UPDATE ON THE HIV/AIDS SITUATION IN SINGAPORE 2021 (JUNE 2022)

1 July 2022

There were 250 new cases of human immunodeficiency virus (HIV) infections reported among Singapore residents¹in 2021. This brings the total number of HIV-infected Singapore residents to 9,129 as of end 2021, of whom 2,255 had passed away over the years. The annual number of new HIV cases among Singapore residents had ranged from 400 to 500 from 2007 to 2017, had decreased to about 320 in 2018 and 2019, and had further decreased to 261 in 2020.

2. Of the 250 new cases in 2021, 95% were male and 68% were aged 20 to 49 years. About 62% had late-stage HIV infection² when they were diagnosed.

3. Sexual intercourse remains the main mode of HIV transmission. 95% (237 out of 250) of the cases had acquired the infection through sexual intercourse. Heterosexual transmission accounted for 33% of cases, while 62% of the cases occurred in men who have sex with men (MSM), including bisexual transmission (3%).

4. 57% of the newly reported cases were detected during the course of medical care³ and typically at a late stage of HIV infection. Another 18% were detected during routine programmatic HIV screening⁴ and 16% were detected from self-initiated HIV screening. The rest were detected through other forms of screening. Cases detected via self-initiated screening tended to be at the early stage of infection. A higher proportion of MSMs (23%) had their HIV infection detected via self-initiated HIV screening compared to heterosexuals (6%). Please refer to the Annex for detailed data for cases reported from 1985 to 2021.

Public Advisory

5. The most effective way to prevent HIV infection is to remain faithful to one’s spouse/ partner and to avoid casual sex, or sex with sex workers. Persons engaging in high-risk sexual behaviour, such as having multiple sexual partners or engaging in casual or commercial sex, are strongly advised to use condoms to reduce their risk of HIV infection and other sexually-transmitted infections. Condoms should be used consistently and correctly during every sexual encounter. In addition, the use of preventive measures like HIV pre-exposure prophylaxis are highly effective when used as part of a comprehensive HIV prevention strategy.

6. The Ministry of Health and the Health Promotion Board (HPB) urge individuals who engage in high-risk sexual behaviour to go for regular HIV testing. Going for HIV testing is the only way to know one’s HIV status. Regular testing and early diagnosis allow persons living with HIV to be treated early and achieve better treatment outcomes. This also provides an opportunity to protect their partners from infection as persons living with HIV who are on treatment and have an undetectable viral load have practically no risk of transmitting the virus to their sexual partners. With early and effective treatment, people living with HIV can lead lives no different from others.

7. HIV testing is widely available at healthcare institutions, including polyclinics, private clinics, hospitals, and at anonymous HIV test sites where personal particulars are not required when undergoing a HIV test.

8. From 1 August 2022, the National HIV Programme, which is under the National Centre for Infectious Diseases, will be introducing HIV self-testing to complement the existing testing modalities, and encourage self-testing for those who prefer this testing option. HIV self-testing can be done in the privacy of one’s home and involves self-collection of oral specimen using a swab. The results can be obtained within 20 to 40 minutes. HIV self-testing kits will be available at the Department of Sexually Transmitted Infections Control (DSC) Clinic and Action for AIDS (AfA) Anonymous Test Site (ATS) at 31 Kelantan Lane, from 1 August 2022. The HIV self-test kit costs between $20 and $32.

9. The result of a single rapid diagnostic test such as the HIV self-test is not sufficient to make a HIV-positive diagnosis. Therefore, Individuals with a positive result from the self-testing kit should receive further confirmatory testing from a healthcare provider and be referred for treatment. If the test result is negative, it also does not mean that the individual is not infected with HIV. As it can take up to three months for antibodies to develop following HIV infection before they can be detected by the self-test kits, a recent infection may not be detected unless a second test is performed three months after the first test. Those at higher risk of HIV infection should test more frequently and see a health care provider to discuss options for preventive measures and testing. More information about the HIV self-testing can be found at www.ncid.sg/nhivp.

10. More information about HIV and AIDS as well as where to undergo anonymous HIV testing can be found on https://www.healthhub.sg.

