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
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. STD test prices are available below only for reference. The suitable test combination to be done is determined during clinic consultation.
Test in Blood | Basic STD Screen 1 | Basic STD Screen 2 | Basic STD Screen 3 |
---|---|---|---|
HIV | |||
Syphilis | |||
Hepatitis A | |||
Hepatitis B | |||
Hepatitis C | |||
Herpes Simplex Virus Type I and II | |||
Price | $100 | $120 | $160 |
Remarks | Blood tests only | Blood test only | Blood test only |
Test in Blood | Essential STD Screen | Urinary (Male) Urethritis | Urinary (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 |
Remarks | Hold 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 Blood | Comprehensive 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 |
Remarks | Hold 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.
Source: Action For Aids (AFA) Singapore.
Below are the details and price of each test offered here in our clinic.
Test Name | Time taken for results | Price | Remarks |
---|---|---|---|
Alere HIV AG/AB Combo (4th Gen) | 10-20 minutes | $150 | Able 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 – 2300
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).
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.
EXPOSURE | ESTIMATED RISK* |
---|---|
Receptive anal intercourse | 1 in 90 |
With ejaculation | 1 in 65 |
No ejaculation | 1 in 170 |
Insertive anal intercourse | 1 in 666 |
Not circumcised | 1 in 161 |
Circumcised | 1 in 909 |
Receptive vaginal intercource | 1 in 1000 |
Insertive vaginal intercourse | 1 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 injury | 1 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.