How Do I Get Tested For An Anonymous HIV Test In Singapore

These 3 letters H, I, and V put together, or commonly known as the Human Immunodeficiency Virus, sets alarm bells ringing in most people’s minds. Often, the anxiety and concern that goes through one’s mind can often be allayed through a simple consult with our doctors to assess your risk and or a test to decide what to do next.
Still concerned? Read on to find out more and take the next step to schedule a consultation and Anonymous HIV Testing in Singapore with our doctors.

How is it Even Possible to Get HIV Tested Anonymously?

Yes it is that simple with our “3 step test” guide
Step 1:

  • Walk into our clinic at Robertson Walk.
  • Let our staff know you are here for the “AHT”.

Step 2:

  • Private consultation with the doctor.
  • The doctor will proceed with the “3 Step Test”.

Step 3:

  • After 20 minutes your results will be ready.
  • Reviewing of your HIV test result with our doctor.

Who Should Get HIV Tested?

If you have a concern for HIV transmission or even a sexual health concern, we advise you to see us get your queries addressed.
Where appropriate, we will support you with the HIV test.

How Is HIV Testing Done? I am Scared of Needles

A small finger prick is done, it will be slightly uncomfortable, and a few drops of blood are collected. No needles are involved.

How Long Do I Have to Wait for the HIV Test Results?

The results take 20 mins to be ready and your doctor will discuss the results with you

How Much Does the Anonymous HIV Test cost?

Rapid Fingerprick HIV (3rdGen Test) – (90 days after exposure)
$53.60 (after GST)
Rapid Fingerprick HIV Combo Test (4thGeneration) – (28 days after exposure)
$160.60 (after GST)
All results take 20 mins. Consultation charge is between $20 – $30.

Anonymous HIV Testing in Singapore is only available in our Robertson Walk Branch.

Upholding Patient Confidentiality is our utmost priority. Therefore reports will NOT be snail mailed by post. Results can be communicated via phone or email.
During the private consultation, you can speak to our doctors about all of your HIV-related concerns. The doctor will then recommend the correct HIV Test or STD test.
Our registered doctors will administer the HIV and STD tests, which are approved by the Health Sciences Authority (HSA)


Other Reads:

  1. Low HIV Risk Doesn’t Mean No HIV Risk
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. What are the Causes of Abnormal Penile Discharge?
  4. HIV PrEP for Travel – How You Need to Know
  5. An Overview on STD from an STD Doctor
  6. Why Do I Have AbnormalVaginal Discharge
  7. How Late Can a Period Be (Delayed Menstrual Cycle)
  8. Everything You Need to Know about Herpes Simplex Virus
  9. How Do I Treat Oral Herpes (Cold Sores)
  10. Syphilis Symptoms – Painless Sore & Ulcers
  11. HIV Symptoms – What You Need to Know
  12. 10 Common HIV related Opportunistic Infections

Low HIV Risk Does Not Mean NO HIV Risk

As we approach the year-end festivities and parties, I am reminded of an article published more than 5 years ago on HIV (Human Immunodeficiency Virus) scares amidst getting a needle stick injury from infected blood.
http://news.asiaone.com/News/AsiaOne+News/Singapore/Story/A1Story20110801-292087.html
The story above went that a partygoer had been going to famous clubs and jabbing people with an HIV tainted syringe, presumably of her own blood, to take revenge on them.
The following excerpt reproduced from the AsiaOne article, explains this risk further
Quoting Professor Roy Chan, president of voluntary organization Action for Aids, said it is possible for HIV to be contracted in the way described. But for that to happen, the blood has to be injected within a few hours of it being drawn from the infected person.

“The needle must also penetrate the skin of the victim and reach some blood deposits.
“And it is possible for people who have been exposed to tainted blood to seek post-exposure treatment within the first day or two at a hospital to reduce the risk of contracting the infection,”

Prof Chan told TNP.

What are the odds?

