Non-Occupational Post-Exposure HIV Prophylaxis

Introduction to PEP

Post-Exposure Prophylaxis (PEP) is any prophylactic (preventive) treatment started immediately after exposure to be pathogen (such as a virus) with the aim to prevent infection.


What is PEP?

PEP is the use of Antiretroviral Therapy (ART), often becoming the standard of care for healthcare workers, who hold on to the risk of occupational exposure to HIV. PEP should ideally be initiated within 72 hours of exposure, failing which is not advised.


Who needs PEP?

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

  • A known HIV-infected partner and or
  • HIV at-risk groups (commercial sex workers, IV drug users, men who have sex with men – including bisexual men) and or
  • A person who was forced into any sexual act involuntarily (raped).

Before PEP Prescription

A detailed history of the exposure if crucial in evaluating a patient. An assessment will then be done by the doctor to determine the likelihood of HIV transmission. The level of risk can be estimated with the following table:

ExposureEstimated Risk
Needle stick injury0.33%
Receptive anal intercourse1%
Insertive anal intercourse0.04%
Receptive vaginal intercource0.1%
Insertive vaginal intercourse0.05%
Receptive fellatio with ejaculation (Oral Sex)0.04%
Sharing needles0.67%

The patient will then be advised on the risks, benefits and alternatives of PEP. Should the decision be made to proceed with treatment, it would be important to follow-up for: potential side effects of the medications, repeat HIV screenings as well as reinforcement of counselling messages.


Course of PEP

The full course for this PEP drug combination will be for a duration of 28 days. AfA Is working closing with DSC Clinic to bring you PEP at very affordable rates.


Adverse Effects of PEP

Any drugs prescribed have the potential possibility of side effects.

These symptoms includes nausea and diarrhoea.

It is advisable to check with your healthcare provider on what are the possible side effects on the medications being prescribed to you.


Do you think you need PEP?


Other Information

  • Exposure to saliva, urine, tears and sweat are not thought to be infectious
  • HIV transmission from splashes of contaminated fluids to mucosal surface (i.e. nostrils, mouth, lips, eyelids, ears, genital area and the anus) or non-intact skin is likely to be low, although it has not been accurately justified
  • PEP treatment is not 100% effective, best reports quote that PEP can potentially decrease the possibility of transmission by 81%

Job Opportunity: MTS Coordinator (update)

If you’re a citizen or a permanent resident and if looking for a career change that is both challenging and fulfilling, join Singapore’s leading independent, non-government organisation of HIV experts.

AFA dedicates it’s mission to fighting AIDS/HIV infection in Singapore. It draws upon a network of healthcare professionals, advocates, educators and volunteers, to implement educational, testing, treatment and welfare programmes.

We will not be able to achieve our mission from individuals. It takes an entire team united behind something big.

Together, we are Doing it Better.


We are looking for an energetic, passionate, people-oriented team player with a positive attitude to join our team dedicated to the cause of educating the diverse community and providing care and support to PLHIV (People Living with HIV).

If you a self motivated and people-oriented who believe you have what it takes to value add to the community programme, you are who we are looking for. Join us and add your voice and talents to our programmes.

General Job Scope:

– assist in driving and maintaining MTS’ operating vehicle
– ensure infection control compliance of MTS operating vehicle and all operational related equipment/supplies/facilities
– 5 day work week: 9 am to 6 pm. (incumbent must be able to support our operation on weekends and public holidays)

This is a full time position with a 3 month probation period.

Remuneration will be based on candidate’s work experience and qualification

Salary range  : Negotiable

Please send your cover letter together with your resume inclusive of recent photo, A photocopy of a valid Class3/3B Singapore driving License, together with your salary expectation below.

Requirements

– Posses at least with Class 3/3B driving licence
-able to converse effectively in English, Malay/Chinese/Tamil/Dialects

Education and Experience:

– minimum “O” or “A” levels,
– familiar with Microsoft office applications
– background in healthcare/ counselling an added advantage

Key Competencies:

Background in healthcare/ counselling is an advantage otherwise training will be provided, organisation and planning skills, work management and prioritising skills, verbal and written communication skills, problem solving ability, attention to detail, accuracy, flexibility, reliability, teamwork, resourceful etc. Ability to speak dialect is welcomed


All job applicants would be deemed to have given full consent to the collection, use or disclosure of personal data as a condition of pre-employment, under Personal Data Protection Act. Job applications received after the closing date will be removed and deleted from AfA’sdatabases.


