HIV Treatment in Chennai: A-Z About HIV & AIDS

Written and medically reviewed by Dr Shah Dupesh, MBBS, DCE, FASM · Consultant Andrologist
First published 14 November 2019 · Last reviewed and updated 24 September 2026

Vanakkam, Namaste, and Welcome to Dr. Shah’s Clinic for Male Infertility &
Sexual Health.

In this article, I am going to tell you everything under the sun about HIV Treatment in
Chennai. We are also going to discuss HIV testing & its diagnosis, and its management.
Let me give you the short answer first. Read on!

That last point is the one that changes lives, and almost nobody is ever told it. I will
explain it properly in a minute.

As a practicing sexologist
doctor in Chennai, I have seen numerous patients suffer from HIV due to an improper diagnosis
or in some cases missing the diagnosis altogether. Moreover, I have seen something else again
and again. A man who is far more frightened than his actual medical situation warrants,
because everything he knows about HIV he learnt in the 1990s.

1. HIV Treatment: what it does, and how well it works

HIV treatments are exceedingly well proven. While there is no clinical cure as such for
the infection, taking treatment definitely prolongs the lifespan of the patients.

Patients hear that and assume I am being kind to them. I am not.

Antiretroviral therapy stops the virus from multiplying. Moreover, it lets your CD4 cells
recover, which is what rebuilds your immunity. Not just that, it drops the amount of virus in
your blood so low that standard lab tests cannot find it. Advances in therapy have extended
the life expectancy of people living with HIV so much that the conversation in my clinic is
now about long-term health rather than survival (Fleming, 2026).

Now, this next part is where I still see patients lose years. Treatment starts on the day you are diagnosed, whatever your CD4
count is. The old practice of waiting until CD4 fell to some threshold was abandoned long
ago. There is no such thing as starting too early, and every month of delay is immune damage
you do not get back.

So, in 2026 this is not a cure. It is a chronic condition controlled with one tablet a
day.

2. Undetectable = Untransmittable (the fact that changes everything)

If you are on HIV treatment and your viral load stays under 200 copies per millilitre, you
cannot pass HIV to a sexual partner. Clinicians call this U=U, Undetectable equals
Untransmittable (Lauren, 2026).

Here is an interesting fact, and I want you to read that again. Not “low
risk”. Not “much safer”. You cannot pass it on.

Two conditions attach to that sentence, and they matter. Your viral load must have been
under 200 for at least six months, and you must keep taking your tablets. One good report in
March does not make you safe in April. Moreover, you stay safe only for as long as you stay
suppressed, which is why we keep checking.

The evidence was built over years of following couples where one partner had HIV and one did
not. The landmark trial showed that treating the positive partner dramatically cut
transmission (Cohen, 2020). Later studies followed thousands of couples having sex without
condoms while the positive partner was suppressed, and recorded no transmissions at all.

And yet awareness of U=U is still very poor in India. A study among men in Mumbai found
exactly this gap (Chaudary, 2026), and what I see in my own Chennai clinic every week matches
it. Men who think they can never marry. A man who has not touched his wife in two years. All
of it over something the treatment has already fixed.

However, U=U is established for sexual transmission at a suppressed viral load. If
your viral load drifts up, from missed doses or a failing regimen, that protection is not
guaranteed, and low-level viraemia is still being studied (Vojnov, 2026). That is why we
monitor, and why you take the tablet every single day.

Can we still have children?

This is the question men come to an andrology clinic to ask, and they usually take twenty
minutes to get to it.

Yes. A man whose viral load has been suppressed for six months can conceive naturally with
his wife, through ordinary unprotected intercourse, without putting her at risk. You do not
need sperm washing. You do not need IVF. You do not need to adopt. Of course your wife should
be tested and looked after properly, and if she is negative she can take PrEP for extra
reassurance while you are getting suppressed, with its own negative test first and
three-monthly checks.

3. What HIV is, and what it does to your CD4 cells

HIV stands for Human Immunodeficiency Virus.

The virus is an RNA virus and specifically affects the body’s CD4+ T helper cells.
These CD4 cells are highly critical in maintaining the body’s overall immunity. Think of them
as the commanders that tell the rest of your immune system what to do.

Each of those labelled parts matters clinically, because each is a place a drug can
interfere. Reverse transcriptase is how the virus copies its RNA into DNA, and several of the
commonest antiretrovirals exist purely to block it. The capsid is the newest target of all, and I
will come to that at the end of this article.

Once the virus destroys enough CD4 cells, an acquired state of deficiency results, leading
to multiple infections and malignancies caused by other micro-organisms. That condition is
called AIDS.

