HIV in Women

What is HIV?

HIV stands for human immunodeficiency virus. It harms your immune system by destroying a type of white blood cell that helps your body fight infection. This puts you at risk for other infections and diseases.

HIV can spread in different ways:

• By having unprotected vaginal or anal sex with a person who has HIV. "Unprotected" means not using condoms or medicine to treat or prevent HIV. This is the most common way it spreads.
  • Anal sex is the riskiest type of sex for getting or spreading HIV. The rectum's lining is thin and may allow HIV to enter the body during anal sex.
  • During vaginal sex, HIV can enter the body through the delicate tissue that lines the vagina and cervix.
• Rarely, through oral sex with a person who has HIV.
• By sharing drug needles.
• Through contact with the blood of a person who has HIV.
• From mother to fetus during pregnancy.
• From mother to baby during childbirth, or breastfeeding.

About one in four people in the United States who have HIV are women. Women who have HIV have some different problems than men:

• Complications such as
  • Repeated vaginal yeast infections
  • Bacterial vaginosis
  • Severe pelvic inflammatory disease (PID)
  • A higher risk of cervical cancer
  • Menstrual cycle problems
  • A higher risk of osteoporosis
  • A higher risk of heart disease, especially heart attacks
  • Entering menopause younger or having more severe hot flashes
• Different, sometimes more severe, side effects from the medicines that treat HIV
• Drug interactions between some HIV medicines and hormonal birth control
• The risk of giving HIV to their fetus while pregnant
• The risk of giving HIV to their baby during childbirth or breastfeeding

There is no cure, but there are many medicines to treat both HIV infection and the infections and cancers that come with it. People who get early treatment can live longer and healthier lives.

HIV Medicines

What is HIV?

HIV stands for human immunodeficiency virus. It harms your immune system by destroying CD4 cells. These are a type of white blood cells that fight infection. The loss of these cells makes it hard for your body to fight off infections and certain HIV-related cancers.

Without treatment, HIV can gradually destroy the immune system and advance to AIDS. AIDS stands for acquired immunodeficiency syndrome. It is the final stage of infection with HIV. Not everyone with HIV develops AIDS.

The treatment of HIV with medicines is called antiretroviral therapy (ART). It involves taking a combination of medicines every day. ART is recommended for everyone who has HIV. The medicines do not cure HIV infection, but help people with HIV live longer, healthier lives. They also reduce the risk of spreading the virus to others.

HIV medicines reduce the amount of HIV (viral load) in your body, which helps by:

• Giving your immune system a chance to recover. Even though there is still some HIV in your body, your immune system should be strong enough to fight off infections and certain HIV-related cancers.
• Reducing the risk that you will spread HIV to others.

There are many different types (called classes) of HIV medicines. Some work by blocking or changing enzymes that HIV needs to make copies of itself. This prevents HIV from copying itself, which reduces the amount of HIV in the body. Several types of medicines do this:

• Nucleoside reverse transcriptase inhibitors (NRTIs) block an enzyme called reverse transcriptase
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs) bind to and later change reverse transcriptase
• Integrase inhibitors, also called integrase strand transfer inhibitors (INSTIs), block an enzyme called integrase
• Protease inhibitors (PIs) block an enzyme called protease

Some types of HIV medicines interfere with HIV's ability to infect CD4 immune system cells:

• Fusion inhibitors block HIV from entering the cells
• CCR5 antagonists and post-attachment inhibitors block different molecules on the CD4 cells. To infect a cell, HIV has to bind to two types of molecules on the cell's surface. Blocking either of these molecules prevents HIV from entering the cells.
• Attachment inhibitors bind to a specific protein on the outer surface of HIV. This prevents HIV from entering the cell.

Pharmacokinetic enhancers are another type of medicine. They are sometimes taken along with certain other HIV medicines. Pharmacokinetic enhancers increase the effectiveness of the other medicine. They work by slowing the breakdown of the other medicine. This allows that medicine to stay in the body longer at a higher concentration.

