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HIV is a virus that can pass on primarily through sex and sharing of unsanitised drug needles. The former is the primary mode of transmission particularly unprotected vaginal or anal sex. Thankfully oral sex is considered negligible risk for HIV.
HIV itself infects the cells of the immune system thus making you more prone to other infections and conditions that a healthy immune system would fend off. As the immune system weakens even minor infections can prove fatal. Medication can be used to control HIV but this will be lifelong treatment.
Anyone with a risk (unprotected sex with a casual partner) should get tested. If a risky exposure occurred within 72 hours then there is medication that can be used to prevent HIV from developing in your body but this will be discussed a little later.
Even those without symptoms should get tested because symptoms of HIV are unreliable.
This is an important point because HIV often has no symptoms in the early stage. Some may experience severe symptoms such as high fever, marked body aches, chills, runny nose, sore throat and fatigue approximately 3 weeks after infection but there is considerable overlap with other conditions such as the flu and Covid 19. Therefore symptoms at the early stage are unreliable and should not be used to exclude or diagnose HIV. Testing is the only accurate way to do this.
Later on in an untreated infection other broad symptoms may appear as your immune system is weakened. For example you may experience diarrhoea, weight loss, persistent fever, cough, unexplained rashes, swollen lymph nodes and even some forms of cancer (in late stages of HIV). However, because these symptoms appear late they should not be the primary course of diagnosis.
Testing is performed primarily through blood tests. The two most common ways this is done is via rapid or laboratory tests. The majority of modern tests will be accurate from 28 days after an exposure but below is a list of tests with their window period:
Accurate from 10 days or more after exposure but this is expensive and takes up to 2 weeks for results to return.
This is accurate 28 days or more after exposure and is ready within 15 to 20 minutes.
This is of similar accuracy to the rapid test and takes 2 to 3 days for results to return.
Even if any of the above tests are negative we recommend a follow up test at 3 months from the exposure to be safe.
Once you have been infected with HIV and it has been in your body for more than 72 hours then there is no cure. Within 72 hours there is a medication known as Post exposure prophylaxis (PEP) that can be used but this is discussed later.
However, even if you have been confirmed with HIV then the virus can be suppressed with long term medication. Most modern options are effective and well tolerated so those living with HIV can essentially lead normal lives but it does require daily medication for life.
If left untreated, HIV will continue to multiply in your body and significantly weaken your immune system. If this process is allowed to progress then there is a point when the immune system is no longer able to recover even if treatment is started. This is known as Acquired Immunodeficiency Syndrome (AIDS) and means that your immune system is so weak that even minor infections from other sources can be catastrophic. It is important to note that you cannot have AIDS without having HIV first.
Primary prevention of HIV starts with being safe. Practicing safe sex (condoms) goes a long way to protect you against HIV.
However, if the exposure was unprotected or the condom failed then PEP is an option within the first 72 hours of an exposure. This medication is anti-HIV and it aims to stop and eliminate HIV within the blood thus resulting in a cure. It is very effective when started early and newer iterations of this medication is very well tolerated. The course is 28 days long to ensure good cover.
The reason it is only effective in the first 72 hours is because at this stage of a new infection HIV remains within the blood and can be targeted effectively. After 72 hours HIV starts to enter other tissues of the body and can lie in a dormant state. Once it has left the blood the medication is no longer effective as a cure which is why there is still no cure for HIV at present.
Feel free to come and speak to our friendly and approachable doctors about any issues you may be having. Remember we still cover all the GP stuff as well.
Trichomonas is a fairly common parasite passed on through sex and affects women more often.
In a majority of people with Trichomonas, symptoms can be absent making it difficult to identify without testing. However, if symptoms are present then the below list shows the common presentation:
HPV is a virus that can infect many areas of the body. There are over 100 strains and the majority are low risk and reside on the skin and can cause conditions such as warts. While this isn’t pleasant it can be easily treated. Approximately 40 HPV strains can be passed on through sex but 12 to 14 of these are considered high risk for certain types of cancer.
Low risk strains of HPV may produce warts. Those that are passed on sexually may produce genital warts which are fleshy growths from the skin around the genital and anal region. High risk strains often have no symptoms until it is too late. If we take cervical cancer as an example, many women who are developing this cancer due to HPV have no symptoms at all.
Gonorrhoea is a bacterial infection that is commonly passed on through unprotected sex (vaginal, anal and oral).
Chlamydia is another bacterial infection exclusively passed on during sex (oral, vaginal and anal). As with gonorrhoea the risk is much higher in unprotected sex but if protection is not used correctly then the risk is increased as well.
Herpes/Herpes Simplex Virus (HSV) is a virus that affects the skin. There are two major types known as type 1 and type 2. Typically HSV type 1 affects the mouth area and is associated with cold sores (passed on through kissing). HSV type 2 typically affects the genital area and is associated with sexual transmission.
HSV presents as painful/burning blisters that are often clustered together on the skin. For some the initial symptom will be a tingling sensation in the affected area before visual symptoms appear. Symptoms are very similar to shingles which is a condition caused by another member of the Herpes family.
Syphilis is a bacterial infection primarily passed on through sex. However, if an infected person has symptoms and that comes into contact with damaged or broken skin then it is possible to pass on even in the absence of sex.
The first stage of Syphilis presents with sore(s) at the location the infection entered the body, typically around the genital region but it can present on the anus or mouth as well. The sores tend to be round and are painless which can lead to a delay in identifying them.
The second stage usually presents with a widespread rash that can be anywhere on the body but the typical areas tend to be the hands/feet and torso region. The rashes are not itchy and they can appear quite flat, sometimes making them easy to miss.
Both are bacteria that can potentially be present on the skin, particularly around the genital region. They can be passed on through skin contact of contaminated areas as well as through sex.
You should consider screening if you have symptoms of a possible STD, if you have had a recent risky exposure (unprotected sex with a casual partner), or both.
Yes, you can. The common misconception is that oral sex is not considered ‘real’ sex and therfore has no risk but the opposite is true. Often oral sex is performed without protection and this is why infections such as chlamydia and gonorrhoea can pass on through oral sex.
Thankfully the majority can be cured but there are some such as Herpes and HIV that can be treated but not cured. This is why prevention is better than cure and ensuring safe sex goes a long way to reduce your risks.
At STD Screening Singapore we aim to provide caring, compassionate, and non-judgemental expertise on all sexual health and sexually transmitted disease/infection (STD/STI) related issues.
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