Treatment breaks this cycle. Stop the copying, and your CD4 count starts climbing back
up. That is really all there is to it.

4. HIV and AIDS are not the same thing

This confusion causes real distress.

HIV is the virus. AIDS is a late stage of untreated HIV infection. Having HIV does
not mean you have AIDS, and on treatment, most people never will.

So what does AIDS actually do? In AIDS, the immune system is damaged badly enough that
organisms your body would normally shrug off begin to cause serious illness.
Tuberculosis, certain pneumonias, cryptococcal meningitis, some cancers. A diagnosis of AIDS
is usually given when the CD4 cell count drops below 200 cells/mm³, or when one of those
defining illnesses appears.

The important part is this. AIDS is a stage of the illness, and it is not the end of the
road. Even at this point the damage is substantially repairable, because treatment rebuilds
the immune system. I have started patients on ART with a CD4 count in the 60s cells/mm³ who are working,
married and well today.

5. The three stages of HIV, and how long each really takes

HIV infection typically progresses in multiple stages. HIV treatment with antiretroviral
therapy can help patients in all suspected stages of the disease, and it slows the progression
from one stage to the next.

A. Acute infection. In this stage the patient may have flu-like symptoms:
fever, sore throat, rash, swollen glands, usually two to four weeks after exposure. However,
a large number of patients have no symptoms at all. Crucially, in this stage patients are very
contagious and carry a large amount of virus in the bloodstream.

B. Chronic (latent) infection. The virus stays active but at lower levels, often for
years, and the patient usually feels completely well. The virus persists in reservoirs around
the body, including the lymph tissue in your gut, which is why treatment controls HIV but
never quite eliminates it. A person can remain infectious throughout this stage without
knowing they are infected.

C. AIDS, the final stage. The immune system is severely damaged. Patients
commonly report fever, chills, swollen lymph nodes and weight loss, and opportunistic
infections become common.

Now, how long does this take? You will see “three to five years” quoted in a lot
of places. That figure is wrong. In cohorts following untreated infection, the median time
from HIV infection to AIDS is around nine years (Zhang, 2008).

I am not telling you this so you can relax. A median means half of people take longer and
half take less, and some progress a great deal faster than nine years. However, the panic I
see in my clinic, men convinced they have months to live after one exposure, is itself doing
harm. So please get tested, and do it this week.

6. How HIV spreads

The common modalities of HIV spread are sexual intercourse and the sharing of needles.

The realistic routes of transmission, in rough order of how often I see them in practice:

1. Penetrative intercourse without a condom. By far the commonest route. Receptive
   anal sex carries the highest risk per act and vaginal sex a lower one, but both transmit.
2. Sharing needles or injecting equipment.
3. Mother to infant during pregnancy, delivery or breastfeeding. Now largely
   preventable with treatment.
4. Oro-genital sex. Possible, but rare.

A word about needles, because this one causes needless terror. This is about shared
injecting equipment. HIV survives poorly once blood has dried in the open, so the sight of a
discarded needle on the road is not the risk people imagine it to be. However, that is not the
same as zero. If you are actually pricked by a used needle, go to casualty the same day and
let a doctor decide about PEP. Do not make that call yourself.

There are a few other routes you will find on CDC lists. Kissing where blood is exchanged
from bleeding gums or sores, pre-chewed food, a bite that breaks the skin. Of course they are
documented. However, they are so rare that they are practically case reports, and they are not
a live risk in your daily life.

Who is actually at higher risk, and why

Let me deal with this part plainly, because it is where people either panic or wrongly
relax. Risk follows what you do, not who you are. There is no such thing as a safe
category of person and there is no such thing as a condemned one.

That said, some acts do carry more risk than others, and it is not useful to be coy about
it.

• Receptive anal sex carries the highest risk of any sexual act. The rectal lining is
  thin and tears easily. In one prospective cohort, receptive anal sex was independently
  associated with more than a threefold increase in seroconversion (Namwat, 2024), and Indian
  work describes it as the act that drives transmission in this group (Thakur, 2026). This
  applies whether you are gay, bisexual or a heterosexual couple who have anal sex, which plenty
  do and almost nobody mentions to their doctor.
• Men who have sex with men carry a higher population risk in India, and that is a
  statement about epidemiology, not morality. If this is you, PrEP is a conversation worth
  having.
• Bisexual men occupy a position nobody likes to name. If you have male partners and a
  wife or girlfriend who does not know, you are the link between two circles that never meet.
  I say this without a shred of judgement, and I have had that conversation many times in this
  room. Testing protects both of them, and it protects you.

