209 new HIV cases in Singapore in 2023, with total number of infections at 9,540
HIV self-testing kits will be available for sale at selected Guardian and Watsons pharmacies by the end of January 2025, as part of efforts by the Ministry of Health (MOH) to encourage regular testing within the community.
With the introduction of such kits, individuals will now have greater access to HIV testing and the option to test themselves in the comfort and privacy of their own homes, without the fear of stigma, Senior Minister of State for Health Janil Puthucheary said on Nov 30.
“This initiative goes beyond the addition of another testing modality in our fight against HIV. It empowers individuals to take charge of their own health, and it reinforces the idea that early detection is crucial for the initiation of treatment,” he added.
Dr Janil was speaking at the 14th edition of the Singapore Aids Conference organised by non-governmental organisation Action for Aids Singapore (AfA Singapore).
In 2023, 209 new cases of HIV infections were reported among Singapore residents. The total number of HIV-infected Singapore residents stood at 9,540 as at the end of 2023, of whom 2,457 have died.
The initiative to introduce HIV self-testing started as a pilot programme in 2022 led by the National HIV Programme, with community partners AfA and the Department of Sexually Transmitted Infections Control (DSC) Clinic.
“In that process, HIV self-testing has been shown to be safe, to be effective and to be widely accepted among the key populations and the general public,” said Dr Janil.
The OraQuick HIV Self-Test Kit is also on sale on National Skin Centre Pharmacy’s website at $21.85. The kits will have an oral swab for detecting the body’s natural antibodies, and results can be obtained after at least 20 minutes.
Dr Janil said the 95-95-95 targets set by the Joint United Nations Programme on HIV/Aids aim to have 95 per cent of people living with HIV know their diagnosis, 95 per cent of people diagnosed with HIV receive treatment, and 95 per cent of people receiving treatment achieve a suppressed viral load by 2030.
He said Singapore is making progress, with 85 per cent of people living with HIV here knowing their diagnosis, 94 per cent of those diagnosed receiving treatment, and 93 per cent of those on treatment achieving viral suppression.
More than half of newly detected HIV cases here had late-stage infection at the time of diagnosis, making up 51 per cent of cases in 2023, 52 per cent in 2022, and 62 per cent in 2021, according to MOH. The proportion of late-stage infection detected through selfinitiated HIV testing made up only 15 per cent of cases in 2023, 17 per cent in 2022, and 16 per cent in 2021.
A law was amended in March to exempt people with HIV from disclosing the risk of contracting the virus to their sexual partners as long as they have maintained undetectable viral loads for at least six months. This change is meant to encourage individuals with higher risk of getting HIV to get tested regularly and start treatment.
Dr Janil stressed the importance of providing support systems and follow-up to guide individuals who use these kits on what to do next, especially if they test positive.
This is where community partners will help these individuals confirm their status, access treatment or offer emotional support, he said.
“I would like to emphasise that self-testing is an additional tool, and it is not a replacement of our broader HIV testing efforts. Visiting a clinic or engaging with community-based testing programmes should remain the preferred method, and these pathways will continue to be available,” he added. He said the Government will work closely with community partners to ensure the kits are used effectively.
MOH said on Nov 30 that the result of a single rapid diagnostic test such as the HIV self-testing kit is not sufficient to make a diagnosis of HIV infection. Individuals who test positive should receive further confirmatory testing from a healthcare provider and be referred for treatment.
If the test result is negative but the individual has had a recent unprotected sexual exposure or is at a higher risk of HIV infection, it may take up to three months to develop antibodies to HIV that will be detected on the testing kits. Repeat HIV testing is advisable.
MOH and the Health Promotion Board recommend that every adult should get tested at least once in their lifetime, regardless of risk factors. Individuals who engage in high-risk sexual behaviours should go for regular HIV testing every three to six months.
“HIV can be treated effectively with modern HIV medicine or antiretroviral therapy. With early and effective treatment, people living with HIV can lead lives no different from others,” said the ministry.
“They can also protect their sexual partner from infection, if they are on regular treatment and have a stable undetectable viral load.”
Dr Martin Chio, a senior consultant at the National Skin Centre and former head of the DSC Clinic, said the accuracy of the self-test kits is comparable with blood tests at the clinic, and will make HIV testing more accessible.
“Making sure that 95 per cent of the estimated infected population know the diagnosis – that has always been a hurdle. This will help people to not have to make appointment and take time off to go for a test.”
Associate Professor Sophia Archuleta, head of infectious diseases at the National University Hospital and a clinical adviser of the National HIV Programme, said: “The self-test kits have been in use internationally for several years, and are accurate with simple-to-follow instructions.”
She added that all positive HIV tests need to be followed up with a confirmatory test.
“Normalising HIV testing as part of routine health screening is important in reducing stigma. Everyone should know their HIV status.”
Those who wish to speak to someone about HIV, or require sexual health-related information or counselling, are advised to contact the DSC Clinic on 1800-252-1324 and/or AfA on 6254-0212.
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