So realistically what are the exact numbers and risk for such exposure? There haven’t been any studies of HIV infected needle transmissions studied outside the healthcare setting but the numbers in a comprehensive study are:

  • Blood Transfusion –  9250/10000 or 93% risk
  • Needlestick – 23/10000 or 0.23% risk
  • Needle sharing – 63/10000 or 0.63% risk

So far there hasn’t been any case reported or recorded, in the world of a successful HIV transmission from a needlestick attack or a needlestick injury outside the healthcare setting

So What about Tattoos or Piercings?

Again through numerous studies, the risk of HIV transmission through tattoos and piercings depend on a number of factors. Mainly the sterilization techniques of the equipment used.
Transmission occurs if the equipment (needles/tattoo gun) were contaminated with blood from a previously tattooed individual who carried HIV. Or even the use of dyes, wiping material (sponges/clothes) contaminated with blood. These are liquid solutions where at room temperature HIV virus may remain for up to 2 weeks
This percentage again is closely associated with the needlestick injury risk of 0.23%. However, repeated use of the needle/tattoo gun for the process does increase the overall risk percentage

What is the take-home message?

Around the world, HIV is a disease that has a stigma in society. And surrounding this stigma is a lot of unknowns and ultimately fear.
Only recently again in 2018 the media picks up on such another case in India where HIV transmission occurred during a blood transfusion.
https://www.channelnewsasia.com/news/asia/pregnant-woman-in-india-contracts-hiv-after-blood-transfusion-in-11063528
The good news is that in Singapore, all blood products are tested and screened by the authorities
If you suspect an episode which could lead to a possible HIV risk – tainted needle, needle attack, transfusion error, do speak to your doctors early to discuss this risk with us. If within 72 hours, there are options such as HIV Post Exposure Prophylaxis (PEP) which can significantly decrease the risk of HIV transmission by more than 90%

Low HIV Risk Doesn’t Mean NO Risk

From all of us at Dr Tan and Partners, stay safe and enjoy your festive season.
Take Care!

Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. The HIV Pro-Virus DNA Test can be done 10 days post exposure.
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. What are the Causes of Abnormal Penile Discharge?
  5. What are the Symptoms of HIV Infection and AIDS?
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. What is HPV Vaccination (Gardasil 9)
  9. 10 Causes of abnormal Vaginal Lumps and Bumps
  10. An Overview of Gonorrhoea
  11. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  12. Syphilis Symptoms (Painless STD Sores & STD Rashes) 


References

  1. Padian N Transmission of HIV Possibly Associated with Exposure of Mucous Membrane to Contaminated Blood.MMWR Morb Mortal Wkly Rep11;46(27): 620-3, July, 1997
  2. Bernard EJ Texas jury concludes saliva of HIV-positive man a “deadly weapon”, sentenced to 35 yrs jail.com, available online at: www.aidsmap.com/page/1430404/, 16 May 2008
  3. Pretty IA et al. Human bites and the risk of human immunodeficiency virus transmission.Am J Forensic Med Pathol. 20(3):232-9, 1999
  4. Gilbart VL Unusual HIV transmissions through blood contact: analysis of cases reported in the United Kingdom to December 1997.Communicable Disease and Public Health 1: 108-13, 1998
  5. Baggaley RF Risk of HIV-1 transmission for parenteral exposure and blood transfusion: a systematic review and meta-analysis.AIDS 20(6): 805-812, 2006
  6. Nishioka SA, Gyorkos TW. Tattoos as risk factors for transfusion- transmitted diseases. International Journal of Infectious Diseases 2001;5(1):27-34.
  7. Messahel A, Musgrove B. Infective complications of tattooing and skin piercing. Journal of Infection and Public Health 2009;2(1):7-13.
  8. Garland SM, Ung L, Vujovic OV, Said JM. Cosmetic tattooing: A potential transmission route for HIV? Australian & New Zealand Journal of Obstetrics & Gynaecolo- gy 2006;46(5):458-9.

