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Human Immunodeficiency Virus Screening Singapore

genital and Anal

What is HIV?

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.

Who should get tested?

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.

What are the symptoms of HIV?

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.

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How can we test for HIV?

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:

PCR RNA blood testing

Accurate from 10 days or more after exposure but this is expensive and takes up to 2 weeks for results to return.

Rapid finger prick blood testing

This is accurate 28 days or more after exposure and is ready within 15 to 20 minutes.

Normal laboratory blood testing

This is of similar accuracy to the rapid hiv 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.

What are the treatment options?

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.

What happens if it is left untreated?

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.

How can we prevent it?

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.

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Frequently Asked Questions

FAQs

When should I go for STD screening?

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.

Can I get STDs from oral sex?

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.

Can STDs be cured?

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.

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