Commercial Sex in Singapore – HIV, STDs and other pitfalls

HIV and STDs in the Commercial Sex Scene in Singapore

Welcome to Singapore. For the uninitiated, commercial sex here is legal. Aside from the regulated commercial sex workers, there are also many unregulated working girls. This article is to give you an idea of the various risks involved if you decide to engage these services.

This article is not meant to encourage or discourage. I will endeavour to state the facts as best I can. As you might already have guessed, good data on this subject is hard to come by. Many of the points made here are based on my personal experience having run a sexual health clinic and having worked at the DSC (government sexual health clinic) and on unpublished data supplied to me during my interactions with the various health authorities.

This article is also not going to discuss the intricacies of how to go about obtaining such services in Singapore. For that, please read this great resource on The Singapore Commercial Sex Scene.

The Law on Commercial Sex in Singapore

The legal age of consent in Singapore is 16.

The legal age for being a commercial sex worker is 18.

In other words you can have mutually consenting sex with a girl above 16. However, if there is financial consideration, she must be above 18 years of age.

If you are above 21, it is no excuse in the eyes of the law to say that you did not know her age or was duped into believing she was older. You will still go to jail and serve a maximum of 7 years.

In 2012, close to 50 men were charged and jailed for procuring sex from a girl under 18 years of age from an online prostitution service. Ignorance was not a viable defence.

Wikipedia is a great resource for more details on the law on commercial sex in Singapore.

Geylang – HIV and STD risks

Geylang is currently the official red light district of Singapore.

The 2 extremes of risk are found here. The safest are the regulated sex workers working out of brothels or ‘houses’. The most dangerous are the freelance girls plying their trade by the side of the road, the so-called ‘streetwalkers’.

The regulated sex workers are required to undergo sexual health screening every month. They are screened for HIV, Syphilis, Chlamydia and Gonorrhea. They may also be screened for throat or rectal Gonorrhea if they have had oral or anal sex. Their licenses are revoked if they are infected with HIV or Syphilis. If they have Gonorrhea or Chlamydia, they are given treatment and allowed to continue working. The last case of HIV detected in these sex workers was many mnay years ago. Gonorrhea and Chlamydia cases are seen frequently.

What does this mean to you? Because of the HIV testing window period, there is still a risk of HIV albeit this risk is very small. This in no small part is also due to brothel owners enforcing rather strict (but not foolproof) condom usage.The chance of contracting Gonorrhea and Chlamydia is ever present even if you use a condom. These sex workers are not screened for other diseases like HPV or Herpes so you are still at a risk of contracting one of these.

Streetwalkers are sex workers who operate without a license. They are usually in Singpaore on a short term social visit pass. Some of them voluntarily attend sexual health screening at the government health centre (no; they are not arrested if they do) but most of them do not. There is obviously very little information we have in terms of HIV/STD prevalence in this group of sex workers. Based on data that is a few years old, we know that Vietnamese sex workers have the highest HIV prevalence rate (about 4%). The theory is that Vietnamese sex workers face a language barrier when trying to bargain for condom usage with their clients. So most of them end up not using condoms. Indonesian sex workers come in second in terms of risk. The theory is that they are usually on their way back to Indonesia from working in the sex industry in the Middle East. Diseases contracted when they were in the Middle East usually go undetected or untreated. Also taking into account the reported HIV prevalence rate amongst sex workers in Bali is actually 25%. Thai female sex workers are relatively low risk. However, Thai transexual sex workers are high risk. We do not know the exact numbers. But there was a study in Bangkok that estimated the HIV prevalence rate among Thai transexual sex workers to be approximately 49%. Mainland Chinese are relatively low risk. You hardly see Filipino streetwalkers in Geylang.

Because it is illegal to tout sexual services, the police (more than) occasionally organises a crackdown. There was a time it was rumoured the police were rounding up 100 streetwalkers EVERYDAY. You really do no want to be around when they are slapping these sex workers up in handcuffs.

All in all, stay away from streetwalkers.

Spas, Health Centres, Massage Parlours – a front for commercial sex – HIV/STD risks

It is an open secret that these places offer much more than just a massage. It is mostly tolerated by the authorities but occasionally there is a crackdown too. Just make sure that the details you write in the sign-in book at reception are accurate. Woe to he who writes fake details that the police cannot verify during the crackdown.