10 Common HIV-related Opportunistic Infections

In late-stage HIV infection, the virus would have spread through the body and attacked the immune system for many years without treatment. On blood tests, the number of viral copies, or viral load (VL), will be very high, while the CD4 cells of the immune system would be very low.
When the immune system is in this weakened state, it is much easier for certain pathogens (bacterial, viral, fungal etc.) to invade and cause an infection – these types of infections are called Opportunistic Infections (OI’s). Sometimes, these infections can cause certain types of cells to become cancerous, and these are also classified as Opportunistic Infections.

What is an Opportunistic Infection?

In a healthy and normal functioning immune system, these pathogens do not usually cause infection, or they may cause very mild disease. Apart from advanced HIV infection, Opportunistic Infections may affect people who are on chemotherapy for cancer, immunosuppression for autoimmune diseases or post-organ transplant, among other conditions.
In HIV, many of these Opportunistic Infections are what we also term as “AIDS-defining illnesses” – that is, if these infections are found in someone who has HIV, we would classify them as having AIDS (Acquired Immunodeficiency Syndrome). Many of the symptoms and signs of late-stage HIV infection are due to these Opportunistic Infections rather than directly from the virus itself.

What is HIV Treatment?

HIV treatment and management consists of taking a set of correct HIV medicines to delay the control HIV, monitoring for and treating any opportunistic infections, and taking care of the patient’s general health and well being.

What are the most common Opportunistic Infections?

This is a list of some of the most common HIV-related opportunistic infections:

1) Candidiasis (Esophageal, Tracheal, Bronchial)

Also known as thrush, candida is a very common fungal organism that is found almost everywhere in the environment and can be isolated from around 30-50% of healthy people. Most of the time, it does not cause any symptoms of infection; however, in people with HIV, there can be invasive candida overgrowth in the esophagus and airways. It is often the first sign of a weakened immune system in previously undiagnosed individuals.

2) Cryptococcosis

Caused by the fungus cryptococcus neoformans, this can infect any part of the body, but most commonly will invade the lungs (pneumonia) or the brain (abscesses).

3) Cytomegalovirus (CMV)

Caused by an intracellular virus, this infection can cause inflammation of the brain, lungs, intestines, and eyes. CMV retinitis of the eye is sight-threatening and should be treated as a medical emergency.

4) Herpes Simplex Virus (HSV)

Another common virus, Herpes Simplex Virus (HSV) can cause symptoms in people with a normal immune system as well – usually cold sores or blisters around the mouth, genital region or anus.
However, in people with a weak immune system, outbreaks tend to be more frequent, severe, and prolonged in duration, and can also invade the lungs and esophagus.

5) Mycobacterium Tuberculosis (TB) & other Mycobacterial infection

Tuberculosis (TB) would most commonly affect the lungs, but may also spread to lymph nodes, brain, kidneys, or bones. Symptoms of TB include recurrent fever, night sweats, chronic cough, and weight loss. Other mycobacteria are very commonly found in soil and around the environment, and very rarely would cause problems in healthy individuals; as Opportunistic Infections, they will usually affect the lungs but can spread throughout the body.

6) Pneumocystis Carinii Pneumonia (PCP)

Caused by a fungus pneumocystis carinii, now renamed as pneumocystis jirovecii, this infection is commonly one of the first signs of a late-stage HIV infection. Symptoms would include shortness of breath on exertion, dry cough, and high fever, and if left untreated can be deadly.

7) Salmonella septicemia

Salmonella is a common bacteria that is usually found in contaminated food or water. In healthy individuals, this may cause an acute ‘food poisoning’ with vomiting, diarrhoea, and sometimes fever. However, salmonella as an Opportunistic Infection can spread throughout the body and cause septicemia, or blood poisoning, leading to multi-organ failure and death.

