Singapore

Singapore / Singapore

OVERVIEW

Contraception

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Singapore, you'll need a prescription for birth control. If you don't already have one, you can visit a gynecologist for a consultation. They will ask you basic questions but will probably not require a pelvic exam. It appears that, if you're a minor, you can confidentially obtain contraceptives. As advised by WTF zine: "It is routine and lawful medical practice for your doctor to keep your medical records confidential. You can also consult a doctor other than the one your family sees. It is also easy to discreetly use birth control methods. For added confidentiality, ask your doctor about how you will be billed on your account or insurance statement. If it explicitly states birth control, you can request for it to show up as miscellaneous fees."

However, if you are under 16 years old (the age of consent), you should be aware of the laws and the fact that pharmacists may not prescribe birth control for you. As stated by the Singapore Medical Association Ethics Committee: "The Committee received a query from a doctor on prescribing contraceptive pills to a teenage girl, who is a foreigner, without her mother’s knowledge. As the girl is below the age of 16, and started sexual activities before turning 14, the doctor wanted to know the legality of continual prescription of contraception and whether he would be culpable in the event of a pregnancy. Based on the information provided, it was highlighted to the doctor that: If the sexual activities took place in Singapore, they would constitute a seizable criminal offence in Singapore under Section 376A of the Penal Code. It does not matter that the sex was consensual, as under the laws in Singapore, the patient is too young to be able to give legally effective consent, and the patient’s sexual partner was thus engaged in criminal activities. This is regardless of whether or not she gets pregnant."

For details on Singaporean population control history, check out the "Pregnancy" section.

What to Get & Where to Get It

Common birth control brands in Singapore are Yasmin, Yaz and Diane-35.

Some people find it cheaper and easier to buy birth control in Malaysia, where brands like Marvelon, Mercilon, Gynera, Diane(35), Nordette, Novynette can be purchased over-the-counter for $6-10 (as of August 2014).

Costs

A one month supply of hormonal BC pills typically costs between $25-40. For an IUD, you can expect to pay around $400-500. For a contraceptive injection, you can expect to pay around $150-200. For a birth control implant, which lasts 5 years, you can expect to pay $400-500.

Emergency Contraception

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Singapore, emergency contraception is only available with a prescription. Note that only the woman can visit the doctor for a prescription and the woman must be at least 16 years old (age of consent).

What to Get & Where to Get It

Note: The longest-lasting EC is currently ellaOne. It lasts up to 5 days (120 hours) after unprotected sex, and it's been approved to be carried in Singapore. Also, copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

Once you obtain an EC prescription, here's some dedicated EC you can find in Singapore:

• Estinor
• Postinor-2
• ella

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

By law, if you are found to have any "serious" STI, such as chancroids, chlamydia, gonorrhea, hepatitis, HIV/AIDS and syphilis, the results must be reported to the Singapore Ministry of Health (SMOH). However, it seems that some clinics offer private and confidential STI tests in Singapore (see section below for details on this).

Regarding STIs, Singapore has especially strict laws concerning HIV/AIDS. Until recently, if you were diagnosed with HIV/AIDS, you weren't allowed to enter Singapore as a tourist or immigrant. While Singapore required no testing in order to receive a basic tourist visa and there were no health checks at the border, this was the official policy. However, in August 2015, Singapore lifted this ban for travelers. As reported by Action for AIDS Singapore: "The ban was lifted 'given the current context with more than 5,000 Singapore residents living with HIV and the availability of effective treatment for the disease.'"

This new ease on restrictions does not apply to long-term visitors, expats or immigrants. As stated by HIVTravel: "Foreign nationals with AIDS or who are HIV-positive are expelled. HIV-positive foreign spouses of Singaporeans are exempt and allowed to remain in Singapore. Entering with ARVs for personal use requires approval by authorities. Use local hospitals with caution: Singapore doctors are required to report anyone found to be HIV-positive to the authorities. Air travellers in transit in Singapore are not affected." Furthermore, "HIV-positive spouses of Singaporean citizens are allowed to stay in the country. Entering with antiretroviral medication for personal use: Prior approval by the Health Sciences Authority (HSA) is required, e-mail: hsa_info@hsa.gov.sg. In practice, such a permit will only be granted to HIV-positive spouses of Singaporean citizens. A declaration is not required at customs, however, the HSA permit needs to be presented in case of a routine check."

