Sex Singapore | Shim Clinic

Sex Singapore: classification and terminology

Sexually transmitted disease
(STD) – refers only to infections that are causing symptoms.
Sexually transmitted infection
(STI) – refers to infection with any germ that can cause an STD, even if the infected person has no symptoms.
Venereal disease
(VD) – term used before the 1990s.
Genitourinary medicine
(GUM) is an expanding specialty which is primarily related to the treatment and prevention of sexually transmitted infections (STIs).
Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.
Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.
Sex or “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.

References

Disease	Organism	Incubation	Symptoms	Investigation
Viral
HIV infection	Human immunodeficiency virus (HIV)	2-4w	50% None, 50% Flu-like: acute seroconversion syndrome	HIV test
			Asymptomatic phase
		3-20y 8y average	AIDS
Hepatitis B	Hepatitis B virus (HBV)	40-160d	Flu-like: prodromal phase Jaundice: icteric phase	HBsAg
Genital herpes	Herpes simplex virus (HSV)	1d-2w	Multiple painful blisters & ulcers	HSV Serology HSV PCR
Genital warts	Human papillomavirus (HPV)	3-6m	Cauliflower growths	HPV test
Molluscum contagiosum	Molluscum contagiosum virus (MCV)	2-7w	Pearly growths	Histology
Bacterial
Syphilis	Treponema pallidum	9-90d	Chancre: 1° syphilis	VDRL test RPR test TPHA test FTA-Abs test
		2-6m	Rash: 2° syphilis
		<1 year	Asymptomatic: early latent
		>1 year	Asymptomatic: late latent
		5-10 years	Benign gumma, Cardiovascular syphilis, Neurosyphilis: 3° syphilis
Gonorrhoea (UK) Gonorrhea (US)	Neisseria gonorrhoeae	1d-2w	Urethral 90%, Cervical 50%, Pharyngeal & Rectal 10%: pain & discharge	Gram-negative intracellular diplococci smear, Gonococcal culture, Gonococcal PCR
Chlamydia infection	Chlamydia trachomatis	1-3w	Pain & discharge	Chlamydia PCR
Protozoal
Trichomoniasis	Trichomonas vaginalis		Female: foul discharge & itch Male: urethritis	BD Affirm™ VP III
Fungal
Candidiasis (Yeast infection)	Candida albicans		Female: cheesy discharge & itch Male: rash	BD Affirm™ VP III
Parasitic
Pubic lice
Scabies	Sarcoptes scabiei

Sexual risk (of HIV/STD/pregnancy), and what you can do before and after exposure.

Timeline	HIV	STD	Pregnancy
Before exposure	Abstain from sex, Be faithful, or Condom use
	Circumcision (males only)		Contraception (females only)
	HIV PrEP (pre-exposure prophylaxis) – Stop HIV infection before exposure	STD vaccine: – Hepatitis vaccine – HPV vaccine	Contraception (females only)
STD / HIV exposure	Unsafe sex / unprotected sex: No condom / Condom broke / Condom slip
0-72 hours	HIV PEP (post-exposure prophylaxis) – Stop HIV infection after exposure	STD testing * – Screening test – to look for asymptomatic infections – from previous exposures	Emergency contraception with the morning-after pill (females only)
2 weeks	HIV DNA Test
1 month	HIV 4th Generation Test – SD Bioline HIV Ag/Ab Combo – Fingerprick blood sampling. – 20 minutes to results
3 months	HIV 3rd Generation Test – OraQuick® HIV-1/2 Antibody – Oral fluid or – Fingerprick blood sampling. – 20 minutes to results	STD testing * – Full & comprehensive – diagnostic test – to look for current infections
Watch for	HIV Symptoms	STD Symptoms
If infected	HIV Treatment	STD Treatment	Abortion

* Males: Do not urinate for at least 4 hours before arriving.
* Females: testing is more accurate when you are not menstruating.

Walk-in clinic. Appointments not required.
Bring NRIC, Work Pass or Passport for registration.

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