In terms of sexual health, the risk level is actually thought to be equivalent to the regulated sex workers in Geylang. In other words, rather low risk. In order to maintain a masseuse license in Singapore, the working girls have to undergo HIV, Syphilis, Gonorrhea and Chlamydia screening every 6 months. Yes this sounds like a long time but the fact is also on the average they receive less than half the number of clients compared to ‘full fledged’ sex workers. Because the screening program is still relatively new, we do not have good data to comment on.

Orchard Towers – ‘4 floors of whores’, HIV and STDs

No surprises that this is neither legal nor regulated. It is however tolerated and I have not personally heard of any police crackdowns at Orchard Towers. If you have please let me know in the comments section below.

The girls working there are quite a hodgepodge so it is difficult to generalize. We can however seperate them into 2 groups roughly. Those who are here on a short term visa and those who have a day job (most often as domestic workers).

The girls who are here on an employment pass and have a dayjob are required to undergo a Syphilis test every 6 months and a HIV test every 2 years. I know this does not offer much reassurance but it is better than the girls on short term visas where we do not know where thay have been or what risks they have taken prior to coming to work in Singapore.

Orchard Towers also poses another unique risk which I have seen a few cases of. Basically, some of these woprking girls are not looking for a quick buck but more of a way out. They would get their targets usually really drunk then go home with them. In the morning after, instead of asking for cash, they are planning to move in and establish a longer term relationship.

Internet Sites

So called ‘online vice rings’, these sites received notoriety when close to 50 people were charged for having sex with an underage girl procured from one of these sites. (See article above).

As a member of one of these sites, you choose the sex worker based on pictures and descriptions provided by the person running the business. Services are then rendered usually in one of the short stay hotels dotted around Singapore. Of course this is neither legal or regulated. We can only hope that the person running the business would take some steps towards ensuring the cleanliness of his sex workers so as not to spoil his reputation and his business. This is purely speculation. I do not have or know of any reliable data. I personally have not seen anyone contract HIV from such online services yet.

Summary

The only way to be 100% sure of not catching HIV or any STDs is to stay in a mongamous relationship.

If you have any kind of contact with a commercial sex worker, you are at risk of contracting an STD or maybe even HIV. This is true even if you wear a condom.

Regulated sex workers are relatively safer.

To protect yourself and the people around you, go for regular screening.

Read this for more information on anonymous HIV screening and the HIV Combo test.

Read this for more information on STD screening.

If you have had a high risk HIV exposure within the last 72 hours, find out more about HIV Post-Exposure Prophylaxis.

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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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243 Comments

  1. Dr.Tan,
    I had sex with a girl chinese in lorong 18. I used condom for vaginal sex. No sign of breaking. we too a shower and then a little touching. BUt i saw the condum was not long enough. I am a bit scared as it was not long enough, because , i fear there may be some contact at the base with some vaginal liquid 9 may be). I also fear is there is any liquid from her vagina contacted while removing , i fear there is some contact. i am on 3rd day. when should i test HI or other tests to acuurately know. and how much they cost?
    I will neer do it again. omgod.

  2. Robert Koo

    Hi doc!!

    I had sex with a Thailand sex worker from those Thailand brothel in Geylang.
    I kissed her tongue also and licked her clitoris both for less than 10 secs, I had an ulcer near my throat while doing so, and I am kind of worried..

    Need some advice

  3. Judy Girl

    Hi doc

    Recently I found out that my boyfriend cheated on me in Vietnam. He claimed to only kiss and dance with the girl, but I don’t believe so because he intended to bring her to the hotel.

    I wish to forgive him, but I want to check that he’s clean before we get back together. What tests would you recommend going for? Its been about 26-32 days till date.

    Thank you so much

    • Dr Justin Sim

      He should go through standard testing, urine and blood STD screening to make sure everything is clear. Those two tests will cover nearly all STDs you need to be worried about.

    • Hi doctor can I ask why is left side of testicals like dropping off and I can feel the veins those when I washed it during shower…. Last year I had a accident where my friend and I was fighting and he accidentally kicked me in my balls… Will it heal?

      • I suggest you see a doctor to get an assessment. It is not possible for me to comment based on your description. You are welcomed to visit our clinics.

  4. is it possible to get ant STD without having intercourse?
    if yes, is it curable?

    • STD stands for sexually transmitted diseases. So no, you cannot get STD without intercourse. However, diseases such as HIV and hepatitis B and C can be transmitted in other ways such as blood transfusion and maternal transmission.

