Editorial

Soon after I started taking anti-HIV therapy almost nine years ago, my viral load fell to undetectable.  It’s stayed there ever since. At the same time, my CD4 cell count has gradually increased from a low of around 250, and according to my latest set of tests, conducted in November, is now a whopping 1900.  I’m therefore looking forward to a long, and hopefully healthy life.

HIV-related illnesses no longer really worry me. But I’m still very much aware that having HIV can have seriously implications for my health. This was underlined by two recent studies – one of which found higher rates of lung cancer in people with HIV; and the other, a higher risk of cardiovascular illness in people with HIV and hepatitis C. Although I neither smoke (the main risk-factor for lung cancer, and a cause of cardiovascular disease) nor have hepatitis C, I still found these studies worrying as I think that they show how having long-term infections like HIV can have subtle effects on your health – for example, I’ve a chronic lung infection.

But don’t panic. It is important to remember that lung cancer is very rare in people with HIV. And there are things that you can do to look after your health.  For example by stopping (or not starting) smoking you can reduce your risk of contracting not only lung cancer, but cardiovascular disease as well.

Another recent study is also worth comment. It looked at unemployment amongst people with HIV in Australia. It found that both medical and social factors were associated with unemployment. Although many people with HIV find that they can carry on in their jobs as normal after their diagnosis, this isn’t always the case. One of the factors associated with unemployment was poor mental health – a reminder that people with HIV often live with multiple health concerns.

Illness

Living with HIV

Drug use

Methamphetamine use is a major health and social concern. Studies have suggested that use of methamphetamine can worsen damage to the brain caused by HIV and increase HIV’s ability to replicate in the brain. Some studies have found higher levels of methamphetamine use amongst HIV-positive individuals than their HIV-negative peers and the use of the drug has also been associated with increased sexual risk taking in some (but not all) research.

Now two case reports have been published showing that methamphetamine use caused strokes in two healthy young women.

Sexual health

Good sexual health is important to everybody, particularly so for people with HIV. Sexually transmitted infections can increase the risk of HIV transmission occurring, and can also be harder to treat and more complicated in people with HIV, particularly if they have a low CD4 cell count.

A recently published study has found that HIV-positive gay men in London have more unprotected penetrative sex than any other group with HIV in the UK’s capital.

Researchers found that 40% of HIV-positive gay men reported unprotected anal sex in the previous three months, including 20% who said that they had unprotected sex with a man whose HIV status they did not know or who was HIV-negative. By contrast, 5% of Africans men and women with HIV said that they had unprotected sex where there was a risk of HIV transmission.

Neither the level of viral load, nor taking anti-HIV therapy was associated with the risk of having unprotected sex in either gay men or Africans.

Another study reported on aidsmap  this week was also concerned with sexual health. It found evidence of sexual transmission of MRSA in HIV-negative heterosexuals. Earlier studies have shown an increase in rates of MRSA amongst people with HIV, with a role for sexual risk taking. This latest study, and an earlier US study, also found that shaving pubic hair may be a risk factor for sexual transmission of MRSA.