08 September 2005

Mr Wang Says, "Huh?"

Sept 8, 2005
Action for Aids' probe dispels sex claims
Group's 106 volunteers deny any improper conduct with patients they were counselling

By Lee Hui Chieh

ALLEGATIONS that volunteers from Action for Aids (AFA) had been sexually intimate with people they were counselling have been found to be baseless, an investigation by the Aids awareness group has concluded.

The group's 106 active volunteers denied having sexual relations or engaging in improper conduct with the people they were counselling.

All the volunteers also denied having heard of other volunteers engaging in such behaviour, and most said they would inform their programme coordinator or AFA's executive committee if they found out about anyone doing so.

Ninety of the volunteers were interviewed face to face over five days, for about 30 minutes each.

Another 16 volunteers who could not make it to the interviews were asked to fill up questionnaires.

The interviews were done by two doctors from the National Skin Centre who are not AFA members - Dr Tan Hiok Hee, who heads its department of sexually transmitted infection control, and Dr Priya Sen, an associate consultant.

In their report, the investigators said: 'The volunteers are intensively trained and appear to maintain extremely high professional standards in their capacity as volunteers. They adhere strictly to the AFA volunteer code of conduct and it would seem that any allegations of AFA volunteers having physical or sexually intimate relations with clients were unfounded.'

For example, all the volunteers said that following AFA's rules, they would not give out their personal contact numbers to those they were helping, and do not lock doors during one-to-one counselling sessions.

The probe was sparked by a report in The New Paper on July 10, which said that five of AFA's volunteers had contracted the virus after becoming volunteers, and that there was concern that 'young male volunteers are coming forward because they see the MSM outreach programme as another avenue for them to meet other gay men'.


For the Health Ministry, however, the matter now appears to be closed.

In a statement yesterday, the ministry said it 'noted that the investigations did not uncover any unethical conduct, and that AFA is strengthening their internal control by instituting a written code of conduct'.
So yet another silly episode in Singapore's war on AIDS comes to an end. But Mr Wang still says, "Huh?"

"Huh?" was Mr Wang's first reaction when he read the original report some time ago about this whole matter. Mr Wang's view was that even if the New Paper had got its facts completely right, there was absolutely nothing wrong with what AFA was doing.

You see, when a HIV-positive person has sex with a non-HIV-positive person, that's very high-risk sex. That's very dangerous. That's something which society should try very, very hard to prevent.

However, when a HIV-positive person has sex with another HIV-positive person, that's zero-risk sex. Both are already infected. Therefore there is no added risk of AIDS if they have sex with each other. Thus if a HIV-positive AFA volunteer has sex with another HIV-positive person, there is no cause for concern.

It is actually a good idea for HIV-positive persons to have sex with each other. The window period between getting the AIDS virus and developing full-blown AIDS is very long. It could be as long as five to 10 years. That's a very long time to expect an relatively healthy adult to completely abstain from sex. Most people are not designed for monkhood.

And complete abstinence is also unnecessary if there is nothing he can pass to his lover which his lover hasn't already got. Even a condom wouldn't be necessary (assuming that neither has other types of sexually transmitted diseases). If two HIV-positive persons become each other's sexual partner, it becomes much more possible for them to avoid seeking sex elsewhere and possibly endangering non-HIV-positive people.
"It's okay, dear. I have it too!"

Also I see nothing wrong with HIV-positive counsellors counselling other HIV-positive people. If anything, these counsellors will be better able to understand and empathise with the personal issues which the HIV-positive persons face. And surely there is nothing very unusual about this? I'm sure that if you go check up on, say, cancer support groups, you will find that some of the counsellors are also cancer patients or ex-cancer patients.

So what is the big deal, please?


Update! See comments section for a brief discussion on HIV superinfection, something which Mr Wang didn't know about earlier. See, you learn something every day.


Anonymous said...

"The probe was sparked by a report in The New Paper on July 10, which said that five of AFA's volunteers had contracted the virus after becoming volunteers, and that there was concern that 'young male volunteers are coming forward because they see the MSM outreach programme as another avenue for them to meet other gay men'."

This is crazy. Are they suggesting that gay men (without HIV) want to meet (and have sex with) gay men who are HIV positive, regardless of the very obvious risk?


Anonymous said...

Who knows, maybe Dr Balaji put them up to it =P

Anonymous said...

you have official medical information to backup your claim that sex between 2 already HIV-infected persons is zero-risk sex?

Gilbert Koh aka Mr Wang said...

Would you like to tell me what you think is the worst that can happen if a person with HIV has sex with another person with HIV?

Unknown said...