Multiple partners, paid sex, and the groups nobody talks about

• Multiple or casual partners. Indian clinic data is consistent here: extramarital and
  premarital contact and multiple sexual partners are strongly represented among men presenting
  with STIs (Pal, 2025), and high-risk behaviour clusters in the 18 to 30 age group (Das, 2025).
  If your dating life has been busy, test on a schedule rather than on a scare.
• Paid sex. Contact with sex workers remains a significant exposure route for Indian
  men, including among migrant workers (Bozicevic, 2026). If this is a repeated pattern rather
  than a one-off, read the next part properly.
• Transgender people face both elevated risk and the worst of the stigma, which is a
  large part of why they present late (Thakur, 2025; Patra, 2026).
• Women who have sex with women. Female-to-female sexual transmission of HIV is
  genuinely rare, and I am not going to invent a risk to frighten anybody. It is not zero, and it
  is not the point. Other STDs pass readily between women, and a woman with a bisexual male
  partner is exposed like anyone else. If you are sexually active, you test. The rest is detail.

One thing I will say to every group on that list equally. Nobody walks into my room and gets
a lecture. I need an accurate history to order the correct tests, and that is the entire
reason I ask.

If you visit sex workers, escorts or massage parlours regularly

This is one of the commonest histories I take, and men almost always tell me about it in
the last two minutes of the consultation. So let me put it in the middle of the article
instead.

The arithmetic is the thing nobody does. A single exposure carries a certain
probability. That probability does not reset each time. Forty visits is not one visit repeated
forty times in terms of how you should think about it, it is forty separate rolls, and the
chance that at least one of them mattered climbs steadily. Men who have been going for years
are usually shocked when I put it that way, because each individual visit felt survivable.

“It was only oral”: where men come unstuck

“It was only oral” and “it was only a massage” are where people
come unstuck. Oral sex carries a genuinely lower HIV risk, and I said so earlier. However,
gonorrhoea, chlamydia and syphilis pass perfectly well to and from the throat, and a
urine-based panel will not see any of it. This is exactly the extragenital blind spot I
described above. If the history includes oral contact, the swab has to include the throat.
That is not me being thorough for the sake of it.

Condoms in these settings are used inconsistently, and the networks overlap. Indian
work on HIV and syphilis co-infection describes precisely this pattern, overlapping casual,
commercial and marital partnerships combined with inconsistent condom use (Shivkar, 2026).
That last word is the one that matters. Marital. Whatever is acquired does not stay in one
compartment of your life.

And you are probably underestimating your own risk. That is not an insult, it is a
documented phenomenon. When a cohort of men who classified themselves as low risk was assessed
properly, that self-classification turned out to be wrong often enough to matter
(Freeborn, 2020). Nearly everyone grades themselves generously.

7. How HIV does NOT spread

Okay, before going further, let me tell you the different modes through which HIV DOES NOT
spread. I put this high on the page deliberately, because the fear here does more damage in
Chennai than the virus does.

1. HIV does not spread through sharing toilets, food or drinks.
2. HIV does not spread through saliva, sweat, tears or closed-mouth kissing.
3. HIV does not spread through air, water, mosquitoes or pets.
4. HIV does not spread by shaking hands, hugging, or sharing a bed.
5. HIV does not spread by sharing a workplace, a hostel room, or a plate of food.

I have had a patient throw away his own steel tumbler. I have had a grandmother ask me if
she is allowed to hold her grandchild. The answer is yes.

8. When to test, and which HIV test to take

If your exposure was within the last 72 hours,
testing is not your first step. A test taken tonight cannot see an infection you picked
up last night. What you need first is
PEP. Go to a hospital casualty now,
or call us, and come back to this section afterwards.

For everybody else, there are three tests that matter, and they differ in how early they
can detect an infection:

The 4th-generation antigen/antibody test is the workhorse and the one I order most
often. It detects antibodies to HIV as well as the p24 antigen, which gives it a shorter window
period than antibody-only tests (Adhikari, 2018). The NAT (nucleic acid test) looks for
the virus itself and turns positive earliest, which is why it is used for confirmation and in
suspected acute infection (Ding, 2025). The rapid antibody test is quick and widely
available but has the longest window.

Day
ranges above are typical practice figures following CDC and NACO testing guidance, not results
from a single study. Your lab will state its own.

Even fourth-generation immunoassays have a real window period, which is why a single early
negative cannot close the question (Pinar, 2025).

If your screening test comes back reactive

This is the hour nobody prepares you for.

A reactive screening test is not a diagnosis. Screening tests are deliberately built
to over-call, because missing an infection is worse than a false alarm. A reactive result must
be confirmed by a second, different test before anybody tells you that you have HIV. Moreover,
false positives genuinely happen.