Apply Today: Good luck!!

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All job applicants would be deemed to have given full consent to the collection, use or disclosure of personal data as a condition of pre-employment, under Personal Data Protection Act. Job applications received after the closing date will be removed and deleted from AfA’sdatabases.

What is a 4th gen HIV test?

The AFA Anonymous Testing Services have been providing simple, quick and affordable HIV testing utilising 3rd generation test kits for both blood and oral fluids. In an effort to improve our services, the AFA anonymous testing clinic and mobile testing services will be introducing the 4th generation test kits.


What’s the difference between 4th and 3rd gen test kits?

Fourth-generation tests kits look for both antibodies AND antigens.

  • P24 Antigens are proteins on the surface of the HIV particle.
  • Antibodies are produced by the immune system in response to the HIV antigens. They fit together like a lock and key.

 

Immune response of HIV infection

3rd generation tests take 6-8 weeks and only tests for antibodies.

4th generation tests are accurate 14 days after exposure, because this is when the p24 antigen becomes high enough to measure; effectively reducing the window period by average of 14 days.

A negative result at 28 days is good news but it is not conclusive. UK guidelines (BASHH) say that an early negative result at 28 days (1 month) needs to be confirmed with a second test 90 days (3 months) after the exposure.

Ask for the 4th Generation Test at one of the following services provided by AFA at $40 per test.

Click to learn more about each service.


More about p24 antigen

One distinctive HIV antigen is a viral protein called p24, a structural protein that makes up most of the HIV viral core, or ‘capsid’. High levels of p24 are present in the blood serum of newly infected individuals during the short period between infection and seroconversion, making p24 antigen assays useful in diagnosing primary HIV infection.

Antibodies to p24 are produced during seroconversion, rendering p24 antigen undetectable after seroconversion in most cases. Therefore, p24 antigen assays are not reliable for diagnosing HIV infection after its very earliest stages. However, HIV infection can be reliably diagnosed earlier with combined antibody/antigen tests than with purely antibody-detecting tests, and fourth-generation antibody/antigen tests are now the standard screening assay in the UK and some other countries.

More about HIV antibodies

Antibodies are protein molecules produced by the immune system in response to allergens, infectious organisms (including viruses, bacteria, fungi and parasites), and sometimes (in autoimmune disorders) the body’s own components.

Infectious organisms and allergens display characteristic proteins called antigens. The immune system recognises and responds to antigens by generating corresponding antibodies. An antibody is designed to ‘fit’ only one particular antigen, rather like a key in a lock. (The word ‘antigen’ in fact derives fromantibody generation.) By locking on to the antigen-bearing intruders, antibodies aim to render them harmless, to kill them outright, or to ‘tag’ them for destruction by other components of the immune system.

One or two weeks after initial exposure to HIV, antibodies to HIV antigens begin to appear in the blood, at concentrations which continue to increase for several more months. These antibodies persist for life, providing distinctive markers which can be identified by HIV screening tests

AIDS 2014 Melbourne Declaration

This declaration affirms that non-discrimination is fundamental to an evidence-based response to HIV and effective public health programmes.

aids-2014-declaration“The enforcement of discriminatory and criminalising laws and policies against Key Affected Populations is deeply alarming.” said Professor Françoise Barré-Sinoussi, AIDS 2014 International Chair, President of the International AIDS Society (IAS) and Director of the Regulation of Retroviral Infections Unit at the Institut Pasteur in Paris. “Such practices clearly violate basic human rights and heavily undermine HIV programmes by posing barriers to access to HIV prevention, treatment, and care. With the declaration we want to reiterate that every individual has the same rights and dignity as everyone else as we are born equal and part of the human family. ”

All individuals and organizations involved in the global response to HIV and AIDS are encouraged to visit and sign the declaration at www.aids2014.org/declaration.aspx and to share it with their networks.

 

“If we really want to change the course of HIV we must make sure that nobody is left behind. AIDS 2014 will be a truly global, inclusive conference and will reflect the principles of the declaration” commented Professor Sharon Lewin, Local Co-Chair of AIDS 2014, Head of the Department of Infectious Diseases, Alfred Hospital and Monash University and Co-Head of the Centre for Biomedical Research at the Burnet Institute in Melbourne.