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HIV and Gynecological Care

HIV can affect menstruation and gynecological health, making you more vulnerable to certain bacterial, viral and fungal infections that take advantage of a weakened immune system. Seeