One in 350 patients is HIV-positive

[warbird]

One in 350 patients is HIV-positive and they don't even know it
By Loh Chee Kong, Daphne Chuah, TODAY | Posted: 18 July 2007 1110 h


SINGAPORE: More Singaporeans could be infected with HIV than they realise.

According to a recent Ministry of Health (MOH) study of more than 3,000 anonymous blood samples collected in hospitals, 0.28 per cent were HIV-positive.

The study, done earlier this year, excluded blood samples from known HIV patients.

This means one in 350 hospital patients who think they are free of the disease are actually HIV-positive. In comparison, there were 2,852 known HIV-infected patients in Singapore as of June last year — or about 0.06 per cent of the population.

The problem is "much more acute" for male patients, with a 15:1 male-to-female ratio in the sample population, said Dr Balaji Sadasivan, Senior Minister of State for Information, Communications and the Arts, and Foreign Affairs, speaking at the launch of a workplace Aids education exhibition.

The stunning findings made for a stark assessment of the HIV/Aids situation in Singapore, and showed the potential minefield health professionals may have to navigate.

Said Dr Balaji: "The methodology ensured that the patients whose blood samples were positive could not be traced ... (so) patients in this survey who've been misdiagnosed and wrongly treated will continue to remain misdiagnosed and will continue to receive the wrong treatment."

While a misdiagnosis of HIV "could be excused" 20 years ago, a misdiagnosis today could "very well lead to complaints of professional failure" against doctors and hospitals, he said.

For instance, some Aids patients could display chronic diarrhoea and weight loss. If a simple blood test for HIV were to be done, the correct diagnosis would be reached.

Without such a test, though, the patient could end up undergoing "expensive and unnecessary" procedures such as MRI (magnetic resonance imaging) and colonoscopy. The diarrhoea and weight loss may be attributed to stress and the wrong treatment would be prescribed, said Dr Balaji.

Last year, Singapore experienced a record high of 357 new HIV positive cases.

Despite the "serious implications" of the latest study, Dr Balaji believes HIV testing — including for medical staff and hospital patients — should not be made mandatory.

"I don't think there should be a problem with healthcare workers, as they should be knowledgeable," he said. "What we need to do is make people understand how they can benefit by volunteering for tests. If we can educate people sufficiently, those who should go for testing will go for testing."

He called on the medical community to "mull over" the findings and come up with "innovative ways" of providing better care for HIV-positive patients.

"The MOH survey … has identified a serious problem. We don't have all the answers but we should be willing to learn and introduce the best practices from others," said Dr Balaji, who is leading a study team to Sydney today to evaluate its HIV prevention programmes.

Dr Roy Chan, the president of Action for Aids — a non-governmental organisation for Aids prevention — believes there is no need to push the panic button.

He told Today: "In any country, Singapore included, there's a proportion of patients who, unknown to themselves and doctors, are infected."

While few countries have tried to determine how many HIV-infected patients are unaware of their condition, he noted that the MOH's findings are in line with the latest estimates for Singapore by the Joint United Nations Programme on HIV/Aids (UNAids).

According to UNAids, 0.3 per cent of adults here are HIV-positive. The MOH has also estimated previously that for every Aids patient identified, there are possibly two to four undiagnosed.

While "there's always a possibility" of a misdiagnosis, Dr Chan thinks that most healthcare workers here are alert to HIV symptoms and echoed Dr Balaji's views that Singapore must continue to encourage voluntary testing, particularly for those with high-risk behaviour.

But Dr Clarence Yeo, a general practitioner, does not think it is easy to spot early HIV symptoms, as some of these are common in other medical conditions, including cancer.

He said: "Beyond looking at the symptoms alone, if the person is also a high-risk patient — for example, he or she has multiple sexual partners or tends not to use protection (during sexual intercourse) — it would be worthwhile to screen and test them.

