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National Behavioural Surveillance Survey 2007 and Health Promotion Board's HIV/AIDS Education Strategies

The first National Behavioural Surveillance Survey (NBSS) on HIV/AIDS in Singapore, conducted in 2007, showed that awareness and knowledge of HIV/AIDS is higher compared to accepting attitudes towards people living with HIV/AIDS. Knowledge about HIV/AIDS prevention and accepting attitudes are key in creating an environment that encourages people whose lifestyles put them at risk of HIV infection to go for testing without the fear of being stigmatised.

Based on the results of the NBSS on HIV/AIDS, the Health Promotion Board (HPB) will develop strategies and programmes that promote protective measures against HIV infection and correct misconceptions about HIV/AIDS to the relevant target groups.
Results of the National Behavioural Surveillance Survey 2007 on HIV/AIDS

The first NBSS on HIV/AIDS 2007, a large population-based survey, obtained statistics on awareness, attitudes and perceptions about HIV/AIDS and sexual practices among Singaporeans. The NBSS on HIV/AIDS was self-administered using the Audio Computer-Assisted Self-Interviewing (ACASI) tool. For more information on ACASI, please refer to Annex 1.

Knowledge of HIV/AIDS Prevention

The NBSS on HIV/AIDS surveyed 1,768 respondents aged 18-69 years on their knowledge of HIV prevention, namely, the ABCs Abstaining from casual sex, Being faithful to one uninfected sexual partner, and correct and consistent Condom use during sexual intercourse. Among the respondents, 80.4% were aware of at least two ways to prevent HIV, and 36.6% were aware of all three ways.

Based on age, respondents aged between 18 29 years showed the lowest awareness of prevention of HIV/AIDS with only 74.9% knowing of at least two ways of preventing HIV/AIDS. Comparatively, 82.8% of those aged between 30 49 years and 80.5% of those aged between 50 69 years were aware of at least two ways of preventing HIV/AIDS.
Ms JoAnn Taylor, Deputy Director, Communicable Disease Education, Adult Health Division, HPB says, Knowledge of the ABCs of HIV prevention is fundamental in protecting yourself and your loved ones against an infection. Based on the NBSS, young adults aged between 18 and 29 years old showed the lowest level of knowledge of HIV/AIDS, therefore we will continue to step up HIV prevention education to this group, reaching out through the community and workplace settings.

Importance of Early Detection

The survey also showed that 66.6% of the respondents agreed that a person infected with HIV can still look healthy. For the remaining 33.4%, this misconception may be one of the contributory factors that prevent them from adopting protective measures if their partners look healthy, or going for screening for HIV if they practise at-risk behaviour.

Along with the ABC education messages, screening and early detection for those at-risk are important. Early detection means people can receive proper medical attention to manage their condition to continue working. More importantly, knowing one s HIV status prevents the spread of HIV. According to Ministry of Health statistics1, more than half of the newly diagnosed cases already have late-stage HIV infection at the point of diagnosis.

Adopting Accepting Attitudes

In terms of accepting attitudes towards people living with HIV, 54.1% of the respondents would care for a close relative who became ill due to HIV/AIDS in their own home. However, only 22.4% and 18.2% of the respondents would share a meal with a person living with HIV, or buy food from a shopkeeper or hawker living with HIV.

Ms Taylor adds, This indicates that although one in two Singaporeans are willing to care for a close relative living with HIV, they are not so accepting towards people living with HIV in a setting outside the home. These negative attitudes can be a barrier for the at-risk to know their HIV status as they might fear being discriminated against. To address this, HPB has in place strategies and programmes that reach out to workplaces and the community to educate on the modes of transmission of HIV and protection against infection. We hope that Singaporeans will provide a more supportive environment towards people infected with HIV.

For a comprehensive report on NBSS, please refer to Annex 2.

HPB's HIV/AIDS Education Strategies and Programmes

The objectives of HPB s HIV/AIDS education strategies are to reduce infection rates, to increase accepting attitudes towards people living with HIV/AIDS, and to encourage care and support to those infected by HIV. HPB develops programmes to educate on modes of transmission and how to prevent HIV infection, to debunk common misconceptions of the disease, and to promote regular HIV testing among at-risk groups.

Target Group: The General Public

13 For the general public in the community setting, HPB has developed, together with community partners, Positive Living a community art exhibition. Positive Living comprises two sets of art exhibits. The first set Paint our Hopes - consists of 21 individual paintings by people living with HIV (PLHIV) who attend Action for AIDS support groups. The second set is a painting titled New Hope, New Beginning, the result of a collective effort from PLHIV from the Patient Care Centre at Tan Tock Seng Hospital. Positive Living, together with art classes and education workshops, is currently touring the heartlands.

To reach out to the young adults, HPB is organising Love Amplified, an edu-tainment concert on 29 November 2008, to commemorate World AIDS Day. Through the various performances and videos by local artistes, the audience will learn more about HIV/AIDS. They will be called upon to be responsible in order to protect themselves and their loved ones against HIV/AIDS. For more information on Love Amplified, please refer to Annex 3.

For the Chinese-speaking adult population, HPB together with MediaCorp, has developed a drama titled By My Side , supported by the Media Development Authority (MDA). This will be aired on MediaCorp Channel 8 on 28 October 2008 as a lead up to World AIDS Day on 1 December.

Target Group: Working Adults

It is also important to have strategies and programme initiatives in the workplaces, as a large proportion of infected Singaporean adults were working at the time of diagnosis. RESPECT, a workplace programme developed by HPB is available for companies. For more information on RESPECT, please refer to Annex 4.

HPB has worked with Singapore National Employers Federation (SNEF) to set guidelines on managing HIV infection at workplaces. These guidelines were endorsed by the AIDS Business Alliance and disseminated to all SNEF s members, more than 1,000 companies.

Target Group: The At-Risk

For the at-risk group, besides increasing the awareness of the ABC message, emphasis is also placed on educating them about the benefits of regular HIV testing and early detection. HPB has identified particular groups in the at-risk category and have targeted programmes to educate them based on their profile, behaviour and interests. These groups include heterosexual males and young women.

Other at-risk groups are reached through strategic partners which include the voluntary welfare organisations such as Action for AIDS, private sector organisations, and healthcare institutions which include the Department of Sexually Transmitted Infections (STI) Control Clinic and the Communicable Disease Centre.

Key Message for World AIDS Day

In conjunction with World AIDS Day, HPB will extend the reach beyond the Love Amplified concert and TV drama through an educational campaign leveraging on TV interstitials and other platforms such as social networking sites. HPB's message for the general population is on the importance of protecting one s self and loved ones through Abstaining from casual sex, Being faithful to one uninfected sexual partner, correct and consistent Condom use and adopting accepting attitudes towards people with HIV/AIDS.

For those whose lifestyles put them at risk of HIV infection, HPB s message is to prevent HIV prevention through socially responsible behaviour. HPB encourages them to go for regular testing for early detection so that they seek medical attention early to manage their condition.