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AN IN-DEPTH study into the sexual behaviour of homosexual men here is under way.
Entitled Sex In The City: A Health Study, the survey initiated by Tan Tock Seng Hospital (TTSH) also aims to determine the prevalence of syphilis and HIV infection among homosexuals.
Surveys on the gay community have been done before by organisations such as advocacy group Action for Aids (AfA) and gay lifestyle portal Fridae.com, but those did not combine a blood test with questions on sexual habits.
A principal researcher of this study, TTSH consultant Mark Chen, explained that overseas data has shown that gay men are more at risk of syphilis and HIV, the virus that causes Aids, but this has not been proven conclusively here.
'The key objective of this study is to understand the risk factors of this population, and what predisposes them to certain diseases.
'Such information has the potential to improve on prevention and treatment of sexually transmitted infections,' said the epidemiologist.
But the research team has already encountered a hiccup - getting enough homosexual men to take part in the study.
The researchers want 1,000 participants, but in the year since work began, only 40 individuals have submitted to the blood test for sexually transmitted infections (STIs) and volunteered information about their sexual habits in a computerised survey.
Test and survey take 45 minutes.
The response has been poor despite the promise of confidentiality and a small financial incentive of $60 for their time, and a further $30 for every successful referral they make.
A unique feature of this survey is its recruitment method, known as 'chain referral', which is being used here for the first time.
In a typical research survey, anyone suitable can sign up as a participant.
With chain referral, researchers - with help from joint study partners AfA and Fridae.com - identified profiles or 'seeds' to be included in the survey. These seeds then refer other homosexuals they know of to join the study; these participants continue the chain referral by introducing other gay men in their networks to take part.
This route was taken because of the sensitivity of the study topic, said Dr Chen.
The research team, which also includes representatives from the Department of Sexually Transmitted Infections Control Clinic (DSC Clinic) and the National University of Singapore, identified nine profiles they want to study.
These include certain age groups and the main language spoken.
It is apparent the community beyond the first 40 participants remains uncomfortable about just how confidential the collected data will be, although no names or identity numbers are taken down.
Research assistant Ridzwan Abdullah said: 'The most common concern is that the survey is not fully confidential and will be shared with the authorities. But this is not true.
'There isn't even a signed, written consent, or any taking down of particulars.
In Singapore, all STIs must be reported to the Ministry of Health. STIs are reported without identifying the patient, unless it is a case of HIV.
But some people test positive for HIV at anonymous test sites. In those cases, the Health Ministry does not get their names, which is the case with this study.
Dr Chen said: 'We want to emphasise that we have good intentions behind this study. It's strictly confidential and the data collected will not in any way affect them adversely.'
AfA vice-president and TTSH senior consultant Lee Cheng Chuan, who is not involved in the study, said this is the first such local study that links a questionnaire survey with a biological test.
He says the survey is timely as the community of men who have sex with men is an increasing risk group.
'It is good to understand the risk factors to come up with solutions. In research, ethics and protocol are very important. Singapore has rigorous reg-ulations. Those who can participate but are hesitant should have faith in the system.'
Entitled Sex In The City: A Health Study, the survey initiated by Tan Tock Seng Hospital (TTSH) also aims to determine the prevalence of syphilis and HIV infection among homosexuals.
Surveys on the gay community have been done before by organisations such as advocacy group Action for Aids (AfA) and gay lifestyle portal Fridae.com, but those did not combine a blood test with questions on sexual habits.
A principal researcher of this study, TTSH consultant Mark Chen, explained that overseas data has shown that gay men are more at risk of syphilis and HIV, the virus that causes Aids, but this has not been proven conclusively here.
'The key objective of this study is to understand the risk factors of this population, and what predisposes them to certain diseases.
'Such information has the potential to improve on prevention and treatment of sexually transmitted infections,' said the epidemiologist.
But the research team has already encountered a hiccup - getting enough homosexual men to take part in the study.
The researchers want 1,000 participants, but in the year since work began, only 40 individuals have submitted to the blood test for sexually transmitted infections (STIs) and volunteered information about their sexual habits in a computerised survey.
Test and survey take 45 minutes.
The response has been poor despite the promise of confidentiality and a small financial incentive of $60 for their time, and a further $30 for every successful referral they make.
A unique feature of this survey is its recruitment method, known as 'chain referral', which is being used here for the first time.
In a typical research survey, anyone suitable can sign up as a participant.
With chain referral, researchers - with help from joint study partners AfA and Fridae.com - identified profiles or 'seeds' to be included in the survey. These seeds then refer other homosexuals they know of to join the study; these participants continue the chain referral by introducing other gay men in their networks to take part.
This route was taken because of the sensitivity of the study topic, said Dr Chen.
The research team, which also includes representatives from the Department of Sexually Transmitted Infections Control Clinic (DSC Clinic) and the National University of Singapore, identified nine profiles they want to study.
These include certain age groups and the main language spoken.
It is apparent the community beyond the first 40 participants remains uncomfortable about just how confidential the collected data will be, although no names or identity numbers are taken down.
Research assistant Ridzwan Abdullah said: 'The most common concern is that the survey is not fully confidential and will be shared with the authorities. But this is not true.
'There isn't even a signed, written consent, or any taking down of particulars.
In Singapore, all STIs must be reported to the Ministry of Health. STIs are reported without identifying the patient, unless it is a case of HIV.
But some people test positive for HIV at anonymous test sites. In those cases, the Health Ministry does not get their names, which is the case with this study.
Dr Chen said: 'We want to emphasise that we have good intentions behind this study. It's strictly confidential and the data collected will not in any way affect them adversely.'
AfA vice-president and TTSH senior consultant Lee Cheng Chuan, who is not involved in the study, said this is the first such local study that links a questionnaire survey with a biological test.
He says the survey is timely as the community of men who have sex with men is an increasing risk group.
'It is good to understand the risk factors to come up with solutions. In research, ethics and protocol are very important. Singapore has rigorous reg-ulations. Those who can participate but are hesitant should have faith in the system.'
