HIV Testing & Screening in Singapore
By DTAP Clinic’s HIV Testing Centre, 4th generation HIV tests available
With over 43,000 HIV & STD tests done, DTAP clinic can help you detect sexually transmitted diseases and infections accurately and reliably.
DTAP clinic provides HIV testing, rapid HIV testing (results in 20mins), STD testing & treatment, HIV treatment & management, as well as Post Exposure Prophylaxis (PEP) & Pre Exposure Prophylaxis (PrEP) services for all Singaporeans and foreigners.
HIV Testing & Screening Price (Singapore), 4th Generation HIV Tests Available
Time From Exposure | Recommended HIV Test | Price | Remarks |
---|---|---|---|
Before HIV Exposure | HIV Pre-Exposure Prophylaxis (HIV PrEP) | Price varies according to type of medication dispensed | HIV Pre exposure Prophylaxis (HIV PrEP) is taken to reduce the chance of HIV infection |
Within 72 hours | HIV Post-Exposure Prophylaxis (PEP) | $1928 | HIV Post exposure Prophylaxis (HIV PEP) can reduce the chance of HIV infection within 72 hours after potential HIV exposure |
10 – 14 days | HIV RNA/DNA Polymerase Chain Reaction (PCR) Test | $642 | HIV is detectable in the blood in as early as 10 – 11 days post exposure. HIV RNA/DNA Polymerase Chain Reaction (PCR) Test is also used for HIV positive persons to check the HIV viral load. |
10 days | HIV Pro-Viral DNA Test | $856 | 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. |
from 28 days | HIV P24 Antigen/Antibody Combo Test (4th generation) | $162 | HIV P24 Antigen will appear in the blood between 14 to 20 days. HIV IgM Antibody starts to become detectable in the blood. HIV P24 Antigen & IgM Antibody can be detected with 4th Generation tests (aka HIV Combo tests) |
from 90 days | Rapid Finger prick Blood HIV-1/2 Antibody Test | $54 | Rapid HIV Test: The results of this HIV test are available within 20 minutes |
Above charges exclude consultation
Preserving patient confidentiality is our utmost priority. Therefore HIV test or treatment 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 your HIV-related concerns. The doctor will then recommend the correct HIV Test or STD test.
Our registered doctors will administer the necessary STD or HIV screening tests, which are approved by the Health Sciences Authority (HSA) of Singapore.
HIV Transmission
HIV survives in certain body fluids such as semen, pre-seminal, vaginal fluids, rectal fluids, breast milk and so on. The HIV infected body fluids must come in contact with mucosa membrane, damages tissues or injected in the bloodstream for transmission to occur.
HIV is most commonly sexually transmitted through unprotected sex with an HIV infected individual.
HIV can be transmitted through:
- Blood Transfusion
- Injection Drugs Use
- Needle Stick Injury
- Vaginal Sexual Intercourse (Receptive or Insertive)
- Anal Sexual Intercourse (Receptive or Insertive)
- Mother to Child
- Organ Transplant
Risk of HIV Transmission
Different studies show different HIV Transmission Risk.
Below is a summary based on US CDC MMWR, UK guideline for the use of PEP (UK PEP), 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).
Overview of HIV Transmission Risk
EXPOSURE ROUTE | US CDC MMWR | UK PEP | ALBERTA PEP | ASHM | NEW YORK |
---|---|---|---|---|---|
Blood Transfusion | 90% | 90% | 90% | – | – |
Injection Drugs Use | 0.67% | 0.67% | 0.67% | 0.8% | Higher Risk |
Receptive Anal Sexual Intercourse | 0.50% | 1.11% | 1 % to 30% | 1.4% | Higher Risk |
Needle Stick | 0.3% | 0.3% | 0.3% | 0.2% | Higher Risk |
Receptive Vaginal Sexual Intercourse | 0.01% | 0.1% | 0.1% to 10% | 0.08% | Higher Risk |
Insertive Anal Sexual Intercourse | 0.0065% | 0.06% | 0.1% to 10% | 0.6% | Higher Risk |
Insertive Vaginal Sexual Intercourse | 0.005% | 0.082% | – | 0.04% | Higher Risk |
Receptive Oral Sexual Intercourse | 0.001% | 0.02% | 0.04% | – | Lower Risk |
Insertive Oral Sexual Intercourse | 0.0001% | 0% | – | – | Lower Risk |
Mucos Membrane | – | 0.63% | 0.09% | less than 0.1% | Higher Risk |
As expected there are large discrepancies in the estimated risks. Receptive anal intercourse is invariably the highest risk sex act.
