The best tool

Many are arguing that sexual abstinence is not the best tool for prevention, especially for those potentially at risk, who are already sexual active. Indeed, it is not the best tool for this purpose. A better tool might be to ... chop/seal off these people sexual organs, for this purpose. Thus, using condoms and practicing safeR (i.e. NOT safe and still risky) sex is also not the best tool.

I suppose either the purpose cannot be so narrow, or there are other considerations. The concern is the spread of STDs, especially HIV/AIDS, by and to everyone. Those who are already sexually active are the minority. Sexual abstinence may not be the best tool for this group of people, and neither is safeR sex, but it is a better tool for the majority not sexually active people. Whereas safeR sex is irrelevant to these people.

Other considerations might include the social aspects. Many studies have shown evidence of the importance of children growing up in a healthy family, which minimal requirement is to have faithful husband and wife. Here, sexual abstinence is supportive of this, while safeR sex outrightly disregards this.

Which are of more concern? Detected or undetected HIV carriers?

35 HIV cases detected. What a mild and unalerting title for a piece of Breaking News!

I loves maths, and thus, let me do some simple maths here.

Known figures are:
35 HIV cases detected in 6 months in the CHANGI General Hospital (CGH) among 3 out of 10, or among about 6500 people who opted to be tested.

What does this imply?

It means there might be in total 35 * 10/3 = 116.667 HIV positive among the 6500* 10/3 = 21666.67 patients who visited CGH.

By further extrapolation, it means there might be 116.667 / 21666.67 * 4M = 21538.46 HIV positive people in Singapore.

OK, there is a bias here ... , as patients cannot be used to represent general population. Thus, it needs to be corrected by multiplying by the proportion of people who visited hospital in the past 6 months in Singapore. I don't have it, but let use a low ratio of 1/100, there are about 215.38 HIV positive people in Singapore. This ratio of 1/100 seems too low since 215.38 is only about twice of 116.667 while Singapore has more than 2 similar or larger hospitals like CGH.

Thus, if we use the number of hospitals in Singapore of similar size, which I also don't have the exact figure, but can safely state as > 5, considering SGH, TTSH, AH, CGH, NUH, and many smaller clinics. Then, the number might be 116.667 * 5 ~= 583 HIV positive among only those who visited hospitals in the past 6 months. Note, this is only the estimated number of HIV positive patients, NOT general population.

What we need to pay attention to is not the 35 HIV cases detected. We really need to pay attention to the possibly 116-35=81 undetected HIV cases! From the above estimate, we need to pay attention to the possibly 81*5=405 undetected HIV cases! And if considering the whole population, there are possibly much much more than 405 undetected HIV people who have not visited hospital in the past 6 months, i.e. they are likely to be healthy people.

What are they doing? Without knowing that they are infected, they are living their normal life. What's their "normal" life? At least quite a few of them have a "normal" life of having regular casual sex with multiple partners, including their spouse.

After the first posting, I read this part:

...many of those who did not want the test were elderly or repeat patients who had been tested before. Tests were not offered to those under 21 years old, the age of consent.

OK, seems not as bad, but even after discounting, the estimated HIV positive, healthy and sexually people out there who don't know they have the virus are still among the hundreds!!!

Look deeper

Recently there is a study and the focus is on Indians are ignorant about sex till age 15. From the western perspective, this is a problem, but is it?

If a kid body temperature is found to be 37.8 degrees Celsius, it is an issue from the western medicine perspective, but is it? During the SARS in 2003, guidelines were given to disallowed children with fever to go to school. However, there were a number of kids were being kept away from school for many days because their daily temperature ranges much higher than the "normal" 37 degrees. Later, it was recognized that ... although their measured temperatures were higher than 37 degrees, they are not having fever nor feeling unwell.

So, what's going on? We should not just look at numbers and forget about the context. The normal 37 degrees is an average derived from observations, but not based on theory. For a person who is not similar to those being observed, or even for an individual among those observed, we shouldn't insist that the person normal temperature be that average.

