Sexually transmitted infections tests & treatment

BHIVA issues draft sexual and reproductive health guidelines

Edwin J. Bernard
Estimated reading time 2 minutes
This article is more than 18 years old. Click here for more recent articles on this topic

The first guidelines from the British HIV Association (BHIVA) to consolidate and review existing evidence on most aspects of sexual and reproductive health for HIV-positive individuals are now available for public consultation until Wednesday 6th December 2006.

The guidelines have been developed for anyone who may be involved in the care of HIV-positive individuals, including GPs, gynaecologists, fertility experts and others. They should also be useful to commissioners, public health specialists and individuals living with, or affected by, HIV.

The guidelines authors note, in their introduction, that HIV-positive individuals “have the right to protect their own health, to enjoy meaningful sexual relationships, and reproductive health. These rights come with responsibilities however: in particular, to avoid passing infections on to others.”

Glossary

superinfection

When somebody already infected with HIV is exposed to a different strain of HIV and becomes infected with it in addition to their existing virus.

 

cervix

The cervix is the neck of the womb, at the top of the vagina. This tight ‘collar’ of tissue closes off the womb except during childbirth. Cancerous changes are most likely in the transformation zone where the vaginal epithelium (lining) and the lining of the womb meet.

post-exposure prophylaxis (PEP)

A month-long course of antiretroviral medicines taken after exposure or possible exposure to HIV, to reduce the risk of acquiring HIV.

criminalisation

In HIV, usually refers to legal jurisdictions which prosecute people living with HIV who have – or are believed to have – put others at risk of acquiring HIV (exposure to HIV). Other jurisdictions criminalise people who do not disclose their HIV status to sexual partners as well as actual cases of HIV transmission. 

Consequently, although current guidelines exist from the British Association of Sexual Health and HIV (BASHH) regarding the management of sexually transmitted infections (STIs) in HIV-positive individuals, BHIVA's new draft guidelines cover much broader aspects of sexual and reproductive health needs of people living with HIV.

These include:

**Contraception for HIV-positive women

  • Condom use in the era of criminalisation for HIV transmission
  • HIV superinfection
  • Screening for, and management of, cervical and anal pre-cancer and cancer
  • Fertility issues for HIV-positive women and men, including assisted conception
  • Erectile dysfunction

Where data are lacking - for example, regarding issues of assisted reproduction; superinfection; and preventing and treating cervical and anal pre-cancer and cancer - the draft guidelines make recommendations based on a consensus of expert opinion.

The draft guidelines are also designed to complement existing guidance from BHIVA on the management of HIV in pregnancy; and HIV transmission, the law and the work of the clinical team. They also refer to guidance from BASHH the use of HIV post exposure prophylaxis following sexual exposure (PEPSE), but focus on making all HIV-positive individuals aware of PEP.

The draft guidelines can be downloaded from the BHIVA website. A direct link to the .pdf document is provided here.

Comments should be sent to the BHIVA Secretariat at: bhiva@bhiva.org by Wednesday 6th December 2006.

Related topics
Sexually transmitted infections tests & treatment
Reproductive health
Print