A Guide To HIV PrEP and HIV PEP – Pills for HIV Prevention

Nearly every day here I see a person who is super anxious and has put their life on hold for anywhere from a month to three months in fear that they have contracted HIV from a momentary lapse of judgement. You can lose sleep, your appetite, your hair can fall, you can be visibly emaciated as well with this amount of stress in life on a daily basis for such a long period.
When it comes to staying safe against HIV in a lifestyle where one is exposed to the virus, it is crucial that one adopts multiple precautionary measures against transmission of HIV.
Apart from choosing partners wisely (we always encourage STI testing prior to being sexually active with someone) and using condoms, there is an additional safety precaution when it comes to safeguarding yourself against HIV transmission.
So in this article, let’s talk about the HIV medication you can take to help protect yourself against HIV. Basically, this is a lifestyle choice that you’d have to make based on as much information as possible. Let’s go over some of the details right.

First off, what is HIV and why are we so worried about it?

Would you like to hear the scary part first? Basically, after decades of studying the virus, we still do not have a cure for it. Now, that doesn’t mean everyone with HIV will die of HIV complications but more that if you do pick up HIV sometime in your life, chances are you’ll die with the HIV still in you. How’s that for a daily nightmare?

HIV Infection

HIV stands for Human Immunodeficiency Virus. HIV is a virus spread through certain body fluids that attacks the body’s immune system, specifically the CD4 cells, often called T cells. Now, once the virus starts infecting the cells, it goes on a continuous rampage of self-replication and destruction. Basically the more of the virus that is present, the worse of an infection it can create. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. Untreated, HIV reduces the number of CD4 cells (T cells) in the body. This damage to the immune system makes it harder and harder for the body to fight off infections.
So imagine your body is fighting a losing battle with HIV, other bacteria, virus and fungi know that your body is already weakened and they do attack the body at that time. These are called opportunistic infections.
So in combination of HIV and opportunistic infections (see: 10 Common HIV Opportunistic Infections), the body gets worn down over time until it succumbs to these infections.

HIV-infection

What is AIDS (Acquired Immuno-Deficiency Syndrome)?

AIDS is the most severe phase of HIV infection; basically, it’s the bigger, older, more aggressive older brother that will stop at nothing until your organs cease to function as intended.

HIV mode of transmission

Only certain body fluids—blood, ejaculate or pre-ejaculate material, rectal fluids, vaginal fluids, and breast milk—from a person who has HIV can transmit HIV. Bear in mind that a simple contact or a touch gesture does not guarantee transmission of the virus. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to occur.

How Would I Know if I Picked Up the Virus?

Acute Retroviral Syndrome (ARS) – Initial HIV symptoms
There are a few stages to an HIV infection. The very first few symptoms can occur within five to 12 days of exposure to the virus. This is the ARS (Acute Retroviral Syndrome) phase. Now this stage is particularly challenging to diagnose because more often that now, you wouldn’t even go through this phase.
In the off chance that you do have ARS, the symptoms can be so vague and misleading that it may be discarded as something completely different if you do not provide a history of a situation where you might have picked up HIV.
If at any time after a potential exposure episode you happen to develop features as listed below, it would be wise to seek medical attention as soon as you can.

  1. Fever – This is usually a high-grade temperature (>38.5) accompanied with chills, tremors, and the occasional night sweats
  2. Rash – Look out for an upper chest angry rash that is reminiscent of a chicken pox rash. Think red, fast growing, vesicular like rashes that can be painful or uncomfortably itchy in general.
  3. Muscle aches – That feeling that your body is heavy and you just don’t want to get out of bed.
  4. A sore throat
  5. Swollen lymph nodes – Look out for any abnormal swelling around your neck, behind your neck and under your armpits especially
  6. Mouth ulcers

So ideally these HIV symptoms will all come in about the same time with a recent history of potential exposure. This can prompt your physician towards a diagnosis of HIV ARS.
It’s also important to recognise which stage the virus is in so we can expect certain infections and treatment with the aim of covering as wide a net as possible when dealing with HIV.

That being said, we’re here to emphasize protecting yourself against HIV instead of being vulnerable to it and its effects on life in general. As I earlier mentioned, nearly every day we see people who lose weeks worth of sleep being so anxiously paranoid that they might have picked up HIV.
The ideal would definitely be the prevention of HIV transmission to begin with.

We’ll start with Pre-Exposure Prophylaxis (PrEP)

This is where the modernisation of medicine plays a huge part in society. The idea of Pre-exposure prophylaxis or PrEP is that it works similar to how a vaccine would in terms of offering protection against a disease.
The premise is simple. You take a tablet once a day and if taken correctly; combined with safe sexual practices, and there are no other complications, there is an up to 99% chance you will not get HIV if ever exposed to the virus.
HIV PrEP is basically using anti-retroviral medication (basically HIV medications) to prevent the acquisition of HIV infection by an uninfected person. PrEP is offered here in the form of a combination tablet containing tenofovir and emtricitabine (both medications we use to treat HIV).

Descovy As New HIV Medication For HIV PrEP

Descovy (brand name) is a FDA approved new drug combination of tenofovir alafenamide (TAF) + emtricitabine for use as HIV PrEP, which has shown to be equally effective in preventing HIV infection whilst touting an improved safety profile for renal and bone toxicity.

Descovy is currently available in all Singapore DTAP clinics only. It is a prescription-only medication and must be prescribed by a doctor. Speak to our doctors for more information about Descovy and find out if a HIV-1 treatment that contains Descovy is right for you.

Can Anyone Take HIV PrEP?

HIV PrEP was initially created for people who are in the high risk group for contracting HIV. This included people whose spouses were HIV positive. Trying to have a healthy relationship is trying enough as it is. HIV PrEP allows for intercouse with a significant less amount of stress and worries about contracting HIV.
Among other people who are in this high risk group include people who:

  • are sexually active in the last 6 months and NOT in a sexually monogamous relationship with a recently tested HIV-negative partner, and who
    • is a man who has sex with men, and who… (see: STD risk from unprotected Anal Sex in Men)
      • engage in anal sex
      • has had a sexually transmitted infection in the past 6 months
    • or is a sexually active adult (male or female with male or female partners), and who…
      • is bisexual (riskier if you have a very active sex life with multiple partners at the same time)
      • has sex with partners at increased risk of having HIV (e.g. injection drug users, men who have sex with men) without consistent condom use.

