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  1. #1
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    Human Immunodeficiency Virus (HIV)

    HIV


    From Wikipedia, the free encyclopedia


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    This article is about the virus. For the disease, see HIV/AIDS. For other uses, see HIV (disambiguation).

    "AIDS virus" redirects here. For the computer virus, see AIDS (computer virus).






    Human immunodeficiency virus







    Scanning electron micrograph of HIV-1 (in green) budding from cultured lymphocyte. Multiple round bumps on cell surface represent sites of assembly and budding of virions.



    Virus classification



    Group:

    Group VI (ssRNA-RT)



    Family:

    Retroviridae



    Genus:

    Lentivirus



    Species



    Human immunodeficiency virus 1
    Human immunodeficiency virus 2


    Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS),[1][2] a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.

    HIV infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells.[3] HIV infection leads to low levels of CD4+ T cells through three main mechanisms: First, direct viral killing of infected cells; second, increased rates of apoptosis in infected cells; and third, killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.



    Human immunodeficiency virus







    Scanning electron micrograph of HIV-1 (in green) budding from cultured lymphocyte. Multiple round bumps on cell surface represent sites of assembly and budding of virions.



    Virus classification



    Group:

    Group VI (ssRNA-RT)



    Family:

    Retroviridae



    Genus:

    Lentivirus



    Species



    Human immunodeficiency virus 1
    Human immunodeficiency virus 2











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    What is the risk of getting infected with HIV?

    What is the risk of getting infected with HIV?
    Source: http://www.sgstdclinic.com/sg-hiv-screening

    Blood transfusion - Estimated Risks - 1 in 1

    Needle-sharing injection-drug use - Estimated Risks - 1 in 150
    Percutaneous needle stick - Estimated Risks - 1 in 300
    Receptive anal intercourse - Estimated Risks - 1 in 200
    Receptive penile-vaginal intercourse - Estimated Risks - 1 in 1000
    Insertive anal intercourse - Estimated Risks - 1 in 1500
    Insertive penile-vaginal intercourse - Estimated Risks - 1 in 2000
    Receptive oral intercourse - Estimated Risks - 1 in 10000
    Insertive oral intercourse - Estimated Risks - 1 in 20000








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    Last edited by Meteor; 07-12-2012 at 11:49 PM.

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    HIV Testing/Screening Options

    HIV Testing/Screening Options
    source : http://www.sgstdclinic.com/sg-hiv-screening


    Less than 3 days or 72 hours - no testing is available at this stage.
    You may wish to consider HIV Post Exposure Prophylaxis (PEP) if you have had a high risk exposure, i.e. unprotected sex with a commercial sex worker or high risk contact, or needlestick injury from a IV drug abuser. HIV PEP was shown to be >80% effective in reducing risk of HIV infection. In animal studies, it was shown that the earlier (<48 hrs) PEP is started, the more effective it is, with prevention rates reaching 100%.

    10 - 14 days HIV RNA/DNA Polymerase Chain Reaction (PCR) Test.. result in 2 weeks

    21 - 28 days(3 - 4 weeks) HIV 1.Combination P24 Antigen/Antibody Test (HIV Duo Test) test is for HIV 1 only
    2.Rapid Fingerprick Blood HIV-1/2 P24 Antigen/Antibody Combo (HIV Duo Test)

    More than 28 days(> 4 weeks)HIV Antibody Test (ELISA) Results are 90% accurate at 1 month post exposure
    Results are >99% accurate at 3 months post exposure

    More than 28 days (> 4 weeks) Rapid Oral Saliva HIV-1/2 Antibody Test (Oraquick)or Rapid Fingerprick Blood HIV-1/2 Antibody Test (Determine) - both can get result in 20 mins. Results are 90% accurate at 1 month post exposure Results are >99% accurate at 3 months post exposure









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    Last edited by Meteor; 07-12-2012 at 11:49 PM.

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    Basic HIV and AIDS Information

    Basic HIV and AIDS Information
    Source: http://www.aidsmap.com/hiv-basics
    Source: WHO

    What is HIV?

    HIV stands for human immunodeficiency virus.

    This particular virus was discovered in the mid 1980s and belongs to a group of viruses called ‘retroviruses’.

    HIV attacks the immune system, and gradually causes damage. This can mean that a person infected with HIV is at risk of developing some serious infections and cancers that a healthy immune system can fight off. When a person develops certain illnesses and cancers, they are said to have developed AIDS.

    A test can tell if you have HIV. If you do, this is described as being HIV-positive.

    There is no cure for HIV. However, there are more than 20 anti-HIV drugs, and treatment with a combination of these drugs can mean a longer and healthy life.

