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Singapore HIV Congress 2021

Singapore HIV Congress 2021

Singapore HIV Congress 2021.jpg

About the Congress

The Singapore HIV Congress 2021 is a scientific congress presented by the National HIV Programme, National Centre for Infectious Diseases. This congress brings together clinicians, scientists, and researchers to discuss latest advances in HIV medicine and related fields. The theme for this year's congress is "90-90-90 and beyond". We aim to shine a spotlight on evolutions in HIV testing, treatment, and prevention, particularly in reducing under-diagnosis, increasing treatment uptake, and ensuring that those receiving treatment achieve viral suppression and good health-related quality of life.

Date: Session 1: 27 November 2021, Saturday
          Session 2: 4 December 2021, Saturday


Time: 9am to 1pm

Mode: Zoom Webinar


Session 1: 27 November 2021, Saturday





Opening Remarks

A/Prof Sophia Archuleta, Director, National HIV Programme, NCID


Welcome Address by Executive Director, NCID

Prof Leo Yee Sin, Executive Director, National Centre for Infectious Diseases

Segment 1: Chair - Dr Asok Kurup, Infectious Diseases Specialist,
Infectious Diseases Care Pte Ltd


Progress Update on the HIV Care Cascade in Singapore

Dr Felicia Hong, Senior Assistant Director, Communicable Diseases Division, Ministry of Health


Q & A

Moderator: Dr Asok Kurup


​HIV-1 transmitted drug resistance surveillance: Update on newly diagnosed cases in Singapore

Dr Carmen Low, Senior Scientific Officer, National Public Health Laboratory


​Q & A

Moderator: Dr Asok Kurup


------------------------    Break (15 Minutes)    ------------------------

​ ​Segment 2: Chair - Dr Ling Li Min, Infectious Diseases Specialist, Rophi Clinic,
Mount Elizabeth Novena Specialist Centre


NHIVP Antiretroviral Treatment Recommendations – Updated Recommendations

A/Prof Sophia Archuleta, Director, National HIV Programme, NCID


NHIVP Pre-Exposure Prophylaxis Guidance – Updated Guidance

Dr Wong Chen Seong, Deputy Director, National HIV Programme, NCID


Keynote 1: HIV Cure: Where are we in 2021?

Prof Sharon Lewin, Director, The Peter Doherty Institute for Infection and Immunity


​Q & A

Moderator: Dr Ling Li Min


------------------------    Break (15 Minutes)    ------------------------

Segment 3: Chair - Dr Wong Chen Seong, Deputy Director,
National HIV Programme, NCID


Debate: “This House believes that HIV self-testing should be rolled out in retail pharmacies” 

​Proposition: Dr Stephanie Sutjipto (NCID), Dr Cherie Gan (SGH)


Opposition: Dr Alicia Ang (NUH), Dr Khoo Bo Yan (NCID)


​Keynote 2: LoveYourself Ph - Innovations and Self Care Project

​Dr Ronivin Garcia Pagtakhan, Executive Director of LoveYourself


Q & A and Closing Remarks

Dr Wong Chen Seong, Deputy Director, National HIV Programme, NCID


End of Session 1


Session 2: 4 December 2021, Saturday





Opening Remarks

A/Prof Sophia Archuleta, Director, National HIV Programme, NCID

​ ​Segment 1: Chair - Dr Loh Jiashen, Infectious Disease Physician,
Farrer Park Hospital


​HIV Testing Recommendations

Dr Choy Chiaw Yee, Consultant, National HIV Programme, NCID


Impact of COVID-19 on HIV Testing in Singapore

A/Prof Matthias Paul Toh, Director, National Public Health & Epidemiology Unit


​HIV care and treatment services in the time of COVID-19

A/Prof Sophia Archuleta, Director, National HIV Programme, NCID


Presentation of Viral Suppression Data

Dr Teh Yii Ean, Consultant, Singapore General Hospital


​4th 90 – Living well with HIV and COVID-19 in Singapore

Dr Dariusz Piotr Olszyna, Senior Consultant, National University Hospital


​Q & A

Moderator: Dr Loh Jiashen


------------------------    Break (20 Minutes)    ------------------------

Segment 2: Chair - Dr Wong Chen Seong, Deputy Director,
National HIV Programme, NCID


