December 2020
25th December (Friday) to 1st January 2021 (Friday) : Clinic closed for Christmas and Year End break.
Normal hours will resume on 2nd January 2021 (Saturday).
NOTE: Patients who require HIV post-exposure prophylaxis or other urgent consultations – please SMS or call 9662 5512.
Thank you for your kind understanding.
General Services
Health Screening / Check ups
STD & HIV
Travel Health & Preventive Med
Please note that clinic operating hours may change occasionally. For the latest updates, please click http://prudencefamclinic.com/changes-in-operating-hours/
Psychological Health
Additional Services
A full range of HIV tests are available. Depending on time from exposure, you may wish to consider the following :
Time from exposure |
Available Tests |
Remarks |
0 – 10 days |
Consider HIV PEP if exposure is high risk;Otherwise, consider testing based on timelines below. |
|
10 – 21 days |
HIV PCR | Usually 7-10 working days |
21 – 28 days |
HIV P24 Antigen / Antibody test ( also known as HIV Combo test / HIV Duo test )
|
$120-180 ( incl GST )
usually 1-3 working days
about 20 min |
28 days |
HIV P24 Antigen / Antibody test ( as above )
HIV antibody tests
|
From $120
From $36 ( incl GST )
about 20 min |
3 months and beyond |
HIV antibody tests ( as above ) |
Most circumstances which may expose you to HIV may also expose you to other STIs. You may wish to consider testing for other STIs.
Do note that there may be changes to our clinic schedule from time to time. Please click http://prudencefamclinic.com/changes-in-operating-hours/ for the latest updates.
What is the risk of HIV?
This question may be one of the most common ones from patients coming for HIV counselling and testing. And yet this is probably one of the most difficult questions to answer. Do a search on the internet and you may find numerous websites, from official US CDC ( Centers for Disease Control & Prevention ) sites to Q&A websites, which give a range of figures pertaining to the risk of HIV transmission via various forms of sexual acts. Unfortunately, these figures may not always be the same. The reason for this includes :
To simplify the issue, we have categorised the various sexual and non-sexual exposures based on their approximate risk level. Bear in mind that there can be several factors which increase or decrease the risk, even within each category. Where figures are available and likely to be reliable, we have quoted the lowest and highest estimated risk from various sources but we believe that the risk category is likely to be more relevant for patients trying to understand their chances of infection.
Risk Category | Type of Exposure ( assuming partner is HIV positive ) | Remarks |
Very high risk | Blood transfusion of infected blood | >90% |
Needle sharing amongst IV drug users | 0.67% | |
Receptive anal sex | 0.4% – 3.38% | |
Moderate to high risk | Receptive vaginal sex | 0.08% to 0.19% |
Insertive anal sex | 0.06% – 0.62% | |
Insertive vaginal sex | 0.03% – 0.1% | |
Low risk | Receptive oral sex | Extremely rare |
Negligible / Theoretical risk( theoretically possible but extremely unlikely and no well-documented cases ) | Insertive oral sex‘Rimming’ / Peri-anal licking
Sharing sex toys Biting Spitting Throwing body fluids eg. semen/saliva |
No documented cases; carries risk of other STIs if unprotected Carries risk of other STIs Carries risk of other STIs Risk of wound infection |
Factors which increase the risk | Presence of a concomitant STIPresence of sores or wounds or ulcers
High viral load in partner With ejaculation ( for receptive partner ) |
|
Factors which reduce the risk | Anti-retroviral ( ARV ) treatment in affected partner | 96% reduction(1) |
Consistent and correct condom use | 80% reduction(2) | |
Male circumcision | 50-60% reduction ( in female-to-male transmission) |
1 Cohen MS, Chen YQ, McCauley M, et al; HPTN 052 Study Team. Prevention of HIV-1 Infection with early antiretroviral therapy. N Engl J Med 2011;365(6):493-505.
2 Weller SC, Davis-Beaty K. Condom effectiveness in reducing heterosexual HIV transmission (Review). The Cochrane Collaboration. Wiley and Sons, 2011.
Below: Oraquick HIV rapid test – positive test
What do i do if the test turns out positve?
If the initial screening test is positive, a second blood sample will need to be sent for a confirmatory test called the Western Blot. This test typically takes about 2 weeks to be ready. No fasting or other special preparation is required.
The Western Blot may show:
HIV is certainly a serious infection, but options now exist for patients to have the infection suppressed and controlled. This can help reduce or delay the late complications of HIV infection and help protect your sexual contacts from HIV. Therefore it is crucial to take the first step and be tested.
Some additional information is provided below, together with links to the original site / source.
