A study on HIV risk by NUS researchers has revealed Singapore’s first-ever empirical estimate for the number of men who have sex with men: 210,000.
This is over double of the previous projection of 90,000 individuals, estimated using data from community organisations.
The study also estimated, for the first time, the number of female sex workers here (4,200), the number of their male clients (72,000), as well as the number of intravenous drug users (11,000).
In investigating Singaporeans’ attitudes towards sex work, intravenous drug use and gay sex, the study also found that found that participants regarded injecting drugs to be as socially acceptable as drink driving, while sex work and gay sex were regarded on the same level as children putting their elderly parents in a nursing home.
HPB: findings should be “interpreted with caution”
Singapore has between 400 and 450 new HIV cases a year, with heterosexual men accounting for the bulk of late diagnosis and onward transmission, according to local nonprofit Action for AIDS (AfA).
The NUS study tested out a potential method to systematically survey the number of people with HIV in Singapore, which the researchers described as a “hard-to-reach” population.
“The HIV epidemic in Singapore is classified as low-level, but is likely to be a concentrated epidemic among key populations, such as men who have sex with men,” the study’s report said.
When contacted, the Health Promotion Board, which funded the study, said that these estimates could be useful in assessing the planning and evaluation of HIV prevention programmes.
However, it said that the study’s findings should be “interpreted with caution” given limitations including its small sample size.
To conduct the study, seven researchers from NUS’ Saw Swee Hock School of Public Health surveyed a representative sample of 199 Singaporeans aged between 21 and 70 in 2017.
The researchers deliberately included more women and minority ethnic groups in the sample to improve the estimate’s precision in these groups. They also interviewed clinicians, social workers, counsellors and policymakers involved in AIDS work.
Using the survey results, they then applied a “new and promising” statistical method to generate a national-level estimate for the number of people at risk of HIV.
They also adjusted the figure to include the possibility of under-reporting due to social stigma – which previous estimates had not adequately accounted for, the report said.
The researchers said that the statistical method worked even in relatively conservative societies, and had been used by other countries to estimate sizes of at-risk populations.
However, they admitted that the sample, which did not include any participants younger than 21, could have resulted in a lower estimate.
The study found that younger participants knew more people at risk of HIV, compared to older participants. Younger participants were also “more likely to be liberal” and have “favourable attitudes” toward this group.
AfA executive director Sumita Banerjee said that the organisation was “not surprised” by the study’s “better estimate” of the number of men having sex with men, as younger gay men were now more open about their sexuality.