As we have evolved into prescribing PrEP, we realised that the level of protection it offers should not be confined to a certain group of people but to anyone who is wanting that added layer of protection against HIV transmission.
So really, all you have to do is to speak to your doctor, undergo a few simple tests to ascertain that you are healthy and have had no exposure to HIV prior to that before starting PrEP.
When you first start PrEP you may experience side effects like:

  • nausea
  • dizziness
  • headaches
  • fatigue
  • stomach cramps

More serious side effects include:

  • kidney problems, including failure
  • Liver problems
  • Reduced bone density

This is why, when on PrEP, it is important to regularly monitor the health of the organs that can be affected by this medication. We’ll have to get regular blood and urine screening is done with regular HIV testing and also bone scans if necessary in some cases. It is always best to continue on these medications with the advice of a physician.
Both our Robertson Walk (Singapore) & KL Eco City (Malaysia, Kuala Lumpur) provide Anonymous HIV Testing if you wish to keep your HIV status anonymous.

Frequently Asked Questions of HIV PrEP

1. Can I get STD even if I am on PrEP?

Yes, of course. HIV is just one type of a STI. There are other STI that aren’t even viruses but are bacteria. In these situations, taking PrEP is irrelevant to the situation. PrEP is designed to protect you against specifically HIV, not all STIs.

2. Do I still need condom even if I am on PrEP

Safe sex practices are always encouraged regardless if you are on PrEP or not. Basically, it is better to be safer really. Using a condom adds another barrier of safety in terms of picking up an HIV infection so really, why compromise on that?

3. Do I need regular HIV testing?

This is indeed encouraged. Its best to go for regular routine check-ups & HIV Testing and discuss your lifestyle and potential risk encounters with your physician to clarify any doubts. We’d also need to confirm that you are not already exposed to the virus before or during your time on PrEP.

4. When can I stop PrEP?

Basically, you can determine that. At any time when you see your lifestyle as not posing a risk of you contracting HIV, you may decide to stop taking the medication. There is no hard and fast rule to this. You can be taking the medications for months or decades if you choose to do so.
Either way, it is imperative that you are safe and in good health whilst taking the medication.

5. Do I have to take it on a daily basis?

Taking PrEP on a daily basis is recommended. This is to ensure compliance to the medication and to allow it to build some sort of protection against the virus. However, if your lifestyle does not call for it, you can choose to do event-based dosing where you take a total of four tablets spaced out over four days before and after a risky encounter.
Obviously, this is less stable a method of acquiring protection against HIV but it is an alternative to people who choose not to take medications on a daily basis ie people who have sexual encounters infrequently.

 Here’s a video on Event Based Dosing for HIV PrEP

Now what is HIV Post-Exposure Prophylaxis (PEP)

So now that we have covered PrEP, let’s move on to PEP (Post Exposure Prophylaxis). This is again a very similar ideology to PrEP where we aim to provide as much protection against transmission of HIV to you. Where it differs is that pre-exposure means before an incident that potentially made you vulnerable to HIV whereas post exposure is the period immediately after you have been potentially exposed to the virus.
Early on in this article, I recounted my experiences dealing with very anxious clients who have lost a weeks worth of sleep because they had to wait out the window period to test for HIV (this is at the least ten days).
This is where PEP comes into play. If for whatever reason you feel that you have been exposed to HIV, come in, see your doctor and get PEP prescribed to you within 72 hours of that and if taken correctly, there is an up to 99% chance you will not get infected with HIV.
See the difference? Immediate action within 72 hours after an HIV potential exposure episode can save you weeks worth of anxiety.
So let’s recap what some potentially dangerous incidences are, shall we? If you are in a position where:-

  1. you think you may have been exposed to HIV during sex (for example, if the condom broke), or if you are unsure about your partner’s status
  2. there was an abnormal exchange of body fluids – exposed to blood during intercourse or you noticed open cuts and active bleeding from your partner
  3. shared needles and works to prepare drugs (for example, cotton, cooks, waiter, medical personnel), or
  4. were sexually assaulted

All of the above are just some examples of a risky contact situation which can potentially transmit HIV to you and these are situations where if you have not already been on PrEP, it is advised to get PEP to safeguard against HIV infections.

How do I take PEP?

HIV PEP is a combination of three drugs likely given to you in two tablets. This is similar to PrEP but with the addition of another agent to the regime. Like aforementioned, time is of the essence when it comes to PEP so be quick to get to it and start taking it well within the 72 hours golden period for the best results.
The medications should be taken once or twice daily for a minimum of 28 days consecutively. Keep in mind that this is crucial. Missing out on one dose or even worse, one day’s worth of PEP is definitely not advisable. (HIV PEP is available in all our clinic in Singapore and Malaysia)

How does PEP work?

Essentially, PEP will prevent the replication of HIV in the body. When it cannot replicate, it cannot create a strong enough infection to overwhelm the body’s immune system. Ideally, that will result in the virus eventually dying off because it is unable to further survive in the body with its presence there being insignificant.

How would I know if PEP worked?

As with any medication, we will have to do pre and post therapy testing. Prior to starting PEP, it is ideally advised to get HIV testing done to make sure you have not already been exposed to HIV. Once you have started the medication, try and take them at the same time everyday for at least 28 consecutive days then we’ll have to get you tested within the next two months.
If throughout that time you appear to be well and there is no evidence of HIV picked up in your tests, we can clear you from that particular incident.

Side effects of PEP?

Because the medication regime is somewhat similar to PrEP, you can expect a similar range of side effects but this may be amplified somewhat. Apart from that, it is fairly undramatic.

Can HIV PEP fail?

Yes, unfortunately, there have been reported cases of PEP failure. This means that even with taking medications, the client still got a HIV infection. This is not common and is usually linked to poor compliance or a pre-existing medical condition that may impair the way PEP works.

