HIV treatment
HIV-positive gay men and sex
Gay men are one of the groups most affected by HIV in the UK.
There have been outbreaks of sexually transmitted hepatitis C virus amongst HIV-positive gay men in London, Brighton, Manchester and a number of other cities around the world.
Researchers in Manchester looked at the experiences of men co-infected with HIV and hepatitis C virus. Most of the men in the study acquired the infection at sex parties. Some reported that infection with hepatitis C had contributed to a loss of sexual identity.
Others reported a sense of isolation and depression was common.
There have been prosecutions for reckless transmission of HIV in the UK. Researchers asked a sample of about 40 HIV-positive gay men who had recently had unprotected sex about their understanding of this issue and how it had affected their sexual behaviour.
Only a third of the men had a good understanding of the issue. These men knew that there had been convictions, that these convictions were for grievous bodily harm and that the cases hinged on a lack of consent because the complainant said the accused had not disclosed their HIV status before unprotected sex.
Although some men said they now took care to disclose to their sexual partners, others said that fear of prosecution meant that they now took additional precautions to conceal their HIV status from potential sexual partners and members of their community.
Genital and anal warts
Genital and anal warts are caused by human papilloma virus (HPV) and are very common.
Some strains of this virus can cause pre-cancerous and cancerous cell changes. The Canadian researchers found that the most common type of human papilloma virus present in the anuses of the men in the study was HPV-16, a strain that is associated with a risk of cancer.
Although quite rare, rates of anal cancer are much higher amongst HIV-positive gay men than the general population.
Few men cleared anal infection with human papilloma virus. The strain of the virus with the lowest clearance rate was the cancer-associated HPV-16 strain.
What’s more, over a third of men who were not infected with HPV-16 at the start of the study subsequently acquired infection with this strain. A further 18% became infected with HPV-18, which is also associated with cancer.
Vaccines have recently become available that offer protection against the main cancer-associated strains of HPV. They don’t work if a person is already infected and their use in the UK is currently restricted to teenage girls.
Rates of anal and cervical cancer are higher in people with HIV. Some doctors are therefore wondering if people with HIV should have blood tests to see if they are infected with the strains of human papilloma virus with a high risk of cancer.
Studies are currently underway into the safety and effectiveness of these vaccines in people with HIV.
HIV treatment for children
The study included HIV-positive babies born between 1996 and 2004. Treatment was started before three months of age in 124 babies, with 84 babies starting treatment later.
Rates of HIV-related illness and death were much lower in the babies who started treatment before three months.
Separate research conducted in South Africa has also reached similar conclusions.