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NCID > About NCID > Our Departments > National HIV Programme

National HIV Programme

National HIV Programme

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Human Immunodeficiency Virus (HIV) infection remains a public health priority in Singapore. The National HIV Programme (NHIVP) was established under the National Centre for Infectious Diseases (NCID) to coordinate this country-wide HIV response. Through a multidisciplinary approach, the NHIVP collaborates with clinicians and healthcare professionals, public health practitioners, academics and other stakeholders.

In line with the Ministry of Health's objectives to end HIV in Singapore, the NHIVP will:

  • Coordinate the formulation and recommendation of evidence-based guidelines on HIV testing, prevention, treatment and patient management;

  • Monitor HIV trends in Singapore through working with the National Public Health Epidemiology Unit (NPHEU) to conduct national epidemiological surveillance of HIV and sexually transmitted infections (STIs);

  • Monitor common circulating HIV strains in Singapore, identify and track transmissible drug resistance in HIV, as well as conduct recency testing through working with the National Public Health Laboratory (NPHL) to conduct national HIV molecular surveillance programme​;

  • Provide enhanced training to healthcare professionals to strengthen their competence and confidence in the management of patients with HIV; and

  • Develop HIV education campaigns to increase awareness and reduce related stigma in the general population.

The NHIVP Vision

Aimed at achieving the UNAIDS 90-90-90 / 95-95-95-95 targets and beyond, our vision is to provide quality and holistic patient-centred care for all persons living with HIV in Singapore and build an environment that is free from stigma and discrimination.

 

NHIVP provides policy and strategic oversight for the Enhanced HIV Programme. The programme has been operationalised by the respective Clinical HIV Programmes under NCID, National University Hospital (NUH), Singapore General Hospital (SGH) and Changi General Hospital (CGH) to provide care for persons living with HIV.​

Our Team 

DirectorDr Wong Chen Seong
Deputy Director​​Christine Gao
Clinical Advisors

A/Prof Sophia Archuleta (Senior Consultant)

Dr Choy Chiaw Yee (Consultant)

Dr Teh Yii Ean (Consultant)

Policy Team

Dr Felicia Hong

Geraldine Cheng

Jessey Markose

Karen Chin

Programme Team

Lavinia Lin

Sally Low


For any further enquiries, please email: [email protected]

For more information on HIV testing, prevention and treatment, education resources, and national HIV campaigns and projects, visit here.

HIV self-testing kits will be available for purchase at select retail pharmacies nationwide and at the Action for AIDS (AfA) by end January 2025.​


1. ​What is HIV self-testing?

HIV self-testing is where a person collects his or her own specimen (oral fluid or blood), performs a HIV test and interprets the result, often in a private setting. The result of a single rapid diagnostic test such as the HIV self-test is not sufficient to make a diagnosis of HIV infection. Individuals with a positive result from the self-testing kit should receive further confirmatory testing from a healthcare provider and be referred for treatment.


2. Why are we introducing HIV self-testing in Singapore?

In Singapore, a large proportion of newly detected HIV cases had late-stage infection at the time of diagnosis (52% of cases notified in 2023, 51% in 2022 and 62% in 2021), and the proportion detected through self-initiated HIV testing is relatively low (i.e., 15% of cases notified in 2023, 17% in 2022 and 16% in 2021). This is part of a broader effort to increase access to HIV testing within the community and encourage regular testing.

The World Health Organization (WHO) also recommends HIV self-testing as a safe, accurate and effective way to reach people who may not test otherwise. Globally, countries such as the USA, Canada and Australia have included HIV self-testing as part of their national policies to increase testing coverage.

 

3. Where can we get the HIV self-test kits?

The OraSure OraQuick® HIV Self-Test (OraQuick) kits will be available for purchase at selected retail pharmacies (as well as associated online platforms) nationwide and at Action for AIDS (AfA) from end-January 2025.

 

4. How much are the HIV self-test kits?

The cost of the HIV self-test kit will be between $21 and $33.

 

5. What are the range of HIV self-test kits available? Are the HIV self-test kits licensed/approved for use by HSA or other regulatory bodies?

The OraSure OraQuick® HIV Self-Test (OraQuick), third-generation HIV rapid test kit, will be available to the public. It is an HSA and US Food and Drug Administration-approved oral swab-based test. It is also a pre-qualified WHO rapid diagnostic test.

 

6. Can individuals under 18 years old purchase the self-test kit?

The OraQuick is intended for use by individuals' ages 18 and older and not for use by those under 18. For those that are under 18 and would like to be tested, please contact your doctor or healthcare provider to get tested.

