editorial
 

Dr Roy Chan

Condoms & Conferences

In this issue of the ACT, we bring you reviews of the sessions and papers presented at the 3rd Singapore AIDS Conference. There is also coverage of the debate in the Straits Times Forum pages over several weeks in November and December regarding the promotion of safe sex behaviour and condom use as a means of preventing HIV infection and STI. This topic periodically receives attention in the local scene; conservative members of the public are usually the ones who start the controversy by opposing anything other than the promotion of abstinence till marriage and monogamy after marriage in HIV/STI prevention. Our position has always been that we need to provide much broader and inclusive messages and information than this; by all means promote the "No Sex" message - but not at the expense of removing all information on the usefulness of condoms. The letters to the ST Forum have been reproduced in this issue of the ACT, we have also included information released by the UNAIDS, WHO and CDC on this issue.


The welcome speech at the Opening Ceremony of the 3rd Singapore AIDS Conference, 22 December 2002.

Honourable Minister of State for Health and Environment Dr Balaji Sadasivan, Senator Mechai Viravaidya, distinguished guests and colleagues, ladies and gentlemen -

Since we last met at the 2nd Singapore AIDS Conference in December 2000, another 2 million people have become infected with HIV in Asia alone. There are now over 6.5 million infected people in the region, it is clear that the epidemic has well and truly taken off. The most severely affected countries in the region are Thailand, Myanmar, Cambodia and India; more recently however the epidemic has been increasing rapidly in parts of China, Vietnam and Indonesia.

In Singapore in the last 2 years, 450 or so Singaporeans and Permanent Residents were diagnosed with HIV infection and AIDS. This brings the total number of HIV infections to almost 1800, and over 600 have died from AIDS.

The overwhelming majority of infections (>95%) were transmitted through sexual intercourse. The majority of infections were seen in heterosexual males, with a significant minority among homosexual and bisexual males. 9 cases out of 10 are in males; the proportion in females has not changed much over the years.

While the absolute numbers in Singapore may not be very high, the per capita infection rate tells a different story. When we compare per capita figures, we find that HIV infection in Singapore is more prevalent than many other developed countries in Europe and Asia. For example HIV prevalence in adults at the end of 2002 was 0.146% in Singapore, compared with 0.121 in Australia, 0.119 in the UK, 0.02 in Japan. (USA - 0.61%, Thailand - 1.8%, France - 0.345%).

But numbers do not tell the full story; more important than numbers is the fact that AIDS has now touched the lives of thousands of Singaporeans. We have lost and continue to lose friends and family members, fellow workers and fellow citizens to AIDS. While many have the support of family and friends, others have passed away alone and abandoned, and their memories have been banished by families and friends because of shame and embarrassment.

Modern medicine has now rendered AIDS and HIV infection a treatable disease; it is no more the uniformly fatal infection as it was when it was in the 1980s and early 1990s. Anti-HIV medications can give infected individuals a very good chance to live long, healthy and fulfilling lives.

This conference will have greater active participation by persons living with HIV and AIDS (or PWAs) in the programme. PWAs and other affected individuals will share their perspectives and experiences in plenary number 2, as well as in other sessions. We are very happy that this time there are individuals brave and committed enough to speak up and air their fears and hopes.

I would like to recall these words of Nelson Mandela at the Barcelona AIDS Conference last July, who in calling for greater visibility of positive people said "You must not be ashamed of speaking out ... because when you keep quiet ... you are signing your own death warrant."

At the conclusion of the last conference, delegates affirmed the need -

  1. for multisectorial response and approach to AIDS prevention, care, support and treatment,
  2. for greater participation of and collaboration between government institutions, businesses, community based organisations and non-governmental organisations,
  3. to overcome AIDS-related discrimination and stigma
  4. to provide more accessible and affordable treatment and care
  5. for greater PWA participation in prevention, education programmes, policy discussions and decision-making processes.

We will at this meeting have the chance to assess how far we have progressed or not progressed in these areas over the last 2 years. 

The theme of the conference this year is "Change - Attitudes, Behaviours ... The Future". This was chosen because we believe that it underlines the need to periodically examine and evaluate our knowledge, attitudes and practices with respect to all aspects of AIDS - whether it be prevention programmes, nature and content of educational materials and messages, medical and nursing care, counseling services, research projects, defeating stigma and ignorance, implementing sound workplace policies on AIDS, and so on. If necessary changes must be recommended and made, if we are to move forward and stay ahead of the epidemic.

Tonight we are very honoured to have Minister of State of Health and Environment, Dr Balaji Sadasivan, as our Guest-of-Honour. His presence here is I believe evidence of the  government's commitment to address the problems associated with AIDS, and a reflection of his personal commitment to openness and collaboration.

We are also very honoured to have Senator Mechai Viravaidya from Thailand to deliver the keynote address later on this evening. I wish to thank -

  • my co-chairs Lee Cheng Chuan, Brenton Wong and Grace Chang, and the organising committee of the conference
  • speakers, facilitators and presenters
  • our collaborating organizations the Body Shop and Levi Strauss & Co for the Business Forum, and the Red Cross Society for the Youth Symposium

I would also like to acknowledge the generous support of our sponsors without whom we would not have been able to organise this meeting -.

Our gold sponsors - GlaxoSmithKline, Merck Sharp & Dohme, Pfizer, and the Health Promotion Board; our silver sponsors - Abbott Laboratories, Astra Zeneca, Bristol-Myers Squibb, Wyeth Pharmaceuticals, and our other sponsors - Bayer, Boehringer Ingelheim, Genelabs Diagnostics, Janssen-Cilag, Kyowa-Hakko and Roche

And last but certainly not least the hardworking Conference Secretariat led by Nina Sharma.