HIV

HIV stands for human immunodeficiency virus. It is an incurable virus that attacks the immune system, destroying essential white blood cells that protect the body from bacteria, viruses and other harmful microorganisms. This makes it harder for the body to fight infections, and increases the severity of common conditions and diseases, including cancer.

Acquired Immune Deficiency Syndrome (AIDS) is the final stage of HIV infection.

For figures on HIV/AIDS prevalence in Singapore, view our latest update.

HIV is most commonly transmitted through the act of unprotected sex with a person with HIV, but it can also be transmitted by:

• Sharing injection needles or piercing instruments (e.g. tattoo guns or acupuncture needles) with a person with HIV

• Receiving infected blood or blood products (e.g. blood transfusion, organ transplant)

• During pregnancy, childbirth or breastfeeding

HIV cannot be transmitted by:

• Hugging, touching or kissing

• Insect bites

• Contact via objects such as shared food or toilet seats

Symptoms of HIV vary from person to person, and may differ depending on the stage of infection. Early symptoms include:

• Tiredness

• Weight loss

• Prolonged fever

• Skin rash

• Night sweats

• Persistent diarrhoea

• Lowered resistance to infections

You cannot tell if someone has HIV just by their appearance. The only way to know for sure is to take an HIV test.

HIV can take up to 10 years to develop into AIDS without medical intervention. If left untreated, a person will usually die between 1.5 and 3 years after developing AIDS.

Protecting against HIV

• Be faithful to your partner and do not engage in casual sex

• Be honest about your sexual history with potential new partners, and consider going for a screening together if you are unsure about your HIV status

• Practise safe sex by using condoms, which provide at least 90% protection from HIV

• Visit a reliable service provider who uses clean, sterile needles for any tattoos, piercings or injections

• Accept only HIV-screened blood for transfusion

Undergoing HIV screening is the only way to know if you have HIV.

Most clinics in Singapore offer HIV screening as a routine service. Some can provide results in as little as 20 minutes. Others provide anonymous screening services. Regardless of where you go, your results will be kept strictly confidential.

If you have multiple sexual partners or engage in casual sex often, you should always go for regular screenings so that any STI can be detected and treated as soon as possible. Early intervention is essential for the optimal management of HIV.

Seek and adhere to medical treatment including anti-retroviral therapy, and monitor your HIV viral load closely with your doctor. With effective treatment, the HIV virus can be suppressed to undetectable levels. This benefits your health and also reduces the risk of HIV transmission.

Under the Infectious Disease Act, unless you have maintained a stable undetectable HIV viral load (see below), you must inform your sexual partner of the risks of getting HIV from you before having sex. This is to allow your partner to choose to take appropriate precautions.  

You are considered to have maintained a stable undetectable HIV viral load if you satisfy the following criteria:

• You have stable, consecutive undetectable HIV viral load test results (below 200 copies per millilitre of blood), for at least six months; 
• Your most recent HIV viral load test shows a result of undetectable (below 200 copies per millilitre of blood), and is dated nine months or less before when you have sex;
• You have adhered to medical treatment for HIV infection up to the time of when you have sex; and 
• All the HIV viral load test results mentioned above are from a licenced laboratory in Singapore.

If you satisfy the above criteria, you do not pose a risk of transmission of HIV to your sexual partner. Therefore, you no longer need to inform your sexual partner of the risks of getting HIV from you.

While there is no cure for HIV, anti-retroviral therapy can help to improve the immune system and suppress the virus in your system to undetectable levels. This delays the spread of HIV and the onset of AIDS.

People with HIV taking anti-retroviral therapy are now likely to have a near-normal life expectancy.

You should go for regular follow-up visits for HIV with your doctor, including regular HIV viral load testing, and prescription refills. Medical records documenting that you have done so, serve as evidence that you have adhered to medical treatment.

If you are alleged to have committed an offence, the strongest evidence that you have adhered to medical treatment is an undetectable HIV viral load test result (from a licenced laboratory in Singapore) at the next medical visit for HIV after the sexual activity in question (which should not be more than 9 months after the sexual activity in question). This is because maintenance of undetectable HIV viral load is not possible unless you have adhered to treatment.