    HIV is present in blood, genital fluids and breast milk.

    The main ways HIV can be passed on to someone else are during unprotected sex, by sharing injecting equipment, and from a mother to her baby during pregnancy, birth or through breastfeeding. But there are ways of preventing HIV infection in all of these situations.

    What is AIDS?

    AIDS stands for acquired immune deficiency syndrome. AIDS is the name used to describe a combination of potentially life-threatening infections and cancers, which can develop when someone’s immune system has been damaged by HIV.

    You cannot catch AIDS and there is no AIDS test. HIV causes AIDS and it is HIV that can be passed on.

    Being diagnosed with AIDS means different things for different people. Just because someone has AIDS does not mean they will die – but it is important to have medical care and treatment.

    What is the link between HIV and AIDS?
    AIDS is the name used to describe a combination of potentially life-threatening infections and cancers that can develop in people who have HIV.

    Over time, infection with HIV damages the immune system, This means that the body cannot fight off a number of serious infections and cancers, which are sometimes called ‘AIDS-defining’.

    Just because you are diagnosed with an AIDS-defining illness doesn’t mean that you are going to die. Many of these illnesses can be cured or managed.

    Treatment with combinations of anti-HV drugs can keep the immune system strong, and because of this the number of people who are diagnosed with AIDS has fallen. Thanks to effective HIV treatment, many people who developed AIDS are now very well and can look forward to a long and healthy life.

    What are the symptoms of HIV?
    This varies from person to person. The only way to be sure if you have been infected with HIV is to have an HIV test. You cannot tell from symptoms alone.

    If you have HIV, it’s very important that it’s diagnosed for the best chance of getting treatment and care, and of staying well

    Many people have an illness, often called a ‘seroconversion’ illness, soon after they are infected with HIV. Typical symptoms include a fever, sore throat, headache, aches and pains, and a blotchy red rash.

    In some people this illness is so mild that it passes without being noticed. Some people mistake it for the flu, but for some people it is more severe and they may need to see a doctor. However, because the symptoms are similar to symptoms of many other conditions, HIV might not be diagnosed at the time.

    If you’ve had unprotected sex and notice these symptoms about two weeks later, you might want to consider having an HIV test.

    After this initial illness, it’s not uncommon for people to live with HIV and not to have any symptoms at all. But the virus will still be causing damage to the immune system, and without treatment most people with HIV will eventually become ill because of it.

    HIV-related illnesses can cause a wide range of symptoms. These can include fevers and night sweats, a high temperature, a cough that won’t go away, unexplained weight loss, severe diarrhoea, bad headaches, or persistent mouth and skin problems. Of course, these can all have other causes.

    How do I know if I have HIV?
    An HIV test can tell if you have become infected with HIV. HIV tests are extremely accurate.

    Modern tests can tell if you’ve been infected with HIV very soon after exposure to the virus – normally within two or three weeks.

    If you have HIV, it’s very important that it’s diagnosed. This will give you the best chance of getting the treatment and care you need to stay well.

    How many people have HIV in the world?
    The United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) released their annual figures for World AIDS Day in 2009. They said that at the end of 2008 there were 33.4 million people living with HIV. In 2008 there were 2.7 million new infections and 2 million HIV-related deaths.

    Their report also showed that, at the end of 2008, 4 million people were receiving antiretroviral drugs.

    How many people have HIV in my country?
    http://www.aidsmap.com/e-atlas

    What is the life expectancy of someone with HIV?
    With modern HIV treatment, many people with HIV are living long and healthy lives. In fact, some doctors are hopeful that many people with HIV will live a near-normal life expectancy.

    A lot of effort is going into making effective HIV treatment available to everyone who needs it. However, this is not always possible in some parts of the world. Without treatment, people with HIV will almost always eventually become ill, and their lives may be shortened.

    Your best chance of staying well is to start treatment at the right time. To do this you need to know you have HIV. Many of the people who die from HIV-related illnesses in countries where treatment is easily available were diagnosed very late, often not until they were already very ill.

    How can I support someone I know who has HIV?

    This will depend both on your own and the other person’s circumstances, needs, and character.

    But making it clear that you’re there to offer support, not judging, and listening, are often good places to start.

    Learning about HIV, its effects and treatment may help you to understand the experiences of your loved one, and to be able to discuss their experience or options.

    Finding out about other sources of support – both for the person with HIV and yourself – is also likely to be a good idea. There are many organisations that provide information, advice and support across the world.

    Where did HIV come from?
    HIV is very similar to a virus called SIV (simian immunodeficiency virus), which is found in monkeys.

    There’s now good evidence that it jumped species from chimpanzees to man in the early 20th century.