All in All

To summarise, there are ways to protect yourself from potentially deadly viruses like HIV. You have to be in the know and be responsible for your own health in terms of how you choose to live your life and how to best be safe in it.
As a physician, I am glad to help you out in every step of the way in getting you as safely healthy as possible while allowing you to lead the life you feel will make you happiest and to achieve your full potential.
It is certainly debilitating to catch a virus like HIV when you’re just out doing what you do. It can throw a spanner into your life goals and bring life as you know it into a screeching halt.
Having said that, I hope this article has given you at least a rudimentary idea of how to keep yourself protected and to stay safe. Remember, prevention is always better than cure.
Take care.
This Article is Written By Dr. Kaarthig Ganesamoorthy from Our KL EcoCity Branch in Kuala Lumpur.


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
  13. The HIV Pro-Viral DNA Test can be done 10 days post exposure.

 

STD Risk from Receptive Unprotected Anal Sex in Men

Anal sex, not only consists of penile insertion into the anus (bottom) but also allowing your partner to use his mouth on the anus (analingus) or insertion of fingers and sex toys into the anus.
It is highly recommended to use condoms and lube during anal sex to reduce the risk of contracting a sexually transmitted disease (STD).

What is the STD that you can potentially get from anal sex for Men-Who-Have-Sex-With-Men (MSM)?

1. Chlamydia and Gonorrhea

The reason why we clumped them together in this article is that chlamydia gonorrhoea can present with similar symptoms and may present together in certain patients. These bacteria’s can present in a few ways:

Anal Discharge

Discharge is a term used when liquid is seen coming out of the anus. This is usually very minimal and patients usually notice a small number of stains on their underwear. In very rare situations, the volume may be high and appear yellow in colour. see more of Rectal Gonorrhea

Anal Discomfort

Patients usually present with mild discomfort in the anal region and some of them describe it as a feeling of constant urge to poo. It is never painful, and if patients present with severe pain, it is usually due to haemorrhoids or a tear at the opening of the anus.

Anal Bleeding

This is very rare. If patients present with bleeding, it is usually due to piles or a tear at the opening of the anus.

Lower Urinary Tract Symptoms

The insertive partner (or top) may present with a burning sensation when passing urine, urethral discharge, an increase in urinary frequency, waking up in the middle of the night to pass urine and the feeling of incomplete bladder emptying. However, keep in mind a large proportion of men may not show these symptoms.
It is best to get tested via anal swab or urine test for these bacteria if you have had an exposure as it can be easily treated with antibiotics.
Prostate infection and inflammation can be due to non-Sexually Transmitted infections & Sexually Transmitted Infections.
We provide Rapid Chlamydia & Gonorrhea PCR Screening (Next Day Results).

2. Human papillomavirus (HPV)

HPV is, in fact, one of the most common STD’s out there but is less well known. It is usually transmitted through skin to skin contact, through contact with infected mucous membranes or bodily fluids. In other words, condoms will not protect you from this virus. There are many different strains and can cause anal cancer and cauliflower-like growths in the anus and surrounding skin. It is recommended to see a doctor screen for anal warts, or other genital warts because some warts may be inside the anus and may not be visualised externally.
Warts can be treated and you should see a men’s health doctor if you have any suspicious lumps. It is highly recommended for men who engage in anal sex to get the HPV vaccine.
Rapid HPV Testing (Next Day Results) is available in our clinics.
Check out: How to Get Rid of Warts

Read: Is HPV Vaccine Necessary for Males?

3. Herpes

There are 2 kinds of herpes virus, HSV type 1 and HSV type 2. These viruses can be easily passed through skin to skin contact, which means condoms have a very limited to a negligible role in reducing the transmission. They usually present in the area of contact with multiple, small and painful ulcers or blisters within a week or sometime months after exposure. If there is any suspicion, the doctor will perform a dry swab to diagnose the lesion. Unfortunately, there is no cure but there is treatment available for flares.

4. Molluscum Contagiosum

Molluscum Contagiosum is caused by a virus call Poxvirus and presented with lesions that may appear anywhere on the body. The lesions are small, raised and usually white or flesh-coloured with a dimple or pit in the centre. The size can range from 2 to 5 mm in diameter and may be itchy or sore. This virus can be passed through skin to skin contact or thru contaminated materials such as clothing, towels, pool equipment or even toys. The good news is that these lesions usually do not cause long-term medical problems and can be easily treated. Water Wart Removal is available in our clinics.

5. Syphilis

Syphilis an STD which is transmitted thru any form of sexual contact. It is caused by a bacteria known as Treponema pallidum. This disease can present in many ways, from a single, big and painless ulcer in the area of sexual contact, to rashes around the body and palms. In certain cases, they can cause an infection in the brain and spinal cord. This symptom can present any time between 9 to 90 days after being infected. The good thing is this disease is usually curable with antibiotics.

6. HIV

The riskiest sexual behaviour for getting and transmitting HIV in men is anal sex. The receptive anal sex is much riskier as the bottom partner’s risk is 13 folds higher than the insertive partner. This virus can pass through blood, semen, pre-seminal fluid (Pre-cum) or rectal fluids.
This risk is higher when recreational drugs are used.
Condoms and HIV pre-exposure prophylaxis (PrEP), if used consistently can reduce the risk of getting HIV significantly. The condom reduces the risk of getting HIV by 63% for the insertive partner and 72% for the receptive partner if they engaged in anal sex with an HIV infected partner.
Yes. it is not 100%!!. PrEP can reduce the risk of getting HIV by more than 90%. If you think you have been potentially exposed to the virus and did not use a condom, you can see a doctor within 72 hours of the exposure to start the HIV post-exposure prophylaxis (PEP) treatment.
Also, a regular HIV Test is recommended if you are sexually active with unknown HIV status partners.
If you think you have had an exposure to HIV or any form of STD thru risky sexual activity, it is recommended you get tested and seek treatment early to reduce any untoward complications and risk of passing it to your partner.
Take Care!