It also seems that anyone with an STI is technically not allowed from to immigrate to Singapore. According to Singaporean guidelines, "any person suffering from mental disorder or being a mental defective, or suffering from a contagious or infectious disease which makes his presence in Singapore dangerous to the community" is barred from immigration. However, there is no evidence that the government requires tests for all STIs (other than HIV and perhaps syphilis) in order to grant immigration status.

Supposedly, the most common STI in Singapore in gonorrhea. HIV is also reportedly on the rise and there were 3000 people living with HIV in Singapore in 2013.

What to Get & Where to Get It

Testing Facilities

• DSC Clinic: Seems to be cheapest option in Singapore. "Anonymous HIV testing is offered by Action for AIDS at the DSC clinic and at designated GP clinics. Anonymous testing does not require you to provide any name, NRIC number or contact information. Rapid HIV testing is also now available. Rapid HIV tests are screening tests that produce very quick results, in approximately 20 minutes. All HIV test results are kept strictly confidential." HIV rapid test is $8.50. Tests for other STIs, like gonorrhea, herpes or syphilis, range from about $10-20 each. They say that the average bill for a female visitor comes out to $100-140. Visa and MasterCard accepted. Address: 31 Kelantan Lane, #01-16, Singapore 200031, Tel: 6293 9648, Fax: 6299 4335.
• Shim Clinic Singapore: Address: Private and confidential clinic. Cheaper than most other clinics. You can get basic tests $12-60. Get "8 test panel" for $250. Full female comprehensive for $759. Address: 168 Bedok South Avenue 3, #01-473, Singapore 460168, Hours: 7–11 PM, Phone: +65 6446 7446
• Q Medical Clinic: Screens for Syphilis, HIV, Herpes Type I & II, Hepatitis B, Hepatitis A, Hepatitis C, Chlamydia, Gonorrhea, Candida, Trichomonas, Gardnerella, Mycoplasma, Ureaplasma, Urine Feme & Culture and HVS Feme & Culture. You can request a female doctor. There's 2 locations. Address 1: 428 River Valley Road, #01-09,l Loft @ Nathan, Singapore 248327. 308 Address 2: Telok Kurau Road,#01-06. Vibes @ East Coast, Singapore 423858. Tel: +65 67 026 608 (River Valley), Tel: +65 63 489 068 (Telok Kurau). SMS: +65 98 537 537. Email: health@Qmedical.com.sg.
• Tanjong Pagar Medical Clinic: Provides anonymous HIV tests. Basic screening for $60, standard screening for $200. Full female screening for $380. Address: BLK 1 Tanjong Pagar Palaza #01-06 S(082001), Tel: 64433101, Fax: 64433881, SMS: 96622880, Email: info@tanjongpagarclinic.com.
• Eylon Family Clinic and Surgery: Blood Tests – HIV, Syphilis, Hepatitis A/B/C, Candida Antibody, Herpes Simplex Virus Type I and II, Urine/Swab – Chlamydia and Gonorrhoea PCR, Monilia, Trichomonas, Mycoplasma, Ureaplasma, Urine microscopy and culture, Candida, Vaginal swab culture. Comprehensive Female with additional DNA Probe for Gardnerella, Trichomonas and Candida. Address: 78B, Telok Blangah Street 32, #01-22,, Singapore 102078, Phone: 6802 7208, 8418 7208 (Call for appointment), Mobile: 8418 7208, Fax: 6377 1318, Email: enquiry@elyonclinic.com.sg.
• Kensington Family Clinic: Tests Blood - HIV, Syphilis, Hepatitis A/B/C, Candida Antibody, Herpes Simplex Virus Type I and II, Urine/Swab - Chlamydia and Gonorrhoea PCR, Gardnerella*, Trichomonas*, Candida*, Mycoplasma, Ureaplasma, Urine microscopy and culture, Vaginal swab culture. STI tests range from $60-200, depending on how extensive you want them to be. $20-100 consultation fee. 14D Kensington Park Road, Serangoon Garden Estate, S(557265), Tel: 6288 4882 SMS: 9295 9585
• Dr. Tan & Partners: Does a full range of tests for a bit more expensive than the other private clinics (full women's exam is $525 excluding GST and consulting). They seem very responsive to people on their website. The HIV tests are anonymous. Has 6 locations so check the website for each address.