      • Thank you doctor!!!

        How about some of the STD ( Genital warts,genital herpes) which can spread just by skin to skin contact ..which are highly contagious…or can we simply assume one can not get STD without intercourse ?…
        Having shower, kissing, touching private parts, fingering, handjob will not cause any STD ?

        • Genital warts and herpes can sometimes be transmitted with skin-skin contact (eg, while having sex). Having shower, kissing, touching private parts, fingering and handjob are unlikely to transmit any STD.

  5. Hi doctor,

    I had recently received an oral sex from a massacre. It is protected throughout with condom on, and we had a kiss for a while too. May I know will I still be contacted with any form of STD ?

    • I hope you meant a masseur. It is very unlikely that you can get an STD from a protected oral sex. Having said that, condom is not 100%. If you are concerned, you can get yourself tested for the peace of mind.

  6. eugeneli

    Doctor i have a handjob from a massage lady and she uses her upper body and i am scare that i have hiv

    • Dear Eugene,
      The chances of you contracting HIV from a handjob are practically negligible. The circumstances of the rest of your sexual encounter are unclear to me.
      If you’d like, please come in to get formally tested at any of our centres.

  7. smith

    visited GL ..just did foreplay ..shower,kissing, touching private parts …fingering and hand job ..does it cause any STD/HIV?

  8. Martin

    Hi doctor i just have a question today this afternoon have sex with a girl in orchard tower 1st she give me a oral but with condom after that we have sex I’m just scared that the condom broke when she give a a oral because it touch her teeth then after that we have sex. What is you advise to this?this is my first time doing this I’m just scared that I got the virus and pass it to my wife I really regret it.

    • Martin

      And doctor how long should I wait if I need to be tested coz it’s making me very worried what is your best advise to me?thank you very much.

      • Hello Martin,

        While its good that you used a condom, condoms aren’t 100 percent effective in preventing transmission for HIV. To get tested, which you should, you can opt to come in at day 10 of your contact for a HIV PCR, or after 30 days for a rapid HIV test at any of our centers. We recommend abstaining from sexual contact if you’re unsure of your status at this time.

        • Martin

          10 days after contact is it conclusive ?or the 28 days ?i don’t know may chances of getting hiv and I’m very worried.

          • We consider the HIV PCR to be conclusive after 10 days. But if you would like further re-assurance, you are welcome to repeat the test again at 30 days post exposure.

  9. Hi doctor… M tensed i ve sex with geylong street 18. I had full protected sex with a thi gal.. she bathed made me bath.. she used condom for nlow job ad again lube it changed ad used another condom for sex.. the girl was from house with other girl… Selected the girls from numbrr and they will take in there room.. i sucked her nipples and brest… But nothing come out from her brest .. is i m at risk of hiv….

    • Using condoms reduce the risk of transmission of HIV and STD significantly, however you are still at risk especially from the penetrative sex. I would suggest you get yourself tested for HIV and STDs. You are welcomed to visit any of our clinics to speak to our doctors.

  10. hiv test

    Dear Dr how reliable is ab lab test at 62 days from exposure? Can I be comfortable withi neg result 0.021/N at 62 days? Thank u sir

  11. KingFisher

    Hi Doctor,

    i had protected sex with a sex worker in geylang brothels. on 12 May 2015, i am about 95% sure that the condom did not break. but currently shoulder pain in my body and i am worried i am with infected with hiv.

    Yes i do have this shoulder pain last time, due to my high blood pressure and i also currently taking “Duromine 30mg” given by one of the doctor.

    Am i at risk?

    • Dr Justin Sim

      HIV doesn’t present as shoulder pain so that is reassuring. However protection is still only 95% safe at best and I cannot completely exclude your risk of HIV. Protection certainly reduces that risk but there is still a risk. If you want to be sure then you should get tested. A negative result will help ease any anxiety.

  12. Jacob

    Dear Doctors,

    I had sex with a masseuse yesterday and I continued penetrating her even after ejaculating into the condom. This may have caused semen to leak out from the base of the condom.

    May I know if this action will increase the chances of me or the masseuse getting infected?

    Thanks in advance

    • drtan

      It increases the chance of the masseuse getting infected if you have an STD.

  13. Condom break

    Hi Dr. I put myself at high risk, I went yesterday evening to a massage parlour and had sex with her. Unfortunately it broken and I pulled out immediately after I hear the sound. She claimed that she is clean and she is local Singaporean. So government will always keen about her record, what is my risk and your advice

    • You are at risk of STDs. I would suggest getting yourself tested.

