Much of the recent HIV news has been concerned with the sexual health and wellbeing of people with HIV.
Most people with HIV remain sexually active after their diagnosis.
But sexual problems are widespread.
A lot is known about sexual dysfunction in HIV-positive men, and now researchers have found that women with HIV are more likely to report sexual problems than their HIV-negative peers.
Support and help is available if you encounter problems with sex, so it’s worth mentioning it to a member of your healthcare team.
Smoking and lung cancer
Smoking is the only risk factor for lung cancer in HIV-positive women, US researchers have reported.
Rates of HIV-related cancers have fallen since effective HIV treatment became available.
But doctors have noted an increase in the rates of some other cancers, including lung cancer.
This cancer is generally quite rare in people with HIV. However, researchers want to find out if those with HIV are at increased risk of developing it, and what its risk factors are.
They therefore looked at rates of lung cancer in women with or at risk of HIV. They then compared these rates to those seen in the general female US population.
Their analysis showed that rates of lung cancer did not differ between the HIV-positive and HIV-negative women in their study population.
However, the cancer rate for the women in the study was three times that seen in US women generally.
The women in the study were more likely to smoke than US women generally.
All the women who developed lung cancer were cigarette smokers, and the researchers found that smoking was the only risk factor for lung cancer.
A low CD4 cell count and increasing age were both associated with an increased risk of cancer for the women with HIV.
People with HIV should be given help to stop smoking, say the researchers.
You can find out more about smoking on namlife.org, NAM’s website for people with HIV.
Help to stop smoking will be available from your HIV clinic and GP.
The current issue of NAM's HIV Treatment Update includes a feature article on smoking. HIV Treatment Update is available free to people living with HIV. Visit our online bookshop for more information.
Increases in viral load
Viral load increases in people taking HIV treatment are often preceded by physical or psychological symptoms, British researchers have found.
Modern HIV treatment is very effective and is able to suppress viral load to undetectable levels in most patients.
You’ll get the most benefit from your HIV treatment if you take it as prescribed. Missing doses can lead to viral load increasing, and in some cases the development of drug-resistant strains of HIV.
Researchers wanted to see if patients’ perceptions of their own health could be related to changes in viral load.
They therefore monitored 188 patients taking HIV treatment for the first time for an average of two years.
Viral load increased to detectable levels in about 20% of patients. The researchers found that the risk of this was significantly associated with physical and psychological symptoms.
The researchers speculate that such symptoms could indicate that patients are experiencing distress, which in turn could lead to poor adherence to HIV treatment.
If your HIV treatment is causing side-effects, then you should mention this to your HIV doctor. It’s good to know that it’s nearly always possible to do something about side-effects.
Similarly, if you are unhappy or depressed, it’s good to know that a lot of mental health support is available to people with HIV.
Sexual wellbeing
Many women with HIV have experienced some form of sexual dysfunction, US researchers have found.
The researchers asked approximately 1300 HIV-positive women and 500 HIV-negative women about their sexual function and satisfaction.
They found that women with HIV were less likely to report that they were satisfied with sex.
HIV was also found to be significantly associated with poorer sexual function.
Poor health, indicated by CD4 cell count, seemed be associated with lower levels of sexual functioning in women with HIV.
The researchers suggest that sexual wellbeing should be monitored in routine HIV care.
In the UK, the HIV support organisation Positively Women is also there to help. Their helpline is operated by women who are living with HIV, and can provide a good source of support and referral to other services. They can be contacted on 020 7713 0222.
Beliefs about infectiousness
A US study has found that HIV-positive people who believed that having an undetectable viral load meant they were less infectious were more likely to be diagnosed with a sexually transmitted infection.
The impact of HIV treatment on infectiousness is a hotly debated topic.
HIV treatment reduces viral load in both the blood and sexual fluids. Very few infections are thought to be passed on from people taking HIV treatment who have a low, or undetectable, viral load.
There is real hope that increasing the number of people taking HIV treatment will help to control the pace of the epidemic.
But untreated sexually transmitted infections can increase viral load in genital secretions. And wider increases in HIV risk behaviours could offset the reductions in new infections that are achieved by increasing the number of people taking HIV treatment.
Now US researchers have found that those who believed that people with an undetectable viral load were not infectious were about 33% more likely to be diagnosed with a sexually transmitted infection.
However, those diagnosed with a sexually transmitted infection were just as likely to use a condom as those without such a diagnosis.