History of AIDS
General History
AIDS, an acronym for Acquired Immuno-Deficiency Syndrome, is an infection caused by HIV or Human Immuno-Deficiency Virus. The origin of the HIV in man is not known or proven yet. HIV is passed on from an infected person to a healthy person by the exchange of body fluids, such as blood, semen, vaginal fluid, breast milk and other fluids containing blood. Coming in close contact with other body fluids such as cerebrospinal fluid, synovial fluid and amniotic fluid can also cause HIV infection, thus posing a danger to health-care workers. Common modes of transmission are sexual contact, sharing or being pricked with an infected needle, transfusion of infected blood and perinatal transmission (viz., mother-to-child transmission, where babies born to HIV infected mothers can get the infection either in the womb, during child-birth or from breast-feeding). Those in the high risk category of contracting HIV infection are people with multiple sexual partners and health care workers working with HIV-infected patients.
The term, Acquired Immuno-Deficiency Syndrome, was first used in the United States in 1982 for infections affecting the immune system such as Kaposi's sarcoma and pneumocystis carinii pneumonia. The HIV virus was isolated by US scientists in 1983 and was initially named HTLV-III or LAV (Human T-cell Lymphotropic Virus-type III or Lymphadenopathy- Associated Virus) by an international scientific committee. The Singapore public first heard of such an infection and the discovery of the HTLV-III virus when the existence of an infection called AIDS was reported in newspapers here on 23 April 1983. In 1984, HTLV-III was renamed as HIV or Human Immuno-Deficiency Virus. The term AIDS was then used to denote a certain stage in an HIV-infected person when his immune-system has weakened completely and has given way to multiple infections. Some of the symptoms displayed by AIDS patients are fatigue, weakness, fever, weight loss, loss of appetite, diarrhoea, swollen glands in the neck and armpit, night sweating, cough, breathlessness and different infections, especially of the lungs. AIDS is fatal and results in death. There is no cure or vaccination available for AIDS or against HIV till date.
History of AIDS in Singapore
The first HIV-positive case in Singapore was reported in May 1985 and this patient was warded at the Middle Road Hospital which later became the Communicable Diseases Centre. Soon after this two more cases were reported. All the three cases of AIDS here were discovered by Dr. K.V. Ratnam, a dermato-immunologist at the Middle Road Hospital. The government reacted immediately to the discovery of HIV-positive cases in Singapore by forming the Advisory Committee on AIDS in the same year, 1985. This committee formulated an action plan called the National AIDS Control Programme to implement control measures for the prevention of HIV incidences in Singapore. The Advisory Committee on AIDS was replaced by two boards in 1987, the AIDS Task Force and the National Advisory Committee on AIDS. The two boards took on different tasks to help implement the action plan, the National AIDS Control Programme, which is also known as the AIDS Control Programme. The AIDS Task Force advises the Ministry of Health on scientific and medical matters of AIDS, while the National Advisory Committee on AIDS provides community feedback to the Ministry of Health while also providing advice on AIDS education to the public. HIV-infection was deemed a notifiable disease by the Infectious Diseases Act in 1985 and since then it is compulsory to notify the Ministry of Health when a person tests positive for HIV infection. The act was later amended such that any action by an HIV-infected person that may result in spread of the infection becomes an offence. The first AIDS death in Singapore was reported in April 1987.
Despite of the government's efforts, the number of HIV-positive cases in Singapore has been rising steadily. As of June 1992, there were 124 HIV-positive people in Singapore and by 2002 there were 380 HIV-positive people here. Many of the patients continue to be warded and treated at the Communicable Diseases Centre. In 1988 the government released around S$2-million on its anti-AIDS campaign, which included a S$400,000 educational blitz of radio and television advertisements. The government also lifted its ban on condom advertisements. The charges for AIDS testing was reduced to S$15 from S$20 and testing centres were opened at the Bedok, Bukit Merah, Ang Mo Kio, Clementi and Kelantan polyclinics, at the Kallang Outpatient Dispensary and Maxwell Road OPD. In addition, an AIDS Counselling Centre at Rochore OPD and AIDS helplines for information and counselling were opened.
Description
The control measures implemented by the National AIDS Control Programme include increasing awareness amongst the general public on AIDS, educating the public on modes of prevention and counselling those in the high-risk category. Initially, a greater number of homosexuals than heterosexuals were infected with the disease when the programme was first started in 1985. The focus, therefore was on raising awareness on the methods of prevention, such as the use of condoms. However, when increasing numbers of heterosexuals were affected, a greater emphasis was placed on educating the public at large. Activities the public were encouraged to avoid included having casual sex with unknown people, engaging commercial sex workers and using injectable drugs such as heroin or cocaine. Instead they were urged to maintain responsible sexual behaviour by remaining faithful to one partner.
