WORLD AIDS DAY 2020

On December 1st, the global community unites to commemorate World AIDS Day, showing support for those living with and affected by HIV, and to remember those who have lost their lives to AIDS. This year in particular, the COVID-19 pandemic has laid bare how critically interlinked our health is with issues such as social inequality, human rights, stigma and discrimination, economic security, and political will and stability.

The theme of World AIDS Day this year is “Global solidarity, shared responsibility”. The COVID-19 crisis has demonstrated that, during a pandemic, no one is safe until everyone is safe. We all have a part to play in addressing the dual pandemics of COVID-19 and HIV/AIDS, in order to successfully eliminate them both as a public health threat.

There were approximately 38 million people living with HIV/AIDS in 2019, with an estimated 1.7 million people acquiring HIV in the year, marking a 23% decrease in new HIV infections since 2010. In Singapore, latest figures released in June this year showed 323 new cases of HIV infection reported among residents in 2019, bringing the total number of HIV-infected residents to 8,618 as of end of 2019, of whom 2,097 had passed away. The annual incidence of new infections locally has decreased overall by about 25% when compared to 2007 to 2017.

This decrease of new HIV infections is a result of the concerted and coordinated efforts of both government and community-led initiatives, but there is still much that can be done. In 2014, UNAIDS set an ambitious goal of eradicating the HIV epidemic by 2030. This involved a set of targets called the “90-90-90” vision, which stated that by 2020:

  • 90% of people living with HIV would know their diagnosis
  • 90% of those diagnosed with HIV would be on antiretroviral therapy (ART)
  • 90% of those on treatment would have achieved viral suppression

Singapore has made significant improvements towards the last two goals, with approximately 89% of people diagnosed with HIV on treatment and 94% of those achieving viral suppression; however, we are still relatively lacking in our progress towards the first target, with only an estimated 72% of people living with HIV who have been diagnosed. 

We know that early diagnosis leads to early treatment and better outcomes. Knowing their HIV status early will also help to prevent the spread of infection to others. Providing access to better information and testing for HIV, increasing awareness and uptake of Pre-Exposure Prophylaxis (PrEP), and ensuring long term compliance to antiretroviral therapy (ART) by people living with HIV are some of the primary facets of eradicating the HIV epidemic.

As we approach the end of a tumultuous year, the impact of COVID-19 has forced us to view our global health responses, including the HIV/AIDS response, in a different way. We must now be more committed than ever to ensure no individual or community is left behind – healthcare must be funded and accessible to all, stigma must be eliminated and vulnerable populations offered social protections, and public health systems must be strengthened through investment and sound government policy.

As the WHO has so accurately and succinctly captured:

“Now is the moment for bold leadership for equal societies, the right to health for all and a robust and equitable global recovery. This World AIDS Day, join us in calling on countries to step up their efforts to achieve healthier societies. This World AIDS Day let us demand global solidarity and shared responsibility.”

Tags: HIV Test Singapore, HIV Test, Anonymous HIV Testing

Mycoplasma Hominis

What is Mycoplasma hominis?

Mycoplasma hominis is a tiny bacterium which can be transmitted through sexual contact. It is a member of the Mycoplasma spp. family which also include Mycoplasma genitalium


How is Mycoplasma hominis transmitted?

Mycoplasma hominis is most commonly transmitted through sexual contact – genital-to-genital intercourse as well as oral-genital intercourse. It can also be transmitted from mother to neonate during vaginal delivery.

Most infections are acquired in sexually active adults and colonization, which is when one carries the bacterium but has no symptoms, can occur. 


What are the symptoms of Mycoplasma hominis?

Many individuals with Mycoplasma hominis may be asymptomatic, i.e. they have no symptoms whatsoever. 

In men who do experience symptoms, they may notice possible symptoms of urethritis (inflammation of the urine tube) – pain or discomfort in the urine tract/when passing urine or penile discharge. 

Women with Mycoplasma hominis infrequently have symptoms. However, Mycoplasma hominis can be associated with bacterial vaginosis, a vaginal infection with overgrowth of bacteria that are not normally part of the normal vaginal flora. 

Also read: Common Medical Conditions That Are Asymptomatic


What are possible complications of Mycoplasma hominis?

While there is some research that suggests Mycoplasma hominis infection may be possibly associated with complications in pregnancy and that it may have a correlation with developing pelvic inflammation and infertility, there is currently no consensus or conclusive data about this. 


How is Mycoplasma hominis diagnosed and treated?