So if a lab hands you a reactive rapid test at 8pm, do not spend the night deciding your
life is over. Get the confirmatory test. A meaningful number of those nights end in relief.

9. The test you are given matters more than the place you go to

This is the part of the article I most want you to read, because it is where I see people
harmed by a cheap panel rather than by a virus.

Most advertised “STD packages” do not include a NAAT. They run antibody tests
and a p24 antigen assay, print a clean report, and send you home. The problem is what those
tests can and cannot see.

A NAAT, or nucleic acid amplification test, looks for the genetic material of the
organism itself. Antibody tests look for your immune response, which takes weeks to appear.
Antigen tests sit somewhere in between. For chlamydia and
gonorrhoea, NAAT is regarded as the laboratory gold
standard (Sohaili, 2026), and the gap is not small. In one comparison of
diagnostic practice, chlamydia was picked up in 60% of cases by NAAT against 31.3% by
antigen detection, and 0% by culture. For gonorrhoea the figures were 100% by NAAT against
59.5% by Gram stain and 57.7% by culture (Xiong, 2026).

Read that again. An antigen-based panel found roughly half of the chlamydia that a NAAT
found. If you were one of the other half, your report said negative and you went home.

That is why, in twelve years of practice, I have always used NAAT for HIV, and for
chlamydia, gonorrhoea, hepatitis B, hepatitis C and syphilis. In selected cases I add herpes
testing. For hepatitis B and
hepatitis C in particular, nucleic acid
testing detects infection during the window before antibodies appear (Calderón-Carmona, 2024;
Rodríguez-Rivera, 2026), which is exactly the period a worried patient is sitting in
front of me.

The other thing budget panels miss: where they take the sample from

A urine sample only tells you about the urethra. If exposure was oral or anal, the
infection can be sitting in the throat or the rectum and a urine-only panel will never see it.
When one screening service added throat and rectal sampling on the basis of risk, detection
went from 0.11% to 0.37% (Huxta, 2021). Oropharyngeal gonorrhoea in particular is usually
symptomless and therefore goes undetected (van, 2021).

So when a patient tells me his report was negative, my first question is not what the
result said. It is which test was run, and from where.

10. The window period, in plain numbers

The window period is the gap between getting infected and a test being able to detect it.
Test inside that window and you can be genuinely infected while testing negative.

The practical rule I give patients: a 4th-generation test at 45 days, and if it is
negative, you are almost certainly fine. A test taken three days after an exposure tells
you about infections from more than six weeks ago, not about last weekend.

One exception catches people out. If you have taken PEP, the clock restarts. Test
45 days after you finish the course, not 45 days after the exposure, because the
medication can delay the point at which a test turns positive.

There is a great deal more to say about window periods than belongs on this page. I have
written it up separately, in full:
the HIV window period explained.

11. Where to get HIV treatment in Chennai

This is the question I am asked most. Where do you actually go in Chennai? You have three
realistic options, and they are not equivalent:

Government ART centres run through TANSACS, attached to medical college hospitals and
including the Centre of Excellence at Tambaram Sanatorium, follow the standards of
India’s National AIDS Control Programme (Zala, 2026). When that route suits a patient
better, I refer them there directly.

Our own practice is in T Nagar: No 21, Sree Kalki Apartments, Ground Floor,
Bazullah Road, T Nagar, Chennai 600017, a few minutes from Panagal Park. You can
reach us on 97907 83856. If you are in
Velachery,
Anna Nagar,
Adyar or
Tambaram, you are within
easy reach of this clinic.

Do not let the search for the perfect place delay the test. Testing anywhere beats testing
nowhere.

What happens when you come in

Men put this off for months because they imagine something far worse than the reality.

1. You talk, first. No forms at a public desk, no announcing why you are here.
2. A blood sample. One small draw. It takes under a minute.
3. The result, explained to your face. You will not be handed a slip and sent home to
   work it out yourself.
4. If it is negative, we work out whether you tested inside the window and whether
   you need to repeat it, and we talk about keeping you negative.
5. If it is reactive, we arrange the confirmatory test before anybody uses the word
   diagnosis. If it is confirmed, I start you on treatment personally, and then we decide
   together, based on what you are comfortable with, whether you continue here or I refer you
   on.

The whole visit is usually under thirty minutes. Of course nobody in the waiting room knows
what you are being seen for.

HIV cases in Chennai: what the surveillance data shows

People ask me how common HIV actually is in Chennai, usually because they are trying to
work out how worried to be.