Another example, if there were a study on general knowledge regarding winter, I am quite sure that Singaporeans will have extremely low scores. However, this will not be a worry because such knowledge is not relevant in Singapore, unless the weather changes drastically. Put it another way, it is not that Singaporeans have failed to acquire winter knowledge or Singapore education system has overlooked this area, but the circumstances here doesn't require us to know so much about winter.

So, what does the result Indians are ignorant about sex till age 15 suggest? Does it suggest that Indians are in danger because of this ignorant? Does it mean the India education system is behind time? I seriously don't think so. It should reflect that in India, most people do not need to worry about these knowledge because they are relatively much safer than the western world as they are not too affected by the bad influences from the sexual revolution since the 60's [yet].

Thus, the alarm is that how could we delay or avoid the influence of the terrible sexual revolution?

Approaches are different

It started from an article about youths and teens getting AIDS/HIV in Singapore last week. The author prefers safer sex message over abstinence. Then, there were three articles published in oppose to her article, all published on Monday. Next came two articles highlighting the issue in relation to business organisations, on Tuesday and Friday.

All of them concerns about AIDS/HIV. However, there are two groups being concerned here, the employees, who are typically adults, and the youths and teens. As such, I question is the approach towards employees by corporate management for the sake of business, suitable? ... when applying to the youths and teens.

Employees are adults. Thus, management won't want to influence their attitude towards their sexual life. Employees are not with the company for life. Thus, management is mainly interested in their wellbeing during the years they are serving the company. In the corporate context, the main concern is business performance. Thus, if an employee, regardless being HIV negative or not, can remain productive for the company, managment is happy.

Youths and teens are not adults. Thus, adults of this society share some responsibility in their good wellbeing and upbringing. I agree that judging others by our standard is not nice and unproductive. However, that doesn't mean that we should shunt from expressing what our standard is. I am quite sure that in general, no extra-marital sex is still the best preference by vast majority, even though many may not think that this should be the only preference.

Youths and teens will be in this society, or world whole of their life. Thus, our concern for them shouldn't be limited to when they are young, although our influence on them will be very limited when they are older. When they became adults, they will be influence the youths of their time. Thus, our concern should also not be limited by the youths of our time, but all youths at all time.

In society, we are here to live our life, and work is only a part of it. Getting married with our life partner, building a happy family, and parenting next generation are some of the other parts. Thus, being infected by HIV is not simply a health issue, but it affect many other parts of one's life.

I can understand that managment doesn't have the position and the need to promote abstinence lifestyle to their employees. Doing so has little or no business value for the company. It is also quite unlikely that employees will care about such messages as these are not job or career related.

Thus, from the perspective of management, it may be OK as long as the employee is productive during the employment with the company, and the company can manage when many of them are infected with AIDS/HIV. How getting AIDS/HIV would affect the employee life, family, future, next generation (if any) are quite out of the scope of the management.

However, youths and teens are learning and observing about this world and what is life from those who have been here longer than them. They may not like us to indoctrinate them, but they are still being influenced by adults in many ways since the society they live in have been built by us.

Thus, as adults who care about the society and its future, our concern is much more than that. We don't want just to delay their extra-marital sex behaviors until they are old enough, but we should at least mentioned that extra-marital sex is bad. We don't want just to reduce their risk by teaching safer sex, but we must clearly present the simple logic that risk avoidance is much better than risk managment.

Thus, the corporate's approach in raising awareness about AIDS/HIV among their employees should not be used when targetting youths and teens.

Abstinence is not to say no

Clarification: Abstinence is not to say no.

Abstinence is need not to say no.

I have been educated since I was young that smoking is bad and I shouldn't smoke. They didn't need to tell me how to say no when someone offer me a cigarette. In fact, nobody has offered me any cigarette. Why? ... Because people around me knows that I don't smoke. In addition, most people around me, or I let myself to be with when I have the say, don't smoke.

That is abstinence.

Another analogy. If a guy decided not to play basketball this month, what should he do? Does he need to brush up his skill of rejecting invitation to basketball games? Most likely, there is a reason why he makes the decision, or there must be many other things that he wants to spend his time on. Thus, he should be spending time in all these other things, which quite likely is not related to basketball, such as study, reading book, playing playstation, etc.

That is abstinence.

Abstinence is not for me to always hang around with people who smoke, or carrying a lighter, matchbox, or whatever other smoking peripherals with me whereever I go, or to be interested in discussion on the various brands of cigarette, etc.

Abstinence is not for that guy to carry a basketball, go out in basketball attire, to a basketball court, and keep telling everyone that he does not want to play basketball that month.

Thus, abstinence from extra-marital sex is not to say no, but is to have no need to answer such a question.

Have this decision/intention of not agreeable to extra-marital sex clearly display in your daily behaviors, attire, interests, and etc. Be with friends and people that clearly show similar intentions. Thus, people you meet will not need to ask you questions that you need to answer no.

This is abstinence.

Now, who are being discriminated?

The word "homophobia" has been used in most articles about homosexuality in the media. I have always felt this word is inappropriate and unfair to many people like me, who have homonegativity. Thus, I did a search and found some material at Wikipedia.

I hope journalists and writers can start to use more appropriate terms than homophobia ... , which does not describe most heterosexual people. Here I quote from the section "Similar terms" (emphasis mine):

Similar terms such as heterosexism have been proposed as alternatives that are more morphologically parallel, and which do not have the association with phobia. Heterosexism refers to the privileging of heterosexuality over homosexuality.

Some recent psychological literature suggested the term homonegativity, reflecting the perspective that behaviors and thoughts that are frequently considered homophobic are not fear-based but instead reflect a disapproval of homosexuality.[15][16]

Seeking to avoid both the focus on individual psychology of "homophobia" and the focus on collective cultural factors of "heterosexism," psychologist Gregory M. Herek has proposed the term "sexual prejudice" as referring to "all negative attitudes based on sexual orientation, whether the target is homosexual, bisexual, or heterosexual."[17]

The term homophobia is often used collectively with other terms denoting bigotry and discrimination. In a 1998 address, Coretta Scott King asserted that, "Homophobia is like racism and anti-Semitism and other forms of bigotry in that it seeks to dehumanize a large group of people, to deny their humanity, their dignity and personhood." Likewise, George Yancey, writing in Christian Ethics Today associates "sexism, racism, class distinctions, or homophobia" with one another and views them all as "varieties of discrimination," although he argues that they are not identical.[18]

Singapore-Beijing highway

Just learned about the completion of the Singapore-Beijing highway. The highway will surely boost tourism, but there are critics who afraid it boost tourism also for viruses and diseases. I think extreme protectionisms don't work, both in economy and in fighting diseases.

We have skin to stop most intruders, but also have a defense mechanism within us called the immune system. This system learns and becomes stronger as it encounters challenges.

Similarly, by isolating countries and cities ... is not the way. with high infections won't solve any problem in the long run. First, it is difficult and inhumane to isolate. Second, it leaves these places little resources and attention on tackling the problem.

It seems like this highway forces, or phrasing it nicely, attracted attention and resources from more governments to tackle the problem, seriously.

A third of adult patients accepted HIV test

Many adults refusing HIV test at Singapore hospital, but 'I believe, with time and education, people will no longer opt out' of testing, Lionel Lee, executive director of Action for AIDS (AFA), was quoted as saying.

I hope so too ... . More education efforts to stress on the social correctness of getting tested, and reduce the link or correlation between having such a test and the type of lifestyle.

Hopefully very soon, to tell someone else that one has taken a HIV test suggests that one is being responsible to others, rather than an indication that one's lifestyle is questionable.

Even better, to tell someone else that one hasn't done any HIV test suggests high possibility of a high risk lifestyle.

