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Risk of HIV Transmission Through Blowjob

A recent news report by Channel News Asia titled “HIV-positive man who donated blood during pandemic faces charge of lying about sexual history” may have caused some concern in the community with regards to the issue transmissibility of HIV through oral sex.

Based on the report, people may wonder just how transmissible is HIV via oral sex and how does it compare to other forms of sexual practices like vaginal sex.

Sexual Practice and HIV Transmission Risk

Based on the Department of STI Control Clinic in Singapore, the table below summarizes the risk of transmission of HIV based on the type of sexual practice.

Sexual Practice Estimated risk of HIV transmission from a known HIV-positive individual not on effective HIV treatment

 

Receptive vaginal sex 10 per 10,000 persons
Insertive vaginal sex About 8 per 10,0000 persons
Performing oral sex < 1 per 10,000 persons
Receiving oral sex < 1 per 10,000 persons

 

Can HIV be transmitted via oral sex yes, but the risk is roughly 10x less likely than vaginal sex.

 

So when is there no risk of HIV transmission?

  • Breathing the same air as someone.
  • Touching a toilet seat or door knob.
  • Drinking from a water fountain.
  • Hugging, kissing or shaking hands (although kissing may transfer fluids the level of virus in saliva is so low as to make the risk negligible).
  • Sharing food or utensils.
  • Sharing gym equipment.
  • Skin to skin contact with an HIV positive person even if they happen to have fluid of unknown origin on them (particularly applies to commercial sex workers).
  • Biting or scratching that does not break the skin or draw blood

 

How can we reduce risk of HIV transmission?

  • Monogomous relationship
  • Avoid casual sex or paid sex
  • Always use condoms
  • Regular testing if you are at risk – protect yourself and your loved ones

 

There are no way to know your HIV states unless you go for a HIV Test.

 


 

 

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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)

How Long Can HIV Survive Outside the Body?

There are many fears and misconceptions about HIV survivability and infection risk.
We often get asked some form of this question by people who have come into contact with potentially infected blood or bodily fluids from surfaces or other objects and who are worried about HIV infection risk.
Most importantly, there have been no validated cases of HIV transmission through casual touching of surfaces or objects (e.g. toilet seats, toothbrushes, towels) to date.
However, it is true that HIV has been shown to survive outside the human body for up to several weeks in certain environmental conditions.

How Long Can HIV Survive Outside the Body?

So what does the evidence say so far?

1) Temperatures

  • At > 60⁰C – HIV is killed by heat temperatures of > 60⁰C are sufficient to kill HIV.

HIV is NOT killed by cold – It is known that the survival time of HIV increases in colder temperatures.

  • At 27⁰C to 37⁰C, the HIV can survive for up to 7 days in syringes (fresh blood)
  • At room temperature, the HIV can survive in dried blood for 5 to 6 days.
  • At 4⁰C, HIV can survive up to 7 days in dried blood
  • At -70⁰C, HIV can survive indefinitely without any loss of viral activity – this is the temperature that HIV-infected blood is stored at in laboratory experiments for future testing.

2) pH Level

  • HIV can only survive in a narrow band of pH between 7 and 8

DID YOU KNOW:

  1. HIV has been found to survive for a few days in sewage in laboratory based experiments; however, it has not been detected in urine or stool samples in any real-life setting.
  2. HIV has been found to survive in organs and corpses for up to 2 weeks after death, especially in cooler temperatures.
  3. HIV has been found in low levels in breast milk, with infective transmission possible from mother to baby; however, no studies have been performed to determine how long it is infective once it is outside the body

Semen or vaginal fluids outside the body

There have been no studies on HIV survival in semen or vaginal fluids outside the body, but so far evidence indicates that it is only present at very low levels and is unlikely to pose a risk of infection from contaminated surfaces.

These studies have mainly looked at HIV survivability in laboratory based experiments, and have not taken into account the effect of environmental conditions such as wind, rain, and sun exposure. Further studies are needed to more clearly elucidate the risk of certain exposures.
Also, just because HIV can survive outside the body does not mean that it is necessarily infective. Even when live HIV virus comes into contact with broken skin or mucosa, it must still be present in an adequate dose to establish infection (the tissue culture infectious dose), and must then undergo a complex series of steps before it actually causes an HIV infection.

Survivability ≠ Infectivity

HIV transmission thus far has only been shown to occur through sexual intercourse, contaminated needles (including tattoos and body piercing), blood transfusions, and very isolated cases of dental procedures and eyesplash incidents with infected blood. There have been zero cases of infection from casual contact with a contaminated surface or object to date.