      • Nikiljain14

        do u suggest PEP as the encounter happened before 15 hours . I am inside her not more than 20 to 30 seconds max

        • drtan

          I’m sorry we cannot tell you to take PEP or not. That is considered giving medical advice which we cannot do over the internet. You are welcome to visit any of our clinics for a formal medical consult.

  14. Dear Dr. How conclusive is HIV 3rd generation lab test for 4 weeks from the exposure. Thank u

  15. Dear dr tran…I recently found out my husband has been having an affair with a Filipino spa worker whilst on business trips. He says he used condoms but I don’t believe him. He has had many cold sores and open acne around his mouth. Do spa workers need to be tested regularly in Singapore for stds (including hep b)? I had all the tests done last week and am waiting for results. I’m very worried he has passed a disease to me. I understand a lot of Filipinos carry hep b. Thanks

    • Masseuse in Singapore are required to test for HIV, Syphilis, Gonorrhea and Chlamydia about once every 6 months. I am not aware that they have to be tested for Hep B. I am also not sure what he means by “Spa Worker” because if she does not fall into the category of “Masseuse” who’s licenses are monitored by the Singapore Police and therefore need to be tested, she will not be tested. In other words if her Employment Pass is for a job not classified as “Masseuse”, these testing rules do not apply to her. I think a more prudent thing to do, as you have done, is to test yourself.

  16. hi doctor
    i have a question.
    i had protected sex with girl who work in the house. i mean prostituion. i am paranoid now. because of hiv
    do i have to check up my body? even if the girl was legal worker?
    thank you for reading

    • Dr Justin Sim

      If she is a legal worker then she is checked every month but the tests do not rule out a recent infection within 3 months. You may want to get tested anyway for peace of mind.

  17. Hi Dr,
    I had protected sex with sex worker from geylang bothel but not protected for oral sex about two months ago. I noticed that there are some spots appear on my upper lip. I found it looks like fordyce spots in websites. And also i feel muscle twitching. Moreover, i feel severe headache for more than 5 days and my eyes are also pain last week but now disapper aldy. I got to go out hot places also and stressful these days. Can these sypmtoms be because of hiv or other STDs? Or because of anxiety? Thank you

    • Dr Elaine Loh

      Your symptoms do not sound like ARS to me. Nonetheless, you should do a STD screen to be safe based on your exposure even if you have no STD related symptoms.

  18. Dear Dr tan
    How to know whether we have std or hiv sickness?

    • Dr Justin Sim

      To be absolutely sure you will need testing. Up to 40% of people with STDs have no symptoms.

  19. Dear Dr.Tan

    I am suffering from confusion for the last 6 days. I had call an Internet based escort agency and had sex with an escort. She was not from Thailand, Philippine or China. And i promise i will never do this again in my life as i felt very bad. my questions are below

    1. I had protected sex with her and the condom was not damaged. but during sex, the condom came a little bit up and the escort pushed the condom down to the bottom again of my penis. So is it something to worry about? because this is always running in my head and your advice can relax me.

    2. Do the Internet based escort agencies go for regular health check for HIV and STDs?

    3. Was is safe to have sex with an Internet based escort compared to other sex workers?

    Your kind reply in details will relax me. Thanks in advance.

    • 1. As long as the condom was still covering the foreskin and the external meatus (opening at tip of the penis), the protection is good. HIV cannot penetrate the skin on the shaft. 2. You mean in Singapore? Strictly speaking, escort agencies only provide escort services. Sexual services have nothing to do with the company and is a private arrangement between you and the escort. So there are no rules or regulations on health checks. 3. Sorry but I find this question rather odd and really do not know how to answer it. Are you asking me if a sex worker you get from the internet has less probability of having HIV/STDs compared to a sex worker you get from a brothel? Anyway, I think what you are trying to do is to find reasons to allay your anxiety of having caught HIV or STDs. To this end, all your questions are essentially pointless (except the first one). There are some facts you need to face up to. Fact 1: You had sex with a person who may have HIV/STDs. This puts you at risk. Fact 2: You used a condom which did not slip or break. This lowers your risk. Fact 3: You do not know for sure at this point in time whether you are infected or not. Conclusion: See a doctor and get screened.