Computer computes

I always feel that a very basic advantage brought by the use of computers is under utilized. Computers do calculations well, and they can easily do complicated conditional computations. Here, it was only after months of motorists slowing down and waiting before ERP gantries then the system of gradual increase and decrease of ERP charges was implemented.

I like this approach, the 15by2015 ... 15by2015 - A Campaign to Strengthen Primary Healthcare Around the World. Most administration procedures seem to remain in the pre-computer era where rules are clear and simple. Follow the link to read how a patient has to pay 7 days of hospital stay because he was fortunately not having HIV, because AIDS/HIV related donations will pay for him if he were HIV positive. This is quite typical in many administrative procedures.

I hope the number 15% is just a guideline, while it can be 17.98% or any more optimal figures since computer does not require a nice number in order to do the calculations correctly.

Furthermore, I suggest a minimum portion of such donations be used for education and prevention.

No need to know is better

Finally, I managed to locate more details about the survey I was searching for. According to this article, Many S'poreans still ignorant about Aids, in AsiaOne.

The survey, which polled 705 people, was conducted by World Vision in conjunction with its One Life Experience (OLE) exhibition on World AIDS Day last December.

I sense that all the other media/blogs that reported the figures in this survey are mocking at us. Without any other reference point, it sounds like Singaporeans are really terrible not know AIDS/HIV that well. However, ... are we that bad? one third is quite on par with the G7 countries in their more thorough survey. Then, regarding mosquito bites, it is only us since I found this article 3 years back, Filipinos highly misinformed about AIDS: survey (I'm sorry to mention Filipinos here.)

Most Filipinos still believe HIV/AIDS can be transmitted by a mosquito bite or by sharing the food of an infected person, a government survey showed...

Besides the figures, again I want to question the ultimate motives of all these AIDS/HIV related organisations. Is their top most priority to stop the spread? Or is it to help the infected ones to live a normal life?

To stop the spread, some of those myths are good so that people can be more careful. It may not transmit throug kissing, but here, kissing is kissing, period. Practically, kissing doesn't usually stop at kissing. Also, medically, kissing with wounded openings in or near the mouth should still allow trasmission of the virus. It may not transmit through mosquito bite. However, if someone who is HIV positive but doesn't know mistakenly suspect that he/she might have been infected by a mosquito and go for a test, then that will make him/her know and be able to take proper step not to unintentionally keep spreading the virus.

In fact, I think we should not need to know so much about AIDS/HIV if we have only one sexual partner, who is our life long spouse, within marriage. Thus, from another angle, the "ignorance" might reflect the high percentage of normal people who don't practice sexual promiscuity.

Priority ~= urgent but =/= correct

I found this earlier report while trying to, but haven't succeeded yet, locate a similar and more recent one done in Singapore. Below is one particular set of key finding and my comments (in italics) on them.

World Vision’s Global AIDS Attitudes Survey

Key Finding – Policy Preferences

... • Children are the top priority for action.
–Publics everywhere are most likely to support programs that help children affected by HIV and AIDS, including children who are orphaned by AIDS and AIDS-related illnesses.

If getting HIV/AIDS is like getting a death penalty, at least the person has enjoyed some of his life. However, for children born with HIV in them, it is like getting a death penalty even before they have life!

• There are marked differences across countries in support for programs aimed at discouraging sexual promiscuity, the widespread use and availability of condoms, and increased availability of clean needles for people who need them.

This suggests different countries have different situations and priorities.

–Programs to discourage sexual promiscuity are a high priority for 39% of adults in the seven countries.

Majority didn't put them as top priority probably because this is something difficult to achieve, and may be sensitive due to "human rights" issues. However, this doesn't mean that it won't work, rather, I think this is the long term solution while the rest aren't solution, but just fighting fire.

–Americans are polarized on all three of these potential measures. One-fifth of the population feels that each should be a low priority or not a priority at in the fight to stop the spread of HIV.

US is a very multi-racial, multi-religious, and therefore, multi-opinions country.

