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In general, testing for HIV can be done via 3 methods of sample extraction :
- Samples taken from the vein and sent to the lab
- Finger prick rapid test kits
- Oral saliva test kits
Types of tests for HIV
The 3 types of tests that we can do would be
Nucleic acid test ( NAT )
A NAT test looks for the actual virus in the blood. It can diagnose HIV as early as 10 days after you’ve been exposed.
Blood is drawn from your vein and the results may take weeks to be available. It is generally not used as a routine screening test as it is very expensive.
In singapore, it may cost up to $600 for a test. However it may be useful if other tests are indeterminate.
A HIV antibody testing
This test looks for antibodies to HIV in your blood or oral fluid. Antibodies are produced by your immune system after you’re exposed to the HIV virus.
The tests usually turns positive within usually 4-8 weeks of an infection. Presence of antibody indicates presence of HIV virus.
Venous sampling, finger prick testing and oral saliva testings are all methods available for HIV antibody tests.
A HIV antibody and antigen combination test
These tests check for a particular p24 antigen that is produced by the HIV virus that can show up within 2-4 weeks after infection.
At the same time, it checks also for hiv antibodies.This test is fast becoming the first test we do if we suspect an hiv infection.
Venous sampling and finger prick testing are available for this test.
On a practical level in the clinic, we would usually do a HIV antibody or antibody/antigen combination test as the initial screening test and if positive, in Singapore, we will send the sample to the lab for a special confirmatory test.
Lag time of HIV positivity
Take note that there is a lag time between the point of exposure and when your blood becomes detectable for HIV. This window period is about 3 months. Therefore if there is a very high suspicion of HIV infection and your first test was negative, please repeat another test 3 months after the initial exposure.
Please consult your doctor for more detail on the timing for these tests.
There are some clinics in Singapore that offer anonymous HIV testing. No identifiable information will be taken during anonymous testing.
HIV infection status declaration
- a person with HIV infection is required by law to reveal his health status to the sex partner before sexual activities
- a person with HIV infection is required by law to reveal his health status to medical personnel / dentist before any invasive procedures.
However, a person who is HIV positive does not require to have his health status revealed to anyone else, including employers or relatives, because the identity of the person is protected. Unauthorised disclosure of health information is prohibited.
Under the infectious diseases act, a positive test for HIV is notifiable to the Ministry of Health.
Treatment of HIV
The treatment for HIV is called anti-retroviral therapy ( ART ). These drugs prevents HIV from multiplying. They give the immune system a chance to recover and produce more CD4 cells.
Even though there Is still some HIV in the body, the immune system is strong enough to fight off infections.
ART involves taking a combination of HIV medications on a daily basis and is recommended for everyone who has HIV. ART cannot cure HIV but can help people with HIV live a longer healthier live. The main goal of HIV treatment is to reduce a person’s viral load to an undetectable level.
Anti-retroviral therapy has to be taken life long. Followups are essential to check for effectiveness of therapy, side effects of therapy and whether there are any complications arising from the HIV itself.
In Singapore, as of September 2020, about 16 anti-retroviral drugs have been added to the list of subsidised drugs. This means that all subsidised patients living with HIV now will receive either a 50% or 75% subsidy, depending on their means-test status when they buy any of these 16 medications.
Financial aid is available. Do not be afraid to seek treatment or help.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)