HIV-RELATED DISCRIMINATION
ONLINE INCIDENT REPORTING FORM
If you feel that you have been discriminated against, mistreated or harassed based on HIV status, Action for AIDS wants to hear about it. By filling out and submitting this form , we will be able to gather and compile records which will be essential for our work in campaigning to stop discrimination and stigma against anyone because of their HIV status in Singapore. You should not have to suffer in silence. Working together, we can overcome unfair treatment in an organised manner.
AfA will not share your name or other identifiable information with anyone without your permission.
This is ONLY for HIV/AIDS discrimination concerns.
Please read the following points before you fill in the form.
- How do I know if I have been discriminated because of my HIV status?
- Any person who treats you unfairly or harasses you because you are HIV positive or have AIDS can be considered to have discriminated against you.
- Discrimination can occur in the following areas:
- in most types of employment when you apply for a job, at any time during your employment or when you leave a job, if you get terminated from a job If you can do the job safely and effectively then you should not be discriminated against;
- when you try to obtain most types of goods or services for example, from shops, dentists, doctors, hospitals, pubs and entertainment places, banks, lawyers, government departments and local councils;
- when you rent, or try to rent, accommodation for example, an apartment or flat, a house, commercial premises, hotel room;
- when you apply to get into, or are studying in any educational institution for example a school, college, polytechnic, ITE or university; private schools and educational learning facilities
- when you try to enter, join or obtain services from a registered club/bar a registered club/bar includes any premises that sells alcohol or has gambling machines.
- I dont have HIV but I have been discriminated in a connection with another HIV positive person.
It is also considered discrimination for anyone to hassle or victimise you or treat you unfairly because:
- you have a partner, spouse, child, relative, friend or work colleague who has (or someone thinks has) HIV;
- you have complained to your employer or another person about a HIV discrimination action;
- you have supported someone with a HIV discriminatory action complaint, or acted as a witness in an HIV discriminatory action situation.
- Do I need to give my name, contact details or my personal details? Can I remain anonymous?
You do not have to give us your name, contact details or personal details.
If you do leave us a contact number, and you would like us to contact you, please say so in the form. If you do not wish to be contacted, we will not divulge not call you. If you would like to remain anonymous, just leave the name, contact details or personal details blank. AfA will keep each report in the strictest confidence and will not share your name or other identifiable information with anyone without your permission.
- Do I need to give my contact name and my details if want the matter to be looked into by AfA?
If you would like AfA to assist in investigating the matter, we will require a name and contact telephone number so we can speak with you and advise you accordingly. We cannot guarantee that the matter can be resolved by AfA.
- Do I need to give the name of the person or people that discriminated against me and/or the organization they work in?
You do not have to provide the name of the person, the name of the company, organisation, school, private or public institution or government agency etc. if you do not want to. If you do, please note that AfA will keep each report in the strictest confidence and will not share your name or other explicit information with anyone without your permission.
- What details do I need to give about the discriminatory incident?
Describe each incident of discriminatory action separately. For each action provide the following information if possible:
- The date the date(s) the discriminatory action occurred. You could just list the month or time of year (e.g. at the end of last year)
- Who was the person/persons who discriminated against, what was their relationship with you (For example: boss, manager, sales person, teacher, principal, landlord, pub/club owner, colleague at work etc)
- Describe the incident. What happened;
- Is the discriminatory action still going on?
- Were there any witnesses; (For example: friend, passer by or family member etc)
- Did you do anything to address this ? (For example, have you made a report to your company, teacher, principal, government department, a lawyer or the police) If so, please tell us who you have made the report to and what happened as a result.)
- Why you believe the discrimination was because of your HIV status?
- What to do if I would like to talk to somebody and not have to fill out the form?
You can approach AfA for advice through the following ways:
Phone assistance
You can call our hotline 6254 0212 to seek advice from our AIDS counsellors who will take down the details provided.
Hotline hours: Monday to Friday 10:00 am to 5:30 pmEmail assistance
Email info@afa.org.sg with your query. Allow 3 working days for our staff to attend to your query.Fax assistance
Fax no: 6256 5903
Allow 3 working days for our staff to attend to your query.Walk in counsellingMain office: 21 Norris Road Singapore 208263
Office hours: Monday to Friday 10:00 am to 5:30 pm.
*Strictly by appointment only please call 6254 0212 to fix appointmentOnline submissionYou can submit your HIV DISCRIMINATION INCIDENT REPORTING FORM online.. Fill out the form below. If a reply is necessary, please allow 5 working days for our AIDS Counsellor to revert back to you.
Please fill in the form and then hit submit' button at the end of this page when you are done.
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