Health Matters: Why we need to destigmatise attitudes towards HIV 

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Despite medical advancements that now allow individuals diagnosed with human immunodeficiency virus (HIV) to live healthy, regular lives, the stigma that surrounds them has seen little progress in terms of social acceptance.

“Unfortunately, discrimination and stigma against HIV infection still exists in Singapore. This can be due to a lack of knowledge on HIV infection, as well as various religious and cultural factors,” says Dr Choy Chiaw Yee, consultant, National HIV Programme at the National Centre for Infectious Diseases (NCID).

This, she adds, results in individuals being unnecessarily stigmatised and isolated by their friends, families and colleagues. “For instance, their food might be prepared and served separately from their families, or they may be fired from their job simply for having HIV infection. In addition, there is also a common misconception that only individuals with certain behaviours are at risk of having HIV infection.”

For the record, HIV cannot be transmitted by touch, saliva or urine – it’s only transmissible through the sharing of body fluids such as blood, sexual secretions and breast milk.

Prejudice against individuals with HIV also discourages voluntary testing for HIV infections among those who feel that they are not in the at risk group. Dr Choy emphasises that anyone who is sexually active is at risk of HIV infection.

“Testing regularly and seeking treatment for HIV infection is a responsible act that helps to protect one and their loved ones. 

“There are various ways individuals can get tested for HIV infection. In addition to the 10 anonymous HIV testing sites, individuals can now purchase HIV self-testing kits at Department of Sexually Transmitted Infections Control (DSC) Clinic and Action for AIDS (AfA) to test themselves in the privacy of their own homes,” she says.

Below, Dr Choy shares more about what it means to be living with HIV today.

What are some advancements in HIV medicine?

Combination antiretroviral agents (drugs that stop the virus from replicating in the body, allowing the immune system to repair itself) have transformed HIV infection from a formerly fatal illness in the 1980s to a chronic condition (although not yet a curable disease) today. 

With antiretroviral agents, mortality attributable to HIV infection has been reduced by at least 80 per cent and the risk of non-AIDS related death by 50 per cent. Individuals living with HIV infection who are on treatment can now live healthy lives no different from the rest of the population.

Another tool that is also available is the use of pre-exposure prophylaxis, or PrEP. PrEP involves the use of antiretroviral drugs to prevent HIV transmission. When taken correctly, it has been shown to be effective in reducing risk of HIV transmission.

How effective are these?

With effective treatment, individuals living with HIV infection cannot transmit the virus onwards to their partners sexually. This is a concept known as U=U, or undetectable equals untransmittable. This is an important concept because it improves the lives of people living with HIV infection by reducing shame and fear of transmission, opens up possibilities for conceiving children without alternative means of contraception and encourages people living with HIV infection to start and stay on treatment. 

The reduction in the risk of transmission also brings us closer to ending the epidemic of HIV infection.

Where can individuals living with HIV seek support from? 

They can reach out to the AfA support group. AfA provides emotional and financial support for people living with HIV in a supportive community. Within the healthcare setting, the healthcare staff and the medical social workers working with people living with HIV infection also provide emotional and financial support through various means. 

This can be in the form of programmes such as the Red Ribbon Project, a women’s support group and volunteer training programme organised by the National Centre for Infectious Diseases. 

Ultimately, the best support can also come from their friends and families who are aware of their diagnosis and supportive of them. Having the support of their regular network helps people living with HIV to feel included and stay committed to their therapy.

For those of us who know loved ones living with HIV, how else can we support them? 

Do not discriminate against them. Instead, do continue to include them in activities that you used to do together and continue the same conversations you had before their diagnosis. 

It’s important to show them that you still see them as the same person as they were and that they are more than their diagnosis. Reassure them that their diagnosis does not change your relationship with them. And if they are ready and wish to speak about their diagnosis, provide a listening ear and have open conversations about HIV infection. 

Lastly, educate yourself about HIV infection. It will go a big step in supporting your loved ones and reassuring them that HIV is a chronic manageable disease.

For more information, visit ncid.sg/nhivp