《BASHH 艾滋病毒感染(性传播疾病)者的性健康》内容预览

Management of Sexually Transmitted Infections in people with HIV
Many people living with HIV remain active sexually. It has been appreciated that provision ofsexual health care for PWHIV has not been optimal [9,10]. Improved physical well-beingfollowing successful antiretroviral treatment has put sexual activity back on the agenda ofPWHIV [11,12]. There is recognised synergy between HIV and STIs which may enhancetransmission of both [13,14] and globally there is evidence that improved STI control reducesHIV spread [15], however there remains uncertainty regarding whether antiretroviral therapy canreduce sexual transmission of HIV [16]. Public health implications have been highlighted byseveral syphilis outbreaks which have disproportionately affected HIV-positive people, especiallymen who have sex with men [17,18]. Non disclosure of HIV-positive status to sexual partners hasbeen reported as a frequent occurrence and is more common in casual encounters and nonexclusive partnerships [19]. In a UK community study of gay men aware of their HIV-positivestatus, 24% reported unprotected anal intercourse (UAI) with more than one partner in theprevious year and 29% reported UAI with partners of unknown or discordant HIV status in theprevious year [20]. 41% who reported being diagnosed with HIV over a year ago, also reportedhaving an STI in the previous 12 months. Among men who have sex with men, there has been arise in a vocal and politicised move towards a celebration of unprotected sex between men withHIV and the creation of positive only sex venues (Dr Paul Flowers, personal communication).


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