A significant amount of research has gone into HIV testing to make sure that at every stage of exposure, the virus can be detected. As such different tests are used at different time junctures. HIV testing is an integral part of being responsible when it comes to HIV. Knowing your status is crucial to the fight against the spread of the disease and getting treatment if you are infected is extremely important. HIV testing continues to be accessible and we are committed to offering both discrete and Ministry of Health approved tests in Singapore.
The tests available includes options like:
As you may already be aware, HIV (Human Immunodeficiency Virus) causes AIDS (Acquired Immune Deficiency Syndrome). The only way to tell if a person is HIV positive or not is to have them undergo HIV Screening.
HIV is communicable and can be passed on from one person to another. High-risk sexual activity with an HIV-infected person remains the most common way to contract HIV.
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The PCR RNA test is extremely effective at detecting HIV viral copies of HIV infection at the very early stage before antibodies are produced in the body.
It is the earliest detection method of an HIV infection. It delivers accurate results from 10-12 days after exposure. This test is also effectively used to measure HIV Viral load counts for patients living with HIV. It is also used in patients who are receiving Highly Active Antiretroviral Therapy (HAART) treatment.
This 4th Generation HIVp24 Antigen/Antibody Combo Test is quite versatile. It detects both HIV antibodies and HIV antigens (p24).
The HIV viral core is mostly composed of the HIV p24 antigen. This protein becomes detectable between 12-20 days after a person has been exposed. The antigen usually peaks around 3-4 weeks. It subsequently drops to lower levels after approximately 5-6 weeks once the HIV antibodies start developing. It is important to note that there are people who will not manifest detectable levels until later i.e., up to 28 days post-exposure. However, the p24 antigen may be detected by the 1 4-day exposure mark.
Hence why for accuracy reasons, we recommend this particular HIV screening test after the 28-day window. You should also be aware that once HIV antibodies start being produced in the body, the p24 antigen levels will decrease and become undetectable once again. This process is called seroconversion. A small number of persons will experience a delayed seroconversion where p24 antigen levels do not decrease because the associated antibodies are not being produced. However, there is no need to worry, the 4th Generation Combo test will screen for both the HIV antibodies and the p24 antigen. It is effective in detecting an HIV infection from the 28-day post-exposure period and beyond.
This 3rd Generation HIV Antibody-only Test only works by detecting HIV antibodies in blood.
HIV antibodies can be detected between 14-20 days after being exposed to HIV. However, there is no hard and fast rule, this process may take longer to occur in some individuals.
According to available statistics, by 90 days post-exposure over 99.9% of people who are infected with the virus will have antibodies that can be detected by the test.
For the few people who do not produce detectable antibodies i.e., delayed seroconversion, a 4th Generation HIV p 24/Antibody Combination test can be administered, and the virus will be detected.
There are times when an accurate HIV diagnosis proves to be elusive. This happens when the more well-known HIV tests like the HIV RNA PCR test, HIV Antibody and Antigen test and HIV Antibody test fail to deliver conclusive results.
Advantages of the Pro-Viral DNA HIV Screening test
- This test has a lower false-positive rate than the HIV RNA PCR test.
- You can use the Pro-Viral DNA HIV Screening test 10 days after you have been exposed to HIV.
This test is particularly effective for diagnosing HIV in the following circumstances:
- Diagnosing HIV in newborn babies who were born to HIV-positive moms
- Testing a person who has seronegative HIV infections. This simply means that the infected person is not productive anti-HIV antibodies which is the indicator that other HIV tests use.
- Diagnosing patients with HIV who maintains an undetectable viral load without the help of medication.
This is a blood test that is being sent to the laboratory for analysis and this particular test specifically tests for the HIV antigen and/or HIV antibodies.
The HIV viral load is made up of the antigen that is being tested for the most part.
This screening test is most accurate after 28 days of exposure. Although the test can identify the antigen in some patients between 12-20 days after they have been exposed to the HIV virus. However, some patients may fail to have a detectable level until later on. Hence the reason why 28 days is a safer time to take the test.
HIV antibody production usually signals a drop in antigen levels. This process is called seroconversion. Data has revealed that a small number of patients can experience delayed seroconversion. This occurs when the patient does not produce antibodies and as a result, the antigen levels do not decrease.
However, there is no need to worry about efficacy, the test detects both the antigen and HIV antibodies.
HIV Pre-Exposure Prophylaxis (PrEP) is a preventative treatment. Anti-HIV medications are employed to reduce the risk of infection significantly.
We recommend this treatment for anyone who participates in high-risk sexual activity.
PrEP is usually taken on a daily basis. It is usually administered in a single pill which is comprised of 2 anti-HIV medications. It used as directed, it can reduce the risk of contracting HIV via sexual contact by more than 90%.
PrEP can be taken in a variety of ways. These include the Holiday PrEP, Event-Based Dosing or EBD.
We strongly suggest that you practice safe sex even while you are using HIV Pre-Exposure Prophylaxis (PrEP). You should still get your regular HIV tests.
Also, remember that HIV PrEP does not offer any kind of protection from other types of STDs.