Keynote Lecture 3: Preparing for an Ageing HIV population

A/Prof Reena Rajasuriar, Department of Medicine, University of Malaya


Keynote Lecture 4: HIV Stigma in Asia – What needs to be done

Prof Adeeba Kamarulzaman, President, International AIDS Society


Q & A and Closing Remarks

Dr Wong Chen Seong, Deputy Director, National HIV Programme, NCID


End of Programme


Registration is free. Click here to register.
If you have any queries, please email

Congress Chair

Dr Asok Kurup.jpg

Dr Asok Kurup

​Dr Asok Kurup is an adult infectious diseases consultant at infectious Diseases Care Pte Ltd, Mount Elizabeth Medical Centre and visiting consultant to the Department of Infectious Diseases, Singapore General Hospital


He was a former visiting consultant at the Communicable Disease Centre, Tan Tock Seng Hospital where he ran outpatient HIV clinics.  He was also a former teaching faculty at the Yong Loo Lin School of Medicine and Duke's Graduate Medical School. He is the current chair of the Antibiotic Stewardship Committee of Parkway Hospitals and the Chapter of Infectious Diseases Physicians of the Academy of Medicine, Singapore.

He has over 40 publications and 80 abstracts. Research Interests: Primary HIV infection, Community-acquired bacterial infections, particularly melioidosis and klebsiella septicemia, invasive fungal infections, control of nosocomial Infections including novel strategies to control MRSA infections.


 Dr Ling Li Min.jpg

Dr Ling Li Min

Dr Ling Li Min is an Infectious Diseases Physician with experience in caring for patients with complicated infectious diseases conditions. Prior to joining Rophi Clinic, Dr Ling was a Senior Consultant at the National Centre for Infectious Diseases (NCID) and Tan Tock Seng Hospital (TTSH) where she led the Intensive Care Multi-Disciplinary Infectious Diseases service since 2009 and Haematology-Infectious Diseases service since 2018.


She completed her specialist training in 2007 and furthered her sub-specialty training in infections in ICU and haematology patients at The Alfred Hospital and Peter MacCallum Cancer Centre in Melbourne, Australia. Since then, she has been caring for a wide range of patients, in particular the critically ill or immunocompromised hosts.


She was also the founding Programme Director for the TTSH Infectious Diseases Senior Residency Programme, as well as an awardee of the Clinician Scientist Career Scheme from 2014 to 2017. Dr Ling has served as a Clinical Senior Lecturer with Yong Loo Lin School of Medicine as well as an Adjunct Associate Professor with Lee Kong Chian School of Medicine.


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Dr Loh Jiashen

Dr Loh Jiashen graduated in 2007 from Yong Loo Lin School of Medicine and went on to complete his specialty training in infectious disease at Tan Tock Seng Hospital in 2016. He has served as a consultant in Seng Kang General Hospital from 2016 to 2020 and assisted in the setting up of various core infectious disease services, like ASP and HIV service. He left for private practice in January 2021 and is currently based in Farrer Park Hospital.​

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Dr Wong Chen Seong


​Dr Wong Chen Seong is a Consultant Infectious Diseases Physician at the National Centre for Infectious Diseases (NCID) and Tan Tock Seng Hospital. Dr Wong is Deputy Director of the National HIV Programme, and Director of the NCID HIV Clinical Programme. He is actively involved in HIV clinical care and research, with interests in the socio-behavioural determinants of HIV/STI, HIV/STI prevention, HIV Pre-Exposure Prophylaxis (PrEP), innovations in HIV service delivery such as telemedicine, as well as HIV and ageing and co-morbidity.


Dr Wong is also actively involved in both undergraduate and post-graduate medical education and training, and is a Clinical Lecturer at Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine, as well as an Associate Programme Director of the National Healthcare Group Internal Medicine Residency Programme.



Keynote Speakers

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Prof Sharon Lewin

​Sharon Lewin is the inaugural director of the Peter Doherty Institute for Infection and Immunity, a joint venture between the University of Melbourne and Royal Melbourne Hospital. She is an infectious diseases physician and basic scientist. Her research focuses on understanding why HIV persists on treatment and developing clinical trials aimed at ultimately finding a cure for HIV infection. She has played a major leadership role in the COVID-19 response in Australia and oversees a significant research effort on modelling, diagnostics, treatments and vaccines from the Doherty Institute. She has published over 350 publications and in 2019 was named a Clarivate Web of Science high citation researcher. She is President-Elect of the International AIDS Society (IAS) and chairs the IAS Global Advisory board for the Towards an HIV Cure initiative.


