay community has hit a record high this year.
The surge is driven by MSM (men who have sex with men) who engage in high-risk behaviour such as unprotected sex with multiple partners. It is attributed to several reasons, including a reduced fear of the virus, drug use and rebellion.
Based on numbers released by the Ministry of Health last week, homosexual transmissions accounted for 32 per cent, and bisexual transmissions 5 per cent, of the 153 new HIV cases detected in the first six months of this year. Last year, MSM cases made up 34 per cent of total HIV infections, and in 2001, just 16 per cent.
The rising numbers could be explained in part by more people getting tested. However, doctors and activists said the rise in HIV prevalence among gay men here mirrors an alarming trend in the West and Asia.
In Bangkok, it nearly doubled, from 17 per cent in 2003 to 28 per cent in 2005.
Concerned by the numbers, Action for Aids (AFA) completed a project earlier this year which suggested that the HIV prevalence rate in Singapore's MSM community is 3.1 per cent.
Out of 960 MSM who took up free and anonymous testing offered by the Aids awareness group in venues and establishments they frequented, 30 tested positive.
While this prevalence rate is probably still among the region's smallest, health officials and social workers are concerned that the trend could spiral into an epidemic.
They point out that many in this high-risk group are young, including teenagers. Nearly one-fifth of men infected in the first six months of this year are aged 20 to 29, although it is not known how many are gay or bisexual.
Dr Lee Cheng Chuan, senior consultant at the Communicable Disease Centre (CDC), said MSM are a risk group involving 'males who are generally more sexually driven by nature'.
AFA's director Roy Chan offers several reasons for the rising MSM infections. 'There's a lot more sexual activity and people are having sex younger,' he said.
He added that the Internet and proliferation of sex-on-premises venues here, such as saunas, have made sexual hook-ups for this group very easy.
Joash (not his real name), 21, was diagnosed with the virus in May this year when he got himself tested.
Being 'curious and playful', the private-school student often logged into gay chatrooms and met strangers for sex. He also tried 'a lot of things, including drugs that people offered me'.
He admits to not having used condoms on several occasions despite knowing the risks, saying: 'We were just too high.'
In gay chatrooms, some men have been known to blatantly seek sex partners who are into barebacking (sex without condoms) or chemsex (sex under the influence of narcotics such as ecstasy and methamphetamine).
Mr Lionel Lee, AFA's executive director, said: 'These drugs impair judgment and many then engage in risky behaviour such as barebacking.
'There is a huge gap between what a person knows and what he practises.'
Chemsex parties are not only a fixture on the gay circuit here. Many Singaporean MSM also fly to cities such as Bangkok, Hong Kong and Taipei where they are rampant.
Mr Lee said: 'Budget airlines have made travel more affordable so there's also a lot of cross-border sex.'
Gay activists said the recklessness of these men is almost a complete reversal of the unity they displayed from the 1980s, when Aids reared its head, to the mid-1990s.
As the virus killed hundreds of thousands in their community, homosexuals were the first to become safe-sex advocates.
Mr Lee said there is a term for the current rebelliousness.
'They call it condom fatigue. Many MSM are sick of hearing about condoms and safe sex.'
In the West, the recklessness can be taken to extremes by 'bug catchers' and 'gift givers'. These are gay men who deliberately expose themselves to, and infect others with, the HIV virus.
Experts note that advances made in HIV medication may have fuelled risky behaviour.
If treated early with anti-retroviral therapy, the virus is no longer a death sentence but a manageable, albeit chronic, disease. This has bred complacency.
'People are no longer dying like flies. Effective medication means we see fewer instances of ill-health among those with HIV,' said DrChan.
However, he and other doctors caution that the virus greatly compromises a person's quality of life. Besides entailing a lifetime of medication and hospital visits, being HIV-positive will scuttle a person's chances when applying for jobs, scholarships and permanent residence in another country.
Meanwhile, Singapore faces other 'invisible' but no less daunting obstacles in tackling the problem.
Some say one barrier is Section 377A of the Penal Code. Activists attempted unsuccessfully to have the law - which criminalises homosexual acts - repealed by Parliament earlier this year.
At the 6th Singapore Aids Conference last month, Dr Chan said 377A 'makes presumptive criminals of all homosexual males and homosexuals are treated as immoral individuals deserving of discrimination'.
This forces MSM to go underground and avoid getting tested. Studies have shown that those who do not know their status are more infectious as they are not on medication, and more likely to infect others.
Dr Chan cited several studies which showed a correlation between homophobia and risky behaviour in countries such as China and Mexico.