HIV Window Period & HIV Test Accuracy
The HIV window period is the time between potential HIV infection and the time an individual can get tested with an accurate result.
When a HIV test or screening is done during the window period, a person may be infected with HIV but the test result will be reflected as negative. This is called a HIV false negative result.
Different HIV tests have different testing window periods, as they will detect different indicators of HIV during the HIV development cycle.
Our doctors will advise you on the most appropriate HIV screening test based on your risk assessment and time frame from possible exposure.
Days | HIV Development Stage | Type of HIV Tests | Remarks |
---|---|---|---|
HIV PEP Period (Day 0 – 3) | After Potential HIV Exposure | No HIV test is available | HIV Post exposure Prophylaxis (HIV PEP) can reduce the chances of HIV infection within 72 hours after potential HIV exposure |
Eclipse Period (Day 0 – 10) | No HIV test is available | ||
Acute HIV Infection Day 10 | HIV Virus RNA/DNA is detectable in blood | HIV RNA/DNA Polymerase Chain Reaction (PCR) Test | HIV RNA PCR test has a low chance of giving a false positive result. If the RNA PCR test gives a report of less than 5000 viral copies per ml, it is likely a false positive. |
HIV Pro-Viral DNA Test | 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. | ||
Acute HIV Infection (Day 14 to 20) | HIV P24 is detectable and peaks at about day 30 | ||
Acute HIV Infection (Day 20 to 23) | IgM Antibodies is detectable | ||
Acute HIV Infection (Day 28 to 48) | IgM Antibodies is detectable | HIV Combination P24 Antigen/Antibody Test (HIV Duo Test) Lab test
Rapid Fingerprick Blood HIV-1/2 P24 Antigen/Antibody Combo (HIV Duo Test) | |
Chronic HIV Infection (Day 90 & above) | HIV Antibody | HIV Antibody Test (ELISA)
Rapid Fingerprick Blood HIV-1/2 |
HIV Testing & Screening at DTAP Singapore
For accuracy and sensitivity, all of DTAP’s STD & HIV Testing clinics use only the most current lab tests that are validated and in line with international Standards. DTAP’s rapid HIV test kits are Health Sciences Authority (HSA) approved.
Both male and female doctors are available at DTAP HIV clinics. They are experienced and undergo training regularly in order to competently handle a wide range of STD-HIV related medical issues.
DTAP provides a discreet, comfortable and private environment for you to discuss your STD/HIV related medical matters.
List of HIV Testing, Screening & Treatment Services at DTAP Singapore:
- HIV Testing & Screening
- Rapid HIV Testing (Results in 20mins)
- Anonymous HIV Testing
- HIV Pre-Exposure Prophylaxis (HIV PrEP)
- HIV Post-Exposure Prophylaxis (HIV PEP)
- HIV Treatment (HAART)
- HIV Pro-Viral DNA Test
List of STD related Services at DTAP Singapore:
HIV Pre-Exposure Prophylaxis (PrEP)
HIV Pre-Exposure Prophylaxis (PrEP) is an HIV preventive treatment that uses anti-HIV medications to greatly reduce the risk of infection.
It is recommended for anyone who engages in high-risk activity – this usually includes men who have sex with men, men who have sex with commercial sex workers, and among people who inject drugs. Most of the time, PrEP is taken daily as a single pill of a combination of 2 anti-HIV medications – if taken properly, this can reduce the risk of contracting HIV through sex by more than 90%.
There are also other ways that PrEP can be taken, including as Event Based Dosing (EBD), Holiday PrEP, and with the T’s and S’s regimen.