So some bored ppl decided to raise a big hooha on the newspaper, so that some ppl have to do an investigation on it, then some very-free ppl can come out and say "yes everything's ok and btw the issue is closed"???

singaporean said...

Err Mr Wang,

there is a school of thought that believes that HIV doesnt cause AIDS. Post hoc, ergo, proctor hoc. Latin shouldnt trouble lawyers, right? :P

Anonymous said...

Mr Wang, somehow I managed to stumble over your blog and I'm very impressed by your insights and thought process...
In other words, I'm a new fan of your blog...haa...
Keep those posts going!

lzyData said...

I say TNP was just looking to sell more copies by spinning something like this into a titillating scandal. And even when they get it all wrong - as they seem to have here - they needn't even print a correction or apology. It's beautiful, this whole racket.

Oh said...

This got me curious and i did abit of google. Seems like there're different strains of HIV and risks of reinfection and superinfection.

Anonymous said...

You shouldn't assume that the local papers get ALL their facts wrong, and that there is no medical basis to the investigation they have launched against AFA. HIV, unlike cancer, is contagious. And it is the complications which eventually kill patients, because their immune system cannot protect them against some illnesses which a normal immune system can.

7-8 said...

I think that one reason why the HIV virus is so dangerous and hard to track down is because it can mutate. Because of this I'm guessing it's not a good idea that a HIV positive person comes into contact with another person's HIV strain. It could be even more virulent (to him) than his own HIV. But of course this is just a hypothesis.

Gilbert Koh aka Mr Wang said...

Anonoymous, you give the TNP waaaay too much credit. Tomorrow I will cite to you what the TNP management has just very recently said about this whole matter.

You'll see that "medical basis" had absolutely nothing to do with the reason why they published the original story. In fact, they are now saying that they didn't even intend to imply that AFA volunteers are having sex with the people seeking counselled. hahaa.

7-8, the link which "Oh" provided isn't working for me now. I will try to click on it later and see what it says.

Anonymous said...

Unfortunately, there is a risk for two HIV+ves to engage in unprotected sex - as mentioned, superinfection. The danger exists because there are different strains of the HIVirus with different resistance profiles. Getting superinfections puts one at risk of developing resistance to existing HIV antiretroviral medications, and exhausting options for treatment.

Gilbert Koh aka Mr Wang said...

That was interesting. I didn't know about the HIV superinfection problem, but I've just poked around the Internet and learned a bit more. It seems like a fairly new discovery (I saw a 2000 article which said that scientists were just starting to consider the question).

Now, I could be a stubborn mule and insist that two HIV-positive people having protected sex with each other is still better than one HIV-positive person having sex with one uninfected person. Or I could point out that even if you have six strains of HIV, you still die only once.

But then it is now 2:10 am and I've just finished wrestling with credit derivatives. So I think I'm going to bed now.

Anonymous said...

Mr Wang, u are good most of the times, but this case i think u saw the tree but not the forest this time. there is an ethical code. when we do counselling, it is a professional job as e counsellor gets e o/r person to open his heart to u. these are info tt u can exploit as an unscrupulous counsellor. I am looking this at a systemic level. Hence, there is reason to be concerned.

Anonymous said...

Agreed. Mr Wang, it is not about HIV+ persons having sex with each other. It is about cousellors having sexual relations with the people they council. The HIV issue is peripheral.

Gilbert Koh aka Mr Wang said...

Well, firstly the investigations conclude that the sex didn't happen. So your issue is a non-issue.

Secondly, your issue was also not TNP's issue. According to their spokesman's latest missive (quoted in yesterday's ST), their main thrust is that AIDS counsellors with HIV set a poor example for HIV patients.

(Of course, I happen to think that their main thrust is also rather dumb. AFTER the guy has ALREADY got HIV, what is the use of having a sexually prim and proper counsellor to act as Role Model? Furthermore a HIV-positive counsellor, as I already said, has the advantage that he can probably emphatise and understand the counsellee better).

Thirdly, I guess I'm sympathetic to AFA because all their counsellors are volunteers anyway. I know, because I previously attended an AIDS workshop conducted by AFA. So I don't think it is necessarily appropriate to hold these part-timers to the same standards as, say, professional psychiatrists.

Finally, you should really think about the facts of our actual situation. This is different from a situation where, say, a senior mentor, say, in a religious group, sexually exploits some young naive girl.

Here in the AFA situation, your counsellee has HIV, and this is known to the counsellor.

That's practically the best safeguard against sexual exploitation that anyone can think of. See Molly's comment right above.

Anonymous said...

mr wang gets it wrong. of course there is an issue. Below is an example of a standard expectation of behavior for counsellors. if there is hint that things aren't too proper, the public has a right to know. this refers to all counsellors and not just to those who have aids. your argument that sex didn't happen, so no issue is absurd. if there is no investigation, how to know.