There are also multidrug combinations, which include a combination of two or more different types of HIV medicines.

It's important to start taking HIV medicines as soon as possible after your diagnosis, especially if you:

• Are pregnant
• Have AIDS
• Have certain HIV-related illnesses and infections
• Have an early HIV infection (the first 6 months after infection with HIV)

You and your health care provider will work together to come up with a personal treatment plan. This plan will be based on many factors, including:

• The possible side effects of HIV medicines
• Potential drug interactions with any other medicines you take
• How many medicines you will need to take every day
• Any other health problems you may have

It's important to take your medicines every day, according to the instructions from your provider. If you miss doses or don't follow a regular schedule, your treatment may not work, and the HIV virus may become resistant to the medicines.

HIV medicines can cause side effects. Most of these side effects are manageable, but a few can be serious. Tell your provider about any side effects that you are having. Don't stop taking your medicine without first talking to your provider. There may be steps you can take to help manage the side effects. In some cases, your provider may decide to change your medicines.

HIV medicines are not just used for treatment. Some people take them to prevent HIV. PrEP (pre-exposure prophylaxis) is for people who don't already have HIV but are at very high risk of getting it. PEP (post-exposure prophylaxis) is for people who have possibly been exposed to HIV.

NIH: Office of AIDS Research

Intestinal Obstruction

An intestinal obstruction occurs when food or stool cannot move through the intestines. The obstruction can be complete or partial. There are many causes. The most common are adhesions, hernias, cancers, and certain medicines.

Symptoms include:

• Severe abdominal pain or cramping
• Vomiting
• Bloating
• Loud bowel sounds
• Swelling of the abdomen
• Inability to pass gas
• Constipation

A complete intestinal obstruction is a medical emergency. It often requires surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Itching

What is itching?

Itching is an irritating sensation that makes you want to scratch your skin. Sometimes it can feel like pain, but it is different. Often, you feel itchy in one area in your body, but sometimes you may feel itching all over. Along with the itching, you may also have a rash or hives.

Itching is a symptom of many health conditions. Some common causes are:

• Allergic reactions to food, insect bites, pollen, and medicines
• Skin conditions such as eczema, psoriasis, and dry skin
• Irritating chemicals, cosmetics, and other substances
• Parasites such as pinworms, scabies, head and body lice
• Pregnancy
• Liver, kidney, or thyroid diseases
• Certain cancers or cancer treatments
• Diseases that can affect the nervous system, such as diabetes and shingles

Most itching is not serious. To feel better, you could try:

• Applying cold compresses
• Using moisturizing lotions
• Taking lukewarm or oatmeal baths
• Using over-the-counter hydrocortisone cream or antihistamines
• Avoiding scratching, wearing irritating fabrics, and exposure to high heat and humidity

Contact your health care provider if your itching is severe, does not go away after a few weeks, or does not have an apparent cause. You may need other treatments, such as medicines or light therapy. If you have an underlying disease that is causing the itching, treating that disease may help.

Jaw Injuries and Disorders

Your jaw is a set of bones that holds your teeth. It includes:

• The maxilla, which is the upper part of your jaw. It holds your top teeth in place and doesn't move. It also supports the muscles involved in chewing and facial expressions.
• The mandible, which is the lower part of your jaw. You move it when you talk or chew. It also holds your lower teeth in place.
• The temporomandibular joints (TMJs), which are two joints (one on each side) that connect your mandible to your skull.

Jaw problems can include:

• Fractures (broken bones).
• Dislocations, which are joint injuries that force the ends of your bones out of position.
• Temporomandibular disorders (TMDs), which are conditions that affect your TMJs.
• Osteonecrosis, which happens when the blood flow to part of your bone is disrupted. It can cause the bone to break down.
• Jaw tumors, which can be benign (not cancer) or cancer.
• Jaw defects, which are birth defects in which your jaw could be missing or deformed.

Diagnostic imaging tests are often used to diagnose jaw injuries and disorders. Your treatment will depend on which jaw problem you have.