Treatment of Opportunistic infections and other STIs

Is there a connection between HIV and other sexually transmitted infections? Yes. Having a sexually transmitted infection (STI) can increase a person's risk of becoming infected with HIV, whether the STI causes open sores or breaks in the skin (e.g. Syphilis, Herpes, Chancroid) or does not cause the skin to break (e.g. Chlamydia, Gonorrhea).

If the STI causes irritation of the skin, breaks or sores, this may make it easier for HIV to enter the body during sexual contact, even when the STI causes no breaks or open sores, the infection can stimulate an inflammatory reaction in the genital area that can make HIV transmission more likely.

In addition, if an HIV infected person is also infected with another STI, that person is three to five times more likely than other HIV infected persons to transmit HIV through sexual contact, because the blood, semen, or vaginal fluids will contain more HIV virus.

Not having (abstaining from) sexual intercourse is the most effective way to avoid STIs, including HIV. For those who choose to be sexually active, the following STI/HIV prevention activities are highly effective:

What are some opportunistic infections?

Some common opportunistic infections are Pneumocystis Carinii Pneumonia (PCP), Tuberculosis, Toxoplasmosis, mouth problems candidiasis (oral thrush) and eye infections due to Cytomegalovirus.

There are however over 100 other (opportunistic) diseases, and cancers known to be related to HIV infection and a weak immune system.

Note that one person may get certain symptoms or infections and another may get completely different ones. Some persons will not get all of them. Some may not get any. Men and women, children and adults, and people from different parts of the world get different kinds of infections.

This explains that there are no definite “symptoms” of HIV infection or AIDS. The symptoms depend on the disease that resulted from the weaker immune system.

Are there any treatments for HIV & AIDS and opportunistic infections?

In addition to drugs and other treatments that can treat, control or prevent opportunistic infections, progress has been made in producing effective drugs that combat HIV directly. These drugs, often known as "'combination therapies” or "the cocktail" slow down the effect of HIV on the immune system by interfering with the replication of HIV.

This form of therapy usually consists of a number of drugs taken on a strict timetable. Some of these drugs are not easy to take and have side effects, when combination therapy is successful, it can improve the health of people with HIV. Taking these drugs sometimes causes remission of symptoms in addition to reduced viral load (a reduced amount of HIV in the blood), increased number of CD4 cells, and reduced likelihood of progressing to AIDS.

Combination therapy does not work in everyone, but it works in most persons infected with HIV. The length of time that the drugs are effective against the virus varies, and drug resistance can set in, making the drugs ineffective.

Note however, that the cost of current antiretroviral treatment is not very affordable and is between US$ 900 and

US$1700 per patient per month. Negotiations are ongoing to lower these prices, and make the treatments more affordable.

On St. Maarten, SVB, and Government doctor cards cover all costs for medicines. Some of the private insurance companies cover HIV others do not. It is advisable to read your policy. If your insurance does not cover HIV treatment, it might be advisable to change the policy, or change to another company. No person infected with HIV ever thought they would become infected. Once you have a HIV infection it will be too late to change.

Some practical steps to take to help you stay healthy if infected are

1) Practice of good hygiene

2) Maintenance of healthy eating practices and regular exercise.

3) Avoidance of the use of alcohol, cigarette and drugs.

HIV/AIDS has become a long-term manageable disease. People can live long and healthy with HIV infection, but it depends very much on the person living with the disease, how well they take care or themselves, and how consistent they take their medications.

Despite the medicines and treatments, it continues to be better not to become infected. Do not be fooled, that because of better treatments it is okay to have unsafe sex. HIV/AIDS is a life-changing disease, but if preventable. You are the only person that can really prevent infection. It’s your choice.

What does Tuberculosis have to do with HIV/AIDS?

Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis. Anyone can become infected with TB; you don't have to have HIV/AIDS or a weakened immune system.

TB bacteria can spread from person to person through coughs, sneezes, and breathing, but usually only after lengthy exposure or close contact with a person with active TB in their lungs or throat.

If you are HIV positive, you should take special care around anyone who has active TB as you may easily develop Tuberculosis due to your weakened immune system. Tuberculosis can be treated effectively, but left untreated cases of active TB can result in death.

Immunizations/Vaccinations

HIV infected babies or children should not receive the BCG vaccine against Tuberculosis but can be vaccinated against all other childhood diseases. They should receive polio vaccine in the injectable, and not in the oral form.

You can discuss the vaccination of your child with your doctor or the nurses of the White and Yellow Cross (Backstreet, Tel: 5422182).

What is Syphilis?