Dr Arlene Chua, an infectious diseases consultant at Tan Tock Seng Hospital and National University Hospital, said: 'There're too many value-laden judgments about the disease. Patients may not come forward because they don't want to risk stigma and discrimination; they have a lot to lose.'
The situation not only prevents effective surveillance but also compromises educational and intervention campaigns and messages targeted at gay men.
Publicity materials, for instance, are not allowed in the mass media. 'We now put them in gay venues. But many MSM, including youngsters below 18, do not go to such places. So where do you find them?' said Mr Lee.
Dr Leo Yee Sin, clinical director of the Communicable Disease Centre, said research in high-risk communities like MSM is crucial.
'We need to study their behavioural profile and understand their motivations before we can recommend preventive strategies,' she said.
Gay businessman Y.G. Ng, 37, is saddened by the risky behaviour of some MSM, and said it will only reinforce the stigma of HIV as a gay disease.
'Having unsafe sex is pure irresponsibility and stupidity. How can you expect support to repeal 377A if you behave like this? We've to help ourselves if we want others to help us,' he said.
But activist Alex Au from gay movement People Like Us believes rallying the gay community to protect themselves will not be easy, not when they are treated like 'second-class citizens'.
They are pessimistic about being able to change things.
'Many gay people are suffering not just from condom fatigue but also from activism fatigue.'
In fact, he thinks the recklessness in the community can be traced to a 'certain nihilism' or self-destructiveness because of the discrimination they face.
'It's hard to tease out the threads but pessimism leads to fatalism which leads to nihilism. It's almost like the gay community is saying, 'Let's party while we can because Rome is going to burn.' '
Other activists, however, feel discrimination should motivate the community to fight harder. News that the Government is considering subsidising HIV medication, they say, is proof that change can happen.
'We just need exemplary MSM to come out openly to tell people that they can lead successful and healthy lifestyles,' said Dr Lee.
[email protected]
<HR width="50%" SIZE=1>
RISING NUMBERS
Percentage of homosexual transmissions among new HIV cases, based on Ministry of Health figures
</TR><!-- headline one : end --><TR>Reduced fear of the virus, drug use and rebellion among reasons for uptrend </TR><!-- Author --><TR><TD class="padlrt8 georgia11 darkgrey bold" colSpan=2>By Wong Kim Hoh
</TD></TR><!-- show image if available --><TR vAlign=bottom><TD width=330>
</TD><TD width=10>
Mark (not his real name) found out seven years ago that he is HIV-positive. Experts say that advances in HIV medication may have bred complacency and fuelled risky behaviour among homosexuals. -- ST PHOTO: STEPHANIE YEOW
</TD></TR></TBODY></TABLE>
<TABLE><TBODY><TR><TD>
</TD></TR></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->The number of human immunodeficiency virus (HIV) infections in the gay community has hit a record high this year.
The surge is driven by MSM (men who have sex with men) who engage in high-risk behaviour such as unprotected sex with multiple partners. It is attributed to several reasons, including a reduced fear of the virus, drug use and rebellion.
Based on numbers released by the Ministry of Health last week, homosexual transmissions accounted for 32 per cent, and bisexual transmissions 5 per cent, of the 153 new HIV cases detected in the first six months of this year. Last year, MSM cases made up 34 per cent of total HIV infections, and in 2001, just 16 per cent.
The rising numbers could be explained in part by more people getting tested. However, doctors and activists said the rise in HIV prevalence among gay men here mirrors an alarming trend in the West and Asia.
In Bangkok, it nearly doubled, from 17 per cent in 2003 to 28 per cent in 2005.
Concerned by the numbers, Action for Aids (AFA) completed a project earlier this year which suggested that the HIV prevalence rate in Singapore's MSM community is 3.1 per cent.
Out of 960 MSM who took up free and anonymous testing offered by the Aids awareness group in venues and establishments they frequented, 30 tested positive.
While this prevalence rate is probably still among the region's smallest, health officials and social workers are concerned that the trend could spiral into an epidemic.
They point out that many in this high-risk group are young, including teenagers. Nearly one-fifth of men infected in the first six months of this year are aged 20 to 29, although it is not known how many are gay or bisexual.
Dr Lee Cheng Chuan, senior consultant at the Communicable Disease Centre (CDC), said MSM are a risk group involving 'males who are generally more sexually driven by nature'.
AFA's director Roy Chan offers several reasons for the rising MSM infections. 'There's a lot more sexual activity and people are having sex younger,' he said.
He added that the Internet and proliferation of sex-on-premises venues here, such as saunas, have made sexual hook-ups for this group very easy.
Joash (not his real name), 21, was diagnosed with the virus in May this year when he got himself tested.