"But if the patient doesn't wish to divulge such personal information, then it would not be obvious to us." - TODAY/yy

[sohjonathan]

Hey bro..

Just heard this news on the radio.. thanks for posting here..

Scary figures man.. Bros here, pls do go for regular check ups..

Hopefully, it'd be none of us here..

[Nuglut]

Read the same. Hope everybody is keeping it safe out there guys. Use both heads bros!

[Megatronzombie]

Read today's newspapers - even scarier, some people are knowingly spreading AIDS around - the paper quoted 'someone' has been implicated of knowingly spreading AIDS by having sex with other persons... could it be one of the FLs?? Scary...

[warbird]

In Singapore, I don't know if it's a criminal offense, a felony, for an individual to knowingly & deliberately spread AIDS by having unprotected sex w/ others. I hope it is. If you know such an individual, you should call the CID.

[AfA_hmor]

Should Aids testing be mandatory?
19 July 2007 10:57:00 PM GMT
Channel NewsAsia
English
(c) 2007 MediaCorp News Pte Ltd. All Rights Reserved

Amid startling statistics that one in 350 hospital patients are HIV-positive, at least one voluntary welfare organisation here has called for mandatory testing of high-risk groups, in what some have described as a highly controversial and intrusive move.
The group - Focus on the Family - said it would be submitting a proposal, drafted together with doctors, to the Ministry of Health (MOH) soon.
High-risk groups, such as men who visit sex workers and sexually-active gay men, should go for compulsory testing, said its director, Mr Tan Thuan Seng.
"We should not allow people who choose high-risk lifestyles to avoid testing and thereby subject innocents in their households and medical workers to unfair risks of infection," said Mr Tan.
"These undiagnosed infected are walking time-bombs as they have the potential to knowingly or unknowingly infect others."
On Tuesday, it was revealed that a recent MOH study of over 3,000 anonymous blood samples collected in hospitals showed that 0.28 per cent of those who thought they were free of the disease were in fact HIV-positive.
This was followed by the news that the MOH is investigating the case of a man suspected of spreading the virus knowingly.
However, MPs and Aids volunteers TODAY spoke to were concerned about how the identification of such HIV-positive carriers is intrusive and stigmatises those affected.
"In implementing it, it's hard to not intrude into the privacy and rights of individuals," said chairman of the Aids Business Alliance, Mr Zulkifli Baharuddin.
Mr Benedict Jacob-Thambiah, an Action for Aids volunteer and the programme director of Heat Consultants, which provides HIV education at the workplace, agreed.
"Mandatory testing of any group only serves to stigmatise, isolate and deepen discrimination. It is not something I would advocate as I do not think any Singaporean should be subject to something that is patently wrong. It does no one any good," he said.
Since December 2004, pregnant women have been subjected to opt-out HIV tests as part of standard antenatal screening here. Only one case of mother-to-child transmission has occurred, and that was because the mother refused her HIV test until very late in her pregnancy, according to the MOH.
Last year, Singapore experienced a record high of 357 new HIV-positive cases.
Making testing compulsory - even for small high-risk groups - could pose some implementation problems, said deputy chairman of the Government Parliamentary Committee for Health, Dr Lam Pin Min.
"It's hard to identify persons in the high-risk groups unless they declare it themselves," he said. "It also makes it very difficult to draw a line on whether you visit sex workers or are sexually liberal or promiscuous.
"So, if you make it a law to self-declare, does it mean that you're breaking the law if you're in one category or the other?"
Those TODAY spoke to were all in favour of better public education, particularly as the HIV/Aids situation here is not seen as dire.
"I don't think the situation has come to the point where there is a real epidemic that requires an intrusion into private lives," said Aids Business Alliance chairman Zulkifli. "We always try to persuade and cajole people, and, in most cases, they respond."

[Big Sexy]

ironically 1 in every 2 to 3 WL has Herpes...and stilll people go to them....

Originally Posted by warbird

One in 350 patients is HIV-positive and they don't even know it