Support

• 24-hr AIDS/STI Helpline: 6295 2944 (pre-recorded messages in 4 languages)
• AIDS/STI Information Hotline: 1800 252 1324 (to speak to a counsellor during office hours)
• Action for AIDS Singapore: "AFA was formed in 1988 in response to the global and local spread of HIV infection. It is a registered Charity and is recognised by IPC (Institution of Public Character) since 2004." Mailing Address: 9 Kelantan Lane #03-01, Singapore 208628 or c/o DSC Clinic: 31 Kelantan Lane #02-16, Singapore 200031. Tel : (65) 6254 0212, Fax : (65) 6256 5903, Email : info@afa.org.sg.

Costs

At DSC (the public clinic), you'll probably find the cheapest rates, where average bills come out to $100-140 (including the consultation). At private clinics, for a comprehensive STI and women's health test, prices will generally be between $400-500 with a $20 consultation fee. If you want a "basic" test, which usually means HIV, syphilis and hepatitis B, that'll be around $20-60 with a $20 consultation fee. For $100-200, you can get a test that covers all STIs without the additional women's wellness/health exam plus the $20 consultation fee.

Medications & Vaccines

What to Get & Where to Get It

Where to get Post-Exposure Prophylaxis (PEP):

• Tanjong Pagar Medical Clinic: $2000 for PEP. "At Tanjong Pagar Medical Clinic, we offer HIV PEP treatment that is safe, well-tolerated, widely used in public government hospitals and in line with international HIV post exposure prophylaxis guidelines." Address: BLK 1 Tanjong Pagar Palaza #01-06 S(082001), Tel: 64433101, Fax: 64433881, SMS: 96622880, Email: info@tanjongpagarclinic.com.
• Shim Clinic Singapore: $2200 for PEP. Address: 168 Bedok South Avenue 3, #01-473, Singapore 460168, Hours: 7–11 PM, Phone: +65 6446 7446

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Pregnancy

Laws & Social Stigmas

In 1970, Singapore began to advocate for population control, telling its citizens to "Stop at Two." The government legalized sterilization and abortion as well. However, by the 1980s, the birth rate had significantly dropped. In reaction to this change, the Singaporean government changed its stance and Prime Minister Goh Chok Tong's government developed a new slogan: "Have Three or More (if you can afford it)." Incentives were also given to mothers who had more than two children. For example, families with a third child received 750 SGD in child relief.

As written on Wikipedia: "Though newer modern policies exhibit 'signs that the government is beginning to recognise the ineffectiveness of a purely monetary approach to increasing birth rates', a former civil servant noted that the government needs 'to learn to fine-tune to the emotions rather than to dollars and cents. It should appeal more to the sense of fulfilment of having children'. Such measures include promoting workplaces that encourage spending time with the family, and creating a 'Romancing Singapore Campaign' that '[directly avoided being linked] to pro-children and pro-family initiatives," since "people get turned off' when the government appears to intervene in such intimate social affairs as marriage."

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

List of Additional Resources

• AWARE: "AWARE is Singapore’s leading gender equality advocacy group. AWARE believes in the rights of women and men to make informed and responsible choices about their lives and to have equal opportunities in education, marriage and employment, and in the right of women to control their own bodies, particularly with regard to sexual and reproductive rights."
• WTF!: A Singapore-based website/zine focused on sexuality, relationships, LGBTQ, sexual assault and safe sex