Interview with Prof Roy Chan, former Director of the National Skin Centre and Founding President of Action for AIDS (Singapore). He explained why sexually-transmitted diseases are managed by dermatologists in Singapore, and also discussed the state of HIV social acceptance and management in Singapore
AFA – Anonymous Client Testing Support (ACTS)
Expression of Interest – Clinic information system
Expressions of Interest are requested from health IT software vendors or developers to provide the first stage of a system to computerise the documentation and workflow of the Anonymous Testing Service. The ATS is one of the testing and support services offered by Action For Aids Singapore, a charity focused on prevention of HIV infection.
The overall scope of the project and scope of this first stage is defined in documentation to be provided on completion of the mutual NDA. An acceptable NDA is attached. AFA will consider accepting any suitable alternative format provided by the prospective vendor, highlighting in clear English all differences between it and the sample form. It is anticipated that phase 1 will be completed by end of August 2015.
The expression of interest process will consist of:
- A maximum 5 page document outlining the scope of the solution and a high level design approach and addressing issues outlined in the documents provided, including if needed hardware requirements, timelines and ability for completion of the additional elements of the solution, IP and escrow arrangements, and 3 relevant client references with contact details. Screen captures and architectural diagrams may be added within reason to the application in addition to the 5 pages.
- A separate costing estimate covering hardware (if relevant), software, integration, implementation support and adjustments following implementation and support for the initial 12 months of operation.
- A separate Statement about approach to provision of a product demonstration. Ability to access example test systems to provide an overview of functionality and capability would be appreciated, at either the initial evaluation or short list stage.
A short list of vendors will be requested to provide:
- Demonstration of the development platform providing a demonstration implementation of a few relevant portions of the main pre-testing data collection form (see attachment A), application of a decision support rule to guide the test selection decision, workflow, and production of report in excel format.
- Demonstration of previously developed software applications if possible.
- A detailed costed proposal for stage 1 with estimated effort for delivering other components subsequently.
It is anticipated that demonstrations and interviews will be conducted remotely using GoToMeeting or similar platform.
Provision of additional tender documentation will be provided on receipt of the attached Non-disclosure agreement, binding on both parties. A confidential tender briefing and question session will be held by teleconference at a date to be agreed.
The closing date for electronic submission of EOI will be 20/07/2015
Please return the NDA electronically (signed and scanned) to
Ms Norani Othman Tel +65 6254 0212 firstname.lastname@example.org
Example of AFA client registration and data collection form is attached as an excel spreadsheet.
As the year draw to a close, we would like to take this chance to look back on a wonderful year, filled with activities, sweat and joy.
So here’s a huge thank you to all our volunteers, members and advocates. We couldn’t have done it without you. Let’s do it (even) better in 2015.
Song – Broke for Free – Night Owl http://freemusicarchive.org/music/Broke_For_Free/Directionless_EP/
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:
|Needle stick injury||0.33%|
|Receptive anal intercourse||1%|
|Insertive anal intercourse||0.04%|
|Receptive vaginal intercource||0.1%|
|Insertive vaginal intercourse||0.05%|
|Receptive fellatio with ejaculation (Oral Sex)||0.04%|
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?
- 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%
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.
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