Other Reads:

  1. The HIV Pro-Virus DNA Test can be done 10 days post exposure.
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. What are the Causes of Abnormal Penile Discharge?
  4. HPV Infection & HPV Vaccination for Men who have sex with Men
  5. Low HIV Risk Doesn’t Mean No HIV Risk
  6. 7 FAQs HIV Preexposure prophylaxis (HIV PrEP)
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know about Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. 10 Common HIV related Opportunistic Infections

 

7 FAQs HIV Pre-Exposure prophylaxis (HIV PrEP)

HIV Pre-exposure prophylaxis (PrEP) is a combination of 2 HIV medicines, sold under the name of Truvada (Tenofovir and Emtricitabine), when taken daily lowers the chances of a very high-risk HIV negative individual from getting infected with HIV.
Do not mistake this for Post-exposure prophylaxis (PEP) which is taken for 28 days after potential exposure to the HIV virus.
The precept is simple, take one pill a day and you are protected from getting HIV.
Also Read: A Guide To HIV PrEP And HIV PEP – Pills For HIV Prevention

7 Frequently Asked Questions on HIV Pre Exposure Prophylaxis (PrEP):

1) How effective is HIV Pre-exposure prophylaxis (PrEP)?

When used daily, it can lower the risk of getting HIV from sexual intercourse by 99%.
The protection against getting HIV from sharing needles is lower at about 70%.
Being on PrEP is NOT AN EXCUSE for going bareback. Using a condom further reduces the risk of getting HIV. Also, PrEP does NOT protect against other STDs. But condoms DO!
Also, remember that medicines work only if they are taken properly.
Also Read: STD Symptoms – That You Need to Know 

2) How to Take HIV Pre exposure prophylaxis (PrEP)

a. Event-Based HIV Dosing


On-Demand PrEP Regimen: 
Planned condom-less sex 24 hours in advance:
Strictly:

  • take 2 pills 2 – 24 hours before sex
  • take 1 pill on the day of sex
  • take 1 pill 24 hours later

If having sex for an extended period of time, perhaps over a few days or a weekend, continue to take a pill every 24 hours until you have 2 sex-free days.

Type: 

  • Only for Anal sex
  • More studies required to show effectiveness in Vaginal/Frontal sex

Considerations:

  • This option is not recommended if you have an active hepatitis B infection. The drugs in PrEP also suppress the hepatitis B virus and so starting and stopping HIV PrEP can potentially cause viral flare-ups and liver inflammation.

b. Daily PrEP

Daily PrEP Regimen: 

  • Lead-in time 7 days.
  • Taken daily at the same time  +/- a few hours ok

Type:

  • Anal, Vaginal/Frontal sex

Considerations:

  • Can be taken any time of the day with or without food
  • In the event a pill is missed, adequate protection is still conferred.

c. Ts and Ss (Tues, Thurs, Sat, Sun dosing)


Ts and Ss Regimen:

  • Daily dosing for 7 days,
  • then dropping down to 4 pills per week on Tues/Thurs/Sat/Sun

Type: 

  • Only for Anal sex
  • More studies required to show effectiveness in Vaginal/Frontal sex

Considerations:

  • If you only have sex once or twice a month, you might not want to take a pill every day.
  • 4 pills per week will maintain a good baseline of the drug in your system and you can choose to increase up to daily 7 pills per week when you know you’re in a more sexually active period.
  • Some people using PrEP On Demand find that they might be taking 4 pills per week most weeks of the month and so opt for structuring this into the Ts and Ss instead.

d. Holiday PrEP

Holiday PrEP Regimen:

  • PrEP before a pre-planned block of time when your risk of exposure to HIV will be higher due to:
    • an increased number of partners of unknown HIV status
    • situations where condoms are not easily or always used
    • where alcohol or substances might be used
    • having sex while travelling to a country with a high HIV prevalence
  • Based on a 7-day period we recommend 7-7-7:
    • 7 days daily dosing before the period
    • 7 days daily dosing during the period (or for as long as the specific period lasts)
    • 7 days daily dosing after the period.

Type: 

  • Anal, Vaginal/Frontal sex

Considerations:

  • 7 days of PrEP before and after your last sexual encounter for several reasons:
    • 7 days lead-in provides adequate levels for both anal and vaginal or frontal sex.
    • 7 days lead in before the holiday or travel will allow the body to adjust to any possible side effects; most people do not experience any, but should you have side effects, these will usually have subsided within a week.

3. Who should consider HIV Pre exposure prophylaxis (PrEP)?

  • If your partner is living with HIV
  • If you are not is a mutually monogamous relationship
  • If you have been diagnosed with an STD in the past 6 months

4. How long after initiation of HIV PrEP will it then provide protection?

The general rule is that you have to be on PrEP for 7 days before you are protected.
There are ways to speed this up and there are circumstances when this is longer. Please check with our doctor when you consult for your PrEP prescription.
Also Read: When To Test For HIV During Or After Completing HIV PEP

5. What are the side effects of HIV PrEP? Is it safe to take it long term?

PrEP is relatively safe. When side effects do occur, most common symptoms are nausea and diarrhoea. Generally, these symptoms usually subside over time. No serious side effects have been recorded and the side effects are never life-threatening.
However, if you do develop side effects that are not improving with time, please contact the doctor that prescribed you the PrEP.

6. How can I purchase PrEP?

You will need to consult a doctor first and he may go through with you your risks based on the type of sexual behaviour. The doctor will also run some blood tests, including HIV, Hepatitis screen, and other blood tests such as full blood count, kidney function test and liver function test. If there are no contraindications, the doctor will then prescribe you PrEP.
Learn more about Anonymous HIV Testing

7. Since PrEP is effective in providing protection, can I not use a condom for oral and anal sex?

Always use a condom. PrEP doesn’t give you 100 per cent protection. Using a condom while on PrEP significantly lowers your risk further. Besides that, HIV PrEP doesn’t protect you against other sexually transmitted diseases (STDs) such as gonorrhoea and chlamydia which can infect the throat, anus and penile urethra.
While on PrEP it is recommended to screen for HIV and other STDs regularly. We provide Rapid HPV Testing & Rapid Gonorrhoea & Chlamydia PCR Testing (Next Day Results).
Learn more about Descovy (New HIV Medication For HIV PrEP)

Descovy (brand name) is a FDA approved new drug combination of tenofovir alafenamide (TAF) + emtricitabine for use as HIV PrEP, which has shown to be equally effective in preventing HIV infection whilst touting an improved safety profile for renal and bone toxicity.

