Sexually transmitted diseases (STD), also known as sexually transmitted infections (STI) or venereal disease are infections that are spread via the 3 common modes of sexual exposure: oral, anal and vaginal intercourse.

In Singapore, patients often face stigmatisation and embarrassment when they are faced with a sexually transmitted disease. We aim to tackle this through providing a practice with access to early STD testing and treatment, in a pleasant, accessible yet quiet environment conducive for a detailed assessment and consultation. Consultations will be strictly private and confidential.

Common STD symptoms may include the following:

  • Painful urination
  • Abnormal penile or vaginal discharge
  • Pain on the groin or genital areas
  • Itch/rash/ulcers/blisters on the genital or anal areas
  • Unusual lumps or growths on the genital or anal areas
  • Generalised vague symptoms like fever, bodyaches, abnormal body rash, tiredness or swollen lymph nodes at the groin, neck or axilla (armpit) regions

couple - asian + caucasian

The list of symptoms above are not exhaustive. We advise patients to undergo a thorough consultation with us so that we can detect these STDs early and treat them early. Untreated STDs can cause many subsequent health problems like infertility, pelvic inflammatory disease, chronic prostate inflammation and more importantly – spread infection to sexual partners.

Most STDs are treatable – even non-curable ones like HIV or genital herpes can be managed with medications to keep a patient in remission for a prolonged duration. Other common STDs like chlamydia and gonorrhea can be tested very accurately with urine or swabs, and treated rapidly with good recovery. Medications for STDs come in the form of injections or oral tablets. Here @ Dr Jeremy Chan Medical Clinic, we aim to keep dosage regimes simple and at the same time provide quick and effective treatment. We are also concerned about side effects of medications and will tailor treatment to each individual patient.

We offer the following STD and HIV screening tests.

Test in BloodBasic STD Screen 1Basic STD Screen 2Basic STD Screen 3
HIV
Syphilis
Hepatitis A
Hepatitis B
Hepatitis C
Herpes Simplex Virus Type I and II
Price$100$120$160
RemarksBlood tests onlyBlood test onlyBlood test only
Test in BloodEssential STD ScreenUrinary (Male) UrethritisUrinary (Female) Urethritis and Vaginitis
HIV
Syphilis
Hepatitis A
Hepatitis B
Hepatitis C
Herpes Simplex Virus Type I and II
TESTS IN URINE/SWAB
Chlamydia and Gonorrhoea Urine PCR
Specific urine culture for Monilia, Trichomonas, Mycoplasma, Ureaplasma,
Urine microscopy and bacteria culture
Gardnerella, Trichomonas, Candida, Mycoplasma, Ureaplasma.
Vaginal bacteria culture (swab)
Price$280$280$360
RemarksHold urine for 2-4 hours.
Accuracy of test increased if urine sample is first void urine in morning
Hold urine for 2-4 hours.
Accuracy of test increased if urine sample is first void urine in morning
Urine and vaginal swabs test.
Not for testing during menstruation
Test in BloodComprehensive STD screen (Male)Comprehensive STD screen (Female)
HIV
Syphilis
Hepatitis A
Hepatitis B
Hepatitis C
Herpes Simplex Virus Type I and II
TESTS IN URINE/SWAB
Chlamydia and Gonorrhoea Urine PCR
Specific urine culture for Monilia, Trichomonas, Mycoplasma, Ureaplasma,
Urine microscopy and bacteria culture
Gardnerella, Trichomonas, Candida, Mycoplasma, Ureaplasma.
Vaginal bacteria culture (swab)
Price$390$470
RemarksHold urine for 2-4 hours.
Accuracy of test increased if urine sample is first void urine in morning
Blood, urine and vaginal swab test.
Hold urine for 2-4 hours.
Not for testing during menstruation.

*Results for tests usually takes about 3-5 working days. For test panels which involves urine testing, we encourage our patients to come in the morning.

This is because first void urine or first urination in the morning has been shown to be more accurate and specific.