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Dr Ronivin Garcia Pagtakhan



​"Vinn" is the founder of LoveYourself, an organization that has risen to become one of the leading organizations in HIV awareness, testing and treatment in the Philippines. Vinn has a PhD, a masters in Nursing and BS Nursing degree from UP Manila. He graduated top of his class and ranked 4 in the national board exam for nursing. Vinn is a nurse educator and practitioner prior to starting LoveYourself.


He was recognized as one of The Oustanding Young Men (TOYM) Philippines for Youth Leadership and Outstanding Young Person of Taguig in 2016 and 2017 and last year 2018, he was recognized as one of the outstanding young persons of the world (TOYP) for Humanitarian Leadership.


Vinn believes that self-worth is an empowering tool that helps the most affected populations such as males who have sex with males gain confidence and, in turn, adopt safer sex practices.


Vinn is a public health champion that is bringing the community together with his passion and optimism to rally against the spread of HIV. Under Vinn's leadership, LoveYourself has established 25 clinics which rank as the top most visited in the country for HIV screening; one of the clinics is the first transgender health clinic in the Philippines called Victoria by LoveYourself to assist in transitioning counseling and HRT.


Prof Reena Rajasuriar.jpgA/Prof Reena Rajasuriar

​Reena Rajasuriar is an Associate Professor at the Department of Medicine, University of Malaya and an adjunct Research Fellow at the Peter Doherty Institute for Infection and Immunity, Melbourne University, Australia.


Reena graduated with her Bachelor of Pharmacy (Hons) and Masters in Clinical Pharmacy from University Science Malaysia.  She worked as a pharmacist and junior faculty at the Department of Pharmacy, University Malaya prior to obtaining her Ph.D in Immunology at Monash University, Australia.  Her doctoral research was focused on immunogenetics and immune activation in HIV.  She returned to Malaysia to establish the core immunology research facility at the Faculty of Medicine, University Malaya, which she currently heads.


Dr. Rajasuriar coordinates the translational research program in HIV immunology and Aging at the Centre of Excellence for Research in AIDS (CERiA), University of Malaya.  Her research focuses on understanding the immunopathogenesis of aging in people living with HIV.  In collaboration with her geriatric colleagues, she established the Malaysian HIV and Aging (MHIVA) cohort to study the phenotype of aging and associated risk factors among PLWH in the LMIC setting.   Reena's work is guided by the hypothesis that the process of aging is more accurately captured by functional vs chronological age, and that studying both social factors and mechanistic/biologic drivers are important in informing our understanding of this process.


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Prof Adeeba Kamarulzaman

​Professor Adeeba Kamarulzaman is a Professor of Medicine and Infectious Diseases at Universiti Malaya and an Adjunct Associate Professor at Yale University. She was Dean of the Faculty of Medicine, UM from 2011 to 2019. She is presently a member of the Malaysian COVID-19 National Recovery Council.


Professor Adeeba has played a leading role in the response to the HIV epidemic in Malaysia and globally and is currently the Chairman of the Malaysian AIDS Foundation and President of the International AIDS Society, is a member of the WHO Science Council, UNAIDS Advisory Group and Co-Chairs the Lancet Commission on Health & Human Rights. Her achievements have been recognised through several national and international awards including an Honorary Doctor of Laws from her alma mater, Monash University, for her contributions to medicine and as a health advocate.



Local Speakers

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Dr Felicia Hong

​Dr Felicia Hong is the Senior Assistant Director with the Communicable Diseases Division at the Ministry of Health, Singapore. She has been with the Health Ministry for 10 years helming various portfolios including patient safety and quality improvement, infection prevention and control, and is currently overseeing the policies related to HIV, TB and other contact transmissible diseases.