Descovy is currently available in all Dr Tan & Partners (DTAP clinics) in Singapore. It is a prescription only medication and must be prescribed by a doctor. Speak to our doctors for more information about Descovy and find out if a HIV-1 treatment that contains Descovy is right for you.

Take Care!


Other Reads:

  1. HPV Infection & HPV Vaccination for Men who have sex with Men
  2. A Guide To HIV PrEP and HIV PEP – Pills for HIV Prevention
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. What are the Causes of Abnormal Penile Discharge?
  5. STD Risk for Receptive Unprotected Anal Sex in Men
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know about Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. 10 Common HIV related Opportunistic Infections

 

HPV Infection & HPV Vaccination for Men who have sex with Men

About 40 types of HPV are passed on through sexual contact. The virus can be spread through skin-to-skin contact that doesn’t involve penetrative sex. Condoms will not necessarily fully protect people from coming into contact with it. Also Read: Anal Pap smear for men

What you need to know about Gardasil 9 HPV Vaccine and HPV in Men who have sex with Men

 

What is Human papillomavirus (HPV)?

The Human Papilloma Virus (HPV) is not one virus, but a family of about 200 different strains that cause common warts, genital warts and some cancers.
Sexually active adults mostly acquire at least one variety of HPV and it’s a near-universal infection in people with HIV. Even people with a one-lifetime partner can get HPV if their partner has it.
About 40 types of HPV are passed on through sexual contact. The virus can be spread through skin-to-skin contact that doesn’t involve penetrative sex. Condoms will not necessarily fully protect people from coming into contact with it.
For most people, HPV will not cause any harm. Only some varieties of HPV can cause cancer and even if you do come in contact with these strains, the chances of developing cancer are very small.
However, some people do not clear the virus from their bodies, and this can cause:

  • Genital warts on the penis and anus. It is also possible to have these types of warts on the lips and in the mouth.
  • Cancer of the anus, penis and oropharynx (back of the throat, including the base of the tongue and tonsils).

Although some other strains of HPV are associated with cancers, two main strains of HPV – HPV 16 and HPV 18 – cause 70% of cervical cancers in women and over 80% of anal cancers worldwide.
It is estimated that HPV is responsible for about 5% of cancers worldwide. However, anal cancer is one of the most common cancers for people living with HIV.

Learn more about Rapid HPV Testing (Next Day Result)

HPV & Men Who Have Sex With Men (MSM)

Every year anal cancer is diagnosed in about two people per 100,000 in the general population.
Men who have sex with men are about 20 times more likely than heterosexual men to develop anal cancer, and men-who-have-sex-with-men who are living with HIV are even more likely (up to 100 times more than the general community).

What is the new Gardasil 9 (HPV Vaccine)?

GARDASIL 9 is a vaccine (injection/shot) given to individuals 9 through 26 years of age to help protect against diseases caused by some types of Human Papillomavirus (HPV).
In boys and men 9 through 26 years of age, GARDASIL 9 helps protect against:

  • Anal cancer
  • Precancerous anal lesions
  • Genital warts – Penile warts, Anal Warts and other areas

These diseases have many causes. Most of the time, these diseases are caused by nine types of HPV: HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58. GARDASIL 9 protects against diseases caused by these nine types of HPV.

What is the difference between Gardasil and new Gardasil 9?

Gardasil only covers 4 strains of HPV: 6, 11, 16, 18.
Gardasil 9 covers that and 5 more strains, 31,33,45,52.

HPV-4 types
(6, 11,16,18)
HPV-9 types
(6,11,16,18,31,33,45,52,58)
Cervical cancer cases 70% 90%
High-grade cervical lesions 50% 75-85%
Low-grade cervical lesions 30-35% 50-60%
HPV-related vulvar cancer cases 70-75% 85-90%
HPV-related vaginal cancer cases 65% 80-85%
HPV-related anal cancers 85-90% 90-95%
Genital wart cases 90% 90%

As you can see, Gardasil 9 has a broader HPV coverage compared to Gardasil.

Frequent Asked Questions (FAQs)

1.) Can I get Gardasil 9 if I am above 26 years old?

Gardasil 9 in Singapore is indicated for boys and men from ages 9 to 26. That does NOT mean that men above the age of 26 years cannot get the vaccine.
If you are above 26 years old, the best thing to do is to have a discussion with our doctor about the pros and cons of the vaccine then make a decision on whether or not you will benefit from it.

 

2.) Can I get Gardasil 9 even if I have had genital warts?

There are 200 different strains of HPV. Even if you have been infected with 1 strain, the vaccine can help protect you against other strains.
Also, there is data to show that people who have received treatment for HPV related cancers and had the HPV vaccine were less likely to get recurrences of their cancers.
So even if you have had or currently have genital warts, you should still have a frank conversation with our doctor about how Gardasil 9 can benefit you.

3.) Can I get Gardasil 9 even though I have already had the older version of Gardasil?

Yes, you certainly can. Scientific data has proven that it is absolutely safe to receive the full dose of Gardasil 9 even though you have already completed the vaccination using the older version of Gardasil.
If you have any concern about HPV infection treatment or you are interested in getting HPV vaccination, please contact us for more information.

Gardasil 9 vaccination is avilable in all our clinics in Malaysia and Singapore.
You can call any of our clinics or email us at hello@dtapclinic.com.sg for an appointment.

Take Care!