HIV Rapid Test

HIV testing and screening has gradually achieved greater accuracy with better technology. Our clinic is accredited by the Ministry of Health Singapore to offer HIV rapid testing. These tests are simple and affordable, and either involve a finger prick, blood draw or an oral swab. Results of the test will be released on-the-spot after 10 to 20 minutes.

The table below, explains the relevant window periods of tests corresponding to HIV infections. 3rd generation tests are able to detect response as early as 21 days while 4th generation test kits are able to detect response as early as 14 days.

A negative result of these tests are good, but another repeat confirmation test is still needed for these tests to be conclusive at 90 days (3 months).

What happens when there is a REACTIVE/POSITIVE result on a HIV rapid test kit?

When a HIV rapid test kit detects a positive/reactive result, a confirmation laboratory test in the form of ELISA or Western Blot needs to be done. These confirmation tests can take up to two weeks.

DSC_6564

Immune-response-of-HIV-infection

Source: Action For Aids (AFA) Singapore.

Below are the details and price of each test offered here in our clinic.

Test NameTime taken for resultsPriceRemarks
Alere Determine™ HIV-1/2 Test Kit* (3rd Gen)10-20 minutes$50-
Orasure Oraquick® Rapid HIV 1/2 Antibody Test* (3rd Gen)10-20 minutes$50Oral Swab, no need for blood taking
Alere HIV AG/AB Combo (4th Gen)10-20 minutes$150Able to test for exposure as early as 14 days

HIV Post Exposure Prophylaxis (HIV PEP)

HIV PEP or post exposure prophylaxis involves using antiretroviral medications to limit or stop the HIV virus from infecting the body after exposure. These medications must be taken as soon as possible, but no more than 72 hours (3 days) after possible exposure. Two to three drugs are usually prescribed, and they must be taken for 28 days.

HIV PEP is quoted in studies at best to reduce transmission of HIV by 81%.

The cost of HIV PEP @ Dr Jeremy Chan Medical Clinic range from $2000 – 2100

Who May Need HIV PEP:

Anyone who experienced condom failure or involved in any form of unprotected anal or vaginal intercourse, receptive fellatio with ejaculation with:

  • known HIV-infected persons and or
  • HIV at-risk groups (commercial sex workers, IV drug users, men who have sex with men – including bisexual men) and or
  • Involuntary sexual activity (rape/sexual assault).

STD testing test tubes2

Estimation of HIV risk

The following table estimates the risk of HIV transmission. However we advise our patients to still undergo a thorough consultation to best estimate and discuss his/her personal risk.

EXPOSUREESTIMATED RISK*
Receptive anal intercourse1 in 90
    With ejaculation1 in 65
     No ejaculation1 in 170
Insertive anal intercourse1 in 666
    Not circumcised1 in 161
    Circumcised1 in 909
Receptive vaginal intercource1 in 1000
Insertive vaginal intercourse1 in 1219
Semen splash to eye<1 in 10000
Giving oral sex<1 in 10000
Receiving oral sex <1 in 10000
Blood Transfusion (one unit)1 in 1
Needle stick injury1 in 333
Sharing injecting equipment (including chemsex)1 in 149
Human Bite<1 in 10000

*Assuming exposure is from a known HIV positive individual not on ART. ART = Antiretroviral therapy

Reference: Fiona Cresswell, Laura Waters, Eleanor Briggs, Julie Fox, Justin Harbottle, David Hawkins, Martin Murchie, Keith Radcliffe, Paul Rafferty, Alison Rodger and Martin Fisher. UK guideline for the use of post-exposure prophylaxis for HIV following sexual exposure, 2015. Int J STD AIDS. 2016 Aug;27(9):713-38.

What to do before starting PEP

Prior to commencement of HIV PEP, blood tests will be done to ensure baseline functions like blood count, liver and kidney function are normal. STD/HIV tests will be done concurrently as well to ensure you are HIV negative before starting PEP. We also advocate concurrent treatment of any STD/STI if there is any.

What to do after completing treatment

Blood tests are again needed to ensure baseline functions like blood count, liver and kidney function are normal. At 28 days, a 1 month post exposure HIV test can be done.

*During the course of completion of PEP, should there be any side effects to medications or queries, do return to consult our doctors.