      • Dear Dr.Tan

        Thanks for your detailed reply. You really are the best, the way you explain and i really mean it. And sorry for asking any question that disturbed you. Requesting for apology again. If i want to ask questions further then can i write to you again?

        Regards

        • No need for apologies. Please feel free to ask any question you want.

  20. Hi,
    I had protected sex with csw at orchard tower. I went through rapid hiv test after 11 days. The test result is non reactive. Should I consider to go through test again.

    Thanks

    • Dr Justin Sim

      Yes you should get tested again at 1 month after the exposure. 11 days is a little too early to be conclusive.

  21. Hi doctor, I had sex with a social escort 6 days ago at her rented condo with protected vagina and oral sex with condom, first time(totally regretted and never want to do it again for life). At the 2nd to 3rd day of the sex, I feel itch on the pubic area, just above the penis and around it. feeling comes and goes in a day, appears slightly red no rashes. Do you think that it is the early sign of hsv-2 herpes and what are the chances of me getting it if her vagina secretion is drip on to the public area. Today, I went to the my nearby GP clinic and let the doctor checked, he said that it’s most likely my skin inflamed or sensitive. Prescribed me with a UNIFLEX cream a.k.a steroid. The feeling of itchiness has already died down. But would go for a herpes blood test done probably 3 weeks later to check for any anti-bodies that have the virus and for HIV .. Will do it on the 3 month mark test.

    Your reply is most appreciated.
    Thanks

    • No way HSV symptoms will appear so early. Itch that appears so early is either just a dermatitis or lice.

  22. Anxious Guy

    I had protected sex with a legal sex worker 6 months ago. and recently I’ve been feeling really tired than usual. I’m in NS. I’ve only been feeling this tired about a few days ago. what do you think?

    • Dr Justin Sim

      It is unlikely that you would experience symptoms associated with HIV (ARS symptoms) this far down the line. The most likely scenario is that you may be tired due the strains of NS or have another minor illness causing the symptoms (like a normal viral illness). However, if you want to be sure then it may be best to get tested.

      • Anxious Guy

        thanks dr sim. i have an anxiety disorder and every time I sneeze or feel sick I would keep thinking I have HIV. and I’m scared to go for a test.

  23. Erm doctor, is it possible (or is there even an existence of such) to use a medicine or poison to target and destroy all cd4 in a body while sustaining immune system with artificial antibodies and anti biotics for a fixed period.
    Thereafter, transfuse new healthy cd4 cells and allow the normal cell splitting and replications to take place?

    • That, my friend, is a great and original idea. There is currently no such thing. Also, I do not think it will work. Our immune system is an extremely complex mechanism. Aside from antibodies, there are so many other parts to it that helps kill off bacteria, viruses and cancer. In fact, the study of immunology is a whole field all on its own. The CD4 cell is literally the general that controls and coordinates all parts of the immune system. Without them around, the body will not be able to fend off all infections even if you give artificial antibodies and antibiotics. That is my take on it. But really kudos to you for even thinking up this idea. Who knows maybe some day we will find a way to do it.

    • Well, cuz i’m one of those waiting for the window period to expire for the testing…

      • It is such an irony…. our medical knowledge in the modern world is so advanced already and yet it cannot stop a virus that only target a certain cells in the body… how I wish there is an engineered cell that can replace cd4 role as well as destroying it..

  24. Hey doc, just had sex with hooker at orchard. My condom got damaged, I think did 90 sec of sex after my condom got damaged. What is the probability that hooker was HIV+ and what is probability that I catch Hiv assuming Hooker is HIV+ given the above condition.
    Also tell how should I proceed and what should I do now?

    • Whether or not the CSW was HIV +ve unfortunately nobody knows. We can hazard a guess by her nationality. Usually Vietnamese are higher risk followed by Indonesian then Filipino then Chinese. But honestly, it is literally a wild guess. Since the condom broke, your risk of catching HIV from unprotected insertive vaginal sex is anything from 1% to 0.1%. You should see a doctor and talk to him/her about PEP.

  25. Good evening Dr. Tan
    Dr I had unprotected intercourse with the woman who works in the club as a cashier. 40 days ago.She didnt tell me about her STD status. i was so scared and got tested by combo test at 10 and 24 days from the exposure. the results were negative. can i be comfortable with results? and how conclusive is the result at 10 n 24 days? Btw there appeared some red and colorless dots on my chest which are non-itchy from the 35th days. is it hiv symptom? If i have to get tested again so which test is preferable? Thank u Dr

    • The combo test at 24 days is already as good as conclusive. TO be official about it, you should get another combo test at 28 days.