 

7. Are pre- and post-test counselling provided at licensed retail pharmacies? Who can the individual contact for counselling support?

The retail pharmacies have been educated to ensure that they are able to provide advice on potential queries. Pamphlets containing information on HIV and where to get pre- and post-test counselling are also available at the pharmacies.
For more comprehensive counselling and advice, individuals are encouraged to contact the Department of Sexually Transmitted Infections Control (DSC) Clinic and/or AfA.

 

8. Who can the individual contact for technical or distress support?

Individuals who wish to speak to someone about HIV testing or results or need any other sexual health-related information can contact the DSC Clinic and/or AfA. Individuals who experience emotional distress and/or have thoughts about harming themselves after a positive test result, can contact Samaritans of Singapore for support.

 

9. What should an individual do if they are worried about their results?

Regular testing and early diagnosis allow persons living with HIV to be treated early and achieve better treatment outcome. With early and effective treatment, persons living with HIV can continue to lead active and productive lives.
Individuals who experience emotional distress and/or suicidal thoughts after a positive test result can call the DSC Clinic and/or AfA. They will be provided with counselling and support and also be advised to visit their healthcare provider for further evaluation and review.

 

10. How accurate is the test, what is the false positive rate, and is it possible to get a false positive result?

The test has a sensitivity of 92%, which means that one false negative result would be expected out of every 12 test results in HIV infected individuals. It has a specificity of 99.98%. This means that one false positive result would be expected out of every 5,000 test results in uninfected individuals.

It is extremely important for those who self-test to carefully read and follow the labelled directions. Even when used according to the directions, there will be some false negative and a small number of false positive results. Additional testing in a medical setting will either confirm a positive test result or inform that the initial result was a false positive result.
Following infection with HIV, it can take up to three months for the antibodies to develop before they can be detected by the test kits. A self-test kit performed during this three month “window period" may not be able to detect an infection. A second test needs to be performed three months after the first test to confirm the results. 

 

11. What can an individual expect from a positive and negative test result?

If the test result is positive, individuals should seek further confirmatory testing from a healthcare provider and be linked to appropriate medical care if needed.​

If the test result is negative, it does not mean that the individual is definitely not recently infected with HIV or does not have HIV. As the rapid oral fluid HIV test detects antibodies produced by the body in response to HIV infection, it can take up to three months following exposure and infection for the antibodies to develop before they can be detected by the self-test kits. The OraQuickTM HIV Self-Test performed during this three month “window period" may not be able to detect an infection. A second test needs to be performed three months after the first test to confirm the results. If an individual has recently engaged in behaviour that puts them at high risk for HIV infection, he/she should see a health care provider to discuss other options for HIV testing or take the test again at a later time.

 

12. How often should an individual get tested for HIV?​

People at higher risk of HIV infection should be tested more frequently. Certain individuals may benefit from more frequent testing (i.e. 3 to 6 monthly) depending on their risk profiles. If an individual actively engages in behaviour that puts them at risk for HIV infection, or their partner engages in such behaviour, they should consider testing on a regular basis. It can take some time for the immune system to produce enough antibodies for the test to detect and this time period can vary from person to person.​​

An individual should undergo HIV testing if they: 

  • ​​Had been recently diagnosed with a sexually transmitted infection;
  • Had sex with an individual whose HIV viral load is above the limit of detection (i.e. RNA > 200 copies/ml);
  • Are currently on pre-exposure prophylaxis;
  • ​Had exchanged sex for money;
  • Had a history of injection drug use or engage in sexual activities under the influence of alcohol or other drugs, or are the partners of such person;
  • Had been diagnosed with or treated for viral hepatitis or tuberculosis; or
  • Had more than one sexual partner since your last HIV test.​

The list is not exhaustive and an individual should be tested at least once a year if they continue to be exposed to the activities listed above.

If an individual feels that they may be at risk, getting screened for HIV is the crucial first step to knowing their HIV status. Knowing their status enables an individual to receive treatment early and prevent others from getting infected.


The NHIVP regularly hosts conferences, seminars and education events to share best practices of HIV prevention, treatment and patient management for healthcare professionals and general public.  


For Healthcare Professionals:

Healthcare Worker Stigma and Discrimination Online Modules (coming soon)

The Healthcare Worker Stigma and Discrimination Online Modules are a series of comprehensive web-based educational modules, aiming to increase HIV-related knowledge, especially regarding HIV-related stigma and discrimination. The goal is to assist healthcare workers in recognising their own unconscious bias and discriminatory attitudes towards people living with HIV, and help them adopt and promote best practices in the care of people living with HIV. The modules are interactive and catered to various roles in healthcare institutions (for example, nurses, doctors, patient service associates, and healthcare students). It will be available to all healthcare workers in Singapore.