In a Nutshell

All in All, if you have touched some surface or fluid that you think may be contaminated with HIV, do not worry – you will not get infected.
However, it is still important to practice proper hygiene and infection control measures to reduce the risk of other infections as well.
If you believe you have had a potential high-risk exposure within the last 72 hours, you may consider Post-Exposure Prophylaxis (PEP) – this course of medication can greatly reduce the risk of HIV infection following an exposure. Please contact us for a consultation if you think you need PEP.

If you are interest to go for an Anonymous HIV Testing, please visit our Robertson Walk Branch.
We are Singapore MOH Approved Anonymous HIV Test site in Singapore.

Take Care!


Other Reads:
Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. What are the Causes of Abnormal Penile Discharge?
  3. HPV Infection & HPV Vaccination for Men who have sex with Men
  4. STD Risk for Receptive Unprotected Anal Sex in Men
  5. Low HIV Risk Doesn’t Mean No HIV Risk
  6. HIV PrEP for Travel – How You Need to Know
  7. An Overview on STD from an STD Doctor
  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

Also on Dtapclinic.com: HIV Test SingaporeSTD Test SingaporeAnonymous HIV Testing

HIV Window Period – Timelines for Accurate HIV Testing

When it comes to HIV testing, two of the most common questions we are asked online or in person are: “When can I test for HIV?” and “Are my results conclusive?”
There is a lot of confusing information out there, so this article will try to break down the timelines for accurate testing, and why this is the case.

These Questions Are Basically Asking – What is the HIV Window Period?

The HIV window period is the time between viral transmission to be able to get a conclusively accurate test result. This time period depends on the type of HIV testing performed – different tests have different window periods, with newer generation testing allowing for earlier and more accurate diagnosis of HIV than what was available in the past.

As testing facilities vary from country to country, it is important to recognize local health authority guidelines and speak to the doctor if you have any uncertainties on your test.
If you are within 10 days from a possible HIV exposure, you are still in an eclipse period. This is the period of time where no current testing can detect the virus. HIV Testing in this time period will have no diagnostic utility.

However, if you are within 3 days (72 hours) from a potential HIV infection, please see your doctor or contact us immediately for Post-Exposure Prophylaxis (PEP).
HIV Post-Exposure Prophylaxis (PEP) can reduce risk of HIV infection or prevent HIV infection.

WhatsApp or SMS service (24/7) : +65 8728 7272

Also Read: When to get HIV Test after HIV PEP

So, What Types of HIV Tests are Available and How Do They Work?

For diagnostic purposes, most countries and guidelines now recommend first-line testing with the 4th Generation Antigen/Antibody test (also known as the Combo or Duo test). Other available testing includes 3rd Generation Antibody-only testing, HIV RNA/DNA PCR viral load and the HIV Pro-Viral DNA Test.
These tests are sometimes available as ‘point-of-care’ rapid tests, or alternatively can be performed in a laboratory with techniques such as ELISA or CMIA (don’t worry too much about the technicalities here). To understand the differences and rationale for each of these tests, we have to first understand what each of them is looking for.

The Core Structure of HIV is Made Up of a Protein (p24 Antigen)!

HIV is a type of retrovirus, and much of its core structure is made up of a protein known as p24 antigen – this is the type of antigen we look for with 4th generation HIV testing.
The p24 antigen usually becomes detectable from 10-14 days post-exposure, reaching a peak at around 3-4 weeks, and dropping to lower levels after 5-6 weeks once HIV antibodies start forming.
HIV antibodies are proteins formed by your own body in response to the virus and usually start forming as early as 14-17 days post-exposure, with 99.9% of patients having a detectable antibody response by 3 months.

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

The HIV Pro-Viral DNA Test

The HIV Pro-Viral DNA test can be used in specific situations where there are challenges to getting an accurate HIV diagnosis with other available HIV tests including HIV Antibody tests (3rd Generation HIV test), HIV Antibody and Antigen tests (4th Generation HIV test) as well as HIV RNA PCR test.

It is especially useful in the following situations:

  1. Diagnosing HIV in newborns born to HIV +ve mothers
  2. Elite controllers with undetectable HIV viral load despite not being on anti-retroviral treatment
  3. Individual with sero-negative HIV infections i.e. People who get infected with HIV but do not develop anti-HIV antibodies : see FALSE NEGATIVE HIV ELISA TEST

It can be used for situations where the diagnosis of HIV is challenging, it has a lower false positive rate compared to the HIV RNA PCR test when used for diagnosis and it can be done 10 days post exposure. 

HIV PCR RNA Test – 12 days or more post-exposure

As the HIV RNA PCR test is more sensitive, the window period is shorter and it can be used 12 days after exposure, as compared to 28 days for conventional Antibody/Antigen Testing.

HIV is a retrovirus. Retroviruses are a type of RNA virus that invades cells, in this case a kind of immune cells known as CD4 cells by injecting its genome directly into it. RNA is slightly different and less chemical complicated than DNA, hence the virus also has a special enzyme known as Reverse Transcriptase that will encode the HIV RNA into HIV DNA which is then merged with the host cell’s genome. Hence, if we can detect the presence of HIV RNA in the blood, we can be certain that there is HIV infection even without symptoms.

