(Caring & Treating Since 2005 - PEP HIV / Post Exposure Prophylaxis)
HIV Post Exposure Prophylaxis (HIV PEP)
PEP HIV or HIV Post Exposure Prophylaxis can reduce your risk of being infected with the Human Immunodeficiency Virus (HIV) after a potential exposure. HIV PEP is only effective if started within 72 hours after HIV exposure. The ideal time to start HIV PEP is within 48 hours from exposure, and the earlier it is started the better.
HIV PEP treatment may be prescribed to anyone with a high-risk HIV exposure and involves undergoing Antiretroviral (ARV) medications or antiretroviral therapy (ART) for a month. The medication is similar to that used for HIV PrEP (Pre-Exposure Prophylaxis); however, the difference is that HIV PrEP is taken daily before any HIV exposure. - HIV PEP Singapore / Post Exposure Prophylaxis
HIV PEP treatment can stop the virus from taking hold in your body before it becomes a full infection. Remember that there is no HIV testing available that can detect HIV from 1 to 10 days after exposure - this is called the eclipse period. As such, there would be no way of knowing whether or not HIV transmission has occurred until it is too late to prevent. This is why PEP is so important to prevent HIV.
We use first-line, WHO and CDC-recommended medication regimen for PEP. If started within 72 hours from exposure, this can reduce the risk of HIV transmission by more than 90%.
Our doctor will counsel you on the suitability of PEP HIV, potential side effects, and may need to perform a rapid HIV test (to ensure there is no previously established infection) and baseline blood tests for kidney and liver function as well. The doctor will also counsel on other STD risks, testing, and treatment or prevention as needed.
HIV PEP only helps to reduce the risk of HIV infection, but PEP HIV cannot protect you from being infected with other Sexually Transmitted Diseases (STDs), such as syphilis, chlamydia, and gonorrhea. - HIV PEP Singapore / PEP HIV
Who needs HIV Post Exposure Prophylaxis (PEP)
HIV PEP should be used only in emergency situations and must be started within 72 hours after a recent possible High-risk exposure to HIV.
High-risk HIV exposure can be classified as non-occupational exposures and occupational exposures. - HIV PEP Singapore
Non-occupational high-risk HIV exposures may include:
- Condom break or condom slip
- Sexual intercourse with a known person with HIV infection
- Sexual intercourse with a person of unknown HIV status
- Sharing or exposure to contaminated needles or blades
- Exposure to blood, semen or genital fluids through open wounds, cuts, sores, ulcers during high-risk sexual activities
- Sexual Assault
Occupational high-risk HIV exposures may include:
- Needlestick injuries
- Exposed mucous membrane to blood or bodily fluids (e.g. eye splash)
- Exposed breaks in skin to blood or bodily fluids
HIV and other STDs are commonly transmitted through high-risk sexual activities
Risky sexual behaviour can include:
- Sex without a condom or barebacking
- Mouth-to-genital contact
- Starting sexual activity at a young age
- Having multiple sex partners
- Engaging in commercial sex trade
HIV PEP Singapore Clinic
Dr. Tan & Partners (DTAP) clinic is a group of licensed medical clinics approved by Ministry of Health (MOH) Singapore. Our experienced and open doctors are well-versed and trained in handling all STD & HIV related medical issues.
We provide a discreet, comfortable and private environment for you to discuss your STD/HIV related medical matters. - HIV PEP Singapore
HIV Post Exposure Prophylaxis (PEP) Price List
Consultation and Medication
Rapid HIV Test (if necessary)
Baseline Blood Tests (if necessary)
* Prices mentioned above are before 7% GST and consultation from $20.00
The HIV PEP medication is also available to be on a weekly basis, so you may not need to pay the full sum upfront. - HIV PEP Singapore
What is HIV PEP (Post Exposure Prophylaxis) in a Nutshell
What are the International Guidelines for HIV PEP?
These are just guidelines. The ultimate decision on whether to start PEP or not requires a detailed analysis of the risk benefit ratio. You must have this discussion with our doctor in a formal medical consultation. - HIV PEP Singapore
Risk of HIV Transmission
A Summary of Risk of HIV transmission - HIV PEP Singapore
Injection Drugs Use
Receptive Anal Sexual Intercourse
Receptive Vaginal Sexual Intercourse
Insertive Anal Sexual Intercourse
Insertive Vaginal Sexual Intercourse
Receptive Oral Sexual Intercourse
Insertive Oral Sexual Intercourse
1 % to 30%
0.1% to 10%
0.1% to 10%
Above is a summary based on US CDC, UK BASHH PEPSE, Alberta guideline for the use of PEP (Alberta PEP), Australian Society for HIV Medicines (ASHM) and New York State Department of Health AIDS Institute (New York).