1) From the US CDC ( Centers for Disease Control and Prevention ) website
Estimated Per-Act Probability of Acquiring HIV from an Infected Source, by Exposure Acta
Type of Exposure | Risk per 10,000 Exposures |
---|---|
Parenteral | |
Blood Transfusion | 9,000b |
Needle-sharing during injection drug use | 67c |
Percutaneous (needle-stick) | 30d |
Sexual | |
Receptive anal intercourse | 50e, f |
Receptive penile-vaginal intercourse | 10e, f, g |
Insertive anal intercourse | 6.5e, f |
Insertive penile-vaginal intercourse | 5e, f |
Receptive oral intercourse | lowe, i |
Insertive oral intercourse | lowe, i |
Otherh | |
Biting | negligiblej |
Spitting | negligible |
Throwing body fluids (including semen or saliva) | negligible |
Sharing sex toys | negligible |
a Factors that increase the risk of HIV transmission include sexually transmitted infections, early and late-stage HIV infection, and a high level of HIV in the blood. Factors that reduce the risk of HIV transmission include condom use, male circumcision, and use of antiretrovirals.
b Donegan E, Stuart M, Niland JC, et al. Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of antibody-positive blood donations. Ann Intern Med 1990;113(10):733-739.
c Kaplan EH, Heimer R. A model-based estimate of HIV infectivity via needle sharing. J Acquir Immune Defic Syndr 1992;5(11):1116-1118.
d Bell DM. Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview. Am J Med 1997;102(5B):9-15.
e Varghese B, Maher JE, Peterman TA, Branson BM, Steketee RW. Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sex Transm Dis 2002;29(1):38-43.
f European Study Group on Heterosexual Transmission of HIV. Comparison of female to male and male to female transmission of HIV in 563 stable couples. BMJ 1992;304(6830):809-813.
g Leynaert B, Downs AM, de Vincenzi I; European Study Group on Heterosexual Transmission of HIV. Heterosexual transmission of HIV: variability of infectivity throughout the course of infection. Am J Epidemiol 1998;148(1):88-96.
h HIV transmission through these exposure routes is technically possible but extremely unlikely and not well documented.
i HIV transmission through oral sex has been documented, but rare. Accurate estimates of risk are not available.
j Pretty LA, Anderson GS, Sweet DJ. Human bites and the risk of human immunodeficiency virus transmission. Am J Forensic Med Pathol 1999;20(3):232-239.
2) From the Canadian AIDS Treatment Information Exchange:
3) From this UK-based patient information website, NAM ( National AIDS Manual ):
Activity | Risk-per-exposure |
---|---|
Vaginal sex, female-to-male, studies in high-income countries | 0.04% (1:2380) |
Vaginal sex, male-to-female, studies in high-income countries | 0.08% (1:1234) |
Vaginal sex, female-to-male, studies in low-income countries | 0.38% (1:263) |
Vaginal sex, male-to-female, studies in low-income countries | 0.30% (1:333) |
Vaginal sex, source partner is asymptomatic | 0.07% (1:1428) |
Vaginal sex, source partner has late-stage disease | 0.55% (1:180) |
Receptive anal sex amongst gay men, partner unknown status | 0.27% (1:370) |
Receptive anal sex amongst gay men, partner HIV positive | 0.82% (1:123) |
Receptive anal sex with condom, gay men, partner unknown status | 0.18% (1:555) |
Insertive anal sex, gay men, partner unknown status | 0.06% (1:1666) |
Insertive anal sex with condom, gay men, partner unknown status | 0.04% (1:2500) |
Receptive fellatio | Estimates range from 0.00% to 0.04% (1:2500) |
Mother-to-child, mother takes at least two weeks antiretroviral therapy | 0.8% (1:125) |
Mother-to-child, mother takes combination therapy, viral load below 50 | 0.1% (1:1000) |
Injecting drug use | Estimates range from 0.63% (1:158) to 2.4% (1:41) |
Needlestick injury, no other risk factors | 0.13% (1:769) |
Blood transfusion with contaminated blood | 92.5% (9:10) |
Sources: vaginal sex;1 anal sex;2 fellatio;3 2 mother-to-child;4 other activities.5
Keywords: HIV, HIV Test, HIV Test Singapore, HIV Testing Singapore, HIV Screening, HIV Singapore, HIV Clinic, HIV Clinic Singapore, Singapore HIV Test, Singapore HIV Testing, SG
Essential $98
Essential Plus $138
Standard $228
Comprehensive Male $328
Comprehensive Female $ 338
All package prices include 1 review of test results.
Add-on tests
A large number of other tests are available for add on, including ECG, Chest X rays and other radiological investigations, PAP smears, HPV tests, HIV and STD tests, and a large number of other blood or urine tests. Some genetic tests may also be available.
Our health screening packages can be tailored to your needs and concerns. Feel free to discuss your screening or testing needs with our doctor during your appointment and we will try out best to assist. Call us at 6251 5512.