8) Toxoplasmosis

This is caused by a parasite called toxoplasma gondii, which is found in the faeces of certain animals (normally cats, rodents, and birds), and can be found in undercooked red meat such as pork. It can cause infection of the lungs, eyes, liver, and brain.

9) Kaposi’s Sarcoma (KS)

This is a type of abnormal growth/tumor of connective tissue – more specifically, of the capillaries (small blood vessels). It can occur anywhere in the body, but if it arises on the skin or mucous membranes, KS will usually appear as firm reddish or purplish lumps. The cancerous changes in the cells are a result of infection by human herpesvirus 8 (HHV8),

10) Invasive cervical cancer

This is a cancer of the cervix, which is the neck of the womb, or uterus. Malignant changes can occur after infection with certain types of human papillomavirus (HPV), and all women (HIV or not) should be screened regularly with pap smears and HPV testing. It is also recommended to get the HPV vaccine (Gardasil 9), to prevent HPV infection, cervical cancer, and genital warts.

How can Opportunistic Infections be prevented?

As these infections only occur in people with a weakened immune system, the most important way to prevent them would be to treat the underlying HIV infection. Highly Active Antiretroviral Treatment (HAART) is very effective at treating HIV and ensuring the virus is adequately suppressed. With a low or undetectable viral load, the body’s immune system has time to recover – and when the CD4 cells have returned to sufficient numbers, the risk of Opportunistic Infections is lowered drastically. The earlier an HIV infection is diagnosed, the earlier treatment can be started and the better the chances of avoiding Opportunistic Infections.
For patients who are diagnosed with HIV later and have low CD4 counts at diagnosis (<500), it is important to consider Opportunistic Infections prophylaxis while we are waiting for HAART to work. This means starting patients on certain medications (e.g. antibiotics, antifungals, and/or antivirals) to prevent some of these specific infections. It may take 6-12 months for the CD4 counts to recover once HAART has been initiated; once the CD4 counts are improved, these prophylactic medications may be stopped.
Other general advice for people living with HIV would include:

  • Reducing or preventing exposure to other sexually transmitted infections
  • Getting vaccinated (e.g. HPV vaccine, annual flu vaccine, pneumococcal vaccine, etc.)
  • Avoiding undercooked or raw foods (including eggs, meat, unpasteurized milks and cheeses, etc.)
  • Avoid drinking untreated water
  • Speak to your doctor about any other changes that may need to be made at home, work, or when on vacation to reduce exposure to OI’s

Take Care!

Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. The HIV Provirus DNA Test can be done 10 days post exposure.
  3. What are the Symptoms of HIV Infection and AIDS?
  4. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  5. What are the Causes of Abnormal Penile Discharge?
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  8. 11 Causes of Dyspareunia (Pain During Intercourse)
  9. What is HPV Vaccination (Gardasil 9)
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. An Overview of Gonorrhoea
  12. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  13. Syphilis Symptoms (Painless STD Sores & STD Rashes) 

What are the Sign​s & Symptoms of HIV / AIDS

Human Immunodeficiency Virus (HIV) is a virus that can be spread through sexual contact, contaminated needles, blood transfusions, and other infected body fluids. It targets the immune system, specifically CD4 cells, and if left undiagnosed and untreated, can overwhelm the immune system and cause life-threatening complications.
HIV symptoms can appear at different times for different people, and some may not recall having any symptoms at all until diagnosis (which can be many years after the initial infection).

What are the Different Stages of HIV Infection?

HIV infection occurs in three main stages:

  1. Acute HIV Infection,
  2. Chronic HIV Infection (Clinical Latency Stage),
  3. and Late-Stage HIV or AIDS (Acquired Immunodeficiency Syndrome).

HIV symptoms may vary depending on the individual and the stage of infection, and some people may not have any HIV symptoms at all.

