HIV

HIV stands for human immunodeficiency virus. It causes a chronic infection that attacks the immune system, destroying essential white blood cells that protect the body from bacteria, viruses and other harmful microorganisms. This makes it harder for the body to fight infections, and increases the severity of common conditions and diseases, including cancer. At the current moment, there is no cure for HIV infection.

Acquired Immune Deficiency Syndrome (AIDS) is a collection of symptoms and disease manifestations that are characteristic of a severely weakened immune system due to advanced HIV infection, which occurs when the infected person is not on treatment.

For figures on HIV/AIDS prevalence in Singapore, view our latest update.

What are the symptoms of HIV/AIDS?

Symptoms of HIV infection vary from person to person and may differ depending on the stage of infection. Early symptoms include:

Tiredness
Weight Loss
Prolonged fever
Skin rash
Night sweats
Persistent diarrhoea
Lowered resistance to infections

You cannot tell if someone has HIV just by their appearance. The only way to know for sure is to take an HIV test.

What are the potential complications of HIV/AIDS?

HIV can take up to 10 years to develop into AIDS without medical intervention. If left untreated, a person will usually die between 1.5 and 3 years after developing AIDS, usually due to severe infections or certain cancers that are associated with HIV infection.

How does HIV spread?

HIV infection is most commonly transmitted through the act of unprotected sex with a person with HIV who is not on treatment, but it can also be transmitted by:

Sharing injection needles or piercing instruments (e.g. tattoo guns or acupuncture needles) with a person with HIV who is not on treatment.
Receiving infected blood or blood products (e.g. blood transfusion, organ transplant).
During pregnancy, childbirth, or breastfeeding, especially if the mother is not receiving HIV treatment.

HIV cannot be transmitted by:

Hugging, touching, or kissing
Insect bites
Contact via objects such as shared food or toilet seats

The incubation period is about 1 to 6 weeks (median 3 weeks).

How do I prevent HIV?

Protecting against HIV:

Be faithful to your partner and do not engage in casual sex.
Be honest about your sexual history with potential new partners, and consider going for a screening together if you are unsure about your HIV status.
Practise safe sex by using condoms, which provide at least 90% protection from HIV.
Visit a reliable service provider who uses clean, sterile needles for any tattoos, piercings or injections.
Accept only HIV-screened blood for transfusion.
Consider using HIV Pre-exposure prophylaxis (PrEP) in consultation with a trained medical provider, as it is highly effective when used as part of a comprehensive HIV prevention plan.

How is HIV/AIDS treated?

While there is no cure for HIV, anti-retroviral therapy can help to improve the immune system and suppress the virus in your system to undetectable levels. This delays the spread of HIV and the onset of AIDS.

People with HIV taking anti-retroviral therapy are now likely to have a near-normal life expectancy.

What is HIV and how is it connected to AIDS?

HIV is a virus that causes a currently incurable infection that attacks the immune system, making it harder for the body to fight infection. Acquired Immune Deficiency Syndrome (AIDS refers to advanced HIV infection. Left untreated, AIDS is fatal.

How long will it be between infection and the onset of symptoms?

Not everyone will have symptoms after being infected with HIV. Flu-like symptoms, including fever, skin rash and tiredness, may appear between 2-4 weeks after infection. If you are concerned about your HIV status, the only way to know for sure is to go for a HIV screening.

What to do if you think you have HIV

Undergoing HIV screening is the only way to know if you have HIV.

Most clinics in Singapore offer HIV screening as a routine service. Some can provide results in as little as 20 minutes. Others provide anonymous screening services. Regardless of where you go, your results will be kept strictly confidential.

If you have multiple sexual partners or engage in casual sex often, you should always go for regular screenings so that any STI can be detected and treated as soon as possible. Early intervention is essential for the optimal management of HIV.

What to do if you have HIV

Seek and adhere to medical treatment including anti-retroviral therapy, and monitor your HIV viral load closely with your doctor. With effective treatment, the HIV virus can be suppressed to undetectable levels. This benefits your health and also reduces the risk of HIV transmission.

Under the Infectious Disease Act, unless you have maintained a stable undetectable HIV viral load (see below), you must inform your sexual partner of the risks of getting HIV from you before having sex. This is to allow your partner to choose to take appropriate precautions.

You are considered to have maintained a stable undetectable HIV viral load if you satisfy the following criteria:

You have stable, consecutive undetectable HIV viral load test results (below 200 copies per millilitre of blood), for at least six months;
Your most recent HIV viral load test shows a result of undetectable (below 200 copies per millilitre of blood), and is dated nine months or less before when you have sex;
You have adhered to medical treatment for HIV infection up to the time of when you have sex; and
All the HIV viral load test results mentioned above are from a licenced laboratory in Singapore.

If you satisfy the above criteria, you do not pose a risk of transmission of HIV to your sexual partner. Therefore, you no longer need to inform your sexual partner of the risks of getting HIV from you.

Do I need to tell my sexual partner that I have HIV?

Yes, unless you have maintained a stable undetectable HIV viral load (see below), you must inform your sexual partner of the risks of getting HIV from you before having sex (when informing your partner of the risks, you cannot avoid telling your partner that you have HIV). This is to allow your partner to choose to take appropriate precautions.

It is an offence not to do so, under the Infectious Diseases Act.

You are considered to have maintained a stable undetectable HIV viral load if you satisfy the following criteria:

You have stable, consecutive undetectable HIV viral load test results (below 200 copies per millilitre of blood), for at least six months;
Your most recent HIV viral load test shows a result of undetectable (below 200 copies per millilitre of blood), and is nine months or less before when you have sex;
You have adhered to medical treatment for HIV infection up to the time of when you have sex; and
All the HIV viral load test results mentioned above are from a licenced laboratory in Singapore.

How do I show that I have adhered to medical treatment for HIV infection?

You should go for regular follow-up visits for HIV with your doctor, including regular HIV viral load testing, and prescription refills. Medical records documenting that you have done so, serve as evidence that you have adhered to medical treatment.

If you are alleged to have committed an offence, the strongest evidence that you have adhered to medical treatment is an undetectable HIV viral load test result (from a licenced laboratory in Singapore) at the next medical visit for HIV after the sexual activity in question (which should not be more than 9 months after the sexual activity in question). This is because maintenance of undetectable HIV viral load is not possible unless you have adhered to treatment.

How common is HIV in Singapore?

View the latest statistics of HIV cases and related deaths in Singapore.

Where can I go for HIV screening?

HIV screening is available at Department of Sexually Transmitted Infections Control Clinic (registration is required) or at any private/poly clinic.

Where can I go for anonymous HIV screening?

Anonymous screening is available at several private clinics in Singapore.

Where can I go for rapid HIV screening?

Only Clinics Offering HIV Rapid Test Kits 2013 [PDF, 82 KB] onwards on rapid HIV screening can offer this service. Please contact your preferred clinic in advance to check.

Where can I find more information on sexually transmitted infections?

For more information on Sexually Transmitted Infections, visit the Department of Sexually Transmitted Infections Control Clinic websites.

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HIV

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