Other Reads:

  1. Low HIV Risk Doesn’t Mean No HIV Risk
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. What are the Causes of Abnormal Penile Discharge?
  4. HIV PrEP for Travel – How You Need to Know
  5. An Overview on STD from an STD Doctor
  6. Everything You Need to Know about Herpes Simplex Virus
  7. How Do I Treat Oral Herpes (Cold Sores)
  8. Syphilis Symptoms – Painless Sore & Ulcers
  9. HIV Symptoms – What You Need to Know
  10. 10 Common HIV related Opportunistic Infections

HPV Vaccination for Men – What You Need to Know

The Human Papilloma Virus (HPV) is a group of viruses which infect the skin and mucous membranes of the body and are transmitted through skin contact or through the transfer of genital fluids.
There are over 200 subtypes, with the majority of them do not cause a clinically significant medical problem. Around 30 subtypes infect the genital area.

HPV in Men: How Do HPV present in Men?

When they present with symptoms, they usually present as genital warts.
Rarely, HPV in men can cause penile, oropharyngeal or anal cancer. This is more common in people living with HIV.

Not everyone infected with HPV will get symptoms.

If genital warts grow, the common areas they grow are on the foreskin, on the shaft of the penis, on the pubic region at the base of the penis, around the anus and inside the anal canal.

Remember, you do NOT need to have anal sex to get warts around the anus.

Remember, condoms do NOT protect you 100% against HPV. So you can get infected with HPV even if you use a condom every time!

Is there a cure for HPV infections in men?

Unfortunately, there is no medication that is available to target the HPV virus specifically.

However, there is treatment available for its symptoms. As the infection is usually self-limiting. 90% of the time, the body’s immunity usually clears the infection after some time.
Warts, however, can be removed by a variety of methods. There are creams, lotions, lasers and other methods for removing warts.

Learn about: “How to Get Rid of Genital Warts

Sometimes, if the warts are really plentiful and limited to the foreskin, circumcision is done to remove all warts, Warts often recur and usually, several genital warts treatments are needed before they go away completely.

Is there an HPV vaccine for Men?

Yes, there is! Gardasil 9 is indicated for use in men and boys to protect them against getting HPV.

Does Gardasil protect you against all strains of HPV in men?

No. It only protects you against HPV 6, 11, 16 and 18, with HPV 6 and 11 causing 90% of the genital wart presentations.

Is the vaccine still beneficial if I have had genital warts in the past?

It may still be beneficial as you may not have been exposed to all 4 strains covered in the vaccine. It is best to discuss this with your doctor.
Also, studies have shown that the HPV vaccine reduces the risk of HPV symptom recurrence in people who are already infected.

Are there any side effects from Gardasil vaccination?

The HPV vaccine is very safe. If any side effects do occur, some of the common side effects include pain, redness, or swelling in the injected arm, headache, fever, feeling tired, nausea, muscle or joint pain. In very rare occasions, a severe allergic reaction may occur.

What is HPV vaccination regimen like?

A total of 3 vaccines are given over a total period of 6 months ( 2nd dose given 2 months after the first dose and the 3rd dose is given 4 months after the 2nd dose)

If you have any concern about HPV infection treatment or you are interested in getting HPV vaccination, please contact us for more information.
Take Care!

 


Other Reads:

  1. Low HIV Risk Doesn’t Mean No HIV Risk
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. What are the Causes of Abnormal Penile Discharge?
  4. HIV PrEP for Travel – How You Need to Know
  5. An Overview on STD from an STD Doctor
  6. Why Do I Have Abnrmal Vaginal Discharge
  7. Everything You Need to Know about Herpes Simplex Virus
  8. How Do I Treat Oral Herpes (Cold Sores)
  9. Syphilis Symptoms – Painless Sore & Ulcers
  10. HIV Symptoms – What You Need to Know
  11. 10 Common HIV related Opportunistic Infections

Why Mixing Poppers and Viagra is Dangerous

This article does not imply in any way that we condone the use of poppers or any recreational drugs. It is to highlight the dangers of recreational drug use, especially when combined with prescription medicines like Viagra.

Erectile Dysfunction and Viagra, Cialis and Levitra
Around the world, there is an increasing number of people seeking medical help for erectile dysfunction. This has led to an increase in sales of drugs such as Viagra, Cialis and Levitra which have been improving the lives of many men affected by the condition. However, there is a smaller population that consume drugs like Viagra recreationally, which has raised concerns and is increasing in consumers.
Viagra has always been coming more popular at “bathhouse” and “house parties. The issue usually arises when consumers start mixing it with other party drugs such as ecstasy, GHB, amphetamine and many more. A more common combination used is Viagra taken with amyl nitrites, which is also known as “poppers”. These days, poppers may consist of assorted alkyl nitrites, mostly isopropyl nitrate and isobutyl nitrate.
Viagra alone, based on its mechanism of action, can cause the blood pressure to drop. Usually, this happens minimally in a young and healthy patient. However, when another blood pressure lowering drug is taken with it, this can cause a further drop in blood pressure. Unfortunately, poppers are one of those drugs and can lead to a deadly drop in blood pressure when consumed with Viagra.

Viagra and Poppers

Besides that, the combination of Viagra and poppers or any drug that lowers inhibitions) have been shown to increase the risk of contracting a sexually transmitted disease thru a few reasons:

  • Consumers can sustain more and longer sexual encounters. This is why it is common in “Party and Play” which leads to multiple partners
  • Decreased inhibitions which may potentially lead to risky sexual practices
  • Poppers itself dilates blood vessels in the anal canal and along with decreased pain sensation, which allows a person to participate longer in anal intercourse, will potentially result in more bleeding. This will definitely increase the risk of transmitting HIV and STD.

Poppers and Health Risk

It is recommended to avoid taking recreational drugs like Viagra and poppers. These are tips you can follow to prevent yourself from getting into medical problems :
1.) Avoid taking Viagra and poppers together. (If consumed less than 24 hours apart it can lead to a significant drop in blood pressure)
2.) Never ingest Poppers. If you have already done so, please present to an Emergency Department.
3.) If your nose is stuffed, do not forcefully snort. This can cause ear and sinus problems.
4.) Poppers are highly flammable. Unless you have firemen in your room, keep them away from the fire.
5.) Avoid taking Viagra and poppers if you have a heart condition or any other significant medical conditions.
Like I said earlier poppers can cause disinhibition and impair your judgement so remember CONDOMS, CONDOMS and CONDOMS. Do not forget Lube!