Mycoplasma hominis can be diagnosed through a culture test, where the bacterium is grown from either a urine sample (if from a male) or a swab sample (if from a female), or a PCR test, which looks for the presence of the bacterial DNA in the aforementioned samples. 

Various types of antibiotic treatment can be used to clear a Mycoplasma hominis infection. However, the choice of antibiotics will depend on whether the specific strain of Mycoplasma hominis isolated has any antibiotic resistance or not. 


How can I prevent or avoid Mycoplasma hominis? 

As with all STDs, safe and responsible sexual practices are crucial in prevention of Mycoplasma hominis infection. These include using barrier protection if possible e.g. condoms, doing regular sexual health screening and also ensuring that you know your sexual partner’s infection status. 

Next read: 10 things you didn’t know about this STD: Mycoplasma Genitalium

Epididymitis

The epididymis is a ductal system behind the testis and serves as a conduit for sperm produced in the testicle to be transported into the Vas Derferens to eventually reach the urethra. Epididymitis is a condition where the epididymis becomes inflamed usually from an infection, though trauma and autoimmune disease is a possible cause.


Signs & Symptoms

Symptoms of epididymitis include localised testicular pain and swelling of the posterior aspect of the testicle. The area can sometimes be warm to touch with redness of the scrotal skin. The area will be  painful when being examined with relief of the pain achieved when the area is elevated. 

Severity and etiology of epididymitis varies with the age of the patient. For young children presenting with testicular pain, a diagnosis of Testicular Torsion needs to be considered first, after which a mumps infection affecting the testicle needs to be ruled out. For sexually active men under 35 years of age, Gonorrhea and Chlamydia are the 2 most common organisms responsible for epididymitis. In older patients, epididymitis can occur concurrently with prostatitis especially if there is an underlying prostatic obstruction such as Benign Prostatic Hyperplasia (BPH) or recent catheterization.

Rapid STD Test for Chlamydia and Gonorrhoea


Most cases of epididymitis can be treated outpatient with oral non-steroidal antiinflamatory drugs (NSAIDS), local application of ice and oral antibiotics. A urine test is sometimes done to determine the organism causing the infection. Patients with epididymitis generally improve within 48 – 72 hours. If the symptoms do not abate within that period, an alternative diagnosis needs to be considered and further imaging such as a scrotal ultrasound performed.

The Signs & Symptoms Of Chlamydia In Women & Men

 

Today we are going to talk about the signs and symptoms of Chlamydia in Men and Women.

Chlamydia is one of the most common bacterial Sexually Transmitted Infections (STIs) worldwide. It is caused by a bacterium called Chlamydia trachomatis. According to the United States Centers for Diseases Control and Prevention, Chlamydia is the most frequently reported bacterial STI in the US, with approximately 2.86 million infections reported every year.

The reason why Chlamydia is so common is because most individuals with Chlamydia do not have any symptoms. In fact, less than 50% of both men and women with Chlamydia develop symptoms. Asymptomatic individuals may be unaware that they are infected and continue to spread it to their sexual partners.

If symptoms do develop, they may occur anytime from days to weeks after the initial infection.


Symptoms of Chlamydia in men

  • Dysuria, or painful urination
  • Urinary frequency and urgency
  • Discomfort along the urethra, or urinary tract
  • Penile discharge 
  • Pain or swelling of the testicles due to a less common but serious infection known as epididymo-orchitis
  • Pain or discomfort in the pelvis due to prostatitis, which is inflammation of the prostate gland

Symptoms of Chlamydia in women

  • Abnormal vaginal discharge which may be different in colour, odour, quantity and consistency
  • Bleeding after sexual intercouse 
  • Abnormal spotting or bleeding in between menstrual periods
  • Painful sexual intercourse
  • Chronic pelvic or abdominal pain and/or fever due to a complication known as Pelvic Inflammatory Disease, whereby the infection spreads upwards to affect the uterus and fallopian tubes.

There are other complications of Chlamydia that can affect both men and women.

Firstly, conjunctivitis, which is an infection of the eye lining, can occur after contact with infected fluids. Symptoms include eye discharge, irritation, redness and lid swelling.

Next, proctitis, which is inflammation of the rectum due to anal sex, usually does not cause symptoms. If symptoms do occur, individuals may experience rectal discomfort, discharge or pain

Lastly, oral chlamydia, which results from providing oral sex, again usually does not cause symptoms. If symptoms do occur, individuals may experience sore throat, painless sores in the mouth, tonsillar swelling and painful swallowing.

