The Ministry of Health is looking into a case of an HIV-positive person who has knowingly infected another through sex, in what could be Singapore's first such case.

This person's partner was not told of the risk of contracting the Human immunodeficiency virus (HIV) which causes Aids, according to a report in The Straits Times today.

The Ministry has declined to say more about the case.

Under the Infectious Diseases Act, it is an offence for someone who knows he is HIV-positive to have sex with another person. If found guilty, the person could be fined up to $10,000 and jailed for up to two years.

Report of this case comes two days after the news that most adults in Singapore who are infected do not know it, and some are being treated wrongly in hospitals.

A study of more than 3,000 leftover blood samples from public hospital patients early this year showed that one in 350 was infected with HIV, a trend which is consistent with an UN Aids estimate.

If accurate, this would mean that Singapore has about 9,000 infected adults, much more than the official figure of 2,852 people, including 25 children, who are HIV-positive, and 1,547 with Aids.
More worryingly, neither the patients in the study nor their doctors were aware.

Infected men outnumbered women 15 to one and all were being treated for other medical conditions.

As the study was done anonymously, none of the infected patients was traced and all will remain undiagnosed unless they undergo a HIV test, said Senior Minister of State (Foreign Affairs and Information, Communications and the Arts) Balaji Sadasivan, who disclosed this on Tuesday.
The Minister, who was speaking at the launch of a workplace HIV/Aids education programme, called it a serious problem with implications for patients, healthcare workers and hospitals.

So far, there has been no report of anyone being charged with deliberately spreading HIV to another person.

But nine men have been punished for lying about their sexual history when donating tainted blood, which could have compromised the safety and integrity of blood stocks here. They were jailed between and 15 months in the last 16 years.

Dr Balaji on Tuesday singled out three kinds of patients who may be undergoing treatment while unaware of their HIV status.

The least serious: a patient who seeks treatment for myopia or short-sightedness and has Lasik treatment which does not have an impact on his condition. His health does not suffer directly from the missed diagnosis, but he has lost an opportunity to be treated early for HIV infection.

More serious: in treating a patient's symptoms, doctors may unknowingly prescribe drugs that worsen his ability to fight disease.

For example, the patient may be given steroids, which reduce his immunity to disease and could trigger HIV-related infections.

Then, there are the patients whose symptoms may be totally HIV-related. But because they have been misdiagnosed, they receive the wrong treatment.

Dr Balaji said many of those at risk refuse to get tested for HIV, fearing the stigma associated with Aids.

Doctors are also not allowed to conduct HIV tests on patients without their consent.

Dr Balaji stressed that he was not pushing for mandatory testing, but urged those at risk to get themselves tested.

Efforts have been made in recent years to ensure that at least the spouses of HIV-positive patients - if not also their extramarital sex partners - are told about their illness.

Since July 2005, the Ministry of Health has been tracing and informing the spouses of infected patients who refused to come clean.

In the last six months of 2005, the ministry had to break the news to 51 spouses, at least two of whom were later found to be infected.

Last year, the ministry had 18 names on its list of spouses to be told. Ten were informed, of whom six have been tested negative. Health authorities are following up on the other eight.

Aids activist group Action for Aids (AFA) encourages patients through support group meetings to tell their partners about their condition, and most do so, said its executive director Lionel Lee.