  26. Dr.Tan,
    About three Weeks ago i had vaginal,and oral sex with a female regulated sex worker in a brothel in geylang.we are did it with condom.i also did an oral sex to her.i end up ejaculating with a hand job.Two Weeks after That when i did a masturbation the tip of my dick felt a bit hurt.the same thing also happened when i urinate companied with a itchy feeling.I also had an itchy feeling That Make me cough for a while.Three Weeks after i did the sex in geylang i get a red eye possibily because i use laptop to much.But my red eye Didn’t dissapear after sleep.Am i contracted with HIV?.Thankyou doc.

    • Does not sound like HIV. But it sure could be Chlamydia. I suggest you go see a doctor and get tested and treated asap.

  27. Hi Dr Tan, ytd i went to get a 4th Gen HIV test post 30 days after my low risk exposure, it cane out negative. Do i need to get another test at the 3rd month? :O

  28. Hi Doctor Tan, so I have this experience hooking with prostitutes in Geylang for the first time 2 years ago( it was my first time). I was introduced by a taxi driver, the place is in a house with glasses, and I can see the girls from outside. I use condom too. The hooker has thai nationality. However, around 16 days after that I develop fever and rash, when I check to doctor, he say that it is rubella, because after the fever , I develop rash started from my face and go below. Also before that the back of my eyes hurt. Additionally, these symptoms last for around 5 to 6 days

    My question is, is my chance to get HIV high? and is the “glasses place house” is a relatively clean from HIV hookers?
    Thank you

    • You had protected sex with a Thai CSW in a brothel in Singapore. Overall your risk is very low but I think no one will tell you that you do not need to test. I do not think your symptoms are significant but really, to be 100% sure that you have not contracted any diseases, HIV or STDs, the only way is for you to do a set of screening tests.

  29. Hi Doctor Tan, i went to get a 4th gen HIV Rapid Test 16 days after my low-risk exposure as i had sex with an escort with a condom. The results came out negative, are 4th Gen Test Kits that accurate? :O Im quite interested to know how come 4th Gen Test Kits can be used within 2 weeks whilst other test kits required 1-3months. Looking forward to your reply Dr Tan 🙂

    • At 16 days post exposure the 4th Gen tests are already very very accurate. The reason is because they pick up P24 antigens as well as antibodies. P24 antigens are detectable in the blood earlier than HIV antibodies. For more info on the different generations on ELISA tests, click here.

      • Thank you for the info Doctor, it really helps and assures me alot! 🙂 Im going back for a Confirmatory test at the Third Month 🙂 So this means that i am safe and clean? 🙂

  30. Dr Tan, approx 2 weeks ago i had sex with an escort i called online, ive had protected oral and vaginal sex with her, the condom was intact and did not break. She gave me a handjob after that. The whole thing lasted for 8 mins and it was protected all the way. Now im getting scared and paranoid of contracting diseases that i dont want 🙁 Is there any signs i shud look out for? 🙁

    • Well, kudos to you for using a condom. That does decrease your risk significantly but it would be naive to think you are completely 100% risk free. There are many STDs you can get. For symptoms of STDs click here. The risk of HIV is also very low but not zero. For HIV symptoms click here. At the end of the day, you should go for screening tests to make sure you do not have any infections.

      • Hi Dr tan, thank you for replying me 🙂 The day after the thing happened i went to this Q Medical Clinic for a check. The doctor there took some blood samples, urine samples and urethra swab and sent it to the lab to run some tests. Last week when i got my results everything came out negative for STI’s, but he told me i still have to go for the 3rd month HIV tesf but he told me not to worry much. Is what he said true?

        • I cannot comment on another doctor’s advice. Please continue to follow up with them.

          • Alright sure thing Dr Tan, thank you for replying me as well 🙂 Erm, since i used the condom, and it did not break as well am i protected from HIV? Because that is what is makibg me paranoid the most. im going for a Oraquick test in 2 weeks at post 28 days.

          • Intact condoms greatly reduce the risk of contracting HIV however, we can never be 100% sure. This is backed by scientific data. i.e. There have been studies on couples who always correctly use condoms but the HIV negative partner still gets infected.

