Anonymous HIV Test in Singapore
What are HIV and AIDS?
HIV is the human immunodeficiency virus. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome). The virus attacks and destroys the body's immune system, which is the body's ability to fight off infections. However this may occur only after many years. It is possible for a person who is infected to have the virus for years before any sign of illness appear. When the illness appears, the condition can cause serious illnesses such as infections and cancers, which will kill the patient if left untreated.
How does someone get HIV?
HIV spreads through contact with contaminated blood, semen, vaginal fluids, or breast milk from infected people. Contact can come from unsafe sex. It can also come from sharing used needles and syringes. Infected women can pass the virus to their babies during pregnancy, childbirth, and breast feeding. It is also possible to become infected with HIV through a blood transfusion, although this is now very rare.
People do not get infected with HIV through casual contact with people at school, work, home or anywhere else. The virus is not spread from contact with sweat, tears, saliva, or a casual kiss from an infected person (Deep or "French" kissing is not advised). Nor can people be infected from contact with forks, cups, clothes, phones, toilet seats, or other things used by someone who is infected. People do not get infected from food prepared by an HIV-infected person. People have not become infected with HIV through insect bites.
How can I avoid becoming infected?
The best way to eliminate the risk of getting infected with HIV is to avoid activities that would allow the virus to be passed to you. By following these suggestions, you will lower your risk of getting HIV:
The only 100 % certain way to avoid infection through sex is to have sex with an uninfected partner or to abstain.
If you are not certain that your sex partner is uninfected, you should use a latex condom correctly every time you have sex.
Do not share needles or syringes.
The most effective way to prevent HIV infection is to remain faithful to one’s
spouse/partner and to avoid casual sex and sex with sex workers.
Persons engaging in high-risk sexual behaviour, such as having multiple sexual
partners or engaging in casual or commercial sex, are strongly advised to use condoms to reduce their risk of HIV infection. Condoms should be used consistently and correctly during every sexual encounter. Such persons should also go for regular HIV testing.
Why should I get tested?
You cannot generally tell by looking at someone whether he or she is infected with the HIV virus. A person can be infected with HIV and not know it. It might take years before the infected person actually fall ill and has symptoms due to AIDS. The only way to be confident that you are not infected with HIV is to get a test.
It is important that you find out if you are infected with HIV so that you do not infect someone else. If you know you are infected with HIV, you should avoid any activity that may pass it on.
It is also important that you find out if you are infected with HIV so that you can receive good medical care. Even if you are infected with the HIV virus, there are therapies which can keep you healthy. However, a timely start of these therapies is critical to ensure success.
Under the Infectious Diseases Act, it is an offence if a person who has reason to
believe that he or she has HIV/AIDS, or has been exposed to a significant risk of contracting HIV/AIDS, does not take reasonable precautions to protect his or her sexual partner, such as by using condoms, even though he or she may be ignorant of his HIV/AIDS status.
Alternatively, the person can go for an HIV test to confirm that he or she does not have HIV/AIDS. Otherwise, the person must inform his or her partner of the risk of contracting HIV from him or her, leaving the partner to voluntarily accept this risk if he or she so wishes.
Anonymous HIV Test
There may be individuals who would like to be tested for HIV but prefer not to be identified to healthcare personnel or do not want to be reported to the Government if tested positive.
Anonymous HIV test hence provides an alternative to conventional HIV testing.
The aim of anonymous HIV testing programme in Singapore is to encourage individuals at risk of HIV infection to go for HIV testing and to do so at an early stage. In 2013, 3 out of every 5 new cases already had late stage HIV infection when diagnosed. With early diagnosis, a HIV positive person can access care and treatment earlier. By knowing their status early, they can also take measures to protect their partners from infection.
How is the Anonymous HIV test done?
Anonymous HIV Test will be performed on individuals upon request and who have
no signs and symptoms of AIDS. Anonymous HIV rapid testing is carried out on oral fluid or blood from finger prick using rapid HIV test kits registered with the Health Sciences Authority. The use of rapid HIV tests will allow results to be ready in approximately 20 minutes. Persons with reactive rapid HIV test results will be asked to provide a venous blood sample for further laboratory-based confirmatory testing.
Pre- and post-test counselling will be provided to all persons who undergo
anonymous HIV testing at the clinics. The person will also be given information on the "window period" for HIV infection. The "window period" refers to the time taken for a HIV-infected person to develop antibodies to the HIV virus. Most people will develop antibodies within 3 months of infection while some may take up to 6 months. During the "window period", an infected person may not show a reactive test on the HIV rapid test or other antibody-based HIV tests which detects the presence of HIV antibodies. Hence, a person would usually be advised by his doctor to be re-tested after the "window period" to confirm his test result if the test was non-reactive and there has been a recent history of high-risk sexual or other exposure. Persons who are found to be HIV-positive will be given appropriate medical advice and counselling.
Will I be forced to reveal my identity if I am tested positive during the anonymous HIV testing?
No, you may remain anonymous if you wish to do so.
What is 4th generation HIV testing?
4th generation HIV testing detects the HIV antibody as well as the P24 antigen.
It allows detection of HIV infection earlier and hence the window period of detection is reduced.
4th generation HIV testing is available at our clinic but involves a needle prick, in order to obtain a blood sample.
What does a PRELIMINARY POSITIVE result mean?
A PRELIMINARY POSITIVE result suggests that antibodies to HIV may be present in your blood or oral fluid. If you have a PRELIMINARY POSITIVE result on the test, you will need to follow up with confirmatory testing with a blood sample by way of Western Blot. You will also be encouraged to take precautions to avoid any chance of spreading HIV until your test result is confirmed.
If you are found to be infected, you may benefit from special medical care. Your healthcare provider may refer you to Communicable Disease Centre (CDC), Tan Tock Seng Hospital or other healthcare instituitions for treatment options, only if you wish to do so. A positive result does not mean you have AIDS, which is the last stage of the infection. There are treatment options that can boost your immune system and delay the onset of AIDS, if started in time. Apart from taking precautions, you can lead a fairly normal life.
What does a NEGATIVE result mean?
A NEGATIVE result means that this test did not detect HIV antibodies in your blood or oral fluid. However, in some cases HIV infection cannot be ruled out completely. If you recently (within 3 months) had any high risk sexual contacts, it is still possible that you are infected with HIV. This is because your body can take several months after you are infected to make HIV antibodies. If you became infected only recently, there may not have been enough time to develop antibodies that can be detected by the test. You should consider getting tested again in 3 to 6 months to be sure of you are not infected. If you had none of the contacts that transmit HIV in the 3 months before your test, a negative test result means you were not infected with HIV at the time of testing.
Our clinic used SD Bioline Combo for the 4th Generation HIV testing for anonymous HIV between February 2016 to 12 May 2017. These tests were subjected to a voluntary recall by the company because the P24 antigen detection may give a false negative result, causing a delay in diagnosis by a day or two. For patients who did the above test during this period and are worried that their date of sexual encounter is such that a day or two makes a difference with the date of testing, we would advise that they repeat the test. Hence if the date of the HIV test is 16 days instead of 14 days from the last sexual encounter, you should repeat the test.
All the affected tests kits have been returned to the supplier and we are now using Allere HIV Combo as the 4th Generation test kit.
Third Generation testing was unaffected.