Take Care!

We are against the use of any kind of recreational drugs in any form. They are dangerous and can even be deadly. The punishments for using or possessing recreational drugs in Singapore are extremely harsh and may even include the death penalty. DO NOT USE DRUGS.
We also do not condone the use of prescription drugs without a proper and formal consultation with a doctor.

Also, Read:

  1. Things to do to maintain your penis health
  2. Weak Erection & Erectile Dysfunction? – Improve Erection Without Pills
  3. 10 Ways to Improve Sexual Performance for Men
  4. An Overview of STD by an STD Doctor
  5. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  6. Weak Erection: Does Size Matters?
  7. What are the Causes of Abnormal Penile Discharge?
  8. Sexual Health Advice for Travellers 
  9. What you need to Know about Erectile Dysfunction 
  10. What You Need to Know about Premature Ejaculation Treatment
  11. What you need to know about Testosterone Deficiency Syndrome
  12. What is HIV / AIDS Signs and Symptoms

How to Get Emergency Contraception “Morning After Pills” in Singapore

Failed contraception, unprotected intercourse: these are causes for concern, especially the day after. As a lady, the associated emotional distress and anxiety can be nerve-wracking and even more so if you are in Singapore for the first time. The “morning after” pill or Emergency Contraception is a safe and effective way of preventing unintended pregnancies.
In some countries, the morning after pill can be obtained over the counter at a pharmacy. However, in Singapore, a doctor’s prescription is required.

Top 5 Pressing Questions on How to Get Emergency Contraception (the “Morning After” Pill) in Singapore

We answer your top 5 pressing questions as you search for answers on how to get emergency contraception/ the “morning after” pill in Singapore.

1. How Do I See a Doctor in Singapore?

Most private clinics offer a walk-in system, but not every clinic may carry the morning after pill, or be staffed by a team familiar with women’s health. While obtaining the morning after pill on time is crucial, it is also as important to speak to a doctor who will be able to address and allay your concerns in a judgement-free safe space.
Dr Tan & Partners clinics are conveniently located around Singapore and we attend to a diverse mix of locals, travelling tourists and expatriates on a daily basis.
The process of obtaining the emergency pill is quick and convenient: simply walk into any of our clinics, register, consult our doctor who will advise you appropriately, and you will be able to collect your medication immediately. No additional trip to an external pharmacy is required.
Payment is usually made by cash in Singapore dollars, (other modes of payment like WeChat Pay etc) or credit cards (Visa/Master/AMEX).

Also Watch: Long Term Reversible Contraceptive: IUD Intrauterine Device

2. What Should I Be Worried about When Taking the Morning After Pill?

Common side effects include nausea, mild abdominal cramps, spotting (bleeding when not on your period) and changes in the next menses date (either slightly earlier or later).
The morning after pill can be taken up to 3 to 5 days after sexual intercourse (depending on the type of pill) but the earlier it is taken, the more effective it is. It does not protect against future occurrences of unprotected intercourse and should not be used as a regular form of contraception.
While it is extremely effective, it is not completely foolproof and if you find that your period is significantly delayed, you should do a blood or urine test to check for pregnancy.

Also Watch: What You Need to Know About Family Planning

3. Which are the Available Morning After Pills in Singapore and How Do I Take Them?

Postinor Ella
Timing Effective up to 72 hours from time of intercourse Effective up to 5 days after the time of intercourse
Dosage 2 tablets taken 12 hours apart 1 tablet taken immediately

4. What Should I Do If I am Already on the Combined Oral Contraceptive Pill but Missed my Dose?

You should speak to your doctor if you are taking the combined oral contraceptive pill (e.g. Diane-35, Yasmin, YAZ, Microgynon etc) but have missed a dose or some doses. If there is a need for you to take emergency contraception, you may have to hold off restarting your regular pill for up to 5 days to prevent interactions between the different medications. Your doctor will advise you accordingly.
Alternative barrier contraception (condoms) should be used during this period and for 7 days after restarting your combined pill.

5. What Other Options Do I Have for Long-term Contraception? How Do I Prevent This From Happening Again?

There are many options available, from the mini pill to the combined pill, to an IUD (intra-uterine device) and even a hormonal implant (Implanon)
We provide a listening ear to better understand your individual needs and will help advise you on the most suitable form of regular contraception for you. – IUD Removal & Insertion are available in our women’s clinic 
Lastly, let us take care of your health needs so that you can focus on enjoying yourself as you travel. Stay Safe
Emergency contraception is available in all of our clinics
Take Care!


Other Reads:

  1. What Is the Cause & Treatment For Oral Herpes (Cold Sores)
  2. How Late Can a Period Be (Delayed Menstrual Cycle)
  3. 10 Causes of Abnormal Vaginal Lumps and Bumps
  4. 11 Causes of Dyspareunia (Pain During Intercourse)
  5. What You Need to Know about HPV Vaccination, Cervical Cancer & Pap Smear
  6. Why Do I Have Abnormal Vaginal Discharge
  7. What is HPV Vaccination – Gardasil 9

How Do I Get Tested For An Anonymous HIV Test In Singapore

These 3 letters H, I, and V put together, or commonly known as the Human Immunodeficiency Virus, sets alarm bells ringing in most people’s minds. Often, the anxiety and concern that goes through one’s mind can often be allayed through a simple consult with our doctors to assess your risk and or a test to decide what to do next.
Still concerned? Read on to find out more and take the next step to schedule a consultation and Anonymous HIV Testing in Singapore with our doctors.

How is it Even Possible to Get HIV Tested Anonymously?

Yes it is that simple with our “3 step test” guide
Step 1:

  • Walk into our clinic at Robertson Walk.
  • Let our staff know you are here for the “AHT”.

Step 2:

  • Private consultation with the doctor.
  • The doctor will proceed with the “3 Step Test”.

Step 3:

  • After 20 minutes your results will be ready.
  • Reviewing of your HIV test result with our doctor.