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Dr Carmen Low

​Dr. Carmen Low is a Senior Scientific Officer in National Public Health Laboratory at National Centre for Infectious Diseases. She is the team leader of HIV surveillance team that provides critical laboratory support to MOH's HIV/AIDS surveillance programme and NCID's National HIV programme, working on projects that include the detection of recent infections, application of next generation sequencing solutions for drug resistance monitoring and epidemiological investigations. She received her PhD from the Department of Microbiology, National University of Singapore. She did her post-doctoral research with the Infectious Diseases Research Group in Singapore-MIT Alliance Research and Technology, working on Mycobacterium tuberculosis and environmental mycobacteria before joining National Public Health Laboratory (NPHL).


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A/Prof Matthias Paul Toh

Adjunct Associate Professor Matthias Toh is a Public Health Physician. He is the current President of the College of Public Health and Occupational Physicians, Academy of Medicine Singapore. He has special interest in disease prevention and control, health promotion and primary care.


He joined NCID in 2019. As Director and Senior Consultant of the National Public Health & Epidemiology Unit (NPHEU) at NCID, he oversees the national HIV registry and coordinates operations for contact tracing. He leads the epidemiology team to provide insights on global and local situation for communicable diseases.


He is an Adjunct Associate Professor with the Saw Swee Hock School of Public Health (NUHS) and Clinical Core Faculty Member for National Preventive Medicine Residency Program. In addition, he provides consultancy to MOH as part of the Epidemiology Investigation Team.


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Dr Teh Yii Ean

​Dr. Teh Yii Ean is a consultant in the department of Infectious Diseases at the Singapore General Hospital. She graduated from the Yong Loo Lin School of Medicine, National University of Singapore in 2011 and obtained her specialist accreditation in Infectious Diseases in 2017.


She has a keen interest in the management of infections in immunocompromised individuals, including hematology and oncology patients, and patients with HIV infection. She is currently the director of the Singapore General Hospital HIV Clinical Programme.


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Dr Dariusz Piotr Olszyna

​Dr Olszyna received his medical degree and a PhD from the University of Amsterdam in the Netherlands. He has been working in the field of HIV for more than a decade with special clinical interests in Pre-Exposure Prophylaxis, Treatment as Prevention, and viral hepatitis co-infections. Dr. Olszyna joined the Division of Infectious Diseases at the National University Hospital in 2008. He is one of the co-founders and presently Clinical Director of the NUH HIV Program and founder of NUH HIV Prevention Service (BEPREP Clinic). Dr Olszyna also serves as the Head of Division of Advanced Internal Medicine at the National University Hospital and Vice-Chairman Medical Board for Education of the Alexandra Hospital.


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A/Prof Sophia Archuleta 

A/Prof Sophia Archuleta is Director of the National HIV Programme, National Centre for Infectious Diseases, and Head of the Division of Infectious Diseases at the National University Hospital, Singapore. She is also a clinician educator and serves as core faculty of the National University Health System Infectious Diseases Senior Residency Programme. Her clinical expertise, and primary interest, is in the care of people living with HIV and its associated conditions.


A/Prof Archuleta joined the Division of Infectious Diseases of the National University Hospital in Singapore in 2008 where she established and led the HIV Programme until 2017. She was appointed Director of the National HIV Programme, National Centre for Infectious Diseases in 2018. She is an Associate Professor of Medicine at the Yong Loo Lin School of Medicine of the National University of Singapore, and serves in various educational leadership roles and national committees on graduate medical education. She is active in teaching learners across health professions and the entire medical education continuum.


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Dr Choy Chiaw Yee

Dr Choy Chiaw Yee is a Consultant Infectious Diseases Physician at the National Centre for Infectious Diseases (NCID) and Tan Tock Seng Hospital. She received her medical training at the Yong Loo Lin School of Medicine and gained membership to the Royal College of Physicians of the United Kingdom in 2016. Having an active interest in HIV clinical care and research, she is a member of the National HIV Programme and Deputy Director of NCID Clinical HIV Programme. She is also actively involved in education and is a Lee Kong Chian Medicine adjunct teaching faculty and NUS medical faculty member.



 Debate Speakers

Dr Stephanie Sutjipto.jpg

Dr Stephanie Sutjipto

​Dr Stephanie is a 3rd year Senior Resident in Infectious Diseases at NCID. Her passion is in HIV prevention and she is actively involved in community education work with Action for AIDS (AFA).