Being 'curious and playful', the private-school student often logged into gay chatrooms and met strangers for sex. He also tried 'a lot of things, including drugs that people offered me'.
He admits to not having used condoms on several occasions despite knowing the risks, saying: 'We were just too high.'
In gay chatrooms, some men have been known to blatantly seek sex partners who are into barebacking (sex without condoms) or chemsex (sex under the influence of narcotics such as ecstasy and methamphetamine).
Mr Lionel Lee, AFA's executive director, said: 'These drugs impair judgment and many then engage in risky behaviour such as barebacking.
'There is a huge gap between what a person knows and what he practises.'
Chemsex parties are not only a fixture on the gay circuit here. Many Singaporean MSM also fly to cities such as Bangkok, Hong Kong and Taipei where they are rampant.
Mr Lee said: 'Budget airlines have made travel more affordable so there's also a lot of cross-border sex.'
Gay activists said the recklessness of these men is almost a complete reversal of the unity they displayed from the 1980s, when Aids reared its head, to the mid-1990s.
As the virus killed hundreds of thousands in their community, homosexuals were the first to become safe-sex advocates.
Mr Lee said there is a term for the current rebelliousness.
'They call it condom fatigue. Many MSM are sick of hearing about condoms and safe sex.'
In the West, the recklessness can be taken to extremes by 'bug catchers' and 'gift givers'. These are gay men who deliberately expose themselves to, and infect others with, the HIV virus.
Experts note that advances made in HIV medication may have fuelled risky behaviour.
If treated early with anti-retroviral therapy, the virus is no longer a death sentence but a manageable, albeit chronic, disease. This has bred complacency.
'People are no longer dying like flies. Effective medication means we see fewer instances of ill-health among those with HIV,' said DrChan.
However, he and other doctors caution that the virus greatly compromises a person's quality of life. Besides entailing a lifetime of medication and hospital visits, being HIV-positive will scuttle a person's chances when applying for jobs, scholarships and permanent residence in another country.
Meanwhile, Singapore faces other 'invisible' but no less daunting obstacles in tackling the problem.
Some say one barrier is Section 377A of the Penal Code. Activists attempted unsuccessfully to have the law - which criminalises homosexual acts - repealed by Parliament earlier this year.
At the 6th Singapore Aids Conference last month, Dr Chan said 377A 'makes presumptive criminals of all homosexual males and homosexuals are treated as immoral individuals deserving of discrimination'.
This forces MSM to go underground and avoid getting tested. Studies have shown that those who do not know their status are more infectious as they are not on medication, and more likely to infect others.
Dr Chan cited several studies which showed a correlation between homophobia and risky behaviour in countries such as China and Mexico.
Dr Arlene Chua, an infectious diseases consultant at Tan Tock Seng Hospital and National University Hospital, said: 'There're too many value-laden judgments about the disease. Patients may not come forward because they don't want to risk stigma and discrimination; they have a lot to lose.'
The situation not only prevents effective surveillance but also compromises educational and intervention campaigns and messages targeted at gay men.
Publicity materials, for instance, are not allowed in the mass media. 'We now put them in gay venues. But many MSM, including youngsters below 18, do not go to such places. So where do you find them?' said Mr Lee.
Dr Leo Yee Sin, clinical director of the Communicable Disease Centre, said research in high-risk communities like MSM is crucial.
'We need to study their behavioural profile and understand their motivations before we can recommend preventive strategies,' she said.
Gay businessman Y.G. Ng, 37, is saddened by the risky behaviour of some MSM, and said it will only reinforce the stigma of HIV as a gay disease.
'Having unsafe sex is pure irresponsibility and stupidity. How can you expect support to repeal 377A if you behave like this? We've to help ourselves if we want others to help us,' he said.
But activist Alex Au from gay movement People Like Us believes rallying the gay community to protect themselves will not be easy, not when they are treated like 'second-class citizens'.
They are pessimistic about being able to change things.
'Many gay people are suffering not just from condom fatigue but also from activism fatigue.'
In fact, he thinks the recklessness in the community can be traced to a 'certain nihilism' or self-destructiveness because of the discrimination they face.
'It's hard to tease out the threads but pessimism leads to fatalism which leads to nihilism. It's almost like the gay community is saying, 'Let's party while we can because Rome is going to burn.' '
Other activists, however, feel discrimination should motivate the community to fight harder. News that the Government is considering subsidising HIV medication, they say, is proof that change can happen.
'We just need exemplary MSM to come out openly to tell people that they can lead successful and healthy lifestyles,' said Dr Lee.
[email protected]
<HR width="50%" SIZE=1>
RISING NUMBERS
Percentage of homosexual transmissions among new HIV cases, based on Ministry of Health figures
