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.
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]