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Dr Khoo Bo Yan

Dr Bo Yan is a 1st-year Resident in Infectious Diseases at NCID. His interests are clinical microbiology and antimicrobial pharmacology, which seem under-appreciated at the moment. His favourite thing about HIV medicine is how it has showcased the utility of applied genetics over the years.

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Dr Cherie Gan

Dr Cherie is a 2nd year ID Senior Resident from Singhealth. She enjoys the wide breadth and depth of conditions encountered in Infectious Diseases and is still discovering her specialized area of interest(s) within ID. When she is not in hospital being fascinated by microbes, she can be found trying out good food to satisfy her gut microbes.

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Dr Alice Ang

Dr Alicia Ang is a 3rd year Senior Resident in Infectious Diseases, National University Hospital. Her favorite part about infectious diseases is how important a person’s social history is in diagnosing& managing their condition. She has a keen interest in infectious diseases in immunocompromised patients, including those living with HIV.

​Keynote Presentations

Keynote 1: HIV Cure - Where are we in 2021?

Professor Sharon Lewin


Despite the great success of antiviral therapy (ART), treatment is life-long for the majority of people with HIV. Antiviral treatment is simple and relatively cheap and close to 70% of people with HIV have access to treatment. However, ART is still not available or secure for many, drug resistance is common globally and there are emerging toxicities from some of the most potent antivirals. The main reason ART is unable to cure HIV infection is the persistence of long-lived proliferating latently infected cells and impaired clearance of HIV-infected cells.


Clinical strategies to achieve a cure are focused on targeting the virus to reduce the pool of infected cells and bolster immune control (reduce and control). This approach has been successful in animal models with some monkeys truly cured or in sustained remission off ART. These strategies have included a combination of TLR7 agonists, broadly neutralizing antibodies, vaccines and immunomodulating agents such as anti-PD1. Clinical trials of TLR7 agonists and anti-PD1 have recently been reported in humans with some promising findings.


Strategies to reduce the pool of infected cells have also included latency reversal agents that can enhance detection of a latently infected cell by increasing expression of viral proteins. A new class of latency reversing agents called SMAC mimetics has recently been reported and was highly effective in animal models. Human clinical trials are awaited. Advances in both ex vivo and in vivo gene therapy also looks promising using gene editing technologies such as CRISPR-Cas 9 to target and eliminate the provirus directly, modifying cells to make them resistant to HIV or enhancing production in vivo of neutralizing antibodies.


There are many challenges in HIV cure clinical research including the need for interruption of ART to detect efficacy, balancing the risk benefit ratio for participants, and ensuring safety of single agents prior to use of combinations. Active engagement of people living with HIV is critical to the success of these programs.


Keynote 2: LoveYourself Ph - Innovations and Self Care Project

Dr. Ronivin Garcia Pagtakhan


LoveYourselft Inc. (LY), is a community of volunteers which has been successful in reaching out to the key affected population of HIV and AIDS. It was founded in 2011 - with a mission of embracing and nurturing one's self-worth to inspire others to do the same and create ripples of positive change in the community and a vision of becoming a model community, empowering, and affirming the self-worth of youth and MSM in the Philippines.


LY has been the home of many innovative and new approaches to reach key populations such as Project Preppy (Pre-exposure Prophylaxis), LoveYourself Caravan/PBSR, Smart-Safe-Sexy Continuum of Care Approach Project (3S) and Introduction of the First Community Run Testing and Treatment Facility (4S) Project, #SafeSpaces Condom Promotion and Distribution Program Victoria by LoveYourself, the first Transgender Health and Wellness Community Center in the Philippines and most recently – introduction of HIV Self Screening (#SelfCare) in the Philippines to name a few.


LoveYourself Inc. is proud of its 8 LoveYourself Branded Community Centers, 2 Private Clinic and manages 15 Champion Community Centers safe space for young and working population who are engaging in risky behavior. For the LY community centers, having a cumulative rate of 150-200 clients daily with 12-14% reactive rate, the centers contribute to 42% of all the newly diagnosed PLHIVs reported in Metro Manila and 20% in the whole country for since 2016 to present proving that LY has a strong understanding of the Philippine context with regard to HIV and AIDS and key populations (MSM, TG, YKP and PWID). These efforts demonstrate a tremendous impact in bridging the gaps in the HIV continuum of care, with the objective of scaling up HIV testing and linking the newly diagnosed PLHIVs to treatment and care, eventually leading to reduced incidence of loss to follow up.