The commonest symptom in a person with HIV infection is – none. Most early symptoms only last for brief periods during the infection and may subside without specific treatments. The only way to be sure if you have HIV is to get a HIV test done. ( Depending on circumstances, you may also need STD tests. ) Do give us a call at 9662 5512 to find out more about HIV and STD tests.
Early symptoms
You may have read or heard about something called ‘acute retroviral syndrome’ ( ARS ) or‘seroconversion illness’ ( SCI ). These refers to a group of symptoms which a person may experience within a few weeks after HIV infection. Acute retroviral syndrome is the result of an inflammatory reaction in our immune system caused by movement of the virus into our bloodstream and beginning to reproduce in large numbers. This occurs in up to 40-90% of infected persons.
Common symptoms in ARS / SCI may include:
These symptoms may also be found in other viral infections. Thereafter, there may not be any symptoms for even many years.
Late symptoms of HIV generally appear after the immune system has been greatly affected and weakened. They usually indicate advanced infection and are therefore more serious. Late symptoms may again include :
In addition, patients may experience:
Without treatment, HIV infected patients usually develop full blown AIDS ( acquired immunodeficiency syndrome ) in time. At this stage, patients are prone to developing lymphomas ( lymph node cancers ), cervical cancer and Kaposi sarcoma ( a form of skin cancer ). They are also prone to infections like tuberculosis and cytomegalovirus ( a type of herpes virus ). With AIDS, the survival time if no treatment is given has been estimated to be 2-3 years on average.
STD stands for sexually transmitted disease. STI stands for sexually transmissible infection.
Conceptually, there may be slight differences between the 2 terms but in most instances, the 2 terms can be used interchangeably. Both refer to infections which a patient catches from another through various forms of sexual contact, including oral, vaginal or anal sex. Sharing of sex toys does not carry a significant risk for HIV, but may constitute a risk for other STDs.
In Singapore, the more commonly encountered STIs include:
Bacteria
Viruses
Parasites / Protozoa
Other conditions sometimes associated with sex or intimate contact ( but are not necessarily considered STDs ):
Some infections, such as HIV, Hepatitis B, Hepatitis C and syphilis, may also be transmitted through non-sexual routes. These may include mother-to-child ( vertical ) transmission, occupational exposures from contact with blood ( eg. laboratory personnel, police or prison officers, healthcare workers ), infections in recipients of blood transfusions or organ transplants and infections amongst intravenous drug users who share needles.
So, how would I know if I have an STD or STI?
Symptoms of STDs, such as painful urination or discharge from the urethra or vagina, may alert you to the presence of infection. However, many patients with STDs do not have any symptoms. These carriers are still capable of passing the infection on to their partners.
Getting a screening test done will be a more reliable way to tell if you have been infected after sexual exposure. The list of available tests can be found here.
Of course, preventing yourself from getting an STD or STI is still the best plan. Here’s what we suggest.
What happens if I have an STD?
Majority of STDs can be treated. It is important to get treated early to reduce the chances of spreading the infection and to minimise the risk of complications and long term problems. A write up on available treatments can be found here.
Common symptoms which are caused by STDs may include:
For men
– discharge from the penis / urethra / anus
– pain when passing urine
– blisters or sores on the penis / pubic region / anus
– rash on the penis / pubic region
– itch or pain in the urethra
– aching, pain or swelling in the testicles
– blood in the semen / ejaculate
– growths or lumps around the penis / anus
– swellings at the groin
For women
– discharge from the vagina / urethra / anus.
– pain when passing urine
– blisters or sores on the vagina / pubic region / anus
– rash on the vagina / pubic region
– itch or pain in the urethra or vagina
– pain during sex
– bleeding during sex
– growths or lumps around the genitalia / anus
– swellings at the groin
Occasionally, symptoms which are non-specific, such as fever, tiredness, bodyaches, rash over the body, including the palms and soles or neck swellings, may be present. These symptoms may happen 1 or several weeks after the sexual encounter.
However, we believe the most important message on this issue is that most STDs can be totally asymptomatic or symptom-less for a long period of time.
STDs can be passed on to sexual partners even when they are not causing any symptoms. The consequences of sexually transmissible infections can include cancer, problems with fertility, prostate irritation and inflammation ( in men ), pelvic inflammatory disease ( in women ) and damage to other organs such as the liver, kidney, heart, spinal cord and brain.
This is why preventive strategies and going through screening tests ( with timely treatment of any infection detected ) are crucial in protecting your loved ones from infection.
In addition to infection, urethral discharge can also be physiological ( normal response of our body to stimulation or hormonal changes ) or even the result of foreign bodies such as retained condoms.
If you experience persistent or increased vaginal discharge, or if you suspect that you may have an infection , call us now at 9662 5512 for appointment.
If you suspect or believe you have urethral discharge, do make an appointment with us now at 9662 5512.
Consultations are private
and discrete.
Same day appointments
usually available.
Please call the clinic at
(+65) 6251 5512 or SMS (+65) 9662 5512
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