Quality of life
People living with HIV have poorer health-related quality of life than individuals in the general population. This is the finding of a comparison of two large surveys conducted in the UK in the past five years.
The study shows that a significant minority of people living with HIV have health problems that affect their day-to-day lives, even though three-quarters of those surveyed were taking HIV treatment and had an undetectable viral load.
Questions were asked about five aspects of quality of life:
- Feelings of anxiety or depression – experienced by 27% of the general population and 50% of people living with HIV.
- Pain or discomfort at the time of completing the survey – reported by 40% of the general population and 42% of people living with HIV.
- Problems performing usual activities such as work or family responsibilities – mentioned by 21% of the general population and 34% of people living with HIV.
- Problems with mobility and walking about – experienced by 20% of the general population and 27% of people living with HIV.
- Problems with washing or dressing without assistance – reported by 5% of the general population and 13% of people living with HIV.
Having HIV was associated with poorer health-related quality of life even after adjusting the figures for factors such as age, gender, ethnicity and smoking that could also influence the results.
The greatest difference was in relation to depression and anxiety.
It is important to recognise that there are things you can do to look after your mental health, including managing depression and anxiety. Support from friends, family and other people living with HIV can be very helpful. There’s professional help too, such as talking therapies and treatment. Talk to your HIV clinic about what's available to you. You can find out more about emotional wellbeing and mental health on our website.
Skin cancer
Having HIV increases the risk of developing melanoma, a type of skin cancer, according to a new analysis. Researchers pooled the results of 21 previously published studies.
Overall, people living with HIV had a 26% increase in their relative risk of melanoma compared to the general population. This is likely to be due to the effects of HIV infection on the immune system – not just weakening of the immune system (as measured by a low CD4 count), but also inflammation and activation of the immune system over a long period.
Skin cancer is more likely to affect people with white skin than people with dark skin. The researchers recommend that fair-skinned people living with HIV should be regularly screened for suspicious skin lesions. They should also be aware of the dangers of prolonged exposure to the sun and use of tanning beds.
Shigella
New research has shed light on the transmission of shigella – a bacterial gut infection that can be spread during sexual contact, in particular oral contact with faeces (shit). Sex that may lead to contact with tiny amounts of faeces is a risk, for example anal sex, fingering or rimming.
There is currently an outbreak of shigella among gay men in the UK, with men living with HIV disproportionately affected.
Researchers talked in detail with 42 men who had had shigella. The symptoms, including severe diarrhoea and stomach cramps, can be extremely unpleasant. Many of the men sought help from their GP but few of the GPs were aware of the possibility of this sexually transmitted infection. Symptoms became so severe for some men that they were later admitted to hospital. Most men had never heard of shigella before it was diagnosed.
Men generally had numerous casual sex partners. Many reported meeting partners or arranging sex parties through sex-seeking websites and apps.
Three quarters reported using recreational drugs. Injecting drugs (‘slamming’) was reported by over a third of the HIV-positive men who had shigella, but men had limited awareness of how to reduce the risk of infections such as hepatitis C when injecting. As highlighted by another recent study of ‘chemsex’, many of the men felt that their drug use had affected their judgement on risk taking.
All men reported oral sex and rimming, and some also reported fisting. Most of the HIV-positive men said that they unprotected anal sex, often with other men who were HIV-positive. While this may avoid HIV being passed on, the study highlights the fact that other, serious infections can be passed on in these situations.
Public Health England and the Terrence Higgins Trust are running a campaign to raise awareness about the risk of shigella amongst gay and bisexual men. You can find out more about shigella, its treatment, and how to protect yourself and others from it, in NAM’s factsheet on shigellosis and at www.tht.org.uk/Shigella.
Editors' picks from other sources
As mixed-status HIV couples weigh risks, more choose to conceive the old-fashioned way
from Washington Post
Couples in which one or both partners are HIV positive have been using adoption, surrogacy or donor eggs or sperm for years, but those avenues are often incredibly expensive. Today, some doctors are endorsing intercourse without a condom as another option, provided the person with HIV has a low viral load and takes medication regularly.
HIV at 30: 'I've faced three decades since my diagnosis'
from Daily Telegraph
Thirty years ago, the human immunodeficiency virus (HIV) was discovered. Here, Paul Clift, who at 59 is one of the UK's longest known survivors, reveals his experiences with HIV – and how attitudes to this once feared disease are changing.
Bug chasing and me
from Beyond Positive
Recently, I have come into contact with a number of people online who have asked me to "poz" them. How did a virus like HIV become fetishised, and what happens when they become positive?
HIV: The power of positive thinking
from The Independent
At 12, Lisa was told that the 'vitamin pills' she'd been taking all her life were in fact antiretroviral drugs. Then she learnt that the woman she thought was her mother was really her aunt; her mother had died of AIDS when she was four. She struggled to cope. Now 19, she's helping other young people with HIV to face the future.