HIV and the liver

It’s very important for people with HIV to have a healthy liver, particularly because the liver processes many of the medicines used to treat HIV and other infections.

But many people with HIV are also infected with the serious infections hepatitis B virus and/or hepatitis C virus. These viruses affect the liver and can cause serious illness, even death. Liver disease caused by these viruses is an important cause of ill health in people with HIV.

Travel

Some countries place entry restrictions on people with HIV, with a few even banning visits just for short trips like tourism or business travel.

Such restrictions have been condemned by organisations such as UNAIDS, who point out that they serve no useful purpose at all but are highly discriminatory.

Since the late 1980s the United States has effectively banned routine entry for people with HIV. If you’re HIV-positive and want to visit the US you have to go through a very complex procedure and obtain a special visa which can take months to obtain. People with HIV who have travelled to the US without this visa have sometimes been stopped by immigration or customs officials, detained, and deported.

On World AIDS Day last year, the US president, George Bush, announced that he’d issued instructions to allow “a more streamlined process” for the issuing of entry visas for people with HIV.

But new draft guidelines issued by the US government suggest that people with HIV will still have to obtain special permission to enter the country and will only be allowed to visit the US twice in any twelve-month period for visits of less than 30 days.

The draft guidelines still require people with HIV to visit a US embassy or consulate before their planned visit and to declare that they have HIV. For a visa to be issued, it’s also necessary for a person with HIV to be in good health, have enough medication for their proposed visit, and to understand the “nature, severity and communicability of HIV.”

Under the new plans people with HIV will still be banned from visiting the US on the routine visa waiver programme and those who do so, and who are detected, could still be detained and deported.

There are over 1,000,000 HIV-positive individuals in the US; the US has a higher HIV prevalence than any other ‘first world’ country and high rates of new infections. What’s more, there’s good evidence that, on the whole, people in the UK and other European countries receive much better HIV care than those in the US and are much more likely to have an undetectable viral load if receiving anti-HIV treatment.

China – a country not known for its commitment to human rights – also has rules that can ban entry to people with HIV. But plans have just been announced to repeal such regulations, meaning that people with HIV will soon be able to enter China more easily than the United States.

Sexual health

Sexually transmitted infections can cause nasty symptoms, be inconvenient and, if left untreated, may lead to long-term health problems.

Having a sexually transmitted infection can also increase the risks of an HIV-positive person passing on HIV to a sexual partner. And HIV-negative individuals with untreated infections are also much more likely to become infected with HIV if they are exposed to the virus.

Sexually transmitted infections like gonorrhoea have been shown to increase HIV viral load in sexual fluids, and the sores and inflammation that herpes causes have been associated with an increased risk of HIV transmission and infection.