  31. Dear Dr.Tan i had sex with streetwalker in Dec 13 with a condom. But after three days from the exposure, i had fewer and insomnia for almost 3 days. when I went to my dr, she said i didnt have fewer and she gave me some medicines. After took them i felt fine. But since the exposure there have been some pain in my left nut. is it HIV symptom? thank u

    • No it is not. This does not mean you do not have HIV. Pain in your testis can be a symptom of some other STD like Chlamydia or NSU.

      • Thank u for the prompt reply. Can it be accurate result if i get tested after 3 weeks from the exposure?

      • Can I get combo test at 24th days? or what test should i get teated at 24 days? thank u

        • The Combo test at 24 days is really as good as accurate but officially you need to get it done again at 28 days.

          • Dear Dr, i have got tested by combo test at 24 days from the exposure. The result wan negative, is it accurate or should i get tested again to get comfortable? iif so, what kinda test should I get since its been 38 days from the exposure. Btw, dr at Unity street said no need to get teated again. Please comment on it. thank u

          • From the data published, the Combo test after 21 days really should be 100% accurate. Click here for more info. However, official guidelines say that the combo test should be done at 28 days. So my hands are tied and I have no option but to tell you to retest at 28 days or more.

  32. Is “fingering” a woman’s private part a mode of HIV transmission (my fingers have cuticles too)? Also, after how many days/months from possible HIV exposure should I conduct a HIV test (using 4th gen test kit)?

    • I do not think fingering a woman poses any risk of HIV transmission.

  33. Hi doc. I just had 2 ulcers on my inner lower lip. I had protoected sex with a worker in geylang 6 days ago. What are the odds?

  34. Hi doc, I was highly drunk and had unprotected sex with a street hooker at orchid tower some 10 days ago, neither of us climaxed.

    Checking the forums, it seems that an HIV test is reflected only after 1 month. What should i do? Should i wait and get myself tested after a month?

    What test 3rd or 4th generation you would suggest?

    Although the hooker told me that she is HIV free but i want to be 100% sure. Thanks in Advance.

  35. Hi Dr.

    I just had protected oral and vaginal sex with a worker in geylang. There were skin yo mouth contact but not much. How high a risk am i in?

    • You are at risk of everything. Condoms reduce the risk but does not eliminate it.

  36. Hi Dr tan,

    I’m had protected sex with unprotected oral sex given with a sex worker on the 14th nov. I don’t think the condom break during the session. I started to have diarrhea for the past two days but its only one time diarrhea each day. ( not sure if it’s due to hot food that I ate as I like spicy food.) I did not have any fever, lumps nor red patches rashe like those show on the internet. However, i believe I have dry skin as I always in an air con enviroment. Therefore I will have itch normally. Just wondering am I at high risk of getting hiv? And also may I also check how does hiv diarrhea feel and will it only be once a day if it’s hiv diarrhea??

    Await for your reply and thank you for your time.

    • Your symptoms do not sound like HIV ARS but you still must get tested to be 100% sure.

  37. Dear Dr Tan, I was wondering will you get any STD or HIV if you received oral sex from a women? What about giving oral sex to a women? I am referring to unprotected oral sex. Thanks.

  38. Hi Dr,

    In regards to orchard towers there are the girls who work in the health/beauty/massage shops ,when you speak about massage parlours/beauty shops requiring the girls to carry a licence does this also apply to the massage shops in orchard towers?
    Are the massage shops girls in orchard towers required to carry a licence that means they need to be tested?
    I wondered this because you have girls floating around bars then you have the girls standing at the shop doors and I assume the girls in the beauty/massage shops all need to be licenced as they don’t move from the massage/health shop.

    Just looking for clarity as to whether the massage shops in orchard towers are the same
    As the other massage/beauty shops In Singapore that you speak of.
    Thanks 🙂

    • That, my friend, is a excellent question. The people who issue the massage/spa license is the Singapore Police Force. One part of the license requirement is to have the masseuse undergo a medical examination. So if these places are licensed (I assume they are if not the police would have shut them down already) and the girls working there are licensed then they are required to undergo the medical exam. Now, there is a possibility, though I cannot be 100% sure, that some of the girls working there are NOT licensed. Yes, the proprietors are taking a huge risk (they can go to jail) by allowing this, but I would not be surprised if it happens.

  39. Sean archer

    hi doctor,

    Are those girls coming to geylang houses for short time are also tested and controlled

    • I am not sure what you mean. If they are licensed sex workers then they are tested.

      • Sean archer

        hi doctor ,

        I mean all the girls in geylang houses are not licensed,?sometime house owner bring them from other countries for short term and they are not licensed or tested,
        Is ther any check on this?

