HIV PEP | SINGAPORE VD™
HIV PEP | SINGAPORE VD™ @singaporevd_com: HIV (human immunodeficiency virus) PEP (post-exposure prophylaxis) treatment to stop HIV infection within 72 hours of exposure, Singapore. Private & confidential service.
Come to sunny Singapore to have your testing and treatment. Singapore Ministry of Health registered general practice (GP) clinic:
| SHIM CLINIC|
168 Bedok South Avenue 3 #01-473
Tel: (+65) 6446 7446
Fax: (+65) 6449 7446
24hr Answering Tel: (+65) 6333 5550
Web: HIV PEP | SINGAPORE VD™
| Opening Hours |
Monday to Friday: 9 am to 3 pm, 7 pm to 11 pm
Saturday & Sunday: 7 pm to 11 pm
Public Holidays: Closed
Last registration: one hour before closing time.
Walk-in clinic. Appointments not required.
Bring NRIC, Work Pass or Passport for registration.
Table of Contents HIV prevention / HIV PEP (post-exposure prophylaxis) treatment can prevent you from getting an HIV infection, and turning HIV positive.
Individuals are eligible for HIV PEP Treatment if all the following criteria are met:
Prompt antiviral therapy may reduce the risk of HIV transmission by as much as 80%.
- less than 72 hours has elapsed since exposure;
- the exposed individual is not known to be HIV infected;
- the person who is the source of exposure is HIV infected or has unknown HIV status;
- mucous membrane or non-intact skin was exposed to a potentially infectious body fluid;
For optimal efficacy, antiretroviral therapy should be started as soon as possible, ideally within 1 hour of exposure. So that you can remain HIV negative.
The medications and dosages are the same as those used for lifelong treatment of HIV patients. However, for HIV PEP treatment, it is taken for only a month.
References Drugs commonly used in HIV PEP: References HIV Risk (2009 figures)
Estimated HIV transmission risk per exposure for specific activities and events
|Activity ||Risk-per-exposure |
|Vaginal sex, female-to-male, studies in high-income countries ||0.04% (1:2380) |
|Vaginal sex, male-to-female, studies in high-income countries ||0.08% (1:1234) |
|Vaginal sex, female-to-male, studies in low-income countries ||0.38% (1:263) |
|Vaginal sex, male-to-female, studies in low-income countries ||0.30% (1:333) |
|Vaginal sex, source partner is asymptomatic ||0.07% (1:1428) |
|Vaginal sex, source partner has late-stage disease ||0.55% (1:180) |
|Receptive anal sex amongst gay men, partner unknown status ||0.27% (1:370) |
|Receptive anal sex amongst gay men, partner HIV positive ||0.82% (1:123) |
|Receptive anal sex with condom, gay men, partner unknown status ||0.18% (1:555) |
|Insertive anal sex, gay men, partner unknown status ||0.06% (1:1666) |
|Insertive anal sex with condom, gay men, partner unknown status ||0.04% (1:2500) |
|Receptive fellatio ||Estimates range from 0.00% to 0.04% (1:2500) |
|Mother-to-child, mother takes at least two weeks antiretroviral therapy ||0.8% (1:125) |
|Mother-to-child, mother takes combination therapy, viral load below 50 ||0.1% (1:1000) |
|Injecting drug use ||Estimates range from 0.63% (1:158) to 2.4% (1:41) |
|Needlestick injury, no other risk factors ||0.13% (1:769) |
|Blood transfusion with contaminated blood ||92.5% (9:10) |
Sources: vaginal sex;1 anal sex;2 fellatio;3 2 mother-to-child;4 other activities.5
- Boily MC et al. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis 9(2): 118-129, 2009
- Vittinghoff E et al. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. American Journal of Epidemiology 150: 306-311, 1999
- Del Romero J et al. Evaluating the risk of HIV transmission through unprotected orogenital sex. AIDS 16(9): 1296-1297, 2002
- Townsend C et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000-2006. AIDS 22: 973-981, 2008
- Baggaley RF et al. Risk of HIV-1 transmission for parenteral exposure and blood transfusion. AIDS 20: 805-812, 2006
- HIV & AIDS Information :: How transmission occurs - Estimated risk per exposure
HIV Risk (2005 figures)
Estimated per-act risk for acquisition of HIV, by exposure route*
*Estimates of risk for transmission from sexual exposures assume no condom use.
|Exposure route||Risk per 10,000|
to an infected source
|Needle-sharing injection-drug use||67||0.67|
|Receptive anal intercourse||50||0.5|
|Percutaneous needle stick||30||0.3|
|Receptive penile-vaginal intercourse||10||0.1|
|Insertive anal intercourse||6.5||0.065|
|Insertive penile-vaginal intercourse||5||0.05|
|Receptive oral intercourse†||1||0.01|
|Insertive oral intercourse†||0.5||0.005|
†Source refers to oral intercourse performed on a man.