• Raising taxes elicits a strong push back: 41% disagree (with 23%strongly disagreeing) that they would be willing to pay more fortheir government to fund HIV and AIDS-prevention, treatment, research and care programs globally.

Surely, if the rightful approach to discourage sexual promiscuity is a "human rights" issue, then the wrongful burdening of such problems on the innocent majority should be rejected.

No Sex Allowed - Milo Turk

CD: Available from cd Universe.

Video: His performance during the American Idol audition, on youtube:

Lyrics: this is the best I could manage to put together the lyrics found on the web:

I'm sitting around minding my biz
Something is wrong and I don't know what it is
My love comes around she's an Oedipus Rex
She starts playing with me, all she wants is Sex
But take it from me hear what I say
I don't need that there's a better way

So I promised her love as she sings along
Cause sex is weak and love is strong
Whoooooooo
No Sex Allowed
I don't want to be part of your crowd
No Sex Allowed
If you don't like it - Get out of Town!

We touch and we feel our bodies just so
whether she's satisfied, I don't know
She complains that she wants to go all the way,
I think about it myself, but then I say
"Stop it now, the subject's getting old,
cause you don't use no birth control…."

She said "listen boy, what's the matter with you,
don't you dare deny that you want sex too,"
I said "it's something that you can't explain,
you're headed for the sun like a fool in the rain."
HIV, pregnancy, and then what's next,
is it really worth it to have sex?

One for all and All for One

Is vaccine for you? Actually, most people had it without saying yes, or even ever had had this question in their head. However, in this era, what's the chance that you will be infected if you were not vaccinated? The chance could be very low for certain infections that certain vaccines are designed for. So, should someone then say, "It isn't for me."

Some years back I heard a discussion regarding should individual choice or rights be ignored for the sake of welfare of the population, and make it compulsory for all to be vaccinated?

In 18 Dec 07 TodayOnline's article: a 56 year-old man said: "It's not for me … It's good for single, young men only. Elder and married men like me who have only one partner are more decent and safe." If a person is safe, there isn't any big different to go for the test, other than the extra few dollars to pay. If only "more" decent and safe, i.e. not 100% safe, isn't it good to be tested? And, even if you have only one partner, not questioning faithfulness, but you can't know for sure if your partner is also decent and safe.

Also, another 54 year-old man said: "Testing isn't for me — the more you know, the more problems there will be." This is similar to choosing not to be vaccinated because somebody would rather die if infected. However, this is not about a single person's life, but about avoiding potential epidemic of infectious diseases that can cause much much more lives.

So, one test for the benefits of all, and all live properly for the benefit of One Human Race.

Being selfish seems more acceptable

After the report of 1 HIV positive in 350 who don't know their HIV status came up, there were some ideas being raised.
One group called for compulsory HIV test. Some say this is tricky as individual rights might be harmed. Then, some suggested selective categories of people go for compulsory HIV test. Some say this is discrimination. Another technically very similar idea is being seriously considered, all patients at hospitals go for opt-out HIV test. Yet, this idea receive little objections.
I think this idea is put in a very smart way. First, although it is targeted at all patients, it is not compulsory. Second, although it is for certain category of people, it is not discriminating. Third, the main reason brought forward seems not to "catch" HIV positive people and to help them get treated, which may upset some who don't want to know, or don't want to get treated. Forth, the main reason seems to say, it is for a selfish kia-si purpose to have better protection for all the health care workers, with an expected appreciation by the public because of the SARs encounter just a few years back.
I guess, by suggesting that it is the rights of health care workers to have better level of protection, it is reasonable to request HIV test be done on all patients. Nowadays, when homosexuals talk about their rights to choose and others don't have right to tell them what to do, the majority one man one woman husband/wife family oriented people have to learn to be more "selfish" and argue about their rights being invaded by homosexuals asking to be treated as normal people.

Does it sound like blackmailing?

The suggestion that to encourage people who are potentially HIV positive to go for HIV test is to promise free medical treatment.