The figures come from two places: NACO’s annual India HIV Estimates, and the TANSACS
state reports. These are revised every year, so I will not put one here. What I can tell you is this. Tamil Nadu is one of the Indian states that responded earliest and hardest to
HIV, NACO’s own HIV Estimates have shown adult prevalence here declining over successive
rounds, and the state has one of the more mature ART networks in the country.

However, the number that matters to you is not the state figure. It is your own status, and
that is a single blood test away. A low prevalence does not protect an individual who had a
genuine exposure, and a high one does not condemn someone who did not.

12. Clinic, ART centre or hospital for HIV treatment in Chennai: choosing honestly

A lot of people search for the “best hospital for HIV treatment in Chennai”,
and I understand the instinct. Serious disease, therefore big hospital. But for most
people newly diagnosed with HIV, that instinct is slightly off.

So:

• Start at a private clinic if what you want is testing done properly, results
  explained to your face, treatment started without delay, and your business kept to
  yourself. That is where most of my patients begin.
• You need a hospital if you are acutely unwell. A serious opportunistic
  infection, suspected TB or meningitis, very advanced disease. That is inpatient medicine,
  and honestly, those patients rarely reach a clinic like mine.
• A government ART centre comes into the picture if, once we have talked, that
  route suits you better. When it does, I make the referral myself.

The medicines are identical. Nobody gets a better antiretroviral because they paid
more. What differs is not the drug. It is everything that happens around the drug, and that
is the part most pages leave out.

The part nobody writes down

A government ART centre registers you. That registration is how the programme runs, and
I want to be fair about it, because the programme genuinely works.

However, registration also means a file, scheduled follow-up, and partner notification. In
my experience it very often means family members come to know as well. In this country that is
not a small thing. The published work on HIV stigma in India says the same thing repeatedly:
fear of disclosure keeps people away from services (Patra, 2026), anticipated stigma shapes
whether men engage with treatment at all (Bhutada, 2023), and a measurable share of people
still endorse coercive responses to a positive status, including public disclosure and
restrictions on marriage and family life (Steward, 2023).

I am not describing a theoretical risk. Over twelve years I have watched patients be moved
out of their own homes by their own families.

How HIV treatment in Chennai works at our clinic

So here is exactly what I say in my room, and I will say it the same way here.

You come to the clinic first. We test, we confirm, and we start treatment. Then we
talk honestly about what you are comfortable with: cost, privacy, travel, and who at home
knows. If a government ART centre, or a centre like VHS here in Chennai, suits you better, I
write the referral myself and hand you over properly. If you would rather keep your care
here, we do that. Either way you are not left untreated, and the decision is made with you,
not for you.

You are allowed to want privacy. That is a legitimate thing to want. It is not
vanity and it is not shame. Your diagnosis is your medical information, and who else gets to
learn it should be your decision.

13. What HIV treatment costs in Chennai

Almost nobody publishes this, and the silence makes people assume the worst.

HIV treatment in Chennai costs far less than most people fear. The drugs are the
same whichever route you take. What you pay for at a clinic is speed, privacy and
continuity: one doctor who knows your case from the first test onwards. Based on what I see
in Chennai practice, the realistic components are:

To give you a rough idea on the testing side: a rapid HIV screening test at a
private lab in Chennai typically runs in the low hundreds of rupees. A 4th-generation
antigen/antibody test costs more than that, and viral load and CD4 testing more again. Those are what I see quoted in practice, chains differ,
and prices move. Ring and ask for today’s number.

If cost becomes a worry at any stage, tell me. That is exactly when I refer patients to a
government ART centre, where antiretrovirals are supplied free. Cost is not a reason to go
untreated in Tamil Nadu, and it is a conversation we have in the room, not something you
have to work out alone.

Call the clinic and we will tell you exactly what a consultation costs before you come in.
Nobody here will quote you one price on the phone and another at the desk.

Dr Shah Dupesh

Consultant Andrologist & Sexologist

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14. The modern HIV regimen: one tablet, once a day

HIV treatment involves antiretroviral medications. Here is where I need to correct something
this page used to say: that treatment means “a combination of 3 pills”.

It still means a combination of three drugs. It very rarely means three separate pills any
more. Modern therapy is usually a single-tablet regimen. Three active drugs
combined into one tablet, taken once daily (Domingo, 2018). Integrase-inhibitor based regimens, usually dolutegravir-containing, are what national and
international guidelines now recommend first line. Some are given as two-drug single tablets
(Sun, 2021).