HIV risk (2002 figures)
HIV Risk Statistics (chances of getting HIV)
|HIV Risk Factors ||HIV Transmission Probability |
|Needle stick injury3 ||1/300 |
|Receptive anal intercourse4 ||1/100 |
|Receptive vaginal intercourse5 ||1/1000 |
|Insertive vaginal intercourse4 ||1/2000 |
|Insertive anal intercourse4 ||1/2500 |
|Receptive fellatio with ejaculation4 ||1/2500 |
|Sharing needles6 ||1/150 |
HIV is the abbreviation for the human immunodeficiency virus, which causes the acquired immunodeficiency syndrome
- Cardo DM, Culver DH, Ciesielski CA, et al. A Case-Control Study of HIV Seroconversion in Health Care Workers after Percutaneous Exposure. N Engl J Med. 1997;337:1485-1490.
- Katz MH, Gerberding JL. Management of occupational and nonoccupational postexposure HIV prophylaxis. Current Inf Dis Reports. 2002;4:543-549.
- Gerberding JL. Prophylaxis for Occupational Exposure to HIV. Ann Intern Med. 1996;6:497-501
- Vitinghoff E, Douglas J, Judon F, et al. Per-Contact Risk of Human Immunodificiency Virus Transmision between Male Sexual Partners. Am J Epidemiol. 1999;150:306-311.
- Peterman TA, Stoneburner RL, Allen JR, et al. Risk of Human Immunodeficiency Virus Transmission From Heterosexual Adults With Transfusion-Associated Infections. JAMA. 1988;259:55-58. [Erratum. JAMA. 1989;262:502]
- Kaplan EH, Heimer R. A Model-Based Estimate of HIV Infectivity via Needle Sharing. J Acquir Immune Defic Syndr. 1992;5:1116-1118.
HIV symptoms which may present in acute HIV infection: These are nonspecific symptoms and can present with other infections; consequently, they are unreliable indicators of HIV infection.
Remember, there is no HIV cure.
HIV window period is the time from HIV infection until a HIV Test can detect any change. Within the HIV window period, the HIV Test would be negative. During this period, the HIV viral load is extremely high, thus making the person highly infectious.
References HIV Test
- 4 weeks after exposure, a negative 4th generation HIV ELISA Test "is very reassuring / highly likely to exclude HIV infection."
- 12 weeks after exposure, a negative 3rd generation HIV ELISA Test "would definitively exclude HIV infection."
HIV ELISA (Enzyme-linked immunosorbent assay) test generations:
References HIV rapid test (20 minutes to results) Two types are available:
- 1st generation: HIV-1 IgG antibody
- 2nd generation: HIV-1 & HIV-2 IgG antibodies
- 3rd generation: HIV-1 & HIV-2 IgG & IgM antibodies
- 4th generation: HIV-1 & HIV-2 IgG & IgM antibodies and HIV p24 antigen
Note: If the clinic attendance is only for the HIV rapid test, then consultation fees are not added.
References HIV PCR (polymerase chain reaction) NAT (nucleic acid test) TORCH
(of HIV/STD/pregnancy), and what you can do before and after exposure.
Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour.
Sun, 26 Apr 2015 18:20:02 +0100 | The British Journal of Psychiatry for Mental Science
Conclusions Decreased stress levels and amygdala activity after incision support the assumption of an influence of NSSI on emotion regulation in individuals with borderline personality disorder and aids in understanding why these patients use self-inflicted pain to reduce inner tension.
South Africa: HIV Infections Decline Over Last Decade
Sun, 26 Apr 2015 11:57:10 +0100 | AllAfrica News: HIV-Aids and STDs
[SAnews.gov.za] Pretoria -According to an International Labour Organisation (ILO) study, the number of HIV infections has declined steadily over the last decade in general terms. (Source: AllAfrica News: HIV-Aids and STDs)
Zimbabwe: Man Dumps Wife After She Tested HIV Positive
Sun, 26 Apr 2015 08:34:00 +0100 | AllAfrica News: HIV-Aids and STDs
[New Zimbabwe] THE Mutare Civil court was left stunned last week after a local man revealed he dumped his wife after she tested HIV positive and was now living with his girlfriend. (Source: AllAfrica News: HIV-Aids and STDs)
Determination of HIV-1 coreceptor tropism using proviral DNA in women before and after viral suppression.