The National AIDS Control Programme is also responsible for protecting the nation's blood supply. It undertakes the routine screening of blood and blood products for HIV, Syphilis and Hepatitis B. Blood donors are filtered with a specially designed questionnaire questioning them on their health status and activities associated with HIV infection. The potential candidates are then asked to sign a declaration that their statements are true. Those who make false declarations may be prosecuted by the Ministry of Health (MOH). The Programme also monitors the spread of the infection by initiating contact tracing, performing routine screening of prostitutes, monitoring results of voluntary blood donors and monitoring results of serological testing in patients with Sexually Transmitted Diseases (STDs). It is also in charge of notification of AIDS cases and collates results and statistics for the MOH. HIV infected persons are treated using approved drugs and counselled under this programme.
The National AIDS Control Programme trains medical personnel, health care workers, paramedical personnel, counsellors, drug rehabilitation officers, teachers, and anyone who might come in contact with an HIV or AIDS infected persons by organising workshops on AIDS prevention and control. It also undertakes research projects and studies to evaluate existing programmes, conduct surveys, study sexual behaviour and conduct clinical epidemiological studies on HIV infection in Singapore. The government works closely with other countries in the ASEAN through an information network to monitor the spread of AIDS in Southeast Asia. It also works closely with the World Health Organisation (WHO) and the United Nations Development Programme (UNDP) in AIDS prevention and control.
Action for AIDS
In 1988, a non-profit organisation, Action for AIDS, was formed by volunteers. The government works closely with this organisation to prevent the spread of AIDS in Singapore. Some of the activities held by Action for AIDS in 1991 include an AIDS candlelight memorial, pop concert by entertainer Boy George and orientation programme for freshmen at the National University of Singapore. The organisation today holds many programmes, which it keeps updating, for all age and ethic groups. As a part of the government's multi-pronged plan for the control of AIDS here, a voluntary quality assurance scheme for testing the quality of condoms was introduced in July 1992. The condom certification scheme requires manufactures and importers to test their product before marketing it, so that it complies with Singapore's standards which are based on international guidelines. This testing is done at the Singapore Institute of Standards and Industrial Research (SISIR).
Author
Naidu Ratnala Thulaja
References
Ministry of the Information and the Arts. (1992). AIDS: Singapore acts (pp. 1-11). Singapore: Author.
(Call no.: RSING 614.5993 AID)
Condom ads allowed for AIDS campaign. (1988, January 4 ). South China Morning Post, AIDS Campaign.
John, A. (2003, May 18). Heroes toil quietly in the humblest of hospitals; Over 100 CDC staff do their best for those down with diseases, in an old facility shunned by many. The Straits Times.
Lee, S. H., Lim, P. L., Low, A., Lam, J., & Tang, K.F. (1988, March 6). Aids hits home. The Straits Times, pp. 1-10.
Ministry to spend $2m on Aids campaign. (1988, November 25). The Straits Times, p. 1.
Nathan, D. (1993, November 25). Anti-Aids campaign to target casual sex . The Straits Times, p. 1.
Toh, S. (1988, December 1). Professionals set up society to fight Aids. The Straits Times, p. 16.
Wider target in Aids-awareness drive. (1993, November 29). The Straits Times, p. 18.
Action for AIDS. (n.d.). Statistics. Retrieved December 9, 2003, from www.afa.org.sg/astats.htm
Centers for Disease Control & Prevention. (2003, June 18). General Information on HIV and AIDS. Retrieved December 9, 2003, from www.cdc.gov/hiv/general.htm
Further Readings
Action for Aids. (1991). The Act: An AFA publication. Singapore: Author.
(Call no.: RSING 362.1969792005 A)
Action for Aids Singapore. (1996). Art against aids : the Singapore Red Ribbon Awards. Singapore: Author.
(Call no.: RSING 704.949362196972 ART)
Ministry of Health. (1991). Handbook on prevention of HIV transmission in the health care setting. Singapore: Author.
(Call no.: RSING 614.5993 HAN)
Training & Health Education Department. (1991). We have AIDS. Singapore: Author.
(Call no.: RCLOS 616.979200222 WE)
Wing, C. (1991). A family guide to HIV & AIDS in Malaysia and Singapore. Penang, Malaysia: Southbound Sendirian Berhad in association with Malaysian Council of Non-Government Organisations for AIDS, and, Action for AIDS Singapore.
(Call no.: RSING 616.9792 WIN)
Anti-Aids campaign focuses on teens. (1988, December 5). The Straits Times, p. 21.
Khoo, V. (1991, December 1). Aids fighters shift into top gear. The Straits Times, p. 3.
Toh, S. (1989, August 16). Group to hold fortnight on Aids and safer sex. The Straits Times, p. 22.
Exploitz.com. (n.d.). Singapore - Aids policy. Retrieved December 9, 2003, from www.exploitz.com/Singapore-Aids-Policy-cg.php
The information in this article is valid as at 2004 and correct as far as we are able to ascertain from our sources. It is not intended to be an exhaustive or complete history of the subject. Please contact the Library for further reading materials on the topic.