Who Should Get HIV Tested?

If you have a concern for HIV transmission or even a sexual health concern, we advise you to see us get your queries addressed.
Where appropriate, we will support you with the HIV test.

How Is HIV Testing Done? I am Scared of Needles

A small finger prick is done, it will be slightly uncomfortable, and a few drops of blood are collected. No needles are involved.

How Long Do I Have to Wait for the HIV Test Results?

The results take 20 mins to be ready and your doctor will discuss the results with you

How Much Does the Anonymous HIV Test cost?

Rapid Fingerprick HIV (3rdGen Test) – (90 days after exposure)
$54.00
Rapid Fingerprick HIV Combo Test (4thGeneration) – (28 days after exposure)
$162.00
All results take 20 mins. Consultation charge is from $22.00

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

Upholding Patient Confidentiality is our utmost priority. Therefore 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 all of your HIV-related concerns. The doctor will then recommend the correct HIV Test or STD test.
Our registered doctors will administer the HIV and STD tests, which are approved by the Health Sciences Authority (HSA)


Other Reads:

  1. Low HIV Risk Doesn’t Mean No HIV Risk
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. What are the Causes of Abnormal Penile Discharge?
  4. HIV PrEP for Travel – How You Need to Know
  5. An Overview on STD from an STD Doctor
  6. Why Do I Have AbnormalVaginal Discharge
  7. How Late Can a Period Be (Delayed Menstrual Cycle)
  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

 

How Do I Get Rid of My Ear Discomfort and Hear Better?

Have you ever felt the need to clean your ears with earbuds from the discomfort of ear wax accumulating inside your ear canal, or wonder where ear wax even comes from?
How do I get rid of this ear discomfort and hear better?
Look no further as we seek to clarify some of the doubts you face and possibly help you hear better.

What Exactly is Earwax?

It is an accumulation of dead skin from the ear canal, dirt and cerumen produced in the ear. Its purpose is to act as a protective barrier for the ear. Ordinarily, your ear should be capable of ‘self-cleansing’ by clearing the ear wax out of the ear canal.
However, problems arise when symptoms appear. Symptoms such as earache and discomfort, blocked ears, ringing sounds in the ear, difficulty in hearing in a noisier environment, ear discharge or even children not doing well in school because of hearing difficulties
 

What Can I Do About It ?

Sometimes because of many reasons, ‘ self-cleansing’ of the ear wax by the body isn’t effective due to the digging of the ears which pushes the ear wax further in, narrow ear canals or even previous ear surgery which affects the ear canal and ear wax that thicker and stickier.
ear-wax
At home, people have tried using QTIPs to pick at the wax or even cotton buds. While this is successful sometimes, it is difficult to remove the chronic or thicker ear wax through this approach. It can also cause external ear infections when this QTIPs scratch the ear canals to cause an abrasion, and worse still if not careful it can cause a eardrum perforation (hole)!
Fret not, if in doubt, there are solutions such as ear toilet by your doctors. This is the removal of ear wax and relieving of patient’s discomfort. There are different methods of removal. By instrumentation under direct visualization to avoid damage to the surrounding ear canal and eardrum and lastly microsuction of ear wax which might be considered as one of the safer options.

Instrumentation and Microsuction (Ear Toliet)

While microsuction and instrumentation carry some inherent risks, this is a safe earwax removal procedures when used with direct visualization by your doctor.
This enables your doctor to clean the ear canal with greater precision and reduce patient discomfort whilst concurrently inspecting the ear canal and tympanic membrane (eardrum) in detail. As an ancillary benefit, this method allows 2-handed working which further minimizes the risks of human error.

Due to the increased precision and stability, microsuction is often used in situations where ear irrigation is inappropriate or for patients with a deficiency in the eardrum (eg hole in the ear) or having previous ear surgeries.
The alternative to this is ear syringing with water pushed into the ear, however, should not be done for any patients with an active ear infection or discharge, a previous hole in the eardrum, any surgery recently in the ears.

Who will benefit from the procedure?

  • Patients with ear infection will benefit as ear irrigation will not be safe in this group of patients;
  • Patient with build- up of ear wax causing symptoms;
  • Patient with anatomical variations of the ear canal;
  • Patient wearing hearing aids; and
  • Children who able to understand instructions and willing to cooperate.

 

What should be done before the procedure?

  • Instillation of Cerumwax softening agents (like olive oil) should be recommended.
  • Instillation of drops approximately 3 times a day 2-3 drops and to remain on the same side approx. 3– 5 mins after

 

What should be done after the procedure?

It is advised that a formal hearing evaluation is conducted after the wax removal procedure to ensure good hearing has been restored, especially in situations where a patient had suffered a loss of hearing before the procedure.
 

How long does the procedure take?

This clinic procedure usually takes between 15-20 minutes.

What else can this be done for?

  • Apart from wax, this can be used for removing foreign body.
  • Ear infection will also benefit from this form of ear toilet.
  • It enables the insertion of a soft medicated sponge for patients with severe ear infection.

We provide Earwax removal with Painless Microsuction, it is offered currently only in Robertson branch and is subject to the doctor’s availability.

If you are interested in this service and wish to find out more, please call the clinic (+65 6238 7810) to make an appointment. Unfortunately for this service we are unable to accept walk-ins.

Speak to one of our friendly doctors today if you would like to address your blocked ear discomfort symptoms! – ear wax removal singapore
Take Care!


Other Read:

  1. How to Remove Your Earwax
  2. Cleaning your Earwax
  3. the 11 Causes Dyspareunia (Pain During Sexual Intercourse)
  4. New HPV Vaccine (Gardasil 9) – What You Need to Know
  5. The Top 7 Reason Men Undergo Circumcision
  6. The Causes of Swimmer’s Ear (Outer Ear Infection)
  7. 7 Myths & Facts about Erectile Dysfunction
  8. Nose Cancer & Nose Cancer Screening – What You Need to Know
  9. 7 Testosterone Boosting Foods that You Can Find in Supermarket 
  10. Genital Warts the Cauliflowe Like Lumps

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.