Have you been tested for HIV? Here’s why the test should be part of your routine health care, and why you might want to get screened anonymously – particularly if you’re an expat.
What exactly is HIV?
HIV (Human Immunodeficiency Virus) is an incurable infection that attacks the immune system. It destroys white blood cells that protect the body against bacteria and harmful pathogens, thereby increasing the severity of common illnesses and health conditions. It also ups the risk of developing cancer.
Early symptoms of HIV can easily be confused with those of the flu. These can include headache, fever, fatigue, swollen lymph nodes, sore throat, muscle and joint pain, night sweats, diarrhoea, thrush and ulcers. Since these signs are associated with common illnesses, it’s crucial to be sure of your HIV status. With proper treatment, including medications to slow the progression of the virus, HIV-positive individuals can lead normal, long lives.
These days, there’s even a pre-emptive treatment (HIV PrEP) that can be taken to prevent HIV-negative people from contracting the virus. Additionally, a post-exposure prophylaxis (HIV PEP) can be taken within 72 hours after exposure to reduce one’s chance of infection.
If untreated, HIV may take up to 10 to 15 years for the immune system to get to a point where it can no longer protect itself. HIV could evolve into AIDS (Acquired Immune Deficiency Syndrome), which is the last, terminal stage of the illness.
Stigma surrounding HIV
In the early 80’s when the HIV epidemic was becoming an increasingly hot-topic health issue, the virus was thought to only affect specific groups of people including gay men and people who inject drugs. This created a culture of fear and ignorance, and the virus became associated with shame. Many people didn’t realise it could also be spread between heterosexual partners, through blood transfusions and from mother to baby via breastfeeding.
Today, the rate of heterosexual transmission of HIV is actually greater than the rate of homosexual transmission in many places. In Singapore, 90 percent of all HIV infections occur through sexual intercourse, according to MOH. Of these cases, 45 per cent are a result of heterosexual intercourse.
Testing for HIV in Singapore
“One of the main barriers to voluntary testing is stigma and discrimination, both at the individual as well as institutional level,” says DR JONATHAN TI of Dr Tan and Partners (DTAP Clinic). “Anyone who tests positive for HIV in Singapore outside of an anonymous testing site has to be notified to MOH, and foreigners are repatriated by law.”
The good news is that anonymous HIV testing can be done at DTAP Robertson Walk branch in Singapore without providing any NRIC, passport or contact number. The clinic is approved by the MOH to conduct anonymous HIV Testing for local and foreigners in Singapore.
There are several different tests that can be done to screen for HIV including finger pricks. Results can even be given in as little as 20 minutes with certain tests.
Although quick and anonymous testing is available, it seems there’s still a lot of work to do in the willingness-to-get-tested department. The most recent data from MOH reveals that only 23 percent of HIV cases in the country were diagnosed through voluntary screening, which includes both anonymous and named testing, explains Dr Ti. This means that close to 80 percent of new HIV cases were tested either through mandatory testing (for example, pre-employment, National Service or pregnancy screenings), or in patients who presented unwell and it was medically indicated. The figures also showed that over 40 percent of HIV cases were diagnosed in the late stages of the infection.
“There is a clear need to improve our rates of voluntary testing. Identifying HIV-positive individuals is the first key step in the care cascade,” he says. “In order to be able to link at-risk individuals to testing services we need to increase awareness, reduce barriers to testing and ensure sufficient and easily accessible testing facilities.”
Testing HIV-positive in Singapore
The MOH would only need to be notified if patients want to receive treatment in Singapore. They would have to be registered to receive further lab tests and prescription medication.
However, foreigners who wish to be treated for HIV in Singapore will not be able to live or work here (they’d only be allowed a short-term visit pass). Dr Ti says that most expats who want to continue living and working in Singapore opt to seek treatment elsewhere. Thailand, he says, is a common choice. Some expats fly there two to three times per year to see their doctor.
Who should get tested?
The Centers for Disease Control (CDC) recommends that everyone between the age of 13 and 64 get tested at least once as part of their routine health care. Those at higher risk should get tested more often, like every three months, says Dr Ti. At-risk individuals may include, but are not limited to:
- Men who have sex with men or transgender women
- Those who have had sex with an HIV-positive partner
- Those who have had multiple sex partners with unknown sexual history
- Commercial sex workers or individuals who have visited commercial sex workers
- People who have injected drugs
- Someone who has had an occupational needlestick injury
- Anyone who has had sex with someone from the groups mentioned above
Dr Ti also advises anyone who’s contracted a sexually transmitted disease (chlamydia, gonorrhea, syphilis and herpes, for instance) in the past year get tested for HIV.
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