Sexual Health Screening
Sexual health screening is important for everyone who is sexually active. Screening should be done at least once a year if you are sexually active. People who are sexually active and engage in risky behaviour, such as having unprotected sex or sex with multiple partners, should get screened every 3 to 6 months. Remember that many sexually transmitted infections (STIs) have delayed symptoms, so don’t wait for symptoms to appear before getting yourself screened.
STI SCREENING
The first thing that comes to mind is often the Human Immunodeficiency Virus (HIV). It’s little wonder why: Acquired Immune Deficiency Syndrome (AIDS), caused by HIV infection, is widely considered a pandemic. The combination of government campaigns, sexual education and social stigma makes HIV/AIDS a headliner.
Other types of STIs, though not as well known, may also be debilitating or even fatal. Common STIs include:
- Gonorrhoea
- Herpes
- Human Papilloma Virus (HPV), commonly known as genital warts
- Syphilis
- Hepatitis B
- Chlamydia
SPOTTING THE MAIN SYMPTOMS OF COMMON STIS:
STIs are primarily spread through physical means, via sexual contact and exchanges of bodily fluids. Some STIs can also be transmitted from a mother to her child during pregnancy and childbirth. Lastly, STIs can also be transmitted through the sharing of infected needles, e.g. through drug abuse or tattoos, and via contaminated blood products.
- Abnormal vaginal or penile discharge
- Painful urination
- Genital ulcers
- Swelling at the groin or genitalia
- Scrotal swelling
- Penile or vaginal odour
- Fever
- Abnormal bleeding
- Lower abdominal pain
However, many people who are infected with STIs, especially women, do not exhibit symptoms, and some pick up STIs from their partners without either partner being aware of it. As such, many do not even know when they are infected. The risk increases with the number of sexual partners or unprotected sexual encounters, but even serial monogamists should get tested!
The stigma surrounding the issues of sexual health, STIs and HIV can be pretty harsh. Many fear that diagnosis will result in discrimination or make them less attractive to future partners. However, regular screening is an important part of being more responsible sexual partners. Further, early detection helps greatly in the treatment and management of STIs. Talking about STIs only remains taboo due to ignorance and fear; with better knowledge of regular testing, communication, and safe sex practices, people can enjoy their sex lives without worries.
If you think you have an STI:
- Abstain from sexual activity for the time being
- Do not self-medicate
- Go to your doctor for a check-up
- Inform your partner(s) so they can seek medical attention too
WHERE CAN YOU GET TESTED?
You can visit the Department of STI Control (DSC) Clinic, Singapore’s public specialist STI facility. The DSC Clinic provides subsidised and confidential advice, checkups, phone counselling, and treatment. Do book an appointment in advance.
For patients who would like to see an STI specialist of their choice, they can also make an appointment to go to the National Skin Centre (NSC) at private rates. Other options include polyclinics and hospitals. While you can seek medical advice at private clinics, some may not have the necessary equipment for STI screenings so read up beforehand.
| Consultation | Obtaining detailed information about your sexual history in order to ascertain what STIs to test for. Clarification of doubts and questions. |
| Genital / Pelvic Examination + Swab | Females: Samples taken via vaginal and cervical swabs Males: Samples taken via penile urethral swabs Additional swabs may be taken from the rectum or throat after risk assessment. |
| Blood test | Testing for other types of STIs (e.g. herpes, syphilis, HIV) |
| Results | Tests typically take around 1-3 weeks to process. Results may be collected personally or via SMS. Counselling and treatment are available for those who test positive. |
| Cost | Females: $100-120 Males: $80-100 Prices reflect approximate subsidised rates and are only offered at the DSC Clinic. |
HIV TESTING AND SUPPORT FOR HIV-POSITIVE PEOPLE
HIV testing detects anti-HIV antibodies. There are three types of HIV antibody screenings:
- HIV ELISA (blood draw)
- HIV Rapid (finger prick)
- Oral Fluid Rapid HIV (oral gum swab)
The human body can take up to 6 months to develop antibodies after exposure to the virus. Hence, your doctor may recommend a repeat test if the first once was done too soon after exposure. Early detection of HIV infection is essential because an early start to treatment improves health outcomes and reduces the chances of spreading the infection to an unwitting partner.
There are seven clinics that provide anonymous HIV testing:
- Anonymous Testing and Counselling Service (ATS) provided by Action for Aids (AfA) at DSC Clinic – Preferred Choice
(31 Kelantan Lane, #01-16, Tel: 6254 0212) - M Lam Clinic (739 Geylang Road, Tel: 6748 1949)
- Dr Jay Medical Centre (115 Killiney Road, Tel: 6235 5196)
- Robertson Medical Practice (11 Unity Street, #02-07, Robertson Walk, Tel: 6238 7810)
- Dr Soh Family Clinic (Blk 966, Jurong West St 93, #01-219, Tel: 6791 7735)
- Cambridge Clinic (Blk 333, Kreta Ayer Rd, #03-27, Tel: 6327 1252)
- Anteh Dispensary Family Clinic & Surgery (368 Geylang Road, Tel: 6744 1809)
Anonymous testing means that if the test shows a positive HIV result, only you and the doctor will be informed. If testing is not done anonymously, positive HIV results will be sent to the Ministry of Health.
All registered medical practices can also perform HIV testing. These include the National Skin Centre, polyclinics, hospitals, and GP clinics. However, such testing is not anonymous and positive HIV results will be sent to the Ministry of Health.
Action for Aids provides support for HIV-positive people, including financial aid, legal assistance, support groups and a buddy programme. You can visit their website to find out more.
VACCINATIONS
Human papilloma virus (hpv) vaccine
Gardasil and Cervarix are the two types of HPV vaccines currently available. They are recommended for all girls and women aged 9 to 26 for effective, long-lasting protection against certain strains of HPV which can develop into cervical cancer. The vaccine also helps to protect men and women from anal cancer and may prevent other HPV-associated cancers.
The vaccine acts as prevention and not treatment, hence it is most effective when taken before the onset of sexual activity and HPV exposure. However, people who are already sexually active should still consider getting themselves vaccinated since the vaccines work against more than one strain of HPV. Speak to your doctor or visit the DSC Clinic if you are unsure if you are suitable for the vaccine.
Hepatitis B vaccine
Hepatitis B is a serious liver infection that may lead to liver failure or cancer. The virus may be transferred through sexual contact. The Hepatitis B vaccine is recommended for all unvaccinated adults and provides effective, long-lasting protection against the virus. Since 1987, most children born in Singapore hospitals are immunised against Hepatitis B.
SCREENING FOR CERVICAL CANCER
Cervical cancer is the 7th most common cancer among Singaporean women. A leading cause of this is HPV, which is mainly transmitted through intimate sexual contact when it enters the body through tiny breaks in the skin. The body is normally able to clear HPV infections; however, some infections may persist and can cause genital warts or anogenital cancer. Even if you have received HPV vaccination, it is still advisable to get regular pap smears. Cervical cancer can still occur due to other strains of HPV which are not covered by the vaccine.
The best protection against cervical cancer is still to go for regular pap smears to ensure early detection. Pap smears are recommended every 3 years, but some women may need them more often. Speak to your doctor about what is best for you. The pap smear is a simple and quick test. While you lie on an examination table, the doctor puts a speculum into the vagina, opening it to see the cervix. A special stick is used to brush a few cells from the cervix. The cells are then sent to the lab to be looked under a microscope to see if they look cancerous.