In India, these drugs are distributed free of cost to patients in the state run government
hospitals. What you are actually given here is set by the National AIDS Control Programme
(Zala, 2026), and the regimens are the same modern ones used internationally. For deeper
technical detail the US Department of Health and Human Services guidelines are the
best-maintained public reference, at
clinicalinfo.hiv.gov, though the regimen your doctor picks will follow
the Indian protocol.

One thing that happens at diagnosis in India and surprises people. You will be screened for
tuberculosis, and you should be offered TB preventive therapy alongside your ART (Zala, 2026), so ask for it
if nobody raises it. TB is the commonest serious infection in people with HIV in this country, and it is
preventable. Take that course too.

What matters far more than which regimen you are on is whether you take it. Adherence is
what drives viral suppression (Assele, 2026), and it is the part of all this that is entirely
in your hands. One tablet, same time every day, no holidays.

15. How treatment is monitored: CD4 count and viral load

Two numbers will follow you for life. Learn what they mean and you will worry far less.

One point of confusion worth clearing up. Most labs report “target not detected”
below roughly 20 to 50 copies/mL, which is what people mean by undetectable. The
threshold that matters for U=U is under 200. A result between the two is worth a
conversation, but it is not a failure.

In my own practice, once a patient is established and stable on treatment, this settles
into a single annual review: CD4, CD8 and a quantitative viral load. In the first year
we look more often, because that is when we are confirming the regimen is doing its job. After
that, one careful check a year, and a prescription you actually keep taking, is what keeps
people well. Do not let anyone talk you into monthly testing you do not need.

In plain terms: viral load tells us whether the medicine is working. CD4 tells us how much
damage is left to repair. Viral load responds within weeks. CD4 recovery takes months to
years, and that is normal. Do not panic if your CD4 climbs slowly while your viral load is already
undetectable. That combination means the treatment is working exactly as intended.

Sustained suppression is also what keeps U=U true for you, and durability of suppression is
itself something we watch, because rebound can occur if adherence slips (Lauren, 2026).

16. PrEP: preventing HIV before exposure

PrEP is pre-exposure prophylaxis: HIV-negative people taking antiretroviral medication to
stay HIV-negative. It is effective at preventing HIV acquisition (Sharma, 2026). We do not talk
about it enough in India, and we should.

PrEP is worth a conversation if you are in an ongoing serodifferent relationship where the
positive partner is not yet suppressed, if you have multiple partners, if you have a
recurring STD history, or if you inject
drugs. It is a daily tablet, and there are now long-acting injectable options.
Cabotegravir, two starter injections a month apart and then one every two months (Moschese, 2026) and lenacapavir, which I cover next.

However, PrEP is not a tablet you start on your own. You must have a confirmed negative HIV
test first, because starting PrEP with undiagnosed HIV breeds drug resistance. Moreover, you
are re-tested every three months while you are on it, with a kidney and hepatitis B check
before you begin.

PrEP is also not a substitute for condoms. It does nothing about syphilis, gonorrhoea or
chlamydia.

17. PEP: the 72-hour window after an exposure

If something has already happened, read this now. The full guide is here:
PEP treatment in Chennai.

You have up to 72 hours to start PEP. Not 24. This page previously said 24 hours,
which was wrong, and if you read that here before, I am sorry. PEP is started no later than
72 hours after the event (Fätkenheuer, 2016), and national guidelines are built around
that same boundary (Cresswell, 2022).

However, do not read “72 hours” as permission to wait. Even at 48 hours it is
over 90% effective if you finish the course (Zhang, 2025). Sooner is better.

Where to go right now: call us on 97907 83856, or go to the casualty or
emergency department of any hospital. You do not need an appointment and you do not need to
wait for morning.

PEP is a 28-day course, not a single tablet, and it must be finished. You will also
need a baseline test before you start, along with kidney and hepatitis B checks, a review
during the course, and another HIV test 45 days after you finish it.

18. The six-month injection, and what is coming next

People ask me whether there is now a six-month injection for HIV. There is, and the
answer needs care, because the same drug does two different jobs.

The drug is lenacapavir, a capsid inhibitor given as a twice-yearly subcutaneous
injection. For prevention, twice-yearly lenacapavir has been shown to be highly
efficacious (Kelley, 2025), with trial efficacy reported at 99.9% or above (Adepoju, 2026),
and it outperforms daily oral tenofovir/emtricitabine PrEP (Jamieson, 2026). Trials have now
extended into pregnant and lactating women (Bekker, 2026).

But there are two things you must know. First: there is no six-monthly injection that
replaces daily HIV treatment. In people
who already have HIV this drug is used alongside other antiretrovirals, and only in difficult,
drug-resistant cases. The long-acting treatment options that do exist are given every two
months, not every six, and only to selected patients.