Since its launching, LY Anglo as the main treatment centers and the rest of the 6 as satellite centers has already diagnosed over 40,000 clients yearly. Of the total number of newly diagnosed PLHIVs, 7,300 were enrolled to LoveYourself Anglo treatment while the remaining were referred to RITM or other treatment hubs for enrolment making LY the second highest PLHIV clients enrolled facility. LoveYourself Anglo is currently being positioned as the first ever community run one stop shop – having prevention-to-treatment services. It aims to create a social enterprise-self-sustaining model.


While the geographical coverage of our LY branded HIV program is focused on Greater Metro Manila and Metro Cebu. LY was able to extend its coverage thru the establishment of the CHAMPION COMMUNITY CENTERS network with the aid of Global Fund ACER Grant. LY was able to establish 15 community centers from Luzon to Mindanao in partnership with Community Based Organizations (CBO) focusing on MSMs/TGs having them manage the community centers.


LY, introduced HIV self-testing in the Philippines in 2020 via a demonstration project called "Self Care". Using sure check self-testing kit, the program reached 2000 clients during its run and had a yield of 14% and linkage to care of 90%. With the support of Global fund thru PSFI and USAID – EPIC project, in 2021 – Self-Care is being scaled up to all the sites of Global Fund in the Philippines.


Keynote 3: Preparing for an Ageing HIV population

A/Prof Reena Rajasuriar


One in three PLWH in the Asia-Pacific region are expected to be over the age of 50 years by 2025.  In addition to individuals with HIV living longer, new HIV diagnosis among older individuals is increasing, with a disproportionate number presenting late.  Older PLWH experience a higher burden of multimorbidity including mental health compared to people without HIV of the same age.  Additionally, the long-term health needs of older PLWH often include issues of pain, episodic/chronic disability, sleep disturbances and fatigue; all of which impact quality of life and extend beyond the capacity of typical HIV programs and health systems.  This presentation will highlight the emerging issues around the care of ageing PLWH and outline opportunities to address them.


​Keynote 4: HIV Stigma in Asia – What needs to be done

Prof Adeeba Kamarulzaman


HIV in Asia and the Pacific is characterised by concentrated and growing epidemics in key populations, particularly clients of sex workers and other sexual partners of key populations, people who inject drugs, and men who have sex with men. These individuals experience a high level of stigma and discrimination resulting in barriers in accessing HIV prevention and treatment services. Stigma experienced by a PLHIV is often multi-level, including self or internalised stigma, community and institutionalised particularly healthcare associated stigma. Successful interventions to address stigma will require a multi-faceted approach addressing each of these settings and the intersectionality of stigma experienced by PLHIV.


Progress Update on the HIV Care Cascade in Singapore

Dr Felicia Hong


The current goal in the fight against HIV is ending acquired immune deficiency syndrome (AIDS) epidemic by 2030. To achieve this, the Joint United Nations Programme on HIV/AIDS (UNAIDS) set up the 90-90-90 targets to reflect the cascade of HIV diagnosis, care and treatment (i.e. HIV care cascade). The targets are to have 90% of people living with HIV (PLHIV) knowing their HIV status, 90% of diagnosed PLHIV on sustained antiretroviral therapy (ART), and 90% of people on ART achieving viral load suppression, by 2020. The United Nations General Assembly High-Level Meeting on AIDS in June this year called on member states to achieve the 95-95-95 targets by 2025. This presentation updates on the Singapore's progress in achieving the targets.


​HIV-1 transmitted drug resistance surveillance: Update on newly diagnosed cases in Singapore

Dr Carmen Low


The prevalence of drug resistance in individuals with newly diagnosed HIV infections reflects the extent to which drug-resistant strains of HIV are being transmitted and remains a priority for the monitoring and control of drug resistance to HIV medications. Through the surveillance of individuals without prior antiretroviral therapy to assess population-based transmitted drug resistance (TDR), this update will provide population characteristics and TDR prevalence on 746 residual specimens successfully sequenced between 2016 to 2020. The high prevalence of nonnucleoside reverse transcriptase inhibitors resistance indicates that efavirenz- or nevirapine-based regimen without prior resistance testing is not ideal in newly HIV infected individuals. Even though a low prevalence of protease inhibitors resistance and triple class resistance was observed, continuous monitoring of TDR to all drug classes is a necessity to implement effective strategies in primary antiretroviral therapy.


