The Health Blog

Dealing with HIV-positive status on an emotional level must also be addressed, with psychological counseling (from one’s regular provider or from a psychologist, psychiatrist, psychiatric nurse practitioner, or social worker, to name a few options) often providing important emotional support for those learning to adjust to living as HIV-positive persons. As during any difficult period in one’s life, there are always choices. People with HIV infection have control over how they choose to define themselves and how they continue to lead their lives. After dealing with the initial emotional trauma of learning of their HIV-positive status, infected people sometimes develop a much greater understanding of themselves and their lives, often making changes for the better, both physically and emotionally. Many people find that they begin to pursue options they had never thought possible or do things they had always wanted to do. A well-chosen counselor can help with this important transitional period.

It is also important for those infected with HIV to maintain a healthy lifestyle and have routine health maintenance examinations. Smoking and illicit drug use should cease. If alcohol consumption is excessive, it should be decreased. Preventive dentistry should be followed, and women with HIV infection should have a pelvic examination and Pap smear every six months. Following the recommendations for protection against other STDs and avoidance of transmitting HIV is essential.

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Hepatitis B is transmitted by infected body fluids, including blood, semen, vaginal secretions, fluid from wounds, and saliva. It is possible that any body fluid from an infected person may carry enough virus to infect another person. Hepatitis B most commonly is transmitted through blood exposure, via sexual contact, and from mother to child. Household contacts of people infected with hepatitis B seem to be at a higher risk of acquiring the infection, even if they are not sexually active with the infected person. In these cases infection probably occurs through unnoticed blood or saliva transmission.

Blood Exposure. The risk behaviors in this category include sharing equipment for injection drug use, tattooing, or body piercing; receiving a needle-stick injury (as a health care worker might); and receiving a transfusion with infected blood or blood products. Since the blood supply has been screened for hepatitis B since 1975, the risk of becoming infected from a transfusion is very low.

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The ulcers in the genital area caused by chancroid are usually painful and look very similar to the ulcers of genital herpes and the first stage of syphilis, although the ulcer from syphilis (the chancre) is usually painless. One difference between chancroid and herpes is that herpes sometimes causes whole-body symptoms, such as fever and headache, and chancroid does not. Chancroid ulcers vary in size from small to very large. They usually start as a red bump, which then erodes, drains pus, and becomes an ulcer. Sometimes—and more often in women than in men—the lesions do not hurt.

About one-third of people with chancroid also develop swelling in the lymph nodes in the groin area. Lymph nodes that are draining pus are characteristic of chancroid and unusual for syphilis or herpes simplex. These symptoms usually take about a week to show up after infection.

Men and women may experience bleeding and pain from the rectum if that is where the ulcers are. In addition to the ulcers and lymph node swelling, women may notice a vaginal discharge and pain with intercourse, and men may have a discharge from the penis and burning with urination. If the lesions are not treated, they may last for one to three months and then resolve, yet they may recur again at a later time.

The ulcers may appear in the mouth, if that is where infection occurred.

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Wanda and Mike were relieved when they went to pick up their HIV results and found out that they both had tested negative. They had decided that if they were going to be sexually involved, they first wanted to be tested for HIV and know that “everything was O.K.” Although the nurse who tested them explained that HIV tests were only one part of an STD screen, they weren’t interested in testing for other infections, because “only HIV can kill you.”

They became sexually intimate without using condoms. Six months into their relationship, Mike developed small, painful blisters on his penis that tested positive for culture for herpes simplex 2. Wanda had a herpes blood test, which showed that she, too, was positive for herpes simplex 2 and that, although she had never shown any symptoms, she had most likely transmitted the infection to Mike. If they had been tested earlier in their relationship, and had found out that Wanda was positive for herpes and Mike was not, Mike and Wanda could have decided whether they wanted to take precautions to help decrease the chance that Mike would become infected.

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PID: The most common symptom of PID, or infection of the pelvic organs, is pelvic or lower abdominal pain. There may also be discharge, spotting of blood between periods or after sex, pain with intercourse, and heavier than usual periods. The color of the discharges can range from clear-white to yellow-green, and they may be thin or thick. The systemic (whole-body) symptoms range from mild to severe,- severe symptoms include fever, chills, and nausea.

Trichomoniasis. A thin, diffuse yellow-green discharge is common with trichomonas infection. Trichomonas often causes irritation and itching of the labia and vagina, and there can be fishy odor as well. There may also be pain with intercourse because of the significant irritation that can occur.

Yeast. The discharge caused by a vaginal yeast infection is often thick, white, and clumpy, and it is sometimes described as looking like “cottage cheese”; however, it may be thinner in consistency. Usually the labia and vagina are irritated and itchy. The irritation can become severe and can cause breaks in the skin.

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