MINISTRY OF HEALTH
NATIONAL CENTRE FOR INFECTIOUS DISEASES
1 JULY 2022

¹Singapore citizens and permanent residents
²CD4+ cell count of less than 200 per cu mm or AIDS-defining opportunistic infections or both
³Includes cases that presented with HIV-specific symptoms and cases with non-HIV related medical conditions
⁴ Includes screening programmes for individuals with sexually transmitted infections, hospital inpatients and those identified through contact tracing

Annex A

Table 1: Number of Singapore Residents Reported with HIV/AIDS (1985 – 2021)

Year	Male	Female	Total	Rates*
1985	2	0	2	0.1
1986	6	1	7	0.3
1987	10	0	10	0.4
1988	15	0	15	0.6
1989	9	1	10	0.4
1990	17	0	17	0.6
1991	39	3	42	1.5
1992	49	6	55	1.9
1993	58	6	64	2.2
1994	76	10	86	2.9
1995	102	9	111	3.7
1996	123	16	139	4.5
1997	157	16	173	5.5
1998	167	32	199	6.3
1999	171	35	206	6.4
2000	193	33	226	6.9
2001	204	33	237	7.1
2002	206	28	234	6.9
2003	212	30	242	7.2
2004	290	21	311	9.1
2005	287	30	317	9.1
2006	327	32	359	10.2
2007	392	31	423	11.8
2008	426	30	456	12.5
2009	418	45	463	12.4
2010	403	38	441	11.7
2011	430	31	461	12.2
2012	437	32	469	12.3
2013	428	26	454	11.8
2014	422	34	456	11.8
2015	423	32	455	11.7
2016	380	28	408	10.4
2017	408	26	434	10.9
2018	290	23	313	7.8
2019	308	15	323	8.0
2020	241	20	261	6.5
2021	238	12	250	6.3
Total	8364	765	9,129

*Per 100,000 resident population.

Table 2: Distribution of HIV/AIDS - Infected Singapore Residents By Modes of Transmission (1985 – 2021)

Mode of Transmission	1985 - 2014	2015	2016	2017	2018	2019	2020	2021	Total
Sexual Transmission
Heterosexual	3965	173	148	155	135	128	96	82	4882
Homosexual	1894	232	213	218	132	161	125	147	3122
Bisexual	488	35	28	44	31	26	28	8	688
Intravenous drug use	116	4	4	0	1	1	3	3	132
Blood Transfusion	3	0	0	0	0	0	0	0	3
Renal Transplant overseas	5	0	0	0	0	0	0	0	5
Perinatal (mother to child)	31	0	2*	1*	0	0	0	0	34
Uncertain/Others	183	11	13	16	14	7	9	10	263
Total	6685	455	408	434	313	323	261	250	9129

*Transmission occurred overseas

Table 3: HIV/AIDS - Infected Singapore Residents By Marital Status and Sex (1985 – 2021)

Marital status		1985 - 2014	2015	2016	2017	2018	2019	2020	2021	Total
Male
	Single	3844	321	282	316	199	214	175	191	5542
	Married	1601	64	68	65	68	67	53	35	2021
	Divorced/Separated	522	29	24	23	12	22	13	8	653
	Widowed	109	9	6	4	11	5	0	4	148
	Total	6076	423	380	408	290	308	241	238	8364
Female
	Single	121	5	1	7	6	2	6	2	150
	Married	351	18	16	11	11	9	10	6	432
	Divorced/Separated	92	9	9	7	3	3	3	3	129
	Widowed	45	0	2	1	3	1	1	1	54
	Total	609	32	28	26	23	15	20	12	765
Total
	Single	3965	326	283	323	205	216	181	193	5692
	Married	1952	82	84	76	79	76	63	41	2453
	Divorced/Separated	614	38	33	30	15	25	16	11	782
	Widowed	154	9	8	5	14	6	1	5	202
	Total	6685	455	408	434	313	323	261	250	9129

Table 4 HIV/AIDS - Infected Singapore Residents by Ethnic Group (1985 – 2021)