PrEP Prescriber Course

The PrEP Prescriber Course is to educate and equip general practitioners, primary care doctors and people who work with individuals at risk of HIV infection with the appropriate knowledge and skills to provide PrEP services.

PrEP Prescriber Course 2022


For Healthcare Professionals and General Public:

Singapore HIV Congress
The Singapore HIV Congress (SHC), started in 2019, is held once every two years. It brings together the medical, scientific and academic fraternity in a forum to present the latest developments in HIV medicine and related fields. The aim of the congress is to provide an avenue for exchange of ideas spurred by new findings in HIV testing, treatment, prevention and HIV stigma in the public domain.

Year​Summary Reports of SHC​​Event Recording
​2023
​Auditorium Rapporteur
CHI Halls Rapporteur​​
​NIL

​2021

SHC 2021: Session 1
SHC 2021: Session 2

Singapore HIV Congress 2021: 90-90-90 and beyond (Session 1)
Singapore HIV Congress 2021: 90-90-90 and beyond (Session 2)


HIV Community Engagement Forum 
The HIV Community Engagement Forum aims to bring together people from all walks of life, such as infectious disease specialists and healthcare professionals who do not specialise in the field of infectious diseases, community members working with HIV populations and the general population with limited or no knowledge of HIV, to engage in dialogues and discussions in order to raise awareness and combat various misconceptions surrounding HIV.

HIV Community Engagement Forum 2023: U=U and You
HIV Community Engagement Forum 2022: Ins & Outs of HIV Testing
HIV Community Engagement Forum 2021: Increasing HIV Testing in Singapore

World AIDS Day

World AIDS Day (WAD) started in 1988 and takes place on 1 December each year. It is an international day for people worldwide to unite in the fight against HIV, to show support for people living with HIV, and to commemorate those who have died from an AIDS-related illness. Every year, NHIVP and Enhanced HIV Programmes at public healthcare institutions commemorate WAD through activities to raise awareness about HIV, challenge misconceptions about HIV transmission and infection, and develop empathy and solidarity between people living with HIV and healthcare workers.
World AIDS Day 2023: Following Jason's Journey – Relationships
World AIDS Day 2022: Following Jason's Journey – Employment
World AIDS Day 2021: Following Jason’s Journey – Diagnosis & Beyond
World AIDS Day 2020: We are in this together


To receive information about NHIVP’s events, please email: [email protected]


Conference Presentations:

  1. Choy, CY. Treatment as prevention: U=U, 11th Singapore AIDS Conference, Singapore, 8 Dec 2018.

Scientific Publications:

  1. Choy CY, Wong CS, Kumar PA, Lin RTP, Low C, Toh MPHS, Huang F, Olszyna DP, Teh YE, Chien MFJ, Archuleta S. “National HIV programme testing recommendations.” Singapore Med J. 2023; doi: 10.4103/singaporemedj.SMJ-2021-466.

  2. Choy CY, Wong CS, Kumar PA, Yeo B, Banerjee S, Leow Y, Olszyna DP, Tan KK, Tan RKJ, Ti J, Chan R, Le D, Kwok C, Archuleta S. "Guidance for the prescription of human immunodeficiency virus pre-exposure prophylaxis in Singapore." Singapore Med J. 2022; doi: 10.11622/smedj.2022043. Epub ahead of print.

  3. Choy CY, Wong CS, Kumar PA, Olszyna DP, Teh YE, Chien MFJ, Kurup A, Koh YL, Ho LP, Law HL, Chua NGS, Yong HYJ, Archuleta S. "Recommendations for the use of antiretroviral therapy in adults living with HIV in Singapore." Singapore Med J. 2022; doi: 10.11622/smedj.2021174. Epub ahead of print.

  4. Tan YR, Kaur N, Ye AJ, Zhang Y, Lim JXZ, Tan RKJ, Ho LP, Chen MI, Wong ML, Wong CS, Yap P. "Perceptions of an HIV self-testing intervention and its potential role in addressing the barriers to HIV testing among at-risk heterosexual men: a qualitative analysis." Sex Transm Infect. 2021;97:514-520.