Chlamydia can be tested using urine or swabs from the throat, rectum, cervix and urethra. Rapid testing is available at our clinics. Treatment involves a course of oral antibiotics to eliminate the bacteria.

Next read: Common STD Incubation Periods


If you would like to find out more about Chlamydia Testing and Treatment, come down to any of our clinics for a consultation.
Rapid Chlamydia & Gonorrhoea PCR Screening (Next Day Results) is available in all our clinics in Singapore.

Just got diagnosed with HIV? What is next?

You have just been recently diagnosed with HIV. You’re likely experiencing a rollercoaster of emotions and have lots of questions which are understandable. As you go through these feelings, whether of anger, fear, sadness or guilt, it is important to first take a deep breath and begin the process of finding a health care provider and as much as possible, look for any form of support available. 


Finding Support

 

1. Friends & Family

As you are coming to grips with the new diagnosis, you may face difficulty as to what the next step will be. You may want to talk about it with a trusted friend or family member. Although you may feel uncomfortable with breaking the news, you may realize that shouldering the burden alone actually makes it more difficult to process the news and that telling someone you trust may be a positive experience as it can help you get the much-needed support and it may actually strengthen relationships. It is important to be informed of the condition yourself – it may be best to obtain information about HIV before telling others about the new diagnosis. There are many myths that surround HIV which contribute to the stigma attached to it but by knowing more about living with HIV can reassure your loved ones that with effective medications available, you can live a long and healthy life.


2. Telling your partner

It is important to let your current or former partners know that they may have been exposed. They then should be tested for HIV. It is encouraging to know that many people living with HIV continue to have relationships and can have children who don’t have HIV. The term ‘undetectable = untransmittable’ (shortened to U=U) was coined and is used as a campaign to prevent sexual transmission of HIV without the use of condoms based on numerous studies that demonstrated this. This is achievable by taking treatment daily and having undetectable viral load levels for at least 6 months. However, until U=U is achieved, the proper use of condoms must be done to prevent transmission. In addition, your partner may also want to consider PrEP, in addition, to use of condom before you achieve undetectable viral loads for at least 6 months.


3. Clinics & Support Groups

As HIV is a chronic medical condition that requires lifelong follow-up and treatment, it is essential to establish a relationship with an HIV health care provider that is as honest and open as possible. You may either be managed at the clinic where the HIV diagnosis was made or referred to an HIV specialist and their team for HIV management. 

Among other tests, the key ones that will be done at the first clinic visit as well as during subsequent visits are HIV viral load as well as CD4 counts. The HIV viral load is a measure of the amount of virus detectable in the blood and the CD4 count is the amount of CD4 cells, which are white blood cells that play an important role in the immune system. The goal for everyone living with HIV is to reach an undetectable HIV viral load as quickly as possible.

Many guidelines recommend that HIV treatment be started immediately after the diagnosis is made. This is because studies have shown that immediate treatment can lower the risk of long term effects on the immune system and reduce the risk of HIV transmission.  

There are many support groups available where you can be a part of, to obtain further information from or would simply like to reach out for a listening ear as you may not be ready to tell your friends or family about the new diagnosis.

Here is a list of support groups available in Singapore & Malaysia:

Action for AIDS (AFA) (Singapore)

Oogachaga (Singapore)

GayHealth.sg (Singapore)

PT Foundation (Malaysia)

Itchy Testicles – Is it a sign of STDs?

It is common to experience a need to itch every now and then, but if you feel the need to scratch all the time it’s probably time to seek some help. Inadvertently, there would be a concern of any possible sexually transmitted diseases (STD), but not all itches are sexually transmitted. – STD Screening in Singapore

Listed below are some of the more common causes of itchy testicles.


  1. Chafing

Chafing is an irritation of the skin caused by repetitive friction. This is typically caused by inappropriately sized clothing and is commonly experienced by guys doing biking or running. It can happen anywhere on the skin but vulnerable areas are the groin, thighs, underarms and even the nipples. Chafing is easy to prevent though, by wearing the right clothes and using some form of barrier cream/ointment like vaseline to protect vulnerable areas.

  1. Jock Itch

Jock Itch, also known as tinea cruris, this is a fairly common condition seen in gentlemen who exercise a lot or are involved in jobs involving heavy physical activity. This creates a warm, moist environment on the scrotum that is ideal for fungal growth. Common symptoms are an itchy and red rash on the scrotum that can be scaly in nature. Treatment is through the use of oral or topical antifungal medications. Jock Itch can be prevented by regular change of clothing after heavy exertion as well as use of antiperspirants.

