Singapore actor’s jail sentence puts spotlight back on ‘incredibly prevalent’ sexually transmitted infection human papillomavirus (HPV)

Former actor Ian Fang was sentenced to 40 months in prison on May 19 after pleading guilty to multiple charges, including sexual offences involving a minor. Reports indicate that many of these encounters were unprotected, and the victim was later diagnosed with human papillomavirus (HPV), a common sexually transmitted infection (STI). The case has renewed public attention on the realities and risks associated with HPV.

While specific data on HPV prevalence in Singapore’s general population remains limited, estimates from the broader Southeast Asia region suggest that around 3% of women carry cervical HPV-16/18 infections at any given time, according to a 2023 report by the HPV Information Centre. Notably, 70.4% of invasive cervical cancers in the region are attributed to HPV types 16 and 18.

Despite being a “very common virus that is incredibly prevalent, with most people encountering it at some point in their life,” says Dr. Sim Tzi Ling, general practitioner at Doctor Anywhere, HPV remains under-discussed and often misunderstood.

Many people are unaware they have HPV because it is frequently asymptomatic, meaning it does not cause noticeable symptoms. “Discussions about sexual health can lead to feelings of embarrassment or stigma. Also, until relatively recently, effective prevention through vaccination wasn’t available so the focus was mainly on managing complications,” Dr. Sim explains.

HPV consists of multiple strains. While it is primarily transmitted through skin-to-skin contact, penetrative sex is not necessary for transmission; the virus can also be spread through oral and anal sex. Dr. Sim emphasises that although condoms can reduce the risk, “they don’t completely eliminate it because the virus can be present on areas not covered by a condom.”

Most HPV infections clear up on their own without causing health problems. This typically happens within 12 months, though it can vary from person to person. This is especially true for low-risk strains such as strains 6 and 11 that cause genital warts.

High-risk types, such as HPV 16 and 18, are responsible for the majority of HPV-related cancers, including cervical, anal, penile, vaginal, vulvar, and oropharyngeal (throat) cancers. Persistent infection with these types can lead to cancer, with the risk depending on the strain and an individual’s immune response.

There’s also a common misconception that HPV only affects women. Dr. Sim clarifies that men can also be affected and can transmit the virus even if they show no symptoms. Additionally, HPV can be contracted from just one sexual partner, dispelling the myth that multiple partners are necessary for infection.

Diagnosis and treatment options

In women, HPV is usually detected through cervical screening either via a Pap smear, which identifies abnormal cells, or an HPV DNA test, which checks for the presence of the virus.

“Regular screening is essential,” Dr. Sim urges. “It can detect cellular changes early and help prevent cervical cancer.”

In men, no routine screening currently exists. However, HPV may be detected through anal swabs, biopsies, or visual inspection if symptoms like genital warts or lesions appear.

If someone tests positive for a high-risk strain, follow-up is critical. Women may need more frequent screenings or a colposcopy, a procedure to examine the cervix under magnification. “The goal is to monitor and manage any precancerous changes before they progress,” Dr. Sim explains.

For low-risk strains, such as those causing genital warts, treatments include topical creams, cryotherapy (freezing), laser therapy, or minor surgery, depending on the size and location of the warts.

Cervical precancerous changes may require procedures such as LEEP (loop electrosurgical excision procedure) or cone biopsy. “These treatments are effective at removing abnormal cells and preventing cervical cancer,” Dr. Sim adds.

She also stresses the importance of open communication: “If you’re diagnosed with HPV, it’s crucial to talk to your partner about it, practise safe sex, and consider vaccination even after exposure, the vaccine can still protect against strains you haven’t encountered.”

Why vaccination matters

There is a persistent myth that the HPV vaccine is only for young girls, but it is recommended for both boys and girls, and even adults up to age 45.

The vaccine is most effective before sexual activity begins, but it can still offer protection to sexually active individuals by covering HPV types they haven’t been exposed to. Although HPV vaccination is not currently part of Singapore’s national immunisation schedule for males, it is encouraged for boys and men, particularly those at higher risk.

The vaccines currently approved in Singapore, Cervarix and Gardasil-9, have been shown to be very safe, with mild side effects such as injection site soreness or low-grade fever. “There is no scientific evidence linking the vaccine to infertility or serious health issues,” Dr. Sim affirms.

Government subsidies are available for females aged 9 to 26 at polyclinics and CHAS GP clinics for Singapore Citizens, and at polyclinics for Permanent Residents. The vaccine is also offered free of charge to female students in Secondary 1 and 2.

For the most accurate and up-to-date information, individuals are encouraged to consult the Singapore Ministry of Health, the National Immunisation Registry, or speak with their general practitioner.