This is achieved through a technology known as polymerase chain reaction (PCR). In PCR, an automated device will process the patient’s sample with various chemicals. The polymerase enzyme and reaction will multiple any HIV RNA material into easily readable genetic information.

4th Generation HIV Test – 28 days or more post-exposure

The 4th generation Antigen/Antibody test has been shown to be conclusive from 28 days or more post-exposure. Remember, this test also checks for HIV antibody, so it will remain accurate for HIV diagnosis even after the p24 antigen levels drop, including years after initial infection.

3rd Generation HIV Test – 3 months or more post-exposure

The 3rd generation Antibody-only test is accepted as conclusive from 3 months or more post-exposure. If testing is done within these respective window periods, there is a chance of a false negative result.
For extremely rare cases where people do not mount an appropriate HIV-antibody response (known as seronegative infections), the 4th generation test will still be able to detect the p24 antigen, which is why it is considered the most accurate first-line test for HIV diagnosis.

You may also have heard of a test called the Western Blot; this is just another type of HIV antibody test that is usually used for confirmation testing, once a preliminary test has shown a positive result. As HIV is a serious and life-changing diagnosis, it’s important we get it right – most diagnostic algorithms require two separate tests showing a positive result before we confirm it to the patient. As the HIV window period may differ with these separate tests, it is important that your doctor chooses the right tests for you.

The last test type we’ll be looking at is the HIV RNA/DNA PCR test, also known as Nucleic Acid Amplification Testing (NAAT). This test has revolutionized HIV screening, especially for people at high risk. This test directly measures the amount of virus in a person’s blood and can detect conclusively from as early as 12 days post-exposure. It is also used to monitor viral load in people with a known HIV infection. Although this test is able to pick up HIV infection at the earliest stage, it is not widely available due largely to costs and turnaround time in Singapore. There is a slightly higher risk of false positive results with the HIV RNA/DNA PCR test.

In Summary

In summary, here are the tests you can do at the appropriate time:
Day 1-3: Consider Post-Exposure Prophylaxis (PEP)
Day 1-9: Eclipse period (no HIV testing available)
Day 10: HIV Proviral DNA Test
Day 12 onwards: HIV RNA/DNA PCR testing (may have false positives)
Day 14 onwards: 4th Generation Combo testing can start to pick up the infection (may have a false negative)
Day 28 onwards: 4th Generation Combo testing is deemed conclusive
Day 90 onwards: 3rd Generation Ab-only testing is deemed conclusive
At the end of the day, it is important to speak to your doctor and inform them accurately about any potential exposure risks, so they can decide on which test is appropriate. And remember, 4th Generation Combo testing is the first line test recommended by most guidelines today. Ask for this test if you have any doubts!

Do come to see us for any further advice on HIV testing, window periods, or other STD Testing, STD Screening & Treatment and sexual health-related matters.

We accept both walk-ins and appointment for all our clinics, please call us or email us at hello@dtapclinic.com.sg.
Take Care!


Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. HIV Pro-Viral DNA Test
  3. HPV Infection & HPV Vaccination for Men who have sex with Men
  4. STD Risk for Receptive Unprotected Anal Sex in Men
  5. Low HIV Risk Doesn’t Mean No HIV Risk
  6. HIV PrEP for Travel – How You Need to Know
  7. An Overview on STD from an STD Doctor
  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

 

Also on Dtapclinic.com: HIV Test SingaporeSTD Test SingaporeAnonymous HIV Testing

Do I Have HIV Rash? Or Are They From Other STD Related Rashes?

Skin rashes and lesions are some of the most common signs and symptoms experienced in HIV infection. There is no single definitive HIV rash – individuals may have different types of rashes of varying severity, distribution, and appearance.
As there are many other conditions that can also cause skin rashes, including allergies, autoimmune conditions, and other infections, it is important to remember that there is no way to diagnose someone with HIV based solely on the presence of a rash. Conversely, there is also no way we can rule out HIV just because someone does not have a skin rash. The only way to know for sure is by doing an HIV test at the appropriate time.