  1. Contact Dermatitis

Contact dermatitis is a type of eczema triggered by contact with a particular substance. The skin can become red and cracked with blistering and sometimes can resemble jock itch. Common causes of contact dermatitis are new soaps and detergents, so if the new soap/detergent is causing itchy testicles, it might be a good idea to swab back.

  1. Lichen Simplex Chronicus

This is what happens when you leave an itch too long without seeing a doctor. After prolonged itchy, rubbing and scratching of the skin, the scrotum can become lichenified. Like lichen on the trees, the skin can become thick and scaly with accentuated skin fold lines. This is an extremely pruritic chronic itch, and the treatment is usually the use of a strong steroid cream to thin out the lichenified skin. 

  1. Psoriasis

Psoriasis is an unpleasant skin condition presenting as reddish rashes with silvery scaling over the whole body. It commonly involves the scrotum and it can be itchy as well. There are also other dermatological conditions which may look similar to psoriasis and can involve the scrotum as well. This is why it is important to see a doctor if there is an odd looking rash over the scrotum that does not go away on its own. 

  1. Pubic Lice

Also known as crabs, Pthirus pubis is a very small insect that parasites humans. Pubic Lice are commonly found attached to the hair in the pubic region but can also be found in other coarse hair elsewhere on the body, for example eyebrows or armpits. Other than the adult insects, eggs known as “nits” can also be found attached to the hair. Pubic lice is normally spread through sexual contact. It is however very easily treatable by over the counter anti-louse preparations. 

  1. Scabies

Sarcoptes scabiei are tiny eight legged mites that live within the human skin. Allergic reaction to the mites, eggs and faeces can lead to an intense itching that is worse at night. Symptoms are a pimple like rash over the scrotum that can be very itchy out of proportion to the rash. Scabies is spread through skin to skin contact and hence can be sexually transmitted. It’s treated with an anti-mite topical preparation known as permethrin. 


The astute reader might realise that not a lot of STDs are found on the above list. The truth is that the majority of STDs do not lead to testicular itching but rather other symptoms like ulcers or discharge. If itchy testicles are still a problem, it is still better to seek a doctor for a medical consultation.

Ureaplasma Symptoms

Signs & Symptoms of Ureaplasma

Ureaplasma are a group of tiny bacteria that can commonly be found in the urinary and genital tracts of men and women. The most clinically relevant type of Ureaplasma species is Ureaplasma Urealyticum, which can cause urethritis (inflammation of the urethra) in men, and bacterial vaginosis in women.

These infections may have few or no symptoms at all for many people, and may only get picked up on routine STD screening or when an individual presents with symptoms from another infection such as Chlamydia or Gonorrhea. For those who develop symptoms directly from a Ureaplasma infection, common presentations would be with pain or burning on passing urine, penile discharge or vaginal discharge, or pelvic/genital discomfort. As their name suggests, these bacteria also hydrolyse urea to produce ammonia, which can result in a strong or unpleasant odour as well.

How is Ureaplasma transmitted?

Ureaplasma is predominantly transmitted through sexual contact (vaginal, anal, and oral sex). However, it is not typically classified as an STD due to its relatively low degree of pathogenicity (ability to cause disease). Although many infections may be asymptomatic or have very mild symptoms, there are still risks for complications including pelvic inflammatory disease and epididymo-orchitis. Studies have also found associations with complications in pregnancy such as preterm labour, as well as infertility in both men and women. As Ureaplasma infection can cause inflammation of the mucous membrane, it can also increase the risk of transmission of other STDs and is commonly found to cause co-infections. 

Testing for Ureaplasma can be done with urine samples or swab tests, and would generally be detected through special cultures or through PCR testing. It would not be detected through a normal bacterial culture for non-STD infections. Treatment of Ureaplasma would generally be a course of oral antibiotics and of course, partner testing and treatment would be recommended as well. STD Testing in Singapore


Next read: 10 things you didn’t know about this STD: Mycoplasma Genitalium

7 Common Causes Of Anal Itching

Anal itching, also known as pruritus ani, is a common condition. Some studies have shown that it can affect as much as 1-5% of the population.

The reason why cases of anal itching are not always relieved with scratching is because of a self-propagating itch-scratch cycle: the scratching exacerbates the inflammation, causing an irresistible urge to scratch even more.