HIV Post-Exposure Prophylaxis (PEP) is an anti-HIV course of medication. It can be started as early as within 72 hours of possible exposure. It is quite effective at preventing or reducing HIV infection risk.
It works by preventing the virus from taking hold in your body effectively staving off a full-blown infection. Unfortunately, there is no HIV testing or screening available that is sensitive enough to detect HIV from 1-10 days post-exposure. This is commonly referred to as the eclipse period.
As such, there is no way of knowing if you have contracted HIV during this period until it is too late to do anything about it. Hence why PEP is so important in the fight against HIV.
We recommend the use the first-line, CDC, and WHO-recommended medication regime for PEP. If it is started with the 72-hour exposure window, the risk of HIV transmission can be reduced by more than 90%.
Firstly, not all HIV-positive persons develop symptoms. However, the most prevalent HIV symptoms that patients experience are throat ulcers (more than one), fever, rashes that present similarly to measles, and several swollen lymph nodes at the neck.
These symptoms usually appear 3 to 6 weeks have the person becomes infected with HIV.
Acute Retroviral Syndrome is the name given for an acute HIV infection. It is often referred to as primary HIV infection. This is the first stage of HIV, and it persists until the body starts to create antibodies against the virus. Throughout this stage, the virus is replicating at a rapid pace.
Acute Retroviral Syndrome usually presents with the symptoms mentioned above namely rash, throat ulcers, and swollen lymph nodes at the neck. These symptoms will eventually dissipate whether they are treated or not.
After this initial period of illness, a patient may remain free of symptoms and feel perfectly fine for several years before the onset of full-blown AIDS. Bear in mind that only about 50% of the people infected with HIV will develop ARS.
Since a person can feel healthy and exhibit no symptoms for many years before they become seriously ill from AIDs, it is highly recommended that you go through HIV screening as soon as possible to discover your HIV Status.
The behaviors that can put you at the most risk for contracting HIV are:
- Risky sexual activity
- Needle sharing
High-risk sexual activity with an HIV-positive partner is the most common way to contract HIV. The risky activity that we are referring to includes, but is not limited to, anal or vaginal sex without barrier protection (condom).
The risk of contracting HIV dramatically increases if a sexual partner has a genital ulcer or there is blood during sexual intercourse.
Another common mode of HIV transmission is sharing needles with a person who is HIV positive. This is common in drug use settings. You should get a rapid HIV test, or a regular test done as soon as possible if you believe that you have been stuck with a contaminated needle.
You can only contract HIV if you have participated in risky sexual behavior or shared needles with an HIV-positive person.
One of the criteria that your doctor will use to decide which HIV test is suitable for you is the timeframe of your sexual exposure. This is due to the fact that all HIV tests have a testing window period that must be adhered to. The window period is the time of infection to when the test is deemed accurate.
Please note that there are no tests available that deliver accurate results within the first 10 days from infection.
After 10 days, it is recommended that you use an HIV RNA PCR test for HIV screening.
After 28 days, a 4th Generation HIV Antibody and Antigen test is recommended for HIV screening.
After 90 days, a 3rd Generation HIV Antibody test is the best choice for HIV screening.
We have put together a helpful guide to help you understand what is available at each stage of exposure.
Before HIV Exposure
You can take precautionary steps before HIV exposure. HIV Pre-Exposure Prophylaxis (HIV PrEP) is recommended to help reduce the risk of HIV infection.
Within a 72-hour period
HIV Post-Exposure Prophylaxis also referred to as HIV PEP is used after potential HIV exposure to reduce the risk of infection with the 72-hour window.
The HIV RNA/DNA Polymerase Chain Reaction (PCR) Test delivers the best results during this time period. HIV can be detected in the bloodstream as early as the 10th day after being exposed. The HIV RNA/DNA Polymerase Chain Reaction (PCR) test can also be used to measure the HIV viral load in HIV-positive patients.
28 days onwards
If you have been exposed to HIV and 28 days or more has gone by, the HIV P24 Antigen/Antibody Combo Test (4th generation) is recommended. You see HIV P24 Antigen occur in the blood between 14 to 20 days. Around the same time, HIV Antibodies also show up in the bloodstream. Both the Antibody and the HIV P24 Antigen are detectable by the 4th Generation tests that is to say the HIV Combo tests.
The results are available in 20 mins.
We recommend the Rapid Finger prick Blood HIV-1/2 Antibody test. One of the reasons, this test is popular is that results are available in 20 minutes.
- Oral, anal, or vaginal sex without the use of a condom or with someone who is HIV positive
- Men who have had unprotected sexual exposure with men.
- Men who have had unprotected sexual exposure with commercial sex workers.
- Men who have had unprotected sexual exposure with persons who use injectable drugs.
This depends on the test you take - a fingerprick test takes as fast as 20 mintues.
Thankfully, most HIV tests can be done today by using a rapid HIV test. This eliminates a lengthy waiting period that can be extremely stressful. Your doctor will be able to perform the test and give you your results in minutes.
If you suspect that you have been infected or maybe you and your partner just want to know your HIV status, feel free to make an appointment at our clinic.
We can be reached via phone, email, or WhatsApp! Or you can simply drop by as a walk-in!