Neo Swee Chye, 30, allegedly lied prior to donating blood at a mobile blood bank at Lorong 24A, Geylang, on June 25 last year.
It is alleged he falsely declared that, in the previous year, he had not given money to a prostitute to have sex with him, he had not been hospitalised, and that he had not lived, or travelled, overseas in the last three years.
The form must be completed and signed by all would-be blood donors, as part of the drill for blood donation.
The questions are specific - and intimate - to find out if the donor is at risk of being infected with either HIV or other transmittable diseases.
Yesterday, Neo appeared in court without a lawyer.
The court interpreter read the charge to him in Mandarin, and explained the possible punishment for the offence.
Neo pleaded guilty.
But, as the statement of facts was read out, Neo started talking, his hand moving about emphatically, as if explaining something.
The interpreter then turned to District Judge Victor Yeo and said Neo was qualifying his plea of guilt.
Neo told the interpreter he had 'ticked the form without knowing what was inside'.
Judge Yeo then asked Neo if he was getting a lawyer to represent him. Neo replied that he did not plan to.
Withdrawing Neo's earlier guilty plea, the judge fixed his case for a pre-trial conference on March 9.
Neo is believed to be the second HIV-infected man to be charged with lying on his blood-donor registration form.
The first was Loo Wah Yew, 43, who lied on his donor registration form on six occasions.
As a result, two patients received his blood by transfusion and were infected.
Loo's case came to light in late 1997.
He was jailed for 12 months after admitting his deceit in January the following year.
It is not known, in Neo's case, if the tainted blood had been discovered, or if anyone became infected as a result.
Replying to a questions form the press, the Ministry of Health said: 'As the case is before the court, it is inappropriate to comment or provide information.'