There are many causes of anal itching.

Here are 7 broad groups of conditions that can present with anal itch.


1. Dermatologic conditions

Topical irritants such as Deodorants, Detergent/fabric softener, Hemorrhoid remedies, Soaps, Suppositories, Talcum powder, Tight clothing and Toilet paper dyes and perfumes can cause Irritant dermatitis leading to itching. Atopic dermatitis, Hidradenitis suppurativa, Lichen planus, Lichen sclerosis, Psoriasis and Seborrheic dermatitis are all conditions that can cause anal itch.

 

2. Dietary irritants

Certain types of foods, when ingested, can become dietary irritants when passed out from the other end. They include foods such as Beer, Caffeine, Chili peppers, Citrus foods, Milk and Tomatoes.

 

3. Anal conditions

Such as Anal fissures, Chronic constipation, Chronic diarrhoea, Fistula, Incontinence, Prolapsed haemorrhoids, Rectal prolapse, Irritable bowel syndrome, Inflammatory bowel conditions and Skin tags.

 

4. Infections

Abscesses, Candidal infections (intertrigo), Corynebacterium minutissimum (erythrasma), Molluscum contagiosum, Parasites (e.g., pinworms, scabies), Staphylococcus aureus infections can cause anal itch. A big group of infections are sexually transmitted infections. These infections have to be considered especially in people who partake in anal intercourse. Some of the infections include Chlamydia, Gonorrhoea, Herpes and Human papillomavirus to name a few.

 

5. Malignancies/Cancers

Such as Bowen disease, Extramammary Paget disease, Squamous cell carcinoma can present with itch.

 

6. Medications

Such as Chemotherapy, Colchicine, Neomycin and Quinidine can trigger itch too.

 

7. Systemic diseases

Aplastic anaemia, Diabetes mellitus, Inflammatory bowel disease, Jaundice, Leukemia, Lymphoma and Thyroid disease can have anal itch as a symptom.

In many instances, we may not actually identify any specific cause and label the itch as idiopathic pruritus ani. The itch could also be due to psychological disorders.

While many people worry that anal itch is due to a sexually transmitted infection, as you can see above, there are so many reasons why a person may develop an anal itch.


 

Diagnosis

The most important thing is to seek medical attention so your doctor can assess you and come to a diagnosis.

The doctor will take a detailed medical history from you and do a physical examination, including an examination of your perineal area and possibly do a proctoscopy. If need be, we may do some swabs to send off for investigation. The doctor may advise for further investigations such as a colonoscopy depending on what is found and your age group.


 

Treatment & Prevention

Treatment of pruritus ani should address the underlying cause. The goal of treatment is also to prevent further irritation and moisture in the affected area and avoiding scratching. Patients should be aware of proper hygiene and avoidance of perfumes, dyes, dietary irritants (especially caffeine), and tight clothing.

Patients should also keep the area dry and be aware of the itch-scratch cycle. A sedating antihistamine can reduce scratching during sleep. If the itch is very bad, wear cotton gloves or socks on the hands at night to prevent scratching. Patients with hemorrhoidal skin tags that make hygiene difficult can clean the area using a handheld showerhead, squirt bottle, sitz bath, or a bidet. After which, pat the area dry or use a hairdryer set on “cool.” Avoid using soap on the anal area as the skin there is sensitive and can dry out easily. Do not scrub the perineal area with anything including toilet paper.

Besides the conservative measures above, low-potency topical steroids can be used for a short duration of time. If the itch persists after treatment, a biopsy can be considered. If you wish to speak to our doctors about the following symptoms, please call us or email us for an appointment at hello@dtapclinic.com.sg

10 Things about HPV (Video)

HPV stands for human papillomavirus. HPV is usually harmless and goes away by itself, but some types can lead to cancer or genital warts.

 Here are 10 things about HPV.

1. HPV is incredibly common.

and It is estimated that 8 out of 10 people will get HPV at some point in their lifetime


2. Next… How is HPV spread?

HPV is one of the most common STI and is spread through genital or skin-to-skin contact. The virus can be spread even when no symptoms are evident.


3. The third point is that HPV doesn’t necessarily stay with you forever.

Patients commonly assume that HPV is a lifelong infection that will stay with them always. Most HPV infections clear up on their own and do not cause any problems. However, overtime persistent infection by certain HPV types can cause cancer and other diseases such as warts.


4. There are many strains of the virus.

HPV is not just one virus, but consists of over hundreds straina . Each virus is labeled with a number to distinguish it from the others, and different viruses can target different areas of the body, causing differentdiseases in humans.