U then go on to say and i quote:"This is different from a situation where, say, a senior mentor, say, in a religious group, sexually exploits some young naive girl."

so u mean to tell me that if it is a senior mentor exploiting young girls, it is not permissible, but if it is aids infected counsellor to another aid infected, it is ok. This is most absurd!

"All forms of sexual behavior or harassment with clients are unethical, even when a client invites or consents to such behavior or involvement. Sexual behavior is defined as, but not limited to, all forms of overt and covert seductive speech, gestures, and behavior as well as physical contact of a sexual nature; harassment is defined as but not limited to, repeated comments, gestures or physical contacts of a sexual nature."

Anonymous said...

Yes. And from only reading Mr Wang's post, I was led to believe that the allegation of sexual relations between cousellors and counsellees WAS the issue. From this part: "...a report in The New Paper on July 10, which said that five of AFA's volunteers had contracted the virus after becoming volunteers, and that there was concern that 'young male volunteers are coming forward because they see the MSM outreach programme as another avenue for them to meet other gay men'." I think it would be expected.

Anonymous said...

I agree. Mr Wang is really painting a distorted picture here. This is not like you to do this. What is your agenda?

Gilbert Koh aka Mr Wang said...

My agenda?

Well, the truth is that AFA has paid me $500,000 to write positive things about them on my blog and help them disguise the fact that in fact, their private "counselling" is just mass orgy sessions where HIV-positive counsellees are emotionally manipulated into surrendering their bodies for sexual exploitation by healthy, unethical non-HIV counsellors who wish to catch AIDS from them.


No, of course not. But then there are none so blind as those who refuse to see.

Anonymous said...

That's good to hear. Just wondering why you have ignored and poured scorn to Annoymous' pertinent points. That's all. maybe the blind ones are not the people who respond to you, but you the enlightened Mr Wang... maybe it is you who chose not to see. Then again perhaps we are the lessor being as you are :
"The genius may sometimes seem to be out of touch with reality, but only because he or she operates at a more profound level."

Anonymous said...

Haha... We can finally agree on that point, Mr Wang.

Gilbert Koh aka Mr Wang said...

Stray Cat / Anonymous

Well, well. There are only nine personality types in the Enneagram system. So you never know. There could be a 1 in 9 chance that you're a genius like me. :)

More seriously, as I've previously mentioned, there are no "better" or "worse" personality types in the Enneagram system. All types have their own strengths. Eg Fives are highly perceptive and intelligent; Ones are highly principled and idealistic; Threes are geared to achieve success in life. Einstein was a 5; Gandhi was a 1; Clinton was a 3.

Each type is also inclined towards specific types of neuroses and psychiatric problems. If Einstein had become mentally ill, most likely he would become suicidal and inclined to kill himself; if Clinton had become mentally ill, most likely he would become violent and inclined to kill someone else.

So says the Enneagram system.

I find that the points raised by Anonymous are now touching on aspects of the ST aticle which I originally didn't think were very interesting (and which I had not posted). Let me dig up the full text of the article and repost it for everyone's discussion.

Anonymous said...

No luck lah. I am most likely an 8.

Gilbert Koh aka Mr Wang said...

Oh. The Saddam type.

hugewhaleshark said...
This comment has been removed by a blog administrator.
hugewhaleshark said...

Yeh, and Castro too. : )

TNP's stance on their article seems to be that counsellors are not practising what they preach, and are contracting HIV as a result. I think that does not relate directly to your arguments on HIV+ persons having sex with each other.

And if the TNP article did in fact raise "concern that young male volunteers are coming forward because they see the MSM outreach programme as another avenue for them to meet other gay men", then you cannot blame AFA for barking the way they did.

hws (formerly anon)

Gilbert Koh aka Mr Wang said...

Yes, a woefully misguided article by TNP in many ways.

Even the "you-should-practise-what-you-preach" line looks somewhat misconceived.

It would be an important argument if the relevant AFA person was, say, conducting public talks to raise AIDS awareness.

But it becomes a rather misconceived and silly argument if the relevant AFA person was counselling a person who has ALREADY got the HIV virus.

The chap already has HIV. Counselling, I imagine, should focus on helping him to deal with personal issues like to tell or not to tell his family; how to deal with the trauma of the knowledge that one has a fatal and incurable disease etc.

I would be surprised if counselling were to proceed along preachy lines like: "Oh, you bad boy, you shouldn't have engaged in high-risk behaviour, why didn't you follow my good, moral example instead?"

Gilbert Koh aka Mr Wang said...

Oh, here's the full text of the ST article.

And AFA's rebuttal of the TNP article.