    How has HIV affected the world?
    Untreated HIV eventually leads to AIDS. The first cluster of AIDS cases were reported in New York and San Francisco in 1981. Doctors noticed that gay men were becoming ill with a rare form of pneumonia (PCP) and a cancer called Kaposi’s sarcoma.

    Researchers worked out that these men had an underlying infection, and that it was likely to be sexually transmitted and blood-borne.

    Further cases of AIDS were soon reported in gay men in other countries, including the UK. But it quickly became apparent that AIDS was affecting other groups as well.

    In 1985, the virus that is now known as HIV was identified.

    Even before HIV was discovered, safer sex and safer drug use had become established ways of reducing the risk of the illness.

    As the virus spread around the world and deaths mounted, research went into finding a cure or vaccine. The first drug found to have an effect against HIV was AZT.

    Other drugs were developed, but it became clear that treatment with one drug alone did not work well in the long term.

    Treatment with two anti-HIV drugs was shown to have more benefit, but the real breakthrough came with development of new anti-HIV drugs that worked against the virus in a number of different ways.

    In 1996, triple-drug HIV treatment was introduced. This treatment was able to reduce the amount of virus in the blood and allow the immune system to strengthen. Thanks to this treatment, the number of AIDS deaths fell dramatically in countries where treatment was widely available.

    However, HIV was spreading rapidly in some of the world’s poorest countries, especially in southern Africa, and wider access to HIV treatment in these countries is only now starting to become a reality.

    The early HIV treatment combinations were difficult to take and many caused unpleasant and long-term side-effects.

    More powerful, easier-to-take and safer drugs gradually became available. Thanks to these, and other improvements in HIV care, doctors have become increasingly hopeful that many people with HIV will be able to live a near-normal lifespan.

    Nevertheless, HIV continues to spread. The infection is spreading rapidly in Eastern Europe, China, India and south-east Asia.

    HIV is now firmly established as one of the leading health concerns of the 21st century, and one of the most significant causes of illness and death in human history.










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    HIV Basics Transmission and Testing

    Source: http://www.aidsmap.com/hiv-basics

    How is HIV transmitted?
    HIV is found in body fluids. It is present in enough quantity to be infectious in genital fluids, blood and breast milk.

    The main ways in which HIV is passed on are unprotected anal, vaginal and oral sex, by sharing injecting equipment, and from a mother to her baby during pregnancy, birth or breastfeeding.

    Condoms provide excellent protection against HIV transmission during sex.

    If you inject drugs, you can reduce the risk of HIV and other infections by not sharing needles or other injecting equipment.

    With the right treatment and care during pregnancy and birth, and by not breastfeeding, it’s nearly always possible to prevent mother-to-child transmission of HIV.

    How is HIV not transmitted?
    You cannot get HIV from kissing, by hugging, or by shaking hands with somebody with HIV – or any other normal social contact.

    Nor can you get HIV by being in the same place as someone with HIV, or by sharing household items such as crockery, cutlery, or bed linen.

    HIV is not passed on by spitting, sneezing or coughing.

    What can I do that is safe?
    Kissing, hugging, massage, and mutual masturbation are all completely safe.

    Condoms provide excellent protection against HIV when used properly for anal, vaginal or oral sex.

    The risk of HIV transmission from oral sex is much lower than for anal or vaginal sex. Some people choose to use condoms or dental dams for oral sex to reduce this risk even further.

    If you inject drugs, you can reduce the risk of HIV and other infections by not sharing needles or other injecting equipment.

    I’m starting a relationship with someone who is HIV-positive, what do I need to know?
    Many people who are HIV-negative are in successful, loving, and intimate relationships with an HIV-positive partner.

    Modern HIV treatment and care can significantly improve your partner’s health and life expectancy. Many people with HIV can expect to have a near-normal lifespan. There’s a lot of support available to help you both deal with the stresses and strains related to HIV that may arise in your relationship.

    It may be reassuring to know that you can stay HIV-negative. It’s completely safe to kiss and hug your partner. What’s more, many couples have intimate and fulfilling sex lives without passing on HIV



    HIV Basics > Testing

    Source: http://www.aidsmap.com/hiv-basics

    How do I know if I have HIV?
    An HIV test can tell if you have become infected with HIV. HIV tests are extremely accurate.

    The tests used today can usually tell if a person has HIV within a month of their infection. However to be certain that a person does not have HIV, it’s recommended to test again three months after possible exposure to HIV.

    If you have HIV, it’s very important that it’s diagnosed. This will give you the best chance of getting the treatment and care you need to stay well.