1) Acute HIV Infection

Within the first 2-4 weeks after initial infection, the virus replicates very quickly and HIV viral load will reach a high level. People may experience flu-like symptoms, which they may describe as ‘the worst flu ever’.
This is known as Acute Retroviral Syndrome or ARS. These acute HIV symptoms may occur in about 70-80% of people.
Acute Retroviral Syndrome ARS / HIV Symptoms may include:

  • Fever
  • Night sweats
  • Swollen glands
  • Sore throat
  • Body rash
  • Fatigue
  • Body aches
  • Headache
  • Nausea and vomiting
  • Diarrhea

Acute HIV symptoms can last between several days to several weeks, until the body can develop HIV antibodies to fight the virus. This is also the stage of the greatest infectious risk to others as the HIV viral load is very high. However, do remember that these symptoms are seen in other common conditions as well, and you shouldn’t assume you have HIV just because you experienced them.
If you are concerned about any symptoms or potential exposure, it is best to see a doctor to have them evaluated and consider HIV testing.
HIV Symptoms in a Nutshell

Different HIV tests are able to detect the infection at different times

The earliest you may be able to detect the virus is with HIV DNA/RNA PCR testing, which can be accurate from 10-12 days post-exposure. Other more common tests would be the 4th Generation HIV p24 Antigen/Antibody test, which is considered conclusive from 28 days post-exposure.
If you have had a potentially risky exposure within the last 72 hours, you can consider a course of medication called HIV Post-Exposure Prophylaxis (HIV PEP). This works to prevent the virus from replicating and taking hold in the body, and can reduce risk of transmission by more than 90%. It is only effective if started within 72 hours.

HIV Window Period & HIV Test Accuracy:

2) Chronic HIV Infection

After the early stage of acute HIV infection, the disease enters into a clinical latency stage, where the virus is developing in the body, but no symptoms are seen. During this time, the virus is still active but will replicate slowly inside the cells – it can still be transmitted to others, but the risks of transmission are lower than during the acute phase.
If you have been diagnosed with HIV and are on HIV antiretroviral treatment (HAART), the virus is often kept under control and you may experience a symptom-free period that can last decades. If the virus can be suppressed to undetectable viral load levels, we would deem the risk of transmission extremely low. This stage of HIV infection can last for 5-10 years.
If you have HIV but are not on treatment, then it will eventually progress to late stage infection, known as AIDS.

3) AIDS (Acquired Immunodeficiency Syndrome)

Late Stage HIV / AIDS (Acquired Immunodeficiency Syndrome)
If you have HIV but are not on antiretroviral treatment, it will eventually weaken your immune system and progress to AIDS, or Acquired Immunodeficiency Syndrome.
Symptoms or signs of late stage HIV / AIDS may include:

  • Rapid weight loss
  • Recurring fever
  • Profuse night sweats
  • Extreme tiredness
  • Swollen glands
  • Persistent diarrhea
  • Mouth or genital sores and ulcers
  • Fungal infections, especially oral thrush
  • Shortness of breath, lung infections (e.g. PCP)
  • Memory loss, limb weakness and other neurological disorders
  • Mucous membrane and skin rashes and lesions (patches of reddish-purplish lesions may be characteristic of Kaposi sarcoma)

Many of these signs and symptoms in AIDS are due to Opportunistic Infections (OI’s), which are organisms that usually only cause infections in people with a weak immune system. People with normal functioning immune systems will typically be able to fight these types of infections off, or suppress them so they do not manifest with significant symptoms.
Common types of OI’s include candidiasis (thrush), pneumocystis carinii pneumonia (PCP), tuberculosis (TB), and salmonella colitis infection, among many others.
In someone who is diagnosed with late-stage HIV and whose CD4 cell count is found to be very low, doctors will usually start on certain medications such as antifungals or antibiotics to prevent these OI’s; they will be kept on these medications as prophylaxis, while they are taking their regular HIV medications, until their CD4 count is high enough (indicating their immune system is strong enough to fight off these infections by itself).
Even if you experience the previously mentioned symptoms, it is impossible to confirm HIV infection unless you get tested. If you are concerned about a possible exposure, please visit our clinics for a consultation and evaluation.
Take Care!