Even while on this medicine, we will still strongly advise the patient to continue practicing safe sex and get regular HIV tests. HIV PrEP does not prevent other STDs.
HIV Post-Exposure Prophylaxis (PEP)
HIV Post-Exposure Prophylaxis (PEP) is a course of anti-HIV medications that can be started within 72 hours of a possible exposure to prevent or reduce the risk of HIV infection.
It can stop the virus from taking hold in your body before it becomes a full infection. Remember that there is no HIV testing or screening 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 the 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%.
DTAP Singapore also has a 24-hour PEP Hotline number (+65 8728 7272) to help in arranging Emergency Appointments.
You may text or Whatsapp this hotline in Emergency situations, and a DTAP Singapore personnel will reply as soon as possible to arrange an appointment with our doctor, even after clinic hours.
DTAP Singapore’s doctors will counsel you on the suitability of PEP, 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.
Polymerase Chain Reaction (PCR) HIV RNA/DNA TEST
The PCR RNA HIV test is used to detect HIV viral copies at the very early stage of HIV infection before antibodies have developed. It is the earliest way to detect an HIV infection and can be used accurately from 10-12 days post-exposure. The HIV PCR RNA test is also used to test for HIV Viral Load counts for people living with HIV and who are undergoing HIV treatment with Highly Active Antiretroviral Therapy (HAART). This test can be performed at all of our clinics; however, it cannot be performed anonymously. Anonymous HIV testing (AHT) can only be performed at our Robertson Walk clinic with our Rapid 3rd or 4th Generation HIV Screening Test kits.
Pro-Viral DNA HIV Screening 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:
- Diagnosing HIV in newborns born to HIV +ve mothers
- Elite controllers with undetectable HIV viral load despite not being on anti-retroviral treatment
- 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 P24 Antigen/Antibody Combo HIV Test (4th generation)
The 4th GenerationHIV p24 Antigen/Antibody Combo Test detects HIV antigen (p24) and/or HIV antibodies.
The HIV p24 antigen is a protein that makes up much of the HIV viral core and can become detectable from 12-20 days post-exposure, usually reaching a peak at around 3-4 weeks, and dropping to lower levels after 5-6 weeks once HIV IgM antibodies start forming. Although this p24 antigen can usually be detectable by 14 days post-exposure, there will be a number of people who may not have detectable levels until later (up to 28 days post-exposure). This is why we say this HIV screening test is most accurate after a 28 day window period.
Once HIV Antibodies start to form, the p24 antigen levels will drop and become undetectable again – this process is known as seroconversion. Very few people will have a delayed seroconversion, where p24 antigen levels do not drop because antibodies are not being formed – however, as the 4th Generation Combo test will test for both p24 antigen and HIV antibodies, it is adequate in detecting an infection any time from 28 days post-exposure onwards.
This test can be performed anonymously at our Robertson Walk, Singapore clinic only.
HIV Antibody-only Test (3rd generation)
The 3rd Generation HIV Antibody-only Test will only detect for HIV antibodies in the blood or saliva. HIV antibodies can become detectable from about 14-20 days post-exposure. However, this process may take longer in some people.
By 3 months post-exposure, over 99.9% of people infected with HIV will have detectable antibodies. For those who do not have detectable antibodies (delayed seroconversion), a 4th Generation HIV p24 Antigen/Antibody Combo test will be able to detect the virus.
Stages of HIV Infection
Stage 1: Acute HIV Infection
Stage 1: Acute HIV Infection
In general, the Acute HIV Infection stage develops within 2 – 4 weeks after exposure to HIV. Human Immunodeficiency Viruses will multiply rapidly, and start attacking the body’s immunity system by destroying CD4 cells. An individual will typically experienced Flu-like symptoms, rash, fever and other HIV signs and symptoms. HIV transmission risk at this stage is the highest. It as there important to go through HIV testing & screening quickly.
Acute-Retroviral Syndrome:
As the whole body is reacting to fight off HIV, one may experience a variety of symptoms affecting all bodily systems. Some other Sexually Transmitted Diseases STDs may display similar signs and symptoms to HIV. Comprehensive STD & HIV screening is available to diagnose those STDs.