"If no free medical treatment promised if tested positive, then people would choose not to test for HIV."

It sounds like a threat or blackmail to the nation, the government, and the general public.

How small is 0.3%?

0.3%, the estimated ratio of HIV positive people who are not aware of it.
0.3% is 0.3 per 100, or 3 per 1000, or about 1 per 350.
Seems small..
Consider these:
The population being studied were from blood samples collected at hospitals.
It is sort of bias towards people whose blood were for some reason collected at hospitals.
Nevertheless, it is not obvious that there are more or less "high-risk" behavior people in this group as compared to the general population.
On the other hand, it is obvious that vast majority of the population do not practice "high-risk" behaviors, and it is reasonable to believe that majority of these 0.3% are those who have "high-risk" behaviors.
Thus, my message to those who want to feel that 0.3% is very low and continue your "high-risk" behaviors:
Among the high-risk communities, the ratio is much higher than 0.3%.
For example, if we assume that there are 10% high-risk behaving people, and among these, 50% do not feel that they are infected without recent testing, then the 1:350 ratio might become 0.5:35, or 1:70 or 1.4%!
Personally, I believe 10% is too high an assumption, and 50% too low. What if it were 1% and 90%? Then we have 0.9:3.5, or 1:3.85 or 25.7%!!!

High-risk behaviour

What a nice term! What do we think of people with high-risk behaviour?
Are these people brave? E.g. some performers put themselves in danger by getting close to dangerous animals such as snakes, crocodiles, scorpions, etc.
Are these people skillful? E.g. stuntman and sports man in sports such as diving and gymnastic who risk injuries to carry out actions of high difficulties for movie filming and other entertaining or fund raising purposes.
Are these people sacrificing? E.g. soldiers who volunteer themselves to fight in the front lines to protect their love ones and homeland.
Sigh, the term usually does not refer to the above. It is use to describe people who have multiple sex partners, and therefore risking themselves and their partners to infection of STDs, HIV and the likes. "High-risk" is too neutral a term to be used. Should use terms such as irresponsible, selfish, lustful, inconsiderate, thoughtless, uncaring, careless, reckless, foolish, negligent, etc.!

Don't do it! However if ... then do it with precaution.

The traffic police knows it is dangerous for motorcyclists to ride in between vehicles rather than on the middle of the lane. They try to educate them to bring across this message. In nowhere did they suggest that, if motorcyclists really cannot abstain from riding dangerously, then please wear more protective gears, just in case.

This blog entry is not about traffic safety. I just find the above to be so common sense that nobody questions the traffic police for only asking motorcyclists to abstain from dangerous riding behaviors, without giving any advice for those who just refuse to the abstainence message.

Now, on the issue of extra-marrital sexual behaviors, historically it has been proper for sexual behaviors within marriage and between husband and wife. Yet, when only abstinence is being taught, many people think that safe sex should also be mentioned. In contrast to the traffic analogy above, this is RIDICULOUS!

Just ask the police or anyone what they think would happen if the motorcyclists were also told after all the talk on riding properly, that if they really cannot abstain, then please wear more protective gears.

Misleading name..

I have been wondering why it is called Action For AIDS. To me, AIDS isn't a nice or good thing, why "Action For" it? Oh, yesterday after reading the president's article in the TodayOnline, voices section (19 June 2007), I think I know why now.

It seems to me the main interest of this organisation is for the welfare of AIDS patients. However, its name gives me the idea that its interests are on AIDS.

I feel there are at least 2 areas of concern here. One is the more humanistic care and concern for people who have got the HIV, while the other is the outright fight against the virus and its spread. The former is more subjective as to how should HIV infected people be taken care of, while the latter is more obvious that everyone should like to have HIV disappear, regardless its possibility.

By the way, I think his article lacks substance and supporting evidence, and I seriously question what has "the urgent repeal of Sections 377 and 377A of the Penal Code that criminalise homosexual behaviour" gotten to do with the issue of his article?