On Neil Road, ostensibly where many members of the gay community in Singapore gather to party, the vibe is upbeat and promising on a Friday evening.
Everywhere you turn, it would seem, there are beautiful faces and dazzling personalities gathering, as people gear up for another weekend.
Fun is certainly in the air, and within easy reach. And yet, just under the radar, frivolity has been set aside, in favour of something a lot more serious.
Heading into some of the nightspots along the stretch, you will see volunteers from Action for AIDS (AFA) set up shop in discreet corners of nightspots like DYMK and Tantric.
The volunteers are there for a purpose: to facilitate anonymous testing for the Human Immunodeficiency Virus (HIV), for any patron who wants to do a test.
When someone tests positive for the virus, this can lead to the Acquired Immunodeficiency Syndrome (AIDS), the most advanced stage of the HIV disease. The emphasis on the anonymous aspect of the testing means it is carried out discreetly and away from prying eyes.
In particular, this outreach program is targeted at the "men who have sex with men" (MSM) community, hence the locale-specific efforts. There have been rising numbers of men testing positive in this subset, leading to the additional focus in this area.
Shining the spotlight of awareness on HIV and AIDS
Professor Roy Chan, Action for AIDS President, says the anonymous aspect of these tests creates a necessary bridge which reaches out directly to those who might be affected, but are yet unable or unwilling to have themselves tested by going to a clinic.
“Testing is the start of the whole process. If a person tests positive, he or she needs to get connected to care. And this is what we hope to achieve. If we don’t test, or if people don’t have the opportunity to get a test in a fairly easy way, they may never know that they are positive until years down the road, when they are really ill. By which time, the prognosis is not so good. And also, they could be transmitting to other people. So you need as early a diagnosis as possible, so that the person can get necessary treatment and care.”
Professor Chan also says making sure Singaporeans remain aware of AIDS and ensuring testing is accessible are both critical in managing HIV-infection numbers in Singapore overall, and in particular, in the MSM community. This would also provide AFA with a better handle on what the statistics indicate, in terms of trends with the illness.
“Twenty-five or 30 years ago, it was much more evident that it was a fatal disease. With the advent of very effective treatment for HIV today, it is not a fatal disease now. Because people are not dying, it is not as visible. But the truth of the matter is that there are more people getting infected today that there were 20 years ago.”
Complacency breeds ignorance
In the attempt to ensure Singaporeans are not lulled into a false sense of complacency with the full effects of HIV or AIDS being masked through treatment today, anonymous testing is being brought to the front burner with the on-going initiative. This helps those who are potentially at-risk to take proactive steps in combating the disease. The anonymous testing service at Kelantan Lane saw 6,600 clients last year, an increase of 8% from the year before.
Volunteers give out information to patrons and let them know the opportunity to carry out a quick check on their health is just a few steps away, in a quiet and low-lit corner of the premise. Agreeing participants fill up a questionnaire, have a swab of their mouths done and can check back in about an hour later for the results. Personal information on the participants is not taken at all – even if results are positive. In addition, any information collated from the questionnaires is merely for data-collection that will help provide more timely and directional outreach efforts in the future.
AFA Programme Manager Joe Wong spoke about the importance of the outreach efforts, and why accessing the MSM crowd in nightspots is an effective strategy.
“Basically, what we are trying to do is to address the needs and the epidemic we are facing right now. This is for the people who are at-risk and are already infected, to support them in terms of HIV-prevention and also treatment. We try to break everything up into very short points when we are giving the results. We tell them this is what is happening right now and how they can follow-up after that, by coming back again for complementary tests. Our preventative programs are creating an impact as more people are actually coming forward to be tested.”
Take the test
Tobias Lim (not his real name), hails from Malaysia and is based in Singapore for his job as an actor. He is an example of someone who chose to get tested anonymously, while out with friends. Lim has a partner who is HIV-positive and he spoke about why he chose to take the test.
“I think this is good for those people who are not sure about their health. I had planned to go for a test already, anyway. I’ve been feeling unwell these few days, so I am a bit worried – I have headaches all the time, so I want to make sure that I’m okay. To be honest, I’m a little bit nervous about the results of the test. This is serious and I really hope that people will take it seriously. I mean, I have a partner who is HIV-positive, and so I don’t want any other people like me to get that same risk. And I have to be responsible for myself as well.”
Singaporean Xavier Wong (not his real name), a professional, echoes the sentiment of safety-first.
“It is a very good thing for the community, because I don’t think enough men who have sex with men get tested. And when you make it mobile and you bring it to them instead, it makes people more receptive. If you are sexually-active, whether you use condoms or not – because of the probability of a gay man having several partners – do the responsible thing and get yourself tested. If you are positive and you pass it on to someone else, do you want that hanging on your conscience? I don’t think so.”
Although the initial assumption might be that testing for the illness is the last thing on anyone’s minds in such an environment, the opposite is true. This is a scenario that works, in the practical application. It might seem a stark reminder of a reality that some might prefer to forget, especially in an environment that is marked by levity and libations. But the intention here is obvious and clear: to prevent rising number in the transmission of this disease in the MSM community and beyond.
The reality is that living with HIV and AIDS is much more manageable than it was in the past. With medication and treatment, quality of living has undoubtedly increased as well. But this also can give rise to the misguided notion that just because the illness is better-managed and treated today, those who are potentially at-risk can drop their guard. With AFA’s bid to reach out directly to the community, this helps to monitor the incidence of HIV rates here and to encourage those who are positive to seek early treatment.