General HIV Symptoms
- Fever
- Night Sweats
- Lethargy
- Malaise
- Swollen Lymph Nodes
- Weight loss
Sign and Symptoms on Skin
- Rash (HIV Rash)
- Ulcer on the penis, vaginal and other parts of the body
Digestive HIV Symptoms
- Nausea,
- Diarrhea,
- Loss of Appetite
Neurological HIV Symptoms
- Headache
Musculo-Skeletal
- Muscle aches
- Joint aches
Stage 2: Chronic HIV Infection (Asymptomatic HIV Infection or Clinical latency)
Stage 2: Chronic HIV Infection (Asymptomatic HIV Infection or Clinical latency)
During the Chronic HIV Infection phase, HIV reproduces at a lower level. HIV-related sign and symptoms will disappear. The immunity system will gradually be weakened and destroyed. It will take a few years before the HIV infection progress to Acquired Immune Deficiency Syndrome (AIDS) or the last stage.
If a person living with HIV is undergoing Highly Active Antiretroviral Therapy (HAART) or HIV Treatment, the infection at the chronic stage can be suppressed. The person needs to adhere strictly to HIV treatment regime.
Stage 3: Acquired Immune Deficiency Syndrome (AIDS)
Stage 3: Acquired Immune Deficiency Syndrome (AIDS)
At this phase, the CD4 for a person living with HIV has fallen drastically. In another words, the person immunity is severally damaged by HIV. With weak immunity a person is prone to get serious infections or bacterial and fungal diseases that otherwise be able to fight off. These sorts of infection and diseases are called Opportunistic infection (OI).
Human Immunodeficiency Virus (HIV) infection can lead to Acquired Immuno Deficiency Syndrome (AIDS) if left untreated. Even with proper Highly Active Antiretroviral Therapy (HAART), the human body can not get rid of HIV completely.
After HIV enters the body, HIV will reproduce rapidly and attack the body’s immune system. AIDS will develop when the immune system is destroyed. AIDS is a set of symptoms caused by HIV infection.
Early HIV testing, treatment and management can delay and even prevent HIV from developing into AIDS. Regular HIV testing can help an individual to determine their HIV status.
Factors Influencing Transmission Risks
- Condoms – There have been many studies on the effectiveness of condoms in reducing HIV risk. Results range from 60% to 90%. The US CDC Condom Report published in 2001 estimated the average protection rate to be 87%. Condom use should therefore be encouraged for all patients.
- HIV Testing, Screening & Treatment as Prevention – People living with HIV on AntiRetroviral Therapy (ART) are about 90% less likely to transmit HIV. This could be due to the decreased viral load.
- Circumcision – Circumcision has been found to reduce the risk of contracting HIV by about 60%. This may be due to the removal of the foreskin which is rich in Langerhan Cells.
- Other Factors:
Male-to-Female Transmission | Relative Risk |
---|---|
Oral Contraceptives | 2.5-4.5 |
Gonococcal Cervicitis (Gonorrhea infection of the Cervix) | 1.8-4.5 |
Candida Vaginitis | 3.3-3.6 |
Genital Ulcers | 2.0-4.0 |
Bacterial Vaginosis | 1.6 |
Herpes simplex virus (HSV) 2 | 2.5 |
Vitamin A Deficiency | 2.5 |
Female-to-Male Transmission | Relative Risk |
Lack of Circumcision | 5.4 – 8.2 |
Genital Ulcer | 2.6 – 4.7 |
Sex During Menses | 3.4 |
Herpes simplex virus (HSV) 2 | 6 – 16.8 |
(Reproduced from the Sanford Guide to HIV/AIDS and Hepatitis Therapy 2014)
The chances of HIV risk will increase when you or your partner are infected with other Sexually Transmitted Diseases.
Please note that you cannot use information contained in this article or anywhere in this website to make medical decisions.
All medical queries should be addressed by your attending HIV Test & Treatment Doctor.
Caring & Treating Since 2005 – HIV Testing & Screening Singapore – DTAP HIV Test Clinic