HIV in Singapore: Importance of Early Identification & Testing

According to MOH Singapore, there were reportedly 250 new cases of human immunodeficiency virus (HIV) infections in 2021. As of the end of that year, there were 9,129 individuals living in Singapore who were HIV-positive, with 2,255 of them having passed away. Between 2007 and 2017, the annual number of new HIV diagnoses among Singaporeans fluctuated between 400 and 500. In 2018 and 2019, this figure dropped to approximately 320, and further decreased to 261 in 2020.

Identifying HIV during the acute phase (prior to seroconversion) is critical, as this phase is short, characterized by a high viral load, and appears to play a disproportionate role in transmission.

Comparison Between 3rd and 4th Generation HIV Testing

Although the standard procedure for HIV testing involves using a highly sensitive and accurate third-generation HIV-1/HIV-2 antibody immunoassay followed by additional testing to confirm reactive results, it has certain limitations. For instance, this method cannot detect acute infections and may struggle to distinguish between HIV-1 and HIV-2.

Furthermore, negative or undetermined Western blot results during early seroconversion can cause a delay in diagnosis. To address these challenges, the Clinical Laboratory Standards Institute (CLSI) and the Centers for Disease Control and Prevention (CDC) have developed an alternative testing method.

The alternative approach commences with a 4th generation rapid HIV test, which aims to detect both HIV antibodies and the HIV p24 antigen. This type of test has the potential to detect HIV during the acute phase of infection since the p24 antigen can be detected prior to seroconversion. Following seroconversion, when the p24 antigen is no longer detectable, the addition of HIV-1/HIV-2 antibodies enables detection.

The 4th generation HIV test can detect HIV earlier than previous testing methods because it can identify p24 antigens in the blood, indicating the presence of certain viral proteins associated with HIV. This provides conclusive evidence of HIV presence in the blood, with detection possible as early as two to three weeks following exposure using 4th generation testing.

At Anteh Dispensary, third and fourth-generation test kits are available for HIV testing, with the former having a testing window of 4-12 weeks and the latter having a shorter window of 2-4 weeks.

When and How to Get Tested?

Blood testing is the most widely used method for detecting HIV, the virus responsible for AIDS. The test looks for antibodies to the virus that are present in the bloodstream of infected individuals. It is crucial for those who have been exposed to the virus to undergo testing as soon as possible. However, it is important to note that follow-up testing may be necessary as it can take between six weeks and six months for antiviral antibodies to develop.

If you have engaged in unprotected intercourse, shared injecting equipment, or suspect that you may have been exposed to HIV, it is advisable to undergo the 4th generation HIV test in Singapore promptly. However, if you have any concerns or doubts, it is best to seek advice from a healthcare professional before proceeding with testing.

If you are pregnant, it is crucial to undergo an HIV test to determine your status and prevent transmission of the infection to your unborn child. It is recommended that all pregnant women undergo HIV testing as part of routine antenatal care.

The type of HIV testing service recommended may vary depending on the duration of exposure. HIV antibodies can take up to 12 weeks to appear in the bloodstream, making it challenging to detect early infection. In some cases, it may take four weeks or longer for an infection to show up in the test results.

Despite this, we highly recommend visiting the PEP HIV Singapore clinic and getting tested for HIV as soon as possible, even if it may not be visible in your bloodstream. We suggest getting tested again two to four weeks later to confirm the results and detect any changes in your bloodstream that may arise.

If you suspect that you may have contracted the infection more than three months ago, please inform us so we can adjust the testing accordingly. If you have not exhibited any symptoms after four weeks, there is a good chance that you may be free from the infection. However, we always recommend visiting our clinic for a quick HIV test to ensure accurate results.

How often should I have 4th Generation HIV tests?

If you frequently engage in unprotected intercourse, it is advisable to undergo annual testing for HIV and other sexually transmitted infections (STIs), even if you do not believe that you are infected. If you engage in unprotected intercourse with multiple partners, it is recommended that you get tested more frequently.

For individuals who engage in transactional intercourse or men who have intercourse with men (MSM) and engage in unprotected intercourse with new or casual partners, it is crucial to undergo testing every three months for HIV.

At Anteh Dispensary, 4th generation testing is utilized for HIV screening, which is highly accurate and can detect most infections after 45 days of exposure. However, to ensure a reliable result, we recommend retaking the HIV test 90 days after exposure.

If you suspect that you may have been exposed to HIV, you should seek care right away, without waiting for a diagnosis. Post-exposure prophylaxis (PEP) medication, when taken within 72 hours of exposure to the virus, can help to prevent the development of the infection.

To get an anonymous HIV test at our clinic, simply walk in and inform our staff that you need one. No identification is required, and you will be assigned a number to protect your anonymity. We do not accept phone reservations, as we are a walk-in clinic.

Additionally, we provide pep and prep drugs if needed, and we are a government-designated anonymous HIV screening center with a history dating back to the 1980s.

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