Acute HIV Seroconversion HIV Rash

In the primary stage of HIV infection, viral replication progresses quickly and the viral load (VL) will be very high. Your body’s immune system will detect the virus and start producing HIV antibodies to try and fight off the virus – this process is called seroconversion. It is this activity of the immune system which can manifest in the typical symptoms of acute HIV infection, also known as Acute Retroviral Syndrome (ARS) – with fever, swollen lymph nodes, and rashes being the most common symptoms.
The seroconversion HIV rash usually develops around 2-6 weeks from exposure. It will appear as reddish macules (flat lesions) and papules (small swollen bumps) spread over a generalized region, typically over the chest, back, and abdomen, sometimes extending to the arms and legs as well. It can be very itchy for some people, but not always. Symptoms of itch can be reduced by antihistamines and topical creams.
These rashes may last a few weeks or months, but will eventually resolve by themselves, even if the HIV infection has not been diagnosed and treated. This happens as the HIV antibodies bring down the viral load and infected individuals enter the clinically latent stage (chronic HIV infection). Many people may have missed the diagnosis of HIV if they were told by a doctor their rash was due to some allergy or viral flu but did not get tested properly.
HIV-infection

Other Infections

When a person contracts HIV, they are also at increased risk of other infections. Some of these are sexually transmitted and can be contacted at the same time as HIV (e.g. syphilis, herpes simplex virus, etc.), while some can occur later in the disease due to a weakened immune system (e.g. candida/thrush). These infections can also cause skin rashes or lesions to develop, so it is important to look out for any abnormal skin changes if you are concerned about any potential exposure risk, and also to inform your doctor of your concerns.

Syphilis

Syphilis is a sexually transmitted infection caused by the bacteria Treponema Pallidum and is commonly diagnosed together with new HIV infection as they share common risk factors. The primary stage of syphilis infection is a painless chancre or ulcer at the primary site of infection (usually genital, rectal, or oral), but it may go unnoticed by many people. The secondary stage of syphilis is a skin rash which can look very similar to acute HIV rash, with reddish papules around the trunk, arms and legs, and usually over the palms and soles as well – most of the time, this rash is not itchy or painful. Most people who present with a skin rash after potential exposure risk should be tested for both HIV and syphilis together.

Herpes Simplex Virus

Another sexually transmitted infection, herpes simplex virus (HSV) can cause small crops of fluid-filled blisters that can start off looking like a reddish rash. They are usually slightly itchy or painful, and may then burst to form small ulcers which will then dry and crust over. Sometimes, the initial herpes outbreak may be preceded by some viral, flu-like symptoms including fever and swollen lymph nodes. There is no ‘cure’ for herpes, but usually, your immune system will help to control the infection and keep it dormant, although reactivation and clinical outbreaks can still occur (around 2-3x per year on average). Herpes can be contracted both together with acute HIV or can recur frequently in late-stage HIV – persistent or chronic HSV lesions in the setting of untreated or late-stage HIV is considered an AIDS-defining illness, as the immune system has been weakened by the HIV virus and can no longer keep the HSV infection suppressed.

Kaposi Sarcoma

Not quite a rash, but rather an abnormal growth of capillary blood vessel tissues, Kaposi Sarcoma (KS) is actually a type of cancer that can be found in late-stage HIV.
It is caused by an infection with human herpesvirus 8 (HHV-8) which is an opportunistic infection and is also considered an AIDS-defining illness as the transformation of the skin cells only occurs in the presence of a weakened immune system. KS appears as either a single or multiple reddish purplish bumps over the skin or mucous membranes.
They are usually painless and not itchy but can cause other symptoms if they grow on internal organs such as the gastrointestinal tract or the lungs (e.g. GI bleeding, shortness of breath, etc.).
Also, read the 10 Common HIV-Related Opportunistic Infections (IOs)

Candidiasis

Also known as thrush, candida is a very common fungal organism that is found 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 a weakened immune system, there may be an invasive overgrowth of the organism which leads to symptoms. Common areas of candida infection are the nails, skin, mouth/tongue, and genital region. Depending on the region affected, symptoms may include an itchy rash, with scaly or flaking skin, sometimes with a soft whitish layer which can be scraped off.
These are just some of the different types of skin rashes and lesions that may be present in an HIV infection. There is no single type of HIV rash that we can consider to be diagnostic by itself. It is important to assess clinical features of the rash, timing, and potential exposure risk. At the end of the day, the only way to diagnose an HIV infection will be through appropriate HIV testing at any of our clinics.
Join the HIV discussion in our Forum with our Doctors. For HIV Testing, you can walk-in to any of our clinics, for an appointment you can email us at hello@dtapclinic.com.sg, or call any of our clinics.
Take Care. Be Safe!


Other Interesting Reads:

  1. What You Need To Know About HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  2. World AIDS Day (2018) #KnowYourStatus
  3. 4 Things You Need to Know About Penile Health
  4. Sexual Health Advice For Travellers 
  5. What are the Symptoms of HIV Infection and AIDS?
  6. Things You Need to Know about Travelling & HIV PrEP
  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. What is the Treatment for Cold Sores? What Causes Cold Sores?
  12. Herpes: Everything You Need to Know!
  13. The HIV Pro-Viral DNA Test can be done 10 days post-exposure.

 

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.

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.

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.

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!


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