​Impact of COVID-19 on HIV Testing in Singapore

A/Prof Matthias Paul Toh


COVID-19 and its associated complications are caused by the SARS-CoV-2 virus. First reported in Wuhan, China, on 31 December 2019, it spread rapidly across the whole world in the first 3 months of 2020 and led the World Health Organization (WHO) to declare a pandemic in March 2020.


Singapore detected its first imported case on 23 January 2020. Soon after, subsequent waves were detected within the local community and workers who live in large dormitories in Singapore.

Singapore sprang into action almost immediately to institute prevention and control measures and a slew of public health actions. These included intensive contact tracing and quarantine of close contacts, active case detection through testing and passive surveillance.


When cases started to rise rapidly in early April 2020, a "Circuit Breaker" was introduced for 4 weeks and extended to 8 weeks eventually. During this period, people who could work from home were not allowed to travel to office. Other than essential services, everyone had to stay at home. Fortunately, the "Circuit Breaker" bore fruit and incidence of COVID-19 dropped. This was followed by relaxation of public health measures and gradual reopening of the economy in phases.


Towards the end of 2020, the world was introduced to new SARS-CoV-2 variants of concerns (VOC) which were more transmissible and deadly. Today (September 2021), the Delta VOC is dominating the world. Singapore is still facing new waves of Delta VOC infections.


An important strategy in HIV prevention and control is early detection through testing and linkage of care to achieve U=U. Self-initiated testing of HIV has been gaining acceptance among MSM in Singapore. Anonymous testing of HIV is available at AfA Singapore and selected clinics across Singapore. In addition to anonymous testing, Singapore has established surveillance of HIV tests through the antenatal HIV Programme and Voluntary Opt-out Screening of HIV of inpatients in public hospitals.


This presentation provides an overview of the HIV screenings in Singapore and whether the COVID-19 pandemic has affected these programmes.


​HIV care and treatment services in the time of COVID-19

A/Prof Sophia Archuleta


The COVID-19 pandemic has impacted and disrupted health care services across the globe. Maintaining the HIV care continuum has required rapid, significant adaptations. In this session, we will examine strategies implemented to ensure continued care and treatment in Singapore. These included telehealth, de-linkage of medical consultations from dispensing of antiretroviral therapy, and other means of reducing the frequency of clinic or pharmacy visits. Changes occurred on the heels of national treatment recommendations being adopted in late 2019 and concurrent to subsidies being extended by the Ministry of Health for ART medications in 2020.


​Presentation of Viral Suppression Data

Dr Teh Yii Ean


The COVID-19 pandemic has resulted in major disruption on the healthcare system and health service delivery worldwide. As countries went into lockdown and resources were diverted to combat the pandemic, prevention, testing and treatment services for PLHIV were inevitably affected.


In Singapore, the pandemic has accelerated the adoption of telemedicine and medication delivery services in healthcare institutions. This has ensured that access to care for PLHIV remain uninterrupted as far as possible.


We examine the impact this had on our patients, specifically to determine if the percentage of patients who had attained viral suppression had decreased in the last one year.


4th 90 – Living well with HIV and COVID-19 in Singapore

Dr Dariusz Piotr Olszyna


For people diagnosed and treated early, HIV is now a long-term condition. This has been achieved by widespread use of combination antiretroviral treatment which has led to high levels of viral suppression. However, people living with HIV (PLHIV) at all stages of their lives face unique health challenges. This presentation will focus on definition of so called "4th Ninety", proposed by some as the next global HIV goal. Both comorbidities and self-perceived quality of life among PLHIV will be discussed. The current pandemic has had a profound impact on delivery of health services and the speaker will discuss how it has affected PLHIVs. There have been various approaches proposed by several health experts on how to address the broader health needs of PLHIV beyond viral suppression; this will be covered in the last part of the presentation. 