    Where can I get an HIV test?
    check out www.afa.gov.sg
    Visiting AFA
    http://www.youtube.com/watch?v=IXGW76RIYFA


    What does an HIV test involve?
    There are several different types of HIV tests. Often a small sample of blood is taken and analysed in a laboratory. Other tests give an initial rapid result using finger-prick blood, or even saliva. It’s often possible to get a test result the same day.

    The tests used today can usually tell if a person has HIV within two or three weeks of their infection. In the past you might have had to wait three months to be certain that your test result is accurate.

    It’s a good idea to talk to the person giving you the HIV test if you have any questions about it.










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    Last edited by Meteor; 07-12-2012 at 11:49 PM.

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    HIV Basics Treatment

    HIV Basics > Treatment
    Source: http://www.aidsmap.com/hiv-basics

    Can HIV be cured?
    There is no cure for HIV. There has been, and continues to be, lots of research into possible cures.

    But treatment with anti-HIV drugs means that many people with HIV are living long and healthy lives.

    How is HIV treated?
    Treatment for HIV involves taking a combination of anti-HIV drugs. This treatment has a very powerful anti-HIV effect and stops the virus from reproducing.

    This allows the immune system to strengthen and fight infections effectively.

    To get the most benefit from your HIV treatment, you need to take it properly. This is often called ‘adherence’.

    What does HIV treatment involve?
    HIV treatment involves taking anti-HIV drugs every day. These cannot cure HIV. However, they can stop HIV from reproducing. This allows the immune system to stay strong.

    There are now more than 20 of these drugs, although they are not all available everywhere in the world. HIV is normally treated with a combination of three different drugs. Most HIV treatment combinations are taken once or twice daily. This treatment has a very powerful anti-HIV effect. Thanks to HIV treatment, many people with the virus can hope to live a long and healthy life.

    You should aim to take all the doses of your treatment. Missing just a few doses a month can mean that your treatment doesn’t work properly, and your HIV may become resistant to the drugs that you are taking.

    Anti-HIV drugs can interact with other some other prescribed drugs, medications you would buy from a pharmacy, herbal remedies and illegal or ‘recreational’ drugs. To reduce the risk of interactions, it’s important to tell your HIV doctor or pharmacist about any other medicines and drugs you are taking.

    You’ll be monitored regularly to see if your treatment is working. If you do encounter a problem with your treatment, it should be possible to do something about it.

    Where can I go for treatment and care?
    Medical care for HIV happens in a wide range of hospital and other medical settings, depending on where you are in the world. You can find out about treatment centres in the country where you live using the e-atlas on this website.

    What can I do to help myself?
    There’s a lot you can do to look after your physical and mental health and general wellbeing.

    Leading a healthy lifestyle is a good start. This includes getting enough sleep, eating a good diet, exercising, not smoking, drinking sensible amounts of alcohol, and avoiding or moderating drug use.

    Attending your clinic appointments is important and, if you are on HIV treatment, then taking it properly is a very important part of staying well.

    Looking after your emotional health is also very important. It’s good to have somebody you trust who you can talk to about your feelings and discuss any problems you may have.

    Living with HIV can be hard at times, and most people need the help of others from time to time. Don’t be frightened to ask for help.

    What are the side-effects of HIV treatment?
    All medicines can cause side-effects, and this includes those used to treat HIV. But it’s good to know that many people find modern HIV treatment easy to take.

    Anti-HIV drugs can cause both short-term and long-term side-effects.

    Common side-effects you might have when you first start a treatment are diarrhoea, feeling or being sick, and headache. Some drugs can also cause problems sleeping, including vivid dreams, a feeling of being ‘spaced out’ or depression.

    Most people find that these side-effects lessen or go away completely after a couple of weeks.

    A few anti-HIV drugs can cause an allergic reaction. You should be screened for risk factors before taking any of these drugs, and then warned about possible symptoms. If you do then have any of those symptoms, you should seek medical advice immediately.

    Longer-term side-effects can involve increased levels in blood fats and sugars, changes in kidney or liver function, or thinning of the bones. You’ll be monitored to see if you develop any of these side-effects.

    It’s worth remembering that you don’t always have to put up with side-effects. Mention them to a member of your healthcare team as it may be possible to do something about them.


    When will I need to start taking HIV treatment?
    There is no definite ‘right’ time to start HIV treatment.

    There are different views on the benefits of starting treatment earlier and later. Guidelines on when people should start HIV treatment vary in different countries.

    You will need to talk to your healthcare team and weigh up the benefits and risks of starting treatment. HIV treatment is lifelong and starting treatment is a big commitment. If you feel comfortable about starting treatment and understand what is involved, you may be more likely to be able to take your treatment properly.

