MSM Stakeholders Meeting 28 June 2014 MSM and HIV Update of Epidemiology
Number
Rate per million population
500
Male
450
Female
400
Rate
140 120
350
100
300
80
250 200
60
150
40
100
20
50
0
0
Year
New HIV Infection & AIDS among Singapore Residents (1985 – 2013)
300 250
Heterosexual Homosexual
200
Bisexual
150
IV drug use Perinatal
100
Renal Transplant
50
Bld transfusion Uncertain
0 Year
No. of notified cases by Mode of Transmission (1985-2013)
Percentage Â
Percentage 100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Homosexual
Bisexual
Intravenous drug use
Perinatal (mother to child)
Renal Transplant overseas
Blood Transfusion
Uncertain
Heterosexual
% Distribution of HIV Infected Singapore Residents by Mode of Transmission (1985 – 2013)
ANONYMOUS TEST SITE STATISTICS 2013
TOTAL CLIENTS
TOTAL NUMBER OF CLIENTS – 2005 TO 2013
8000
7593
6903
7000 6000
6741
6046
5761
5349
6099
7359 6330
5000 4000 3000 2000 1000 0 2005
2006
2007
2008
2009
2010
2011
2012
2013
3500 3089 3000 2248
2000 1522 1500
2538
2482
2500 No. of Clients
NUMBER OF CLIENTS
MSM CLIENTS – 2005 TO 2013
2178 1895
1727
1281
1000 500 0 2005
2006
2007
2008
2009
2010
*MSM clients account for 37% of all tested cases in 2009
2011
2012
2013
180 158
160
147 136
140
121 125
120 No. of cases
HIV RAPID TEST RESULT
HIV RAPID + FROM 2005 TO 2013
100
120 106 92
82
Rapid PosiNve
80
WB Indet
60 40 20 0
2
5
3
6
1
4
5
2
3
2005 2006 2007 2008 2009 2010 2011 2012 2013
6.4
7.0
5.7
6.0 Percentage (%)
HIV POSITIVITY
HIV RAPID +* BY SEXUAL ORIENTATION – 2005 TO 2013
5.0
4.8
5.4 4.7
4.5
4.2
4.0
1.9
2.1 1.1 0.5 2013
4.0 2.8
3.0 2.0 1.0
2.0
1.7 1.6 0.3
1.6
0.0 2005
1.8 0.8
0.4
0.4
2006
2007
1.7
1.6
1.9
2.4 1.9
1.2
1.6 0.2
1.4 0.3
0.4
0.6
1.0 0.4
2008
2009
2010
2011
2012
Overall (n=158/7359)
MSM (n=102/2475)
Hetero Male (n=22/4292)
Female (n=6/551)
*Includes known posiNve cases
45 40
39.7
38.83
35 Percentage (%)
TESTING HISTORY
RAPID + CLIENTS BY TESTING HISTORY – 2009 – 2013
30
30.60 26.9
25 20 15
36.90
25.24 22.33
19.23 14.17
36.07 33.3 32.5 32.91 IniNal Test
20.88
20.80 20
Previous NegaNve, AfA 13.59 11.80
14.2 8.86
10 5 0 2009
Previous NegaNve, Other Clinics
2010
2011
2012
2013
Known PosiNve
60 50 Axis Title
RAPID POSITIVE
RAPID + AMONG MSM CLIENTS BY AGE GROUP -‐ 2009 -‐ 2013
40 30 20 10 0 2013 2012 2011 2010 2009
<20
20-‐29
30-‐39
40-‐49
50 and above
2 3 2 2 4
48 37 53 37 26
38 37 43 26 32
18 22 16 15 12
3 3 3 6 5
N=117 N=86 N=79
80 68.99
70 60 Percentage (%)
SEXUAL ORIENTATION
ALL CLIENTS AND RAPID + CLIENTS BY SEXUAL ORIENTATION – 2013
50
50.6 All Clients
36.55
40
+ve
30 20
13.92
10
12.02 5.6
7.15 5.06
0 Heterosexual Homosexual
Bisexual
Not Stated
SYPHILIS
SYPHILIS TEST RESULTS (2013) # of Syphilis Rapid Prevalence Done Syphilis +ve (Syphilis) Heterosexual
861
1
0.1%
Homosexual
814
9
1.1%
Bisexual
106
1
0.9%
Unknown
8
0
0%
Rapid Syphilis +ve Bisexual 1 9%
Rapid Syphilis +ve & Rapid HIV +ve
1
Heterosexual 1 9% Heterosexual
Homosexual 9 82%
Homosexual Bisexual
Numbers
180
90%
160
80%
140
70%
120
60%
