health (gynaecological) problems happen more often in women with HIV, and can
be more severe, or harder to treat.
screening for sexually transmitted infections (STIs) is an important part of
your health care. Sometimes, you will not have any symptoms if you have an STI,
so regular check-ups are important, especially if you have had unprotected sex.
As well as the risk of illness, including long-term damage to your own health,
having an STI can increase the risk that you will pass on HIV during
unprotected sex. You can find out more about this risk, and how to avoid it, in
booklet HIV & sex. This booklet also has information on the
diagnosis and treatment of STIs.
you have an infection that can be transmitted sexually, your sexual partners
will need to have a sexual health screen and any necessary treatment before you
have sex again so that they can also have any infections diagnosed and treated.
(PID) is a bacterial infection that can
occur in a woman’s upper genital tract, including the womb, fallopian tubes and
ovaries. It can be caused by some untreated STIs such as
gonorrhoea and chlamydia, as
well as other bacteria and infections such as tuberculosis.
is always a serious condition, especially if you also have HIV. Having
untreated PID, or having it repeatedly, can make you infertile (unable to get
in the lower part of your stomach area
during sex, felt deep inside your pelvis
bleeding from the vagina (between periods or after sex).
general sexual health check-up will include tests to see if you have gonorrhoea
or chlamydia. You may need a
scan to see if PID has caused any cysts or abscesses, or an examination called
a laparoscopy. This procedure involves a surgeon making a small cut in the
stomach to insert a tube that allows them to see inside the abdomen and the
pelvis. It is done under a general anaesthetic.
you have PID you will be treated with a combination of antibiotics. Getting
help and treatment early is important to reduce the risk of long-term pain and
recurrence of PID.
human papillomavirus (HPV) is a family of different strains of virus.
HPV is sexually transmitted and very common – most people will have it at some
point in their life. It is possible for your body to clear HPV infection
itself, but women with HIV are much less likely than HIV-negative women to do
so. A vaccine against HPV is available (see page 22).
strains of this virus can cause abnormal cervical cells to develop, which can
lead to cervical cancer if not treated. Women living with HIV, especially if
you are over 40, have a higher chance of developing abnormal cervical cells
caused by those strains of HPV than women without HIV. Treatment for abnormal
cervical cells is highly effective, provided they are detected early.
sure you have regular cervical screening
(smear tests) to check for these cells so that you can receive prompt treatment
to remove them. There are no symptoms of having this sort of HPV. All women with HIV should have a cervical
screen soon after they are diagnosed with HIV, again after six months and then every year after that. This is more
often than is recommended for women without HIV, who are offered this test
every three years. Your GP will need to know about your HIV status to ensure
you are offered annual screening. Talk to your clinic staff if you would like
them to arrange this with your GP. If you don’t have a GP, or haven’t disclosed
your status to them, talk to staff at your HIV clinic about where to have
regular cervical screening.
strains of HPV can cause genital warts, but these don’t always leave visible
signs. They can also be detected by cervical screening and treated by applying
a cream, or by freezing or burning them off.
herpes is caused by two types of
herpes simplex virus (HSV), type 1 and type 2. Both types are highly
contagious and can be passed easily from one person to another by direct
contact. Once you are infected, the virus remains in your body for life,
although you may not have any symptoms much of the time.
herpes attacks can happen more often, last longer and be more painful if you
have HIV, especially if your immune system has been weakened. The antiviral
drug aciclovir can help shorten the duration of herpes episodes. If you are
getting regular episodes of herpes, you may want to consider taking aciclovir
every day to help prevent this.
there is an increased risk of fungal infections if you are HIV positive, such
as vaginal candidiasis (thrush),
treatment works well.
Bacterial vaginosis is an overgrowth of
bacteria in the vagina that occurs in many women, regardless of their HIV
status. Its symptoms can include a discharge which has a ‘fishy’ odour, but
many women have no symptoms at all.
not strictly an STI, but the risk of getting it is increased if you have a new
sexual partner, or multiple sexual partners; you are also more likely to get it
if you are pregnant. Washing the vagina (douching) is a common cause of
bacterial vaginosis. Douching and using scented soap or vaginal deodorant can
upset the balance of bacteria in the vagina. Smoking, using bubble bath and
having an intrauterine device (IUD) fitted can also increase the risk of
can be treated with antibiotics. If bacterial vaginosis is left untreated, it
can cause more serious symptoms and can lead to pelvic inflammatory disease and
infertility. It can increase the risk of mother-to-baby transmission of HIV and
of passing on HIV to a sexual partner.