    However, it is recommended that you should start taking HIV treatment if you are ill because of HIV.

    Where it’s available, testing for the strength of your immune system (called a CD4 count) should help determine whether you need to start treatment. It’s recommended that people whose CD4 cell count is around 350 should start taking HIV treatment.

    Starting treatment at this time reduces your risk of becoming ill because of HIV, and also reduces the risk of heart, liver and kidney disease as well as some cancers.

    For this reason, patients with risk factors for these illnesses are especially encouraged to start treatment when their CD4 cell count is around 350.

    What should I ask my doctor?

    If you don’t understand anything, or if you want to know more about any subject, ask your doctor! Or there may be another member of your healthcare team who can help with a particular issue.

    You should feel able to ask questions or tell your doctor, or another healthcare worker, about things that are bothering you. This will be important in staying as well as possible and increasing the chances of any treatment being successful.









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    Last edited by Meteor; 07-12-2012 at 11:50 PM.

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    Questions and Answers on HIV

    Questions and Answers on HIV

    Q. If a person has sexual intercourse with an infected female, what is the chance of him getting the disease?

    A. The risk of vaginal intercourse without protection may vary between 0.1 to 0.01%. However, there are many other factors which can increase transmission including the presence of genital ulcers, the type of sex act actually performed, sex toys etc. etc.

    Q. The blood tests only tell you after your body has produced the HIV antibodies. How do you find out whether you got the infection immediately after having sexual intercourse with a prostitute?

    A. Be patient. You have to wait for sometime even if you use the newer (and usually used in research) antigen test you will still have to wait for a few weeks.

    Q. Can HIV be transmitted through the act of oral sex or French kissing?

    A. Yes. However, the risk is significantly lower than anal or vaginal intercourse. In oral sex, the person performing the act runs the higher risk but some couples use the oral dam which acts as a barrier or oral sex with a condom. French kissing has relatively low risk unless there are lesions or cuts in the oral cavity.

    Q. Do condom protect one completely from getting AIDS if one practice casual sex often?

    A. The efficacy of the condom is dependent on the quality of the condom
    itself as well as the technique of putting on the condom. However, the studies suggest that the efficacy of STD prevention may be anything between 90 to 99%. Although I agree with you that it does not completely remove the risk of HIV infection certainly if sexual intercourse is taking place with an 'unknown or uncertain' partner some protection is better than no protection.

    Q. How come HIV virus can be transmitted outside the body? like for instance thru a needle?

    A. HIV transmission requires a very direct route for eg. in sexual intercourse there should be penetration and in drug users there should be sharing of needles with contaminated blood inside. I think that you are asking me whether the virus can survive outside the body for a prolonged period of time. The answer to that question is no, however, I have to qualify that statement. If the blood is dried and coagulated the risk of transmission is significantly reduced whereas the risk of transmission is much higher if the blood is still fresh.

    Q. Dr Bella, you mean to say that a person has only 0.1 to o.o1% of getting AIDS if he has intercourse with an infected person. What about Anal sex ,what is the chance of infection then?

    A. Anal intercourse has a higher risk and it can vary between 1 to 10%.

    Q. I have read articles saying some HIV positive people use needle to poke other people to infect them with HIV is this true?

    A. In theory this route of transmission is possible. However, this is not something that happens often and if it does it is already a criminal act and should be reported to the police. The large majority of HIV infected people are very 'normal' and do not behave in a manor you have described above. In fact, they suffer more from our discrimination and isolation

    Q. What is the life expectancy of people diagnosed HIV positive?

    A. The average life expectancy is about 10 years.

    Q. I gather that the HIV virus is present in body fluids in an infected person, what is the risk of a mosquito biting this person and transmitting to the next ?

    A. There is no risk at all of a mosquito biting and transmitting HIV from an infected person to another person

    Q. What are the latest drugs in the pipeline that could make a difference to people with HIV in terms of lesser side effects or reduce the amount of medications that have to be taken?

    A. There are a few drugs in the pipeline. An example of a drug that is taken once a day is Efavirenz. However, it must be taken in combination with two other drugs.

    Q. Does the urine of an AIDS person contain the HIV virus?

    A. Yes, it does. However, you would not get infected by touching the urine. The HIV virus does not transmit this way.

    Q. Why in some cases a person who is infected with the HIV virus does not develop AIDS for many years?

    A. Once the HIV virus enters the body, it begins to replicate and destroy the white cells (CD4 cells) and once the CD4 drops to a certain value a person then has entered the stage we consider as AIDS.

    Q. How effective are the drugs available at present in arresting HIV? what is the life expectancy in treated and untreated cases?

