Lots of HIV figures you see in the newspapers are national averages. What you DON”T know, but SHOULD be looking at, are the rates amongst the sub-groups you are having sex with.
‘Cos by averaging the cases across the entire country’s huge population, the HIV rates looks less scary, the countries don’t look so bad. High risk sub-groups are where most of the HIV cases are concentrated in.
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Your risk :
In Asia, MSM (Men who have Sex with Men) are disproportionately affected by HIV. HIV prevalence amongst MSM in Bangkok estimated at 28%. If you went to Bangkok and had unprotected sex with 3 men who have sex with men, at least 1 of them could be HIV+.
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In Sg, >90% of HIV+ are male. 1/4 these men are/were married. >90% females are/were married. (See diagram)
What does this mean?
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It means that if you (female or male, married or not) are having sex with a MSM, the statistics alone put you at much higher risk.
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If you’re having anal sex, (female or male), the biology puts you at a much higher risk.
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If you think you can get away by having a young girl or boy, that’s the stupidest assumption to ever make in your life. Yes, even if you’re straight.
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In Asian cities where the sex workers don’t ask for condoms, half of them can be HIV+. And because people presume younger sex workers are less risky, more people go for the young ones. Hence, HIV prevalence amongst the under-20yr olds can be >2 times that over the above-20yr olds.
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In Sg, ~50% the HIV infections detected only in the late stage. This means that there are probably many more HIV+ people who are very healthy, unaware of their status, and transmitting it if they’re having unprotected sex.
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That means you could unknowingly spread it to your wife, and by the time you fall ill, it’s been 5 years too late.
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Your life as a consequence
In Dec08, we thought HIV was going to be treated like any other chronic diseases, and generic drugs subsidised (http://mathialee.wordpress.com/2008/12/02/say-yes-to-aids-treatment-subsidies/ )
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( Health Minister Khaw Boon Wan told The Straits Times he agreed with the view that HIV should be treated ‘like any chronic disease’. ‘The committee of experts will apply the same approach as they do when evaluating drugs for other diseases. We should not single out HIV for special treatment,’ he said. ….. Health Minister asked the Communicable Diseases Centre (CDC) to draw up a list of drugs that should be eligible for subsidies. http://app.mfa.gov.sg/pr/read_content.asp?View,11626, Full Report in Comments)
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Over the weekend, we learn that HIV treatments are NOT going to be subsidized. They can now be funded by Medifund.
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(Offering subsidies for all patients could “open a floodgate”, he noted. While previous media reports pointed to the ministry subsidising HIV medication, MOH told MediaCorp on Friday: “Minister Khaw Boon Wan and MOH did not commit in 2008 to subsidising HIV medication.” “Our stand in 2008 was that HIV should be considered like any other chronic disease when evaluating the suitability of providing subsidies for medications.” “MOH has chosen to use the Medifund route to more flexibly help HIV patients with their bills, including that for anti-retroviral drugs if needed. Doing so allows available funds to be focused to provide appropriate amounts of assistance to the most deserving cases.” http://www.todayonline.com/Print/Singapore/EDC100116-0000124/Medifund-to-help-needy-Sporeans-who-require-HIV-treatment )
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This means that you still have to fork out ~$1200 of your salary each month for HIV treatments. That’s if you keep your job, because there are no laws protecting your job. It means that this (http://mathialee.wordpress.com/2008/11/11/living-with-hiv-in-singapore/ ) could still be your life. When you get to a desperately poor stage however, you can now use Medifund. Or you can still go to Thailand to get 3-months supply at a time for $100-200 at anytime.
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What’s my point? What can you do?.
My point is that, please, just NEVER have unprotected sex. ALWAYS use a condom. Condoms are 99% protective, when used 100% of the time, correctly.
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Please remember, HIV is NOT like other Chronic Diseases (and will NOT be treated as one, in terms of subsidies too).
Why?
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One cigarette won’t give you lung cancer. One fatty MacDonald’s meal won’t give you a heart attack. One huge glass of coke won’t give you diabetes. You have to screw up again and again, over years and years, by smoking and eating/drinking unhealthily.
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But HIV is different.
You can do the right thing 99.9% of the time. Use a condom 99% of the time. Be faithful 99% of the time. Probably even abstain 99% of the time.
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But just one slip-up. One mistake. One moment of carelessness when you were drunk.
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Just ONCE. And that’s enough. HIV infection is not something you accumulate through years of casual unsafe sex. It’s something you get in a single sex session.
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And for that you pay. You pay with your health, your dignity, and your finances.
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While the guy next door who ate char kway teow for 50 years and now has a stroke lies in the C class ward with loads of subsidies and sympathy.
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Life is not fair. The world is not fair. People are not fair.
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So don’t let yourself down. You’re the only one who can take care of yourself. Please stay safe, always use a condom (yes, 1 condom, not 2) .
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( I would love to ask you to help spread this message. However, be warned: there will be people who will accuse you of encouraging homosexuality or a gay lifestyle or immorality. Since male homosexuality is against the law, you may be accused of abetting a criminal act. You may lose your friends.)
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( Sources: WHO Best Practices publication “HIV and Men who have Sex with Men in Asia and the Pacific”.
-J Infect. 2006 Oct;53(4):255-9. Epub 2005 Dec 27.
-AIDS. 2000 Dec 1;14(17):2731-40.
- MOH http://www.moh.gov.sg/mohcorp/statistics.aspx?id=246 )
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