Sexually transmitted infections (STIs) such as gonorrhoea, chlamydia, herpes and syphilis can increase the HIV viral load in some of the body fluids of someone who is co-infected with HIV and an STI. The area of the body where the STI is present can act as a ‘reservoir’ for increased viral load in the bodily fluid within that location. For example, someone with vaginal chlamydia may experience an increase in the viral load within their vaginal fluids or someone with anal gonorrhoea may have increased viral load in their anal mucus.
This can have two possible health implications for people who are HIV positive:
- STI co-infection may increase the risk of a person passing HIV to others through unprotected sex
- Some STIs can be have more severe symptoms and be more difficult to treat (particularly for those with a low CD4 count)
As HIV is acquired more easily in the presence of an untreated STI, people who are HIV negative are also at an increased risk of becoming infected with HIV if they have another STI present.
Signs & Symptoms of STIs
Symptoms of sexually transmitted infections (STIs) vary but often include:
- Rashes and itchiness around the genital area (i.e. the penis or vagina) the anus or on the skin
- A smelly or unusual discharge from the penis or vagina
- Pain when going to the toilet
- Pain when having sex
- Lumps, sores and growths around the genitals, in and around the anus or in the mouth
- Lower abdominal and/or back pain
However, some STIs may not produce any of these symptoms.
The leaflet ‘Sexually Transmitted Infections – Do You Know the Facts?’ gives basic information about STIs.
Click here to download a PDF version of this leaflet.
Testing & Treatment
Monitoring general sexual health by having regular STI screenings is, therefore, advisable for everyone who is sexually active – whether they are HIV positive, HIV negative or have an unknown HIV status.
You can access full STI screening services in Sheffield from:
- The Department of Genito-Urinary Medicine at the Royal Hallamshire Hospital
- Sheffield Contraception and Sexual Health Service at the Central Health Clinic on Mulberry Street
If you are receiving healthcare support from the HIV service at the Hallamshire Hospital, you may prefer to organise STI screening via your HIV specialist nurse rather than make a self-referral to these services.
HIV & STIs
If left untreated, some STIs can cause additional complications for people who are HIV positive. Making it even more important that these infections are quickly detected, monitored and appropriate treatments given.
People with HIV may be particularly vulnerable to complications as each virus can increase the severity of the other.
Gonorrhoea & Chlamydia
These bacterial infections can increase the viral load in genital secretions.
People living with HIV may be at an increased risk of being infected with more than one sub-type of the viruses that cause genital warts. Persistant infection of some wart virus types is associated with cervical, anal and penile cancer.
For someone who is HIV positive and also co-infected with Hepatitis, combination therapy to treat both viruses is essential. This is because co-infection can lead to a more rapid progression liver disease and possibly liver cancer or liver failure.