Other Interesting Reads:

  1. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  2. The HIV Provirus DNA Test can be done 10 days post exposure.
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. What are the Causes of Abnormal Penile Discharge?
  5. An Overview of STD – From an STD Doctor
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. Anonymous HIV Testing – What You Need to Know
  8. Low HIV Risk Doesn’t Mean No HIV Risk
  9. What is HPV Vaccination (Gardasil 9)
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. An Overview of Gonorrhoea
  12. What is the Treatment for Cold Sores? What causes Cold Sores?
  13. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes)

What is HIV PrEP & Event-Driven Based HIV PrEP Strategy?

What is HIV PrEP?

HIV PrEP is an option for HIV prevention and involves taking medication that can reduce the risk of HIV transmission by up to 95% if taken properly.
Most of the time, Pre-Exposure Prophylaxis, or HIV PrEP for short is taken as a daily tablet and needs to be taken consistently to provide the greatest level of protection.
HIV PrEP is recommended for at-risk groups, including men-who-have-sex-with-men, patients who have a known partner who is living with HIV (PLHIV), or those with multiple partners of unknown HIV status.

What is the difference between HIV PEP (HIV Post Exposure Prophylaxis) & HIV PrEP?

HIV PrEP should not be mistaken for HIV PEP or HIV Post Exposure Prophylaxis.

HIV PEP is for any individual who is at risk of HIV infection after an HIV exposed to HIV to take HIV medicines for a month to reduce his or her chances of HIV infection.

HIV Pre Exposure prophylaxis and HIV Post Exposure Prophylaxis do not 100% reduce your chances of HIV infection, nor prevent you from being infected with other Sexually Transmitted Diseases (STDs) besides HIV.

HIV PEP as an HIV prevention strategy was first developed for healthcare workers, who are being exposed to contaminated blood or needles prick. It has since expanded to other HIV high-risk activities such as sexual exposure and intravenous drugs used.

Another development of HIV prevention is by using HIV Pre Exposure Prophylaxis (PrEP) as a strategy to reduce the chances of HIV infection even before any potential HIV exposure.

What is Event Driven Based HIV PrEP Strategy?

Some people may find that taking a daily table is just not suitable for them.
If this is the case, they may consider an option called Event-Based Dosing, or EBD for short.
This entails taking tablets one day before the exposure, the days of exposure, and for one day after the last exposure.
It is a much shorter course of tablets than regular HIV PrEP, and can still provide a high level of protection from HIV, with up to 85% risk reduction.
HIV PrEP is most effective when used in combination with other protective strategies such as condoms and regular STD screening.

Descovy As New HIV Medication For HIV PrEP

Descovy (brand name) is a FDA approved new drug combination of tenofovir alafenamide (TAF) + emtricitabine for use as HIV PrEP, which has shown to be equally effective in preventing HIV infection whilst touting an improved safety profile for renal and bone toxicity.

Descovy is currently available in all Dr Tan & Partners (DTAP clinics) in Singapore. It is a prescription only medication and must be prescribed by a doctor. Speak to our doctors for more information about Descovy and find out if a HIV-1 treatment that contains Descovy is right for you.

If you are interested in learning more about HIV PrEP or EBD, please come down to our any of our clinics to speak to our doctors, and see if these options are suitable for you. You can learn more about the What is HIV PrEP or HIV Pre-Exposure Prophylaxis.
We can advise you in more detail on the indications, dosage and timing, and potential side effects of the medications, as well as how to follow up with appropriate HIV Testing and STD testing.
Take Care!


Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. The HIV Proviral DNA Test can be done 10 days post exposure.
  3. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  4. HPV Infection & HPV Vaccination for Men who have sex with Men
  5. STD Risk for Receptive Unprotected Anal Sex in Men
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know about Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. 10 Common HIV related Opportunistic Infections