Healthyvives Health Blog

The relationship between STD and HIV infection is manifold.
1. First of all STD and HIV infection are associated with the same risk behaviours, that is sexual intercourse with multiple partners. Thus the same measures that prevent STD also prevent sexual transmission of HIV infection. The presence of STD has been found to facilitate the acquisition and transmission of HIV infection. It is believed that for those STDs associated with genital ulcer disease such as syphilis, cancroids and herpes, the risk of HIV transmission increases ten-fold. Ulcer diseases have a break in the mucosa. There is a rich collection of CD4 cells on the broken mucosa. The virus easily enters the broken mucosa and infects the CD4 cells. Presence of ulcerative disease increases the risk of acquiring HIV infection ten fold.
2. For those STDs associated with discharge such as Gonorrhea, Chlamydia and Trichomoniasis the risk of HIV disease is four-fold. Thus early diagnosis and the treatment of STD can contribute significantly to a reduction in HIV transmission. Other routes of transmission of HIV and STDs are also similar. In addition to sexual transmission, HIVIAIDS also be transmitted through blood, blood products, donated organs or tissue, and from mother to newborn infant.
3. Many of the measures for preventing the sexual transmission of both HIV infection and STDs are the same. Therefore STD clinical services are important access points for persons at high risk for both HIV and STD, not only for diagnosis and treatment but also for education for prevention.
Adherence Counseling
Today there is treatment available for HIV infected persons. This treatment is known as highly active antiretroviral therapy (HAART) Combinations of three different drugs are used. These drugs may be given as individual drugs or may be formulated into a single tablet. The drugs suppress the virus improve the quality and prolong the life of HIV infected patients. These drugs have to be started at an opportune time and have to be taken life long. If these drugs are taken irregularly the virus will become drug resistant and the disease will progress faster. Resistant strains will be seen in the community. While for other chronic diseases 80% adherence may prevent the progression of the disease, HIV requires more than 95% adherence. Even missing a single dose in a month can bedeleterious to the patient.
Adherence involves change in behaviour so that the patient is disciplined and conditioned to take medication, Adherence counselling should start from the time the diagnosis of HIV is made. Patients should be told about the availability of HAART, the cost of treatment and that it will be started at an appropriate time. The Government of India has set up free antiretroviral treatment (ART) centers. Find a centre in your area. Patients taking HAART must always be monitored by a physician to see the effect of the drug. Hence constant and regular attendance at medical centre is needed. All these aspects have to be stressed during the post test counselling. Once the patient has been started on treatment, check about the drug intake during every counselling session. Enquire about the side effects. Find out of the patient has any difficulties in procuring the drug supply. Encourage the patient to continue the drug therapy. If patients have missed their drugs, ask about the reasons for missing the drugs. Very often patients may forget to take the drug, Help them to overcome this difficulty by using pill organiser, reminders or by using other family members to remind them to take the medication.