    A. The drugs will increase the white cell count and reduce the viral load to undetectable levels but it will not eradicate the virus. Combination drug therapy has only been used for the past 6 to 7 years. The majority of patients on this therapy are doing well.

    Q. How does the presence of other STD infections influence the likelihood of a person getting the HIV infection?

    A. When there is STD's, you are likely to have ulcers or breaks in the skin which allow the HIV virus to enter the body

    Q. Is there a method to detect whether a person has AIDS before HIV antibodies are present in the blood?

    A. HIV antibodies will be present in the blood before AIDS develops. AIDS is the advanced stage of HIV infection.

    Q. How many types of aids virus are there?

    A. Basically there are two main types: HIV-1 and HIV-2.

    Q. What is the likelihood of a person getting AIDS if he or she has sex with an infected person, in terms of percentage?

    A. With unprotected sexual activity following 1 occasion of receptive anal intercourse the rate of infection is between 0.1% to 3%. Following receptive vaginal intercourse the rates of infection is 0.1% to 0.2%. Whereas for insertive vaginal intercourse rates of infection after one exposure are 0.03% to 0.09%. With multiple sexual exposure the risk of transmission is much higher. It is worse with multiple partners and those with HIV infection but untreated. With multiple sexual exposure the risk of transmission is much higher. It is worse with multiple partners and those with HIV infection.










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    Last edited by Meteor; 07-12-2012 at 11:50 PM.

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    HIV Tests for Home Team NSmen

    HIV Tests for Home Team NSmen

    Thursday, 23 l 09 l 2010 Source: The Straits Times
    By: Ang YiYing Additional reporting by Jermyn Chow
    Source: http://www.healthxchange.com.sg/news...eam-nsmen.aspx

    Aim is to protect officers, public but privacy issues have arisen

    NATIONAL servicemen (NSmen) from the police and the Singapore Police Force and the Singapore Civil Defence Force (SCDF) will now undergo mandatory HIV screening.

    The testing is to safeguard the health and well-being of officers, as well as members of the public they come into contact with, says the Ministry of Home Affairs (MHA).

    But the move has also raised privacy issues relating to how information gained about an NSman’s HIV status will be handled.

    Replying to queries from The Straits Times last week, MHA said the screening of Home Team NSmen started this year.

    But it did not elaborate on why the policy was being implemented now or how the tests are done.

    It also did not say how many servicemen would be affected, but according to publicly available statistics there are around 36,000 police and civil defence NSmen, including more than 7,000 in full-time national service (NS).

    The Straits Times understands that the NSmen are likely to undergo the tests from their fifth NS cycle, that is, the fifth time they are activated for in-camp training.

    MHA is not alone in implementing mandatory HIV testing. Since 1995, SAF servicemen have been tested for HIV at least once during full-time NS or during their NS cycles. Contacted for comment, Government Parliamentary Committee
    chairman for Home Affairs and Law Alvin Yeo said the policy would inspire confidence among the public who come into contact with the officers. “They deal with emergencies and crisis situations, so it’s good to know they have no health issues.”

    Asked why he thought it was being enforced now, he replied that the police and the civil defence force complemented the military in the overall defence of the country, so “for the same reasons considered by the SAF, it could have been considered necessary”.

    An NS police assistant superintendent aged 28 said he had been told during a briefing that there was the risk of blood from healthy and infected individuals mixing when injuries are sustained in the line of duty, “so to avoid such things happening, it would be good to post infected people to other lower-risk vocations”.

    Dr Asok Kurup, an infectious diseases specialist, said the risk of HIV transmission through injuries would depend on how widespread HIV infection is among the population, as well as the circumstances of the injury. Even so, the risk of infection through being pricked by a needle used on an HIV-infected patient is at most, 0.3 per cent, he said. He added that the prevalence of HIV infection here and the risk of infections through injuries are low, but not zero.

    Community organisation Action for Aids (AfA) said large studies done in the West have not shown that infected emergency or health workers transmit HIV in the course of their work, but screening can mean early diagnosis and treatment.

    A copy of a call-up notice obtained by The Straits Times states that a fine of up to $5,000 or a jail term of up to three years or both can be dealt to those found guilty of failing to report for the test.

    On the issue of privacy, an NS police sergeant aged 29 said: “It should be voluntary, not compulsory. This is a personal medical health status and is private unless it’s relevant to a person’s full-time career.”

    But NS police Sergeant Satinderpal Singh Sandhu, 29, said he saw the rationale. “You could suffer open injuries while on duty and people coming to your aid could get infected. I think it’s justified.” But he, too, is concerned about the confidentiality of the test results.