HPV is most commonly associated with a risk for certain cancers, including cervical cancer, or oral cancers which involves, the base of the tongue or tonsils. 


5. Next in Cervical cancer

HPV causes more than 99% of cervical cancer cases and Approximately 400 new cervical cancer cases are diagnosed annually in Singapore.  

Cervical cancer ranks* as the 8th leading cause of female cancer in Singapore.


6. In Detection of HPV

A pap smear test is a cervical cancer screening tool that is commonly use to detect cervical cancer or pre-cancerous changes in the cervix.

A more sensitive test like the HPV DNA test can be used to detect certain high risk strains of HPV that can lead to cervical cancer


7. HPV in Men

Men can get HPV and pass it to their partners. HPV has been shown to increase the risk of anal cancer, penile cancer , oral and throat cancers in men.


8. There Is Also a Vaccine that Can Protect You

The HPV vaccine has been shown to be highly effective in protecting people against cervical cancer and warts..

Individuals already infected with HPV should still get vaccinated because the vaccine may protect against additional strains of hpv. However, for maximum benefit, vaccination should occur before an individual becomes exposed to the virus.

Thus it is recommended for preteens to get the vaccine at an early age.

Recently the US Food and Drug Administration expanded its approval of the HPV vaccine to include men and women up to 45 years old As an effort to protect more people from several types of cancer caused by HPV.


9. After HPV Vaccination…

Women should continue to get regular Pap screenings because the vaccine though reduces risk of cervical cancer, does not protect against all HPV types.


10. To Sum Up HPV

The best thing you can do is stay proactive and look after your well-being.

“HPV is something both women and men should be aware and well-informed about, protecting yourself and your loved ones,”

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CD4 Count VS Viral Load – What do you need to know?

The Immune system is made up of a large network of cells that work together to combat infections. Helper T Lymphocytes are a particular type of immune cell that expresses a molecule called the Cluster Determinant 4 (CD4). Helper T lymphocytes are hence commonly known as CD4 cells. The Human Immunodeficiency Virus (HIV) selectively targets CD 4 cells and uses them as hosts for viral replication. As the virus replicates, it destroys its host cell as it releases new copies of the virus. Therefore, as the viral load (which is a measure of the amount of virus present in the body) increases and the host CD 4 cells will decrease. 

HIV Pro Viral DNA Test

HIV Infection

During the early stages of a HIV infection, viral replication occurs at a very fast rate at the expense of CD 4 host cells. A vicious cycle occurs, wherein an increase in HIV viral load attracts more CD4 cells which get infected and become hosts to further increase the viral load. Within the first few weeks of a HIV infection, the CD 4 count falls precipitously. Such a sharp fall in CD4 cells is the hallmark of a HIV infection. 

Upon diagnosis of HIV, it is crucial that the patient’s CD 4 and viral load are measured. The CD 4 count allows the medical team to determine the state of the immune system and plan the appropriate treatment. If the CD 4 count is below 200 units, the diagnosis of Acquired Immunodeficiency Syndrome (AIDS) is established. AIDS is a serious complication of HIV infection and can be fatal, therefore, if the patient is diagnosed with AIDS he/she requires immediate medical attention in a hospital.The viral load will give an indication of how fast the virus is replicating. Current medication used to treat HIV infection targets different parts of  viral replication and interfere in the process of new viruses being produced. Therefore, a fall in viral load after commencing medication is an indicator that the medication is working. 

People Living With HIV

For People Living with HIV (PLHIV), the main goal of therapy is to increase CD4 cell numbers and decrease the viral load to an undetectable level. Monitoring these 2 parameters will guide the treatment regime. In general viral load is measured 2 weeks after starting medications for HIV, then at 4 to 8 week intervals. The expected fall in viral load should be to approximately < 500 copies/ml by week 8 – 16 and < 50 copies /ml by week 16- 24. CD 4 recovery is slower, the first CD4 test is done 3 months after commencing treatment and every 6 months after. In general, a CD 4 count > 300 cell/uL with a low viral load is a good level to ensure that PLHIV does not encounter any opportunistic infections.

Also read: U=U: Science, Not Stigma

CD 4 and Viral load measurements are essential parameters in guiding the medical therapy for PLHIV. Regular check of these parameters ensure that PLHIV are able to maintain an active lifestyle and avoid any infections that may occur due to a lowered immunity.

HIV Screening Singapore