Contracting the Human Immunodeficiency Virus (HIV) is no longer the death sentence that it used to be. Modern antiretroviral therapy can suppress the virus in the body, allowing HIV-positive individuals to live long and fulfilling lives. As such, it is imperative that those who are at risk of infection get tested, such that they can receive life-saving treatment as soon as possible. This is especially so since HIV infection is often asymptomatic, and can go undiagnosed for years otherwise. However, some may be unsure of when and in what circumstances they should get HIV testing. If you are uncertain of whether to get tested, here are some common situations where getting an HIV test is appropriate.

Sexual contact with HIV-positive individuals

HIV is transmitted through the bodily fluids of infected individuals. These fluids include blood, pre-seminal fluid, semen, vaginal fluids, rectal fluids, and breast milk. The fluids need to make direct contact with mucous membranes or damaged tissue to infect the person. Such mucous membranes are found in the vagina, rectum, penis, and mouth. As such, high-risk activities include anal and vaginal sex, with the highest risk being receptive anal sex due to the virus being able to enter the bloodstream through microtears in the rectal lining. If you have engaged in unprotected penetrative sex with an HIV-positive individual, you might have been exposed to the virus. In such cases, getting an HIV test at an STD clinic would be advisable.

Engaging in high-risk sexual activity

Individuals who engage in sexually risky behaviour should consider getting tested as well. As mentioned before, unprotected vaginal and anal sex are the highest-risk sexual activities. Transmission of HIV through oral sex is much rarer, but there is an increased risk if the partner has open sores in their mouth. If you have recently engaged in these activities with a new partner, and are unsure of their HIV status, it is recommended to get tested. For those who engage in casual sex with multiple partners, regular testing about once every 3-6 months is advised. This is because they are at a significantly increased risk of infection, since their partners may not even be aware that they are HIV-positive.

Possible exposure to HIV-infected blood

HIV can also be spread through the blood. One of the lesser-known modes of transmission is through sharing needles or syringes. While this is not common in Singapore, there are some specific situations where this could be a cause for concern. For instance, individuals who have had surgery overseas or received a blood transfusion in a country with less stringent testing of donated blood may risk exposure to HIV-infected blood. Getting a tattoo could also put one at risk if the provider does not have appropriate measures for hygiene, and reuses a needle for multiple customers.

Window period

In any case, there are a variety of HIV tests available, each with a specific window period. HIV is undetectable during the first 3 days after infection. In this early stage within 3 days of exposure, one may consider starting post-exposure prophylaxis (PEP), a short course of antiretroviral drugs which reduces the chance of infection after high-risk exposure.

The amount of virus only reaches detectable levels about 10 days after infection, at which point an HIV RNA/DNA Polymerase Chain Reaction (PCR) Test can be conducted. This test takes about 1-2 weeks to produce results. About 14 days after infection, STD clinics can conduct more rapid tests, some of which produce results after 20 minutes. Other lab tests can also be conducted to confirm the results, delivering results in about 1-3 days. In the meantime, it would be best to avoid sexual contact after suspected exposure to the virus.

Conclusion

Whether it is for a routine test, or due to an instance of exposure, getting tested for HIV is essential for your own, and your partner’s well-being.