100
50%
HIV PosiNves Detected
Samples sent for WB test
WB posiNve 80
40%
60
30%
40
20%
20
10%
0
0% 2006
2007
2008
2009
Year
2010
2011
2012
2013
WB posiNve referred to Care
Successful Linkage to Care D%C
OUTREACH HIV TESTING PROJECT IN VENUES FREQUENTED BY MEN WHO HAVE SEX WITH MEN (MSM) ROUND 6 AUGUST -‐ OCTOBER 2013
OUTREACH HIV TESTING PROJECT IN VENUES FREQUENTED BY MEN WHO HAVE SEX WITH MEN (MSM) ROUND 6 AUGUST - OCTOBER 2013
5 bar/clubs participated Total samples: 629
7 saunas participated Total samples: 649
Others Total samples: 15
1400 1200
Participant
1000 800 600 400 200 0
Bar/Club
Sauna
Event
Total
2007 Study
532
363
65
960
2008 Study
532
655
38
1225
2009 Study
589
645
43
1277
2010 Study
487
761
25
1273
2011 Study
297
1012
0
1309
2013 Study
629
649
15
1293
Participants by Venues (2007 to 2013)
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
<=29
30-39
40-49
50-59
>=60
2007 Age Group
51.77%
30.94%
14.27%
2.81%
0.21%
2008 Age Group
49.14%
31.51%
14.37%
3.67%
0.24%
2009 Age Group
50.52%
32.24%
13.97%
2.87%
0.40%
2010 Age Group
50.20%
28.01%
16.29%
4.33%
1.18%
2011 Age Group
48.83%
27.58%
18.26%
5.81%
0.92%
2013 Age Group
56.04%
27.18%
12.16%
4.03%
0.59%
Age Groups by Year (2007 – 2013)
2013 - Oraquick HIV +ve >60 0% 50-59 5% 40-49 16% <30 46%
30-39 33%
Oral Swab HIV-positive by Age Group 2013
70%
60%
50%
40%
30%
20%
10%
0%
<30
30-39
40-49
50-59
>60
2007 30 HIV +ve
40%
40%
13%
7%
0%
2008 32 HIV +ve
44%
31%
13%
13%
0%
2009 21 HIV +ve
52%
33%
14%
0%
0%
2010 35 HIV +ve
61%
20%
16%
2%
0%
2011 27 HIV +ve
46.15%
38.46%
15.38%
0.00%
0.00%
2013 40 HIV+ve
46.00%
33.00%
16%
5.00%
0.00%
Oral Swab HIV+ by Age Group and Year
1600
10.00% 9.00%
1400
8.00% 1200 7.00% 1000
6.00% HIV +ve
800
600
5.00%
3.13%
2.61%
400
3.14%
2.75%
3.00%
2.06%
1.64%
4.00%
2.00%
200
1.00%
0
0.00% 2007 Study
2008 Study
2009 Study
2010 Study
2011 Study
2013 Study
Overall Oral Swab HIV-positivity by Year
Total test Done Prevalence Rate
700
10.00% 9.00%
600 8.00% 500
7.00% 6.00%
400
5.00% 300
4.00%
200
2.60% 1.50%
100
0 Bar/Club Prevalence Rate
3.00%
2.70%
2.29% 2.00%
1.69%
1.50%
1.00%
2007 Study
2008 Study
2009 Study
2010 Study
2011 Study
2013 Study
532
532
589
487
295
612
2.60%
1.50%
1.50%
2.70%
1.69%
2.29%
HIV Oral Swab-positivity in Bars/Clubs by Year
0.00%
1200
10.00% 9.00%
1000
8.00% 7.00%
800
6.00% 600
5.00%
4.10%
4.30% 4.00%
3.70%
400
2.90%
2.70%
3.00%
2.17%
2.00%
200
1.00% 0 Saunas Prevalence Rate
2007 Study
2008 Study
2009 Study
2010 Study
2011 Study
2013 Study
363
655
645
761
1008
605
4.10%
3.70%
2.70%
2.90%
2.17%
4.30%
HIV Oral Swab + in Saunas by Year
0.00%
Where do you meet your sexual partners (survey form n=1335) Participants can circle more than one option on where they meet their sexual partners.
Of those who had regular partners 50% always used condoms
Condom use in the last 6 months with regular partners (survey form n=1331)
Of those who had casual partners 65% always used condoms
Condom use in the last 6 months with casual partners (survey form n=1335)