HIV and STIs

Avoiding sexually transmitted infections (STIs) is important for everyone’s health, but it is especially important if you have HIV. This is because STIs can not only cause illness (in some cases, more so in people with HIV), but they can also increase the risk that you will pass on HIV during unprotected sex, even if you have an undetectable viral load. STIs can raise the amount of virus in your sexual fluids to a very high level, possibly making you much more infectious.

Lymphogranuloma venereum (LGV) is a bacterial STI caused by strains of the common STI chlamydia. Over recent years, there have been outbreaks of LGV amongst gay men in several cities in the UK, but it has not always been clear what put men at risk of LGV infection.

Now, researchers from Brighton report that unprotected receptive anal sex is the key risk factor for LGV infection in men who have sex with men. Fisting, anonymous sex and sex while taking the drugs GHB or GBL were also found to be risk factors.

They also found that a very high proportion (89%) of the men with LGV in the study were also HIV positive.

LGV causes symptoms such as swollen lymph nodes, fever, muscular pain and a general feeling of being unwell. Symptoms can become severe if left untreated, and lead to longer-term health problems, but the infection can be treated with antibiotics.

Using condoms consistently and correctly during sex and using latex gloves for fisting can protect you against LGV infection. Using condoms with shared sex toys or cleaning them thoroughly with hot soapy water between uses also reduces the risk of acquiring LGV.  

Regular sexual health check-ups are important. Tell staff about the kind of sex you are having or other factors that could increase your risk of STIs. This means you can be offered the right tests and receive appropriate support.

You can find out more about LGV – including how to protect yourself and others against infection – in NAM’s factsheet on aidsmap.com, and about other STIs and looking after your sexual health in our booklet HIV & sex.

HIV and TB

Worldwide, tuberculosis (TB) is the single biggest cause of serious illness and death in people with HIV. In most cases, TB can be cured by treatment with a combination of antibiotics.

Multidrug-resistant TB (MDR-TB) is a growing international health problem and involves infections that are resistant to the key first-line anti-TB drugs, isoniazid and rifampicin. Unlike standard TB treatment, which usually lasts six months, treatment for multidrug-resistant TB is recommended to last for 24 months.

Researchers in Ethiopia have been looking at a large number of studies to see if there is any relationship between having HIV and being at higher risk of having MDR-TB.

This analysis found that people with HIV were more than twice as likely to have a strain of TB that was resistant to first-line drugs. The researchers say that their findings highlight the importance of collaboration between HIV and TB treatment programmes.

Many people find it difficult to take TB treatment as prescribed or to complete the whole course of treatment, which is necessary to get rid of all the TB bacteria. This contributes to the development of drug-resistant TB bacteria. Over a quarter of people with multidrug-resistant tuberculosis in the UK are not completing the recommended course of treatment, research has shown.

For more information on HIV & TB in the UK, you may find our HIV & TB booklet helpful, and The Truth About TB website, produced by TB Alert. Our email newsletter for people working in resource-limited settings regularly covers TB research and you can find a complete archive of these newsletters at www.aidsmap.com/hatip