Ethnic Group	1985 - 2014	2015	2016	2017	2018	2019	2020	2021	Total
Chinese	5270	340	275	299	209	197	172	157	6919
Malay	891	72	88	82	59	92	65	61	1410
Indian	326	22	29	27	29	20	15	22	490
Others	198	21	16	26	16	14	9	10	310
Total	6685	455	408	434	313	323	261	250	9129

Table 5: HIV/AIDS - Infected Male Singapore Residents by Age and Modes of Transmission (1985 – 2021)

Age group and mode of transmission			1985 - 2014	2015	2016	2017	2018	2019	2020	2021	Total
Male	Heterosexual
		15 – 19	7	1	0	1	0	2	0	0	11
		20 – 29	314	13	10	17	8	5	2	4	373
		30 – 39	801	25	17	19	16	25	13	18	934
		40 – 49	976	41	30	31	25	21	12	12	1148
		50 – 59	752	34	41	38	38	32	28	16	979
		60 & above	555	30	23	26	27	28	22	20	731
		Total	3405	144	121	132	114	113	77	70	4176
	Homosexual/Bisexual
		15 – 19	46	4	2	4	3	6	5	0	70
		20 – 29	652	80	82	77	45	42	32	29	1039
		30 – 39	919	93	67	75	42	52	49	46	1343
		40 – 49	559	56	60	62	41	52	36	45	911
		50 – 59	168	29	25	38	26	29	21	24	360
		60 & above	29	5	5	5	6	6	10	11	77
		Total	2373	267	241	261	163	187	153	155	3800
	Others
		0 – 14	17	0	2	0	0	0	0	0	19
		15 –19	8	0	1	2	1	1	0	0	13
		20 –29	40	2	1	1	0	2	0	3	49
		30 –39	91	2	3	3	2	0	3	5	109
		40 –49	79	3	5	5	1	4	1	1	99
		50 –59	45	4	4	3	5	1	3	1	66
		60 & above	18	1	2	1	4	0	4	3	33
		Total	298	12	18	15	13	8	11	13	388
	Total
		0 – 14	17	0	2	0	0	0	0	0	19
		15 – 19	61	5	3	7	4	9	5	0	94
		20 – 29	1006	95	93	95	53	49	34	36	1461
		30 – 39	1811	120	87	97	60	77	65	69	2386
		40 – 49	1614	100	95	98	67	77	49	58	2158
		50 – 59	965	67	70	79	69	62	52	41	1405
		60 & above	602	36	30	32	37	34	36	34	841
		Total	6076	423	380	408	290	308	241	238	8364

Table 6: HIV/AIDS - Infected Female Singapore Residents by Age and Modes of Transmission (1985 – 2021)

Age group and mode of transmission			1985 - 2014	2015	2016	2017	2018	2019	2020	2021	Total
Female	Sexual
		15 – 19	12	0	0	0	0	0	1	0	13
		20 – 29	147	2	5	7	4	1	0	2	168
		30 – 39	153	8	3	3	4	4	5	3	183
		40 – 49	114	9	7	6	4	4	3	3	150
		50 – 59	93	7	8	5	4	4	7	2	130
		60& above	50	3	4	3	5	2	3	2	72
		Total	569	29	27	24	21	15	19	12	716
	Others
		0 – 14	15	0	0	0	0	0	0	0	15
		15 –19	0	0	0	1	0	0	0	0	1
		20 –29	6	0	0	0	0	0	1	0	7
		30 –39	8	1	1	0	0	0	0	0	10
		40 –49	8	1	0	0	1	0	0	0	10
		50 –59	1	1	0	0	1	0	0	0	3
		60 & above	2	0	0	1	0	0	0	0	3
		Total	40	3	1	2	2	0	1	0	49
	Total
		0 – 14	15	0	0	0	0	0	0	0	15
		15 – 19	12	0	0	1	0	0	1	0	14
		20 – 29	153	2	5	7	4	1	1	2	175
		30 – 39	161	9	4	3	4	4	5	3	193
		40 – 49	122	10	7	6	5	4	3	3	160
		50 – 59	94	8	8	5	5	4	7	2	133
		60 & above	52	3	4	4	5	2	3	2	75
		Total	609	32	28	26	23	15	20	12	765