HIV Post Exposure Prophylaxis (HIV PEP Singapore)

HIV Prevention / HIV PEP (Post Exposure Prophylaxis)

HIV Post Exposure Prophylaxis (HIV PEP) refers to the taking of a course of Antiretroviral (ARV) medication after a recent high risk exposure (usually within 72 hours) to minimise the risk or to prevent HIV infection or transmission. 

 

Have you been exposed to HIV? Did your condom break? Did you have risky sex with a high risk partner? Are you within the window period of 72 hours? How do you prevent the transmission and spread of HIV? Do a HIV test today to be safe. 

 

Tanjong Pagar Medical Clinic is an approved Anonymous HIV Test (AHT) Clinic by the Ministry of Health Singapore.

How is HIV transmitted and in what situations would HIV PEP be required?

HIV PEP is recommended when there is:

1) high-risk sexual exposure (any unprotected anal or vaginal intercourse, receptive oral intercourse with ejaculation) with:

  • a partner known to be HIV-infected, or
  • a person in a high HIV risk group (commercial sex workers, IV drug users, men who have sex with men/ bisexual men) or
  • in sexual assault

2) sharing of or exposure to contaminated needles or blades, particularly needle-stick injuries

3) exposure to contaminated blood or semen or genital fluids, especially through open wounds and cuts, sores and ulcers

In such situations, HIV PEP is highly recommended and can help to prevent the transmission of HIV and AIDS.

Generally, exposures to saliva, urine, tears and sweat are not thought to be infectious, and the risk of HIV transmission from splashes of contaminated fluids to mucosal surface or non-intact skin has not been accurately quantified.

What is the risk of HIV Exposure?

Table 1. Exposure and transmission risk/exposure with known HIV-positive source who is NOT on antiretroviral treatment

Type of exposureEstimated risk of HIV
transmission/exposure*
Receptive anal intercourse (RAI)1/70 (with ejaculation)
1/155 (withdrawal)
Insertive anal intercourse1/160 (uncircumcised)
1/900 (circumcised)
Receptive vaginal intercourse1/1250
Insertive vaginal intercourse1/2500
Receptive or insertive oral intercourseUnable to estimate risk –
extremely low
Needle stick injury1/440

* Based on prospective studies, not cross-sectional data or figures derived from modelling. Does not take into account source viral load, which if undetectable markedly reduces risk estimates.

Reference: National PEP Guidelines Reference Group. Literature review for the National guidelines for post-exposure prophylaxis after non-occupational and occupational exposure to HIV. [monograph on the internet] Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine: Sydney, 2016. Available from www.ashm.org.au/ pep-guidelines

When should HIV PEP (Post Exposure Prophylaxis) be started?

HIV PEP should be started as soon as possible after exposure up to 72 hours. The ideal time period to start PEP is within 24 hours from exposure, although it has been shown to be effective up to 72 hours post-exposure.

The earlier HIV PEP is started, the more effective it is in preventing HIV transmission and infection.

If the exposure is more than 72 hours, HIV PEP will be considered on a case by case basis depending on the risk of exposure.

What are the side effects of HIV PEP treatment?

We prescribe the latest HIV PEP medications with minimal side effects and highly tolerable. The more common side effects with older PEP treatments may be nausea, diarrhoea and/or anorexia.

These side effects are generally not serious and not permanent and should resolve after the medication is stopped or completed.

What kind of tests need to be done before taking HIV PEP?

Baseline HIV test, full blood count, liver and renal function tests will be performed to detect any pre-existing abnormality prior to treatment and can be repeated at 2 weeks.

There will be a follow-up visit after 4 weeks to repeat full blood count, liver and renal function tests as well as and a HIV test.

Follow-up HIV tests are recommended at 3 and 6 months post exposure.

HIV Post Exposure Prophylaxis (HIV PEP Singapore)

What are the HIV PEP medications or regimens to take?

For exposures to sources with KNOWN HIV status, we recommend a 3-drug or triple oral drug combination.

For exposures to sources with UNKNOWN HIV status, we recommend a 2-drug oral drug combination.

It is recommended to take one month’s course of PEP.

At Tanjong Pagar Medical Clinic, we offer HIV PEP regimens that are well tolerated, with minimal side effects, drug–drug interactions, dosing requirements and pill burden.

Our prescription practices are consistent with HIV PEP regimens in local government hospitals and in line with international HIV post exposure prophylaxis guidelines.

What to do while on HIV PEP?

While on HIV PEP, do not take any other medications without first consulting the doctor. Do not stop the HIV PEP without first consulting the doctor. If you cannot tolerate the side effects, return to consult the doctor.

HIV Post Exposure Prophylaxis (HIV PEP Singapore)

What is Cost of HIV PEP?

For a 2-drug oral drug combination, the cost is $1050 for one month’s course of medication.

For a 3-drug oral drug combination, the cost is $1800 for one month’s course of medication.

Other costs involved:

  • Baseline HIV test – $85 (recommended)
  • Baseline liver/kidney function tests – $70 (optional)
  • STD screening – from $80 (optional)
  • Consultation – $30 to $80

All prices subject to prevailing GST.

Please call 64433101, or SMS 96622880 or email info@tanjongpagarclinic.com for more information.

Are other forms of STD/STI testing required?

If you have had a high risk exposure, we would also recommend testing for other common STDs or STIs such as syphilis, gonorrhea and chlamydia.

Our STD / HIV clinic provides a full range of STD and STI testing services which can be done at the same time as the HIV testing.

Please see here for a full list of STD testing and screening profiles. HIV and STD tests can be customized to suit your risk profile.

The timing of the testing should be discussed with our doctor but generally we recommend testing at 2 weeks, 1 month and 3 months.

HIV PEP Singapore

Other Testing Services at Tanjong Pagar Medical Clinic

Tanjong Pagar Medical Clinic is an approved Anonymous HIV Test Clinic by the Ministry of Health Singapore.

Testing for STD/STI – Our STD / HIV clinic provides a full range of STD and STI testing services which can be done at the same time as the HIV testing. Please see here for a full list of STD testing and screening profiles. HIV and STD tests can be customized to suit your risk profile.

Testing for HIV – We offer a full range of HIV testing as well as rapid and fast HIV tests, either by oral saliva swab or by fingerprick blood. Results in 20 minutes!

Prevention of HIV – If you have had a recent high risk exposure (less than 72 hours), you may wish to consider HIV Post Exposure Prophylaxis (PEP), which may help to prevent HIV transmission and potentially save your life!

Prevention of STD – We offer vaccination against Hepatitis virus and Human Papillomavirus (HPV).

Please call 64433101, SMS 96622880 or email info@tanjongpagarclinic.com for more information.

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