Second, availability and price in India lag well behind the trial results, so do not plan
around it. Of course I would rather you hear that from me than discover it at a pharmacy
counter.

What I tell my patients is this. Everything is moving towards fewer doses and more privacy,
and that is genuinely good news. However, the tablet in your hand today is the one keeping you
undetectable.

19. Condoms: still one of the best tools you have, still not a guarantee

Of course, one must not forget that the age-old condom is still one of the best ways to
prevent the spread of infections. However, please bear in mind condoms still do NOT
guarantee a 100% protective strategy.

I say that sentence carefully, because men hear it two different ways and both of them are
wrong. Some hear “not 100%” and quietly decide there is no point bothering at all.
Others treat a condom as a wall, and then sit in front of me genuinely stunned by a reactive
result. The truth sits between those two, and you deserve the actual numbers rather than a
slogan.

What the 80% figure really means

Used for every single act of penetrative sex, condoms reduce HIV transmission by about
80% (Weller, 2002). That is a very large reduction, and it is exactly why condoms remain
the first thing I recommend. But read the condition again, because the whole sentence turns on
it: every single act. That 80% is measured in people who used a condom consistently, not
in people who used one most of the time. Occasional use does not buy you 80% of the benefit; it
buys you far less, because a single unprotected act is enough.

The second thing nobody tells you is that condoms also fail mechanically, and they do it
more often than the packet implies. These are not rare freak events. In a cohort of 892 women
at high risk of sexually transmitted disease, 21,852 condoms were tracked: 2.3% broke during
intercourse and a further 1.3% slipped off (Macaluso, 1999). A separate study of 20,148 acts
of intercourse put male condom breakage at 3.1% and slippage at 1.1%
(Valappil, 2005). Among brothel-based sex workers in Singapore, across 1,885 uses, breakage ran
at 1.2% and slippage at 2.1% (Wong, 2000).

Put those percentages next to how often people actually have sex and the point lands. A
couple using condoms twice a week is looking at a meaningful chance of at least one break or
slip inside a year. That is not an argument against condoms. It is an argument for knowing what
to do on the night one fails, and for not treating a condom as a reason never to test.

Why condoms break, and what actually prevents it

Breakage is rarely bad luck. When it was studied properly, the behaviours that predicted it
were specific and fixable: unrolling the condom before fitting it to the penis, using no
additional lubricant at all, using an unsuitable lubricant, and longer duration of
intercourse (Golombok, 2001). So use a lubricant, and use the right kind — a
water-based or silicone lubricant, which is what condoms are designed and tested to be used
with. Oil, petroleum jelly, lotion and cooking oils have no place anywhere near a latex
condom.

On material, the evidence is the opposite of what many people assume. Latex is the best
mechanical performer. In a randomised trial, a non-latex condom broke or slipped during
intercourse or withdrawal in 4.0% of first uses compared with 1.3% for latex, with a breakage
rate around eight times higher (Walsh, 2003). Non-latex versions exist for a genuine reason
— latex allergy — and they remain far better than nothing, but if latex suits you,
latex is the sensible default. Store them somewhere cool and dry, check the expiry date, open
the packet with your fingers rather than your teeth or a fingernail, and never reuse one.

What a condom does not cover

Here is the part that surprises people most, and it matters more than the breakage figures.
A condom covers the shaft of the penis. It does not cover the scrotum, the base, the groin or
the surrounding skin — and several infections travel by skin-to-skin contact with exactly
those areas rather than by fluid alone.

So a condom protects very well against the infections carried in semen and blood, HIV
foremost among them, and much less well against the ones that live on skin. In a prospective
cohort of women attending a sexually transmitted disease clinic, consistent condom use without
any breakage or slippage showed no significant protective effect against acquiring HSV-2,
the virus behind genital
herpes (Gallo, 2008). That was one cohort and its confidence interval was wide, so read it
as a warning rather than a verdict — but it points the same way as everything else:
herpes, HPV and syphilis are not reliably stopped by a condom. Among men who have sex with men
in north India, condom use was inconsistent in 95% of participants and a history of paid sex was
independently associated with HPV infection (Dash, 2026).

This is the bridge to the next section, and it is the practical reason I keep repeating it:
the infection a condom misses is very often the one that then makes HIV easier to catch.

20. Is there a connection between HIV and other sexually transmitted diseases?

Yes, and it runs in both directions.

Having another sexually transmitted infection raises your risk of acquiring HIV if you are
exposed. Syphilis in particular is associated with increased HIV acquisition (Wu, 2021), and
HSV-2 infection increases HIV acquisition risk as well (Stone, 2023). Ulcerative infections, herpes,
syphilis and chancroid, are the clearest culprits, because a break in the
skin or mucosa is an open door (Morales-Múnera, 2025).