    AfA president Roy Chan stressed that it was crucial to put in place measures to protect the identity of those tested, especially those who test positive, and to ensure their service and prospects are unaffected; he also called for a system of support, including pre and post-test counselling.

    Asked about policies governing HIV test results, the Health Ministry said it is notified when someone tests positive, but maintains patient confidentiality, as required by the Infectious Diseases Act.











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    Last edited by Meteor; 07-12-2012 at 11:50 PM.

  9. #9
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    Infectious diseases act (chapter 137) part iv control of aids and hiv infection

    INFECTIOUS DISEASES ACT
    (CHAPTER 137) PART IV CONTROL OF AIDS AND HIV INFECTION

    Source : http://statutes.agc.gov.sg/non_versi...thod=part&sl=1

    Person with AIDS or HIV Infection to undergo counselling, etc.
    22. —(1) The Director may require any person who has been diagnosed as having AIDS or HIV Infection —

    (a) to undergo counselling at such time and at such hospital or other place as the Director may determine; and

    (b) to comply with such precautions and safety measures as may be specified by the Director.[5/92;13/99]

    (2) Any person who fails or refuses to comply with subsection (1) shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $10,000 or to imprisonment for a term not exceeding 2 years or to both.[5/92]

    Sexual activity by person with AIDS or HIV Infection
    23. —(1) A person who knows that he has AIDS or HIV Infection shall not engage in any sexual activity with another person unless, before the sexual activity takes place —

    (a) he has informed that other person of the risk of contracting AIDS or HIV Infection from him; and

    (b) that other person has voluntarily agreed to accept that risk.

    (2) A person who does not know that he has AIDS or HIV Infection, but who has reason to believe that he has, or has been exposed to a significant risk of contracting, AIDS or HIV Infection shall not engage in any sexual activity with another person unless —

    (a) before the sexual activity takes place he informs that other person of the risk of contracting AIDS or HIV Infection from him and that other person voluntarily agrees to accept that risk;

    (b) he has undergone the necessary serological or other test and has ascertained that he does not have AIDS or HIV Infection at the time of the sexual activity; or

    (c) during the sexual activity, he takes reasonable precautions to ensure that he does not expose that other person to the risk of contracting AIDS or HIV Infection.

    (3) Any person who contravenes subsection (1) or (2) shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $50,000 or to imprisonment for a term not exceeding 10 years or to both.

    (4) For the purposes of this section, a person shall not, only by reason of age, be presumed incapable of engaging in sexual activity.

    (5) For the purposes of this section, a person shall be deemed to know that he has AIDS or HIV Infection if a serological test or other test for the purpose of ascertaining the presence of HIV Infection carried out on him has given a positive result and the result has been communicated to him.

    (6) No prosecution shall be instituted for an offence under subsection (2) except with the written consent of the Public Prosecutor, but a person charged with such an offence may be arrested and be remanded in custody or released on bail notwithstanding that the consent of the Public Prosecutor to the institution of a prosecution for the offence has not been obtained, except that the case shall not be further prosecuted until that consent of the Attorney-General has been obtained.

    (7) In this section, “sexual activity” means —

    (a) sexual activity occasioned by the introduction into the vagina, anus or mouth of any person of any part of the penis of another person; or

    (b) cunnilingus.

    Blood donation and other acts by person with AIDS or HIV Infection
    24. —(1) Any person who knows that he has AIDS or HIV Infection shall not —

    (a) donate blood at any blood bank in Singapore; or

    (b) do any act which is likely to transmit or spread AIDS or HIV Infection to another person.[5/92;13/99]

    (1A) For the purposes of this section, a person shall be deemed to know that he has AIDS or HIV Infection if a serological test or other test for the purpose of ascertaining the presence of HIV Infection carried out on him has given a positive result and the result has been communicated to him.

    (2) Any person who contravenes subsection (1) shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $50,000 or to imprisonment for a term not exceeding 10 years or to both.[5/92;13/99]

    Protection of identity of person with AIDS, HIV Infection or other sexually transmitted disease
    25. —(1) Any person who, in the performance or exercise of his functions or duties under this Act, is aware or has reasonable grounds for believing that another person has AIDS or HIV Infection or is suffering from a sexually transmitted disease or is a carrier of that disease shall not disclose any information which may identify the other person except —

    (a) with the consent of the other person;

    (b) when it is necessary to do so in connection with the administration or execution of anything under this Act;

    (ba) when it is necessary to do so in connection with the provision of information to a police officer under section 22 or 424 of the Criminal Procedure Code 2010;

    (c) when ordered to do so by a court;

    (d) to any medical practitioner or other health staff who is treating or caring for, or counselling, the other person;

