Go for repeat HIV tests to be sure

20 Mar 2008, The Newpaper

Question

Name of the Person: Ng Wan Ching

Prove you're clean so I can ditch the condoms

S'pore men pay for China girlfriends' HIV tests before unprotected sex

They even enter docs' room to confirm results for 'peace of mind'

THE middle-aged Singapore man waiting anxiously in a clinic in Geylang didn't know it, but he has one thing in common with a top politician from halfway around the world:

16 March 2008

THE middle-aged Singapore man waiting anxiously in a clinic in Geylang didn't know it, but he has one thing in common with a top politician from halfway around the world:

They are both willing to go to extremes to avoid using a condom. They want sex, in the parlance of the depraved, in the raw. Disgraced New York Governor Eliot Spitzer was willing to pay US$4,300 (about $6,000) for a high-class prostitute willing to do away with protection.

In Singapore, some men are sending their China lovers for quick, anonymous HIV tests just so they could do without condoms. At the Geylang clinic, The New Paper on Sunday team watched as the 50-something man sat with his girlfriend, dressed in a short black skirt and a low-cut pink top showing off her cleavage.The 30-something woman, from China, looked a little impatient. Why did she have to go through this?

All because her Singapore boyfriend demanded it and so, Ms Qi agreed to take the test.

According to two doctors who are approved by the Ministry of Health to do anonymous HIV oral testing by OraQuick, more women like Ms Qi have been visiting them over the last six months.

FROM CLIENT TO LOVER

They are there at the behest of boyfriends who have used their services as prostitutes and, over time, developed relationships with them.Ms Qi said: 'I have known him for six months now. At first, he was a client, but now he's a regular and he's more like a boyfriend to me. 'And he wants to have unprotected sex.'

Hence, the HIV test. In 20 minutes, she had her results - negative.

Her boyfriend, looking pleased, paid up and they walked out together, holding hands.

Dr Chua Thiam Eng, from the Cambridge Clinic in Kreta Ayer Road, said: 'This is a new patient-type that we have recently noticed. 'They tell me that the results don't matter to them; it's their friend outside who wants to know.' He then tells them that if they want their friend to know, they can invite their friend in to look at the results.

Many of them do ask their boyfriends to go into the clinic. 'It's always the gentleman who pays for everything,' Dr Chua said. He noticed such patients showing up about six months ago. 'On average, we see one to two such patients a week. They come and, behind them, there's always a man,' Dr Chua said.

At the Anteh Dispensary Family Clinic & Surgery in Geylang, the other private clinic that has been approved by the Health Ministry to do anonymous HIV testing with OraQuick, Dr Joyce Liang has also been noticing the same trend. She also sees one or two such patients a week. Dr Liang said: 'Most of these men look like they are in their 50s.  'I think with the publicity of the quick test, which does not involve any taking of blood, they realise they can have peace of mind quite easily. That's why they ask their girlfriends to come.' Sometimes, the women turn up on their own.

Dr Liang said: 'But in my office, they tell me that they were asked by their friend to come for the test. And some of them are really quite indignant and offended.'

The China women who go for the test range in age from their 20s to 40s. The doctors know they are from China from their accents and dressing style.

Dr Chua, who sees mainly those aged between 20 and 30, said: 'They usually have long hair and are fair and very attractive. The way they dress is more for partying than for working.' Both Dr Liang and Dr Chua said that about one in 10 of the people who go for anonymous HIV testing are women from China.

In the last 20 months since OraQuick was approved for anonymous testing, Dr Liang has used more than 800 test kits and Dr Chua, more than 1,000.

Each test will cost the patient $38 to $50 for the test kit and $12 for the consultation.

There are three other main groups of people who go for anonymous HIV testing:

Men who have sex with men; Wives and girlfriends of men who have had sexual contact outside of the relationship;  Young men, both locals and expatriates, who feel that they may have been exposed to the virus during sexual activities.

Dr Chua said: 'There's a group which are made up of expatriates who are here on employment passes. 'They need to take the HIV test regularly. If they have been exposed, they want to know before renewing their passes.'

So far, between him and Dr Ling, they have had 13 patients who tested positive.

None of them are women from China.

Dr Tan Sze Wee, chief executive of Rockeby Biomed, the official distributor of OraQuick, said: 'The monthly sales of OraQuick has gone up more than two-fold for these two clinics from a year ago.' A year ago, the two clinics combined were using about 50 to 60 test kits a month. Today, they are using 150 to 200 test kits a month.

Overall monthly sales of OraQuick is between 300 and 400 test kits.

Dr Tan said: 'The increase is partly due to the awareness generated by the Ministry's programmes and OraQuick's own publicity.' He believes that the number will continue to rise. 'Singapore is the first country in the world to approve OraQuick for statutory testing, which means the test can be used for students' passes, work permits and employment passes,' Dr Tan said.

MUST GIVE NAMES

OraQuick is also available at 60 other private clinics and at two of National Healthcare Group's polyclinics at Bukit Batok and Toa Payoh, but the patients there have to give their names. Over at the Kelantan Clinic, where people can also go for anonymous HIV testing, blood tests are used. Dr Tan said: 'We are now discussing with the clinic the possibility of using OraQuick.' OraQuick is the only commercial tool that uses oral fluids (saliva) to test for HIV. Other test kits in the market require blood to be drawn. However, OraQuick is only a screening tool. It has a 0.4 per cent chance of giving a false positive for HIV, so anyone who is tested positive by the kit should go for a confirmatory test.

Reply

Reply from MOH 

The report “Prove you’re clean so I can ditch the condoms” (TNP, 16 Mar) by Ms Ng Wan Ching may give readers the wrong impression that a non-reactive ("negative") result from a HIV screening test such as the OraQuick test would mean that a person is "clean" and that there is no need to practise safe sex.

The main purpose of HIV testing is to detect those who are HIV-positive, so that the affected person can seek early treatment and counseling. Knowing one's HIV status could also help prevent further transmission.

HIV screening tests such as OraQuick test for the presence of HIV antibodies. Ninety-seven percent of persons will develop antibodies in the first 3 months following the time of their infection. In very rare cases, it can take up to 6 months to develop antibodies to HIV. The time between HIV infection and the development of antibodies is called the "window period".

People whose HIV screening results are non-reactive ("negative") should be aware that the test may not be reactive in people with very recent infections (i.e. if the person is in the window period). In fact, those who are in the window period are extremely infectious and can spread HIV to their partners.

Repeat HIV testing is therefore advisable for anyone who has obtained an initial non-reactive result within the first 3 months after the last potential exposure to HIV.  The repeat test should be done more than 3 months after the last potential exposure. To be on the safe side,  he should always practise safe sex.

HIV transmission in Singapore is largely through unprotected sex.  MOH strongly encourages individuals who engage in high risk behaviour to take proper precautions to prevent the transmission of HIV and to go for regular HIV testing.