  40. katong Boy

    MAy I know about syphilis case? IS it still happen in Singapore?

  41. Dear Dr. Tan,

    You mentioned that the last case of HIV in Singapore’s legalised commercial sex workers was many years ago. May I know where did you find the publication or journal that supports this statement(for citation)?

    Thank you.

    • This kind of data is never published. It is brought up in certain select meetings and forums that I attend.

      • Dear Dr. Tan,

        Thank you, it seems I have to find other publications.

        • Sorry i couldn’t help. If you manage to find any, please share with us here. Thanks.

  42. Dear Dr Tan,

    I got very very very stupidly drunk a few days ago, and had sex with a street walker from Clarke quay (unprotected, so out of character I am usually safe) not entirely sure on race, possible Filipino. Engaged in unprotected oral, vaginal and anal for a maximum of 20 minutes. Neither party climaxed. I can not comprehend my stupidity. After 10 hours I went to get a std jab and antibiotics, after 30 hours I started PEP medicine. The side effects are monumental, I feel constantly ill, and also noticed I have a white coating on my tongue.

    What are my chances of being infected? People post high risk and low risk quotes all the time, but they vary so much. Any advice would be helpful.

    Thanks.

    • From the description of the side effects you obviously did not get the PEP meds from us. You are probably on the old regime which is no longer recommended for PEP. The doctor who gave you the meds should have taken the time to discuss the risk with you. Honestly this kind of unprofessional conduct just leaves a really bad taste in my mouth. Giving out of date medicines and leaving the patient to find advice on the internet? Geez. Anyways, the baseline risk of what you did is about 0.1% to 0.6%. That is assuming she is HIV +ve and not on ART. There are also a lot of other factors that modify this risk. Call me old fashion but I think the onus is on the doctor who saw you to take responsibility and deal with these queries you have. You should address these questions to him. If you want me to take over your medical care, you are welcome to visit my clinic anytime.

  43. Hi I just went to have sex with a legal prostitute at one of the houses. The next day I was down with a sore throat and a flu. Am I contracted with hiv?

  44. worriedmale

    Hi doc, I have some small bump on my thigh appearing after commercial sex. It happen about 1 week later after the sex, the bump sometime is not itchy but other time it is.

    It has Been like 9mth now since the sex but I’m still worried. There is no sore at my penis, coulld this be STD?

    • Dr Elaine Loh

      I suggest you come in to get the rash checked properly. It is impossible to diagnose a skin condition without seeing it, hence we will not be able to tell you if it is STD related, even though you had a risky exposure.

  45. Iveone

    Dear Dr.Tan,
    In your article, you say the regulated sex workers are required to undergo sexual health screening every month and the last case of HIV detected in these sex workers was many mnay years ago. Does it mean the regulated sex workers are safe? Is everybody required to check HIV status every month?

    • Are you kidding? Of course not! I am just stating the facts. If the sex worker contracts HIV 1 week after her check up and you have unprotected sex with her just before her next check up then good luck to you. Also, they may have many other STDs like Herpes and HPV that are not screened for. Only the regulated sex workers undergo monthly tests. There are many people in Singapore on tourist visas or student visas or other kinds of work visas who also are sex workers. Since they are unknown to the authorities, no one controls whether they go for tests or not. The fact is simple: commercial sex is risky. Using a condom reduces the risk but not to zero. I am not making a judgement if it is good or bad or if anyone should do it or not. These are just the facts.

  46. Bharath

    Dr.Tan,

    How about the girls in circular street (most are philiphines) where in few pubs they give lap dance to customers.
    Do they get tested regularly?

    Thanks

    • If they are just here on a social visit pass then they are not tested at all. Some are here with a work pass but moonlight at pubs. Depending on what type of pass they are on, they get tested by very infrequently. On the average they get tested for HIV once every 2 years.

  47. Dear Dr. Tan,

    1.Is it Syphilis curable? if so, within how many days and months? and how long the treatment will go?

    2.is it Syphilis HIV related?
    3. can Syphilis reactive will develop to HIV without having sex again?
    4.is it TPHA reactive related to HIV?

    Thank you in advance
    Nick5

    • drtan

      1. Yes. Please ask your doctor for more advice. Treatment varies for different groups of patients. 2. In what way? 3. I do not understand this question. 4. HIV can cause the TPHA to be false positive.

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