Sat, 25 Apr 2015 01:46:02 +0100 | AIDS Research and Therapy
CONCLUSIONS: We demonstrated that pvDNA tropism in women with HIV-1 suppression is concordant with prior RNA tropism results, even after a median time of >4 years. pvDNA tropism testing may be useful to determine eligibility of patients with viral suppression to switch to a CCR5-antagonist based regimen as well as for research purposes.
Herpes Virus Entry Mediator, which Decreases in HIV Infection, Can Enhance the Suppressive Activity of Regulatory T Cell and Predict Recovery of CD4+T-cells During HAART.
Sat, 25 Apr 2015 01:34:02 +0100 | Current HIV Research
In this study, we found that the blockage of the HVEM could weaken Tregs' suppressive activity to effector T cells (Teffs). HVEM expression is reduced during the asymptomatic phase of HIV infection and fairly predictive of the recovery of CD4+T-cells in response to highly active anti-retroviral therapy (HAART), more so than nadir CD4+T-cell count or viral load. Taken together, these findings demonstrate the importance of HVEM in relation to Treg function and HIV disease progression, which would have therapeutic implications and provide insight into the pathogenesis of acquired immune deficiency syndrome (AIDS).
CDC Warns of HIV, HCV Outbreaks Among Injection Drug UsersCDC Warns of HIV, HCV Outbreaks Among Injection Drug Users
Sat, 25 Apr 2015 00:28:29 +0100 | Medscape Medical News Headlines
Once again, the agency urged clinicians to talk to patients about all pain-management options, and not just prescription analgesics, which can be dissolved and injected illicitly. Medscape Medical News (Source: Medscape Medical News Headlines)
Antibody response to VZV vaccination in HIV infected children
Sat, 25 Apr 2015 00:00:00 +0100 | HIV and AIDS Review
Conclusion Serological immune response to varicella vaccination in HIV-infected children was insufficient. (Source: HIV and AIDS Review)
Clinical data and practical experience related to Stribild as an option in patients with HIV infection
Sat, 25 Apr 2015 00:00:00 +0100 | HIV and AIDS Review
Publication date: Available online 16 April 2015 Source:HIV & AIDS Review Author(s): Miłosz Parczewski , Magdalena Witak-Jędra Single tablet combination of tenofovir disoproxil fumarate, emtricitabine, elvitegravir and cobicistat [TDF/FTC/EVG/COBI] has been licensed for the use in HIV infected individuals as Stribild®. In treatment naïve subjects high virological efficacy of the regimen was proved. Recently use of this combination has been investigated as the switch option for the virologically suppressed individuals without drug resistance to the components of the compound. In twin studies – STRATEGY-NNRTI and STRATEGY-PI non-inferiority of the switch to TDF/FTC/EVG/COBI was confirmed, discontinuations due to adverse events were infrequent and no emergence of integrase dru...
The impact of the activities of Ghana AIDS Commission on new HIV infections in Ghana: An intervention time series analysis
Sat, 25 Apr 2015 00:00:00 +0100 | HIV and AIDS Review
Publication date: Available online 15 April 2015 Source:HIV & AIDS Review Author(s): Patrick Aboagye-Sarfo , Ute Mueller , James Cross The study examines the impact of Ghana AIDS Commission (GAC) activities on new HIV infections. Secondary data from 1 January 1996 to 31 December 2007 were obtained from the Ghana National AIDS Control Programme and Biostatistics Department of the Health Ministry. Intervention time series analysis was applied separately to the data from the northern and southern sectors due to data collection mechanism and location of two tertiary teaching hospitals. The impact of GAC activities is measured by the statistical significance of the coefficients of the intervention variable. The intervention variable is coded as zero (0) for the period before and one (...
Recovery of the wild type atomic flexibility in the HIV-1 protease double mutants
Sat, 25 Apr 2015 00:00:00 +0100 | Journal of Molecular Graphics and Modelling
Publication date: Available online 24 April 2015 Source:Journal of Molecular Graphics and Modelling Author(s): Valderes De Conto , Antônio S.K. Braz , David Perahia , Luis P.B. Scott The emergence of drug resistant mutations due to the selective pressure exerted by antiretrovirals, including protease inhibitors (PIs), remains a major problem in the treatment of AIDS. During PIs therapy, the occurrence of primary mutations in the wild type HIV-1 protease reduces both the affinity for the inhibitors and the viral replicative capacity compared to the wild type (WT) protein, but additional mutations compensate for this reduced viral fitness. To investigate this phenomenon from the structural point of view, we combined Molecular Dynamics and Normal Mode Analysis to analyze and compare the va...