HIV Post Exposure Prophylaxis (HIV PEP) For Suspected HIV Exposure

Caring & Treating Since 2005 – Post Exposure Prophylaxis

PEP HIV (HIV Post Exposure Prophylaxis), or just PEP in short, can reduce your risk of being infected with the Human Immunodeficiency Virus (HIV). PEP HIV is most effective if started within 72 hours upon suspected HIV exposure. The ideal time to start PEP is within 48 hours from exposure. The earlier the treatment, the better.

PEP HIV treatment may be prescribed to anyone with high-risk HIV exposure. It involves undergoing Antiretroviral (ARV) medications / antiretroviral therapy (ART) for a full month. The medication is similar to that used for HIV PrEP  (Pre-Exposure Prophylaxis); the difference being that HIV PrEP is taken daily before any HIV exposure. Tags: HIV PEP Singapore / Post Exposure Prophylaxis

HIV PEP Singapore

A PEP regime can be as easy as taking 1 tablet per day for a total of just 4 weeks.

10 Days After Exposure, HIV Proviral DNA testing is available at all our clinics in singapore.

Who needs HIV Post Exposure Prophylaxis (PEP)

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

If you think you may have been exposed to HIV, do come down and consult our doctors immediately.

HIV Post Exposure Prophylaxis WhatsApp (24/7) : +65 8728 7272

Both HIV PEP & HIV PrEP are available in all our clinics

We also have a 24/7 PEP Hotline number (+65 8728 7272) to help in arranging Emergency Appointments. You may text or Whatsapp this hotline in Emergency situations, and we will reply as soon as possible to arrange an appointment with our doctor, even after clinic hours.

We offer a discreet, comfortable and private environment for you to discuss your STD/HIV related medical matters. – HIV PEP Singapore

PEP HIV Treatment – Stopping HIV

HIV PEP treatment can stop the virus from taking hold in your body before it becomes a full blown 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 in preventing 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

HIV PEP Singapore Clinic

Dr. Tan & Partners (DTAP) clinic is a group of licensed medical clinics approved by the Ministry of Health (MOH) Singapore. Our experienced and open doctors are 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

Post Exposure Prophylaxis (PEP)Cost
Consultation and Medication
Rapid HIV Test (if necessary)$54
Baseline Blood Tests (if necessary)$150

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

We use the current PEP Medicines with fewer side effects and better HIV prevention. This is in accordance with the latest International Standards. Our Rapid HIV test kits are the Health Sciences Authority (HSA) approved.

We use the College of American Pathologist accredited labs for HIV & STD tests that are in line with the highest international standards for accuracy and sensitivity.

HIV Post Exposure Prophylaxis Whatsapp service (24/7) : +65 8728 7272

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

How many HIV PEP pills I need to take a day?

There are many HIV PEP regimes available. Our Doctors will analyse your unique situation and recommend you the suitable HIV PEP regime.

The different regimes require 2 HIV PEP pills a day and 1 HIV PEP pill a day.

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.

We may recommend repeat baseline blood tests, HIV Test and STD Screening

  • 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.

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 a doctor in a formal medical consultation. – HIV PEP Singapore

Individuals are eligible for HIV PEP if they are:

  • exposure occurred within the past 72 hours; and
  • the potentially exposed individual is not infected or not known to be infected with HIV; and
  • mucous membrane or non-intact skin was significantly exposed to a potentially infectious body fluid; and
  • the source is HIV-infected or the HIV status is unknown.

According to the New York Health Department HIV PEP Guidelines, HIV PEP treatment should be recommended in the following exposures:

  • Receptive and insertive vaginal or anal intercourse
  • Needle sharing
  • Injuries with exposure to blood or other potentially infected fluids from a source known to be HIV-infected or HIV status is unknown (including needlesticks with a hollow-bore needle, human bites, and accidents)

According to the same NYHD HIV PEP Guidelines, HIV PEP treatment should be evaluated on a case-by-case basis in the following exposure scenarios:

  • Oral-vaginal contact (receptive and insertive)
  • Oral-anal contact (receptive and insertive)
  • Receptive penile-oral contact with or without ejaculation
  • Insertive penile-oral contact with or without ejaculation

Factors that increase HIV risk:

  • Source person is known to be HIV-infected with high viral load
  • An oral mucosa that is not intact (eg, oral lesions, gingivitis, wounds)
  • Blood exposure — it is important to note that blood exposure can be minimal and therefore not recognized by the exposed person.  If the exposed person reports frank blood exposure, PEP would be indicated
  • Insertive penile-oral contact with or without ejaculation

HIV PEP treatment should be recommended in the following exposures:

  • Receptive and insertive vaginal or anal intercourse
  • Needle sharing
  • Injuries with exposure to blood or other potentially infected fluids from a source known to be HIV-infected or HIV status is unknown (including needlesticks with a hollow-bore needle, human bites, accidents)

Risk of HIV Transmission

A Summary of Risk of HIV transmission – HIV PEP Singapore

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.

What is PEP (Post Exposure Prophylaxis) in a Nutshell

HIV PEP Singapore, post exposure prophylaxis

Dr Julian Ng during an interview. Female doctors available by appointment.