Common STDs that can accelerate acquisition of HIV include:

1. Syphilis
2. Chlamydia
3. Gonorrhea
4. Herpes
5. Hepatitis B
6. & Hepatitis C

The reverse is also true: other STDs spread more readily among people with untreated HIV.

When visiting an STD clinic, it is
wise to get tested for all of the above along with HIV. Do not test for one thing and go home.
Get the whole panel.

21. Why we test for everything, not just the thing you are worried about

Patients almost always come in worried about one infection. That is rarely how STDs behave.

Co-infection is common, and it runs hardest alongside HIV. A systematic review and
meta-analysis of people living with HIV found high rates of concurrent syphilis, gonorrhoea,
chlamydia or trichomonas (Zhang, 2025). Indian clinic data shows the same pattern, with
co-infections and HIV appearing together in men attending STI services (Bairy, 2025).

The relationship goes both ways, which is why this matters so much. Another STD raises your
risk of acquiring HIV if you are exposed, and syphilis in
particular is associated with increased HIV acquisition (Wu, 2021), while HSV-2 does the
same (Stone, 2023). Ulcerative infections, genital
herpes, syphilis and chancroid, are the clearest culprits, because a break in the
skin is an open door (Morales-Múnera, 2025).

So a single-infection test tells you about a single infection. It does not tell you whether
you are safe. When you come to me for one thing, I test for the panel, because the thing you
did not ask about is the thing that catches people out.

22. If you are a woman who has just found out about a partner

I see this every few weeks. A woman comes in, usually alone, usually composed, having just
discovered that her husband or boyfriend has been with somebody else. She is not there about a
symptom. She is there because she is frightened.

Let me say the useful things plainly.

You cannot judge this on symptoms. In a study of pregnant women, STIs occurred at
similar rates in those with symptoms and those without, which is precisely why asymptomatic
detection matters (Bakir, 2025). Feeling well tells you very little.

The stakes are different for you. Untreated chlamydia in women can lead to pelvic
inflammatory disease and to infertility (Klasner, 2024). That is not said to frighten you. It
is said because this is entirely preventable if it is found now, and much harder to undo later.

A basic kit is not enough. Rapid antibody kits and simple panels are what many
patients are offered, and they carry the same blind spots described above. You want NAAT-based
testing, and you want the full panel rather than one reassuring line on a report.

You do not need your husband’s permission, his presence, or his agreement to be tested. You
can come alone, and plenty of women do.

23. Home kits, self-tests and what happens to your data

I do not recommend self-testing for HIV or for any STD, and I want to give you the real
reasons rather than a slogan.

A self-test is an antibody test. It carries the longest window period of any method, so a
negative result soon after an exposure tells you almost nothing. It cannot do a NAAT, it cannot
sample your throat or rectum, and it cannot tell you what else you should have been tested for.
If the result is reactive, you are alone in a room with the most frightening sentence of your
life and nobody to tell you that a screening result is not a diagnosis.

Then there is the question nobody asks the commercial panels: what happens to your
result?

I cannot speak for how any particular laboratory handles data. What I can tell you is how
this clinic works, and you should ask the same question wherever you go.

• Your result is given to you, by me, in person.
• It is not sent to your employer, your family, your insurer or your partner.
• Nobody at reception is told what you are being seen for.
• If you are positive, we decide the next step together. If a referral suits you better,
  it is made on your terms, with the full picture in front of you.

If you want the full panel done properly, that is what the
STD clinic page covers. Your sexual history is your private
life. The result belongs to you. That is not a service
I advertise, it is simply how a consultation should work.

HIV treatment in Chennai: your questions answered

These are the questions I am asked most often, and the ones people search for at night. Short answers here; the detail is in the sections above.

The bottom line

All said and done, following safe practices can definitely lower your chances of getting an
HIV infection. The age old saying ‘Prevention is better than cure’ applies
best to this notorious disease.

But if prevention has already failed, I want you to hear the other half of it clearly:
HIV in 2026 is a treatable, controllable, one-tablet-a-day condition, cost need not stand in
the way of treatment in Tamil Nadu, and as long as you stay on treatment and stay suppressed, you will not pass it to the person you
love.

The only version of this disease that still destroys lives is the undiagnosed one.

I hope you enjoyed reading this article. This is Dr Shah, consultant
andrologist in chennai. Please do share this article
to all your friends and loved ones. On this subject, sharing really does help someone.

If you are worried about HIV & want to get an HIV test in chennai, do get in touch with
us below.

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