    (e) to any blood, organ, semen or breast milk bank that has received or will receive any blood, organ, semen or breast milk from the other person;

    (f) for statistical reports and epidemiological purposes if the information is used in such a way that the identity of the other person is not made known;

    (g) to the victim of a sexual assault by the other person;

    (h) to the Controller of Immigration for the purposes of the Immigration Act (Cap. 133);

    (i) to the next-of-kin of the other person upon the death of such person;

    (j) to any person or class of persons to whom, in the opinion of the Director, it is in the public interest that the information be given; or

    (k) when authorised by the Minister to publish such information for the purposes of public health or public safety.[5/92;13/99]

    (2) Any person who contravenes subsection (1) shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $10,000 or to imprisonment for a term not exceeding 3 months or to both.[5/92]

    (3) For the purposes of subsection (1) (a), the consent of the other person includes —

    (a) if that person has died, the written consent of that person’s spouse, personal representative, administrator or executor;

    (b) if that person is below the age of 16 years, the written consent of a parent or legal guardian of that person; and

    (c) if, in the opinion of the medical practitioner who undertook the test for HIV Infection for that person, he has a disability by reason of which he appears incapable of giving consent, the written consent in the following order, of —

    (i) a legal guardian of that person;

    (ii) the spouse of that person;

    (iii) a parent of that person; or

    (iv) an adult child of that person. [13/99]










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    Last edited by Meteor; 07-12-2012 at 11:50 PM.

  10. #10
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    Infectious diseases act (chapter 137) part iv control of aids and hiv infection

    INFECTIOUS DISEASES ACT
    (CHAPTER 137) PART IV CONTROL OF AIDS AND HIV INFECTION
    Source : http://statutes.agc.gov.sg/non_versi...thod=part&sl=1

    Disclosure by Director, medical practitioner and recipient of information
    25A. —(1) The Director may disclose any information relating to any person whom he reasonably believes to be infected with AIDS or HIV Infection to —

    (a) any medical practitioner or other health staff who has been exposed to a risk of infection from AIDS or HIV Infection; or

    (b) any first responder who has experienced a significant exposure to blood or other potentially infectious materials of any patient.[13/99]

    (2) In subsection (1), “first responder” means any police officer, member of the Singapore Civil Defence Force or any person who provides emergency response, first aid care or other medically related assistance either in the course of the person’s occupational duties or as a volunteer.[13/99]

    (3) Subject to subsection (4), a medical practitioner may disclose information relating to any person whom he reasonably believes to be infected with AIDS or HIV Infection to the spouse, former spouse or other contact of the infected person or to a Health Officer for the purpose of making the disclosure to the spouse, former spouse or other contact.[13/99]

    (4) The medical practitioner shall not disclose any information under subsection (3) unless —

    (a) he reasonably believes that it is medically appropriate and that there is a significant risk of infection to the spouse, former spouse or other contact;

    (b) he has counselled the infected person regarding the need to notify the spouse, former spouse or other contact and he reasonably believes that the infected person will not inform the spouse, former spouse or other contact; and

    (c) he has informed the infected person of his intent to make such disclosure to the spouse, former spouse or other contact.[13/99]

    (5) Where the medical practitioner is unable, by any reasonable means, to counsel or inform the infected person, he may apply to the Director to waive the requirements of subsection (4) (b) or (c) or both.[13/99]

    (6) The Director may approve the application made under subsection (5) if, in the opinion of the Director, it is medically appropriate to disclose the information and that there is a significant risk of infection to the spouse, former spouse or other contact.[13/99]

    (7) No person, to whom any information relating to a person who is reasonably believed to be infected with AIDS or HIV Infection has been disclosed under this section, shall disclose such information to any person other than the persons specified in subsection (8) or as provided in subsection (10).[13/99]

    (8) The persons referred to in subsection (7) are —

    (a) the infected person himself;

    (b) a person who is authorised under section 25 (1) (a) to consent to such disclosure; and

    (c) any person who is authorised to disclose such information under subsection (1), (3) or (6) or section 25 (1).[13/99]

    (9) Any person who contravenes subsection (7) shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $10,000 or to imprisonment for a term not exceeding 3 months or to both.[13/99]

    (10) A person, to whom any information relating to a person who is reasonably believed to be infected with AIDS or HIV Infection has been disclosed under this section, may apply to the Director for approval to disclose such information to any person or class of persons. [13/99]

    (11) The Director may approve the application under subsection (10) if he is satisfied that such disclosure is in the interests of public health or public safety.[13/99]











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    Last edited by Meteor; 07-12-2012 at 11:51 PM.

 

 

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