Syphilis is caused by the bacterium Treponema Pallidum. If untreated, it goes through three stages, with different symptoms at each stage.

During the first stage, a single chancre (painless sore) forms on your genitals, rectum, or mouth or throat. It will disappear on its own in a few weeks, without treatment; however, the bacterium will stay in your body, and can later cause the later stages of the disease. Not all persons will recognize that they have such a sore, and may not know they are infected.

The second stage occurs about six months later. Sores and a rash may occur anywhere on your body. You may feel like you have the flu, with headache and aches and pains in your joints or bones. Without treatment, these symptoms may come and go, but again the bacterium will stay in your body.

Symptoms of the third stage may take 10 to 20 years to develop. They can be very serious and can result in blindness, heart or brain damage, and, in some cases, death. People with HIV/AIDS seem to develop third stage syphilis much faster than others.

Syphilis is diagnosed by a blood test, and treatable with antibiotics.

What is Gonorrhea?

Gonorrhea is caused by the bacterium Neisseria gonorrhea. It may cause a thick discharge (stuff that comes out) from your penis or from your vagina, and sometimes a burning feeling while you are urinating (peeing). In many people, men but especially women, there may be no symptoms.

Gonorrhea can also occur in your rectum or throat. It can develop into a chronic, serious infection if not treated. It can spread through your blood to other parts of your body, and can lead to sterility (inability to have children) in women; it can cause pelvic inflammatory disease (PID).

Gonorrhea is treatable with antibiotics. If you have it, anyone you are having sex with should be checked, and if necessary, treated.

There is no blood test for this infection. Usually your doctor will treat you based on the symptoms, he/she can do a swab and look under the microscope for clues of the bacterium, or does a culture test.

What is Chlamydia?

Chlamydia Trachomatis is a bacterium that causes one of the most common STIs. Symptoms of Chlamydia include a burning feeling when you are urinating (peeing) and sometimes a (slight) discharge from your penis or vagina.

Chlamydia can also infect your throat, rectum, and eyes. The majority of people, men but especially women, will not have any symptoms at all. If left untreated in men, Chlamydia can cause an inflammation of the epididymis: the thin storage-tube that connects your testes (balls) to your urethra (the tube you pee through).

In women, it can cause pelvic inflammatory disease (PID) and cause sterility. Chlamydia can be treated with antibiotics. If you have Chlamydia, anyone you are having sex with should be treated; otherwise, you and they can get re infected repeatedly. There is a blood test, and there are tests on urine (men) or cervical swabs (women) available to determine infection.

What is Herpes?

A virus, called Herpes Simplex, causes herpes. There are two strains, HS 1 and HS 2. It used to be that HS 1 especially caused fever blisters around the mouth (cold sores), and HS 2 was called genital Herpes.

Because of freer sexual practices, HS 1 and 2 have partially exchanged places, and it has become more obscure and less important which type is causing your infection. They both lead to a grouped area with small clear fluid filled blisters, usually on a painful red underground. The blisters usually dry up within days to weeks without treatment, but the virus stays in the body lifelong, and can cause recurrences of such outbreaks.

The virus is especially transmittable when having active blisters, but can also be transmitted to others without having active blisters visible. Treatment can shorten the course of an outbreak, and make it less painful, but it cannot cure the infection. Once infected with Herpes a person will stay so life long.

Pregnant women known to have Herpes should always inform their doctor, because if she has an outbreak in the vaginal area during labor, she can transmit the virus to her baby. The baby should then be born by C-Section to prevent infection.

It is advisable to use condoms or abstain from sex when having active outbreaks. It can even be advised to continue using condoms when not having an outbreak.

When having regular outbreaks it is sometimes recommended to start maintenance therapy, where you would take daily medicine to prevent future outbreaks. This treatment will however not cure the infection, but only suppress its effects. There is a blood test to determine if you have Herpes infection.

What are Genital Warts?

Genital Warts are caused by Human Papilloma Virus. The warts are not dangerous, but can be cosmetically unpleasant. The virus can be transmitted through direct contact with the wart, but also when there are no warts visible, there is a small chance the virus might transmit from one person to the next.

Warts can be treated in several ways. (Application of a medicine, usually repeatedly needed, freezing, burning, operation, etc). Your doctor can advise you in that. Treatment will however not cure the infection. Once you are infected, you will stay so for life.

Condoms can only prevent transmission to a certain extent if the warts would covered by the condom, and there is no direct skin contact between wart and skin of the partner. Some (not all) strains of Human Papilloma Virus, can increase a woman’s chance of developing Cervical Cancer.

There is presently no blood test for HPV. Certain types of PAP smears can determine clues about the existence of infection.

Back to top