Recommendations and Guidelines

NHIVP Antiretroviral Treatment Recommendations – Updated Recommendations

A/Prof Sophia Archuleta


Since the advent of combination antiretroviral therapy (ART), the mortality attributable to HIV infection has been reduced by 80%. Newer antiretroviral agents (ARVs) are highly efficacious, have minimal side effects as compared to older drugs, and can be formulated as single-table combination regimens with a reduced pill burden. Despite these advances, 680 000 people died of AIDS-related illnesses worldwide in 2020. As of end 2019, a total of 8618 Singapore residents have been diagnosed with HIV infection, of whom 2097 have died. The NHIVP developed the “Recommendations for the Use of Antiretroviral Therapy (ART) in Adults Living with HIV in Singapore” to guide physicians on the ART prescription based on patients’ needs, tailored to local context with unique domestic considerations. Reviewed and updated every two years, the purpose of the national recommendations is to enhance the care of people living with HIV, providing the best possible treatments to patients.


The latest review and key updates to the ART recommendations includes 1) Cost considerations, 2) Selection of ART, 3) Switching ART in the setting of virologic suppression and 4) Monitoring parameters in patients with HIV infection.


NHIVP Pre-Exposure Prophylaxis Guidance – Updated Guidance

Dr Wong Chen Seong


Pre-exposure prophylaxis (PrEP) is a supplementary preventive measure against HIV. In recent years, trials involving PrEP have suggested that it may also be considered in specific groups as an additional strategy to prevent HIV infection. Recognising that physicians in Singapore may wish to prescribe PrEP for their patients, the NHIVP convened a PrEP Workgroup in May 2019, to develop a "Guidance for the Prescription of HIV Pre-Exposure Prophylaxis (PrEP) in Singapore" for physicians on prescribing PrEP as an additional tool to prevent HIV infection. Updated every two years, the Workgroup's guidance this year is an updated adaptation of current major international guidelines on PrEP from the WHO, the US CDC, British HIV Association (BHIVA), the Australasian Society for HIV Medicine (ASHM), European AIDS Clinical Society and the Taiwan AIDS Society, as well as a previous local guideline created by the PrEP taskforce in April 2018.


The latest review and key updates to the PrEP guidance includes the following:


  1. Special Clinical Scenarios pertaining to the safety of TDF/FTC, addition of TAF/FTC as potential regimen for cis-gender men who have sex with men and trans-gender women who have sex with men with indication of renal impairment and chronic HBV infection, and a new section on what to do in the setting of an indeterminate HIV antigen-antibody test.

  2. Contraindications to PrEP in individuals with known impairment of renal function.

  3. The appropriate use of TAF/FTC regimen

  4. Serum creatinine and anti-HCV monitoring for key populations


HIV Testing Recommendations

Dr Choy Chiaw Yee


In recognition of the morbidity and mortality associated with HIV, the Joint United Nations Programme on HIV/AIDS (UNAIDS) aims to end the epidemic by setting and striving to achieve the ambitious 90-90-90 targets. However, Singapore is still not performing well in the first 90. Hence, the NHIVP developed this set of recommendations based on adaptations from the major international guidelines of the World Health Organisation (WHO) and the US Centers for Disease Control and Prevention (CDC) with the goals to:


1) Increase the uptake of HIV testing nationally;

2) Allow earlier detection and identification of individuals with HIV infection;

3) Facilitate timely linkage to clinical services; and 

4) Reduce further transmission of HIV infection in Singapore by increasing testing and linking positive cases to care early.


Debate Motion

"This House believes that HIV self-testing should be rolled out in retail pharmacies"

Proposition: Dr Stephanie Sutjipto, Dr Cherie Gan

Opposition: Dr Alicia Ang, Dr Khoo Bo Yan


HIV self-testing (HIVST) is where a person collects their own specimen and performs a HIV test in a private setting and interprets the result, either alone or with someone they trust. HIVST has the potential to increase testing, leading to earlier diagnosis with greater convenience for test users. Globally, studies have found a high acceptability of HIVST and the test results show a high sensitivity and specificity with minimal errors. On the other hand, concerns have been raised, which include lack of counselling, challenge of ensuring linkage to care, and potential for coercive use of self-testing devices and their accuracy. Hence in Singapore, HIVST are currently only allowed to be done in a clinic setting, with pros and cons on rolling out in retail pharmacies, which will be debated by our Senior Resident ID physicians at the Congress.

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