Opening Hours: 8.30am to 2.30pm (daily)
6.30 pm – 10.30 pm(on Mon, Wed, Fri & Sun)
Telephone Number:+65 9662 5512

[ HIV Tests ]

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 )

  • HIV Combo lab test

 

  • SD Bioline p24 Ag/Ab Combo ( rapid ) test

 

From $120 ( incl GST )

 

usually 1-3 working  days

 

about 20 min

28 days

HIV P24 Antigen / Antibody test ( as above )

HIV  antibody  tests

  • ELISA-type antibody test
  • Oraquick ( saliva ) rapid test
  • DetermineTM ( fingerprick ) rapid test / SD Bioline HIV 1/2 rapid test
From $120

 

From $30  ( 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.

 

 

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 :

  • Patients or subjects of research often engage in multiple different sex acts in each sexual encounter.
  • Patients or subjects of research may engage in multiple encounters ( either reported or unreported, involving different sex acts each time ) within a short period of time, in between getting their HIV tests done.
  • There is inherent difficulty in doing research and getting precise statistics in a discipline which is very private and often still carries significant stigma. Much of the information on number of partners and types of sex acts depend on subjects’ self-reporting.

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

xx

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:

  • Negative ( good news! But consider repeating antibody test in 3 months if there has been risk of exposure )
  • Indeterminate ( Consider repeating antibody test or P24 Combo test in 1 month if there has been risk of exposure )
  • Positive ( Our doctor will discuss the subsequent options for treatment and follow up with you )

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

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

References

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:

Risk of HIV Transmission From Different Types of Unprotected Sex
Number of Individual Studies Range of Estimates Meta-Analysis Estimate
Receptive anal

4

0.4%-3.38%

1.4%

Insertive anal

2

0.06%-0.62%

Receptive vaginal

10

0.018%-0.150%

0.08%

Insertive vaginal

3

0.03%-0.09%

0.04%

3)  From this UK-based patient information website, NAM ( National AIDS Manual ):

Estimated HIV transmission risk per exposure for specific activities and events

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

References

  1. Boily MC et al. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis 9(2): 118-129, 2009
  2. Vittinghoff E et al. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. American Journal of Epidemiology 150: 306-311, 1999
  3. Del Romero J et al. Evaluating the risk of HIV transmission through unprotected orogenital sex.AIDS 16(9): 1296-1297, 2002
  4. Townsend C et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000-2006. AIDS 22: 973-981, 2008
  5. Baggaley RF et al. Risk of HIV-1 transmission for parenteral exposure and blood transfusion. AIDS 20: 805-812, 2006

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Same day appointments usually available.
Please call the clinic at (+65) 6251 5512 or SMS (+65) 9662 5512

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