STIs

If you have sex, you run a risk of getting sexually transmitted infections (STIs). If you have safer sex, that chance is much slighter, but still not zero. Information about the symptoms, the possible consequences and the treatment of the most common STIs can be found on www.soaaids.nl. This section looks at what is specifically relevant for people with HIV.

If you have HIV, it is good to be alert for STIs:

  • You run a greater risk of getting hepatitis C.
  • There are interactions between certain HIV medicines and the medicines for hepatitis C.
  • An attack of genital herpes can last longer and be more serious if your immune system is weak.
  • The progression of syphilis is often no different for people with HIV than for anyone else, but it can also be more rapid and more serious. The first symptoms are little spots on your skin all over your body, especially on the palms of your hands and the soles of your feet; a flu-like feeling; bald patches on your head; eye problems; and warts on your genitals or around your anus.
  • An STI can potentially cause a temporary increase in your viral load and a drop in your CD4 cell count.
  • If you have an STI, it is potentially easier for you to pass on your HIV:
    • Some STIs can cause damage to the skin and mucous membranes of your penis, vagina and anus.
    • An STI can increase the viral load in your blood, sperm and vaginal fluid.

LGV
LGV is an aggressive strain of chlamydia that occurs primarily in gay men with HIV. You can read more about it in this article.

Hepatitis C
Hepatitis C (HCV) is a serious and hard-to-treat chronic liver disease. The treatment of hepatitis C is difficult and not always successful by any means. In recent years, hepatitis C has become more and more common among people with HIV. Hepatitis C is almost only ever passed on sexually between gay men with HIV, usually through unprotected sexual contact. The treatment of hepatitis C is given by the HIV doctor and HIV nurse at an HIV treatment centre, usually in consultation with a liver doctor.

STI check
If you have multiple sexual partners (or if your partner has multiple sex partners), it is advisable to get checked for STIs twice a year. If you have many contacts, three or four check-ups a year is even smarter. The sooner you find out that you have one, the easier the STI will be to treat in most cases – and the sooner you will not have to worry about passing it on to others. STIs can also lower your immunity. If you have syphilis or chlamydia for a long time, for example, those can lead to serious consequences including paralysis and infertility. Your regular blood test in connection with your HIV does not check for all STIs. And a complete STI check-up should also include a physical examination. You can go to an STI policlinic for a complete STI check-up, but some HIV treatment centres are also STI policlinics.

Checking for HPV in both women and men
The HPV virus can cause cervical cancer in women. The chances of that are greater for women who have HIV. Men who have sex with men can have exactly the same HPV virus. In a small percentage of men, that can lead to anal cancer after 20 or 30 years. Women with HIV are given a smear test once a year; men will be given an anoscopy by a dermatologist only if there is a reason for doing so.

Vaccinations against hepatitis A and B
A blood test done in hospital will show if you have ever had hepatitis A and/or B. If you have had either one before, you will have antibodies and you cannot become reinfected. If you are sexually active and have not had hepatitis A or B, it is advisable to get vaccinated against them. You can get vaccinated for free at the STI policlinic of your local health authority (GGD) and by HIV nurses in Amsterdam. If you choose to have your family doctor give you the vaccination, you will need to pay for that yourself. If you have HIV, it is advisable to get tested again afterwards to make sure the vaccination against hepatitis B is effective. People with HIV often need an extra injection before the vaccination is fully effective.

 

 

 

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