  5. Choy CY, Wong CS. "SARS-CoV-2 and Advanced HIV Infection." Annals Acad Med Singapore. 2020; 49(12):1042-1043.

  6. CY Choy, CS Wong. "It's not all about COVID‐19: Pneumocystis pneumonia in the era of a respiratory outbreak." J Int AIDS Soc. 2020;23(6):e25533

  7. Tan RKJ, Kaur N, Chen MI, Wong CS. "Developing a typology of HIV/STI testing patterns among gay, bisexual, and queer men: a framework to guide interventions." Qual Health Res. 2020;30(4):610-621

  8. Tan RKJ, Wong CS. "Mobilising civil society for the HIV treatment cascade: measures of democracy and its impact on diagnosis rates among PLHIV." J Int AIDS Soc. 2019;22(8): e25374

  9. Ho ZJM, Huang F, Wong CS, Chua L, Ma S, Chen MI, Lee VJ. "Using a HIV registry to develop accurate estimates for the HIV care cascade - the Singapore experience." J Int AIDS Soc. 2019;22(7):e25356.

  10. Wong CS, Kumar PA, Wong CM, Choong CH, Lim O, Chan YY, Ibrahin MA, Chio MT, Tan RKJ, Chen MI. "Acceptability of HIV Pre-Exposure Prophylaxis (PrEP) and Opinions on PrEP Service Delivery Among Men who have Sex with Men in Singapore: A Qualitative Study."  AIDS Educ Prev. 2019;31(2):152-162.

  11. Tan RKJ, Teo AKJ, Kaur N, Harrison-Quintana J, Wong CS, Chen MI. "Extent and selectivity of sexual orientation disclosure and its association with HIV and other STI testing patterns among gay, bisexual and other men who have sex with men." Sex Transm Infect. 2019;95:273-278.

  12. Tan RKJ, Teo AKJ, Kaur N, Harrison-Quintana J, Chen MI, Wong CS. "Cost and anonymity as factors for the effective implementation of PrEP: an observational study among gay, bisexual, and other men who have sex with men in Singapore." Sex Health. 2018;15(6):533-541.

  13. Wong CS. "HIV Prevention: The Promise of Pre-Exposure Prophylaxis in Singapore." Annals of the Academy of Medicine of Singapore. 2017;46(7):265-66.

  14. Tan XQ, Goh W-P, Venkatachalam I, Goh D, Sridhar R, Chan HC, Archuleta S. "Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital." PLoS ONE. 2015;10(1): e0116987.

  15. Wong CS, Lye DC, Lee CC, Leo YS. "Acute HIV Infection in Singapore: predominance of men who have sex with men." Singapore Medical Journal. 2011;52(12):860-3.



All national recommendations and guidelines documents will be reviewed and updated every two years.

Document

First approved

Last reviewed

Description

HIV Testing Recommendations

Full text

Summary slides

2021

​2023

Adapted from the major international guidelines of the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC), the NHIVP developed the HIV Testing Recommendations to:

  1. Increase the uptake of HIV testing nationally;
  2. Allow earlier detection and identification of individuals with HIV infection;
  3. Facilitate timely linkage to clinical services; and 
  4. Reduce further transmission of HIV infection in Singapore by increasing testing and linking positive cases to care early.

​Pre-Exposure Prophylaxis (PrEP) Guidance

Full text

Summary slides

2019

2023

The NHIVP convened a PrEP Workgroup in May 2019, to develop a guide for physicians on prescribing PrEP as an additional tool to prevent HIV infection. Updated every two years, the Workgroup's guidance is an adaptation of current guidelines on PrEP from the WHO, the US CDC, British HIV Association (BHIVA), the Australasian Society for HIV Medicine (ASHM), European AIDS Clinical Society and the Taiwan AIDS Society, as well as a previous local guideline created by the PrEP taskforce in April 2018. The guidance aims to:

  1. Assist clinicians in their evaluation of patients who are seeking PrEP; and
  2. Assist clinicians in commencing and monitoring their patients on PrEP.

Antiretroviral Therapy (ART) Recommendations

Full text

Summary slides

2019

2023

The NHIVP developed the Use of Antiretroviral Therapy (ART) in Adults Living with HIV in Singapore to guide physicians on the ART prescription based on patients’ needs. Based on international guidelines, which had previously been applied in Singapore prima facie, the national recommendations are tailored to the local context to consider unique domestic considerations. Reviewed and updated every two years, the purpose of the national recommendations is to enhance the care of people living with HIV, providing the best possible treatments to patients.

Primary Care Recommendations

Full text

Summary Slides

2023

​​-

The Primary Care Recommendations aim to guide physicians in providing comprehensive care to people living with HIV in both HIV specialty or primary care setting. It is an updated adaptation of current major international guidelines, including the New York State Department of Health Institute (NYSDOH), the European AIDS Clinical Society (EACS) and the Infectious Diseases Society of America (IDSA). 

 
















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