Factors Influencing Transmission Risks
Condoms & Circumcision
Compared to not using a condom and being uncircumcised, by using a condom and being circumcised can reduce HIV risk to a certain extent. The condom creates a barrier that minimizes infection risk. Some studies have found that the removal of foreskin, which is rich in Langerhan cells, can reduce the risk of contracting HIV by about 60%.
HIV Status of Partner
The Viral Load of HIV positive partner. In acute HIV infection (first 4 weeks of infection), the viral load can be very high, and at this stage it is unlikely that your partner is aware of the infection as testing is not yet accurate. The higher the viral load, the greater the risk of HIV transmission.
Sexually Transmitted Diseases (STDs)
The risk of HIV infection will be increased if you or your partner are also infected with other Sexually Transmitted Diseases (STDs), such as chlamydia, gonorrhea, syphilis, and herpes.
Are there any side effects for HIV PEP?
The newer HIV PEP Drugs that we use have fewer or no side effects for the majority of people. However, some people (<10%) may still experience minor side effects, which include:
- Nausea and loss of appetite
- Loose stools or diarrhea
- Tiredness and muscle ache
- Difficulty sleeping and strong dreams
Most of these side effects will resolve after 5-7 days of starting the medication. If you are experiencing any side effects, please inform our doctors so they can help prescribe some symptom-relieving medications. There are no long term side effects caused by taking a course of PEP, and any adverse effects are reversible upon stopping the treatment.
It is also important to consult our doctors if you are taking any other medication when you are under PEP treatment. - HIV PEP Singapore
What to do Before HIV PEP (Post Exposure Prophylaxis)?
Our doctor will speak to you first to determine your individual risk assessment, and whether or not PEP is indeed recommended for your exposure. Next, we would advise on baseline blood tests including a kidney and liver function test and a baseline HIV test. These tests are to ensure that you are safe to start and continue the PEP medication. For example, if an individual has underlying kidney impairment, the dosage and timing of the PEP medication may need to be adjusted by the doctor.
We also cannot give PEP medication to someone who already has an established HIV infection but is not aware of it, as this can increase the risk of the virus developing resistance to the medication when the PEP course is completed.
Our doctor will counsel you in detail on the indications, timing and dosage, and side effects of the medication.
What to do after HIV PEP (Post Exposure Prophylaxis)?
Once you have completed your HIV PEP treatment, you can return to the clinic and see the doctor.
- 1 month after your HIV exposure
- 3 months after your HIV exposure
We know that this can be a very anxious time for you to wait, and can say that 1 month post-exposure and upon completing PEP, your HIV test is already close to CONCLUSIVE. However, as per international guidelines, we would still recommend one last test just as a precaution at 3 months post-exposure.
We have never encountered any patient in our clinics that has completed PEP treatment and tested negative at 1 month post-exposure but tested positive at 3 months if the PEP medication was taken properly and there were no other high risk exposures during that time period.
It is also important at this time to test for other STDs, such as chlamydia, gonorrhea, and syphilis - these are all much more common than HIV and may also remain clinically silent (without symptoms). Of course, these infections are generally less serious compared to HIV, and can be treated and cured. However, early diagnosis and early treatment means better outcomes for your health, as well as more peace of mind for yourself and your future partners.
Please speak to our doctors if you are concerned about other STDs.
We aim to provide honest, reliable, and judgment-free answers to your questions about sex, sexual health, HIV and other STDs.
Can I take PEP after every round of unprotected sexual intercourse?
PEP is not the right choice for someone who is potentially exposed to HIV frequently - for example, if you have unprotected sex with a partner who is HIV positive, or engage in other high-risk behavior regularly. Because PEP is given after an exposure, more medications are required to block the virus from potentially transmitting than with HIV PrEP (Pre-Exposure Prophylaxis). Therefore, PrEP may be more suitable for individuals at ongoing substantial risk for HIV exposure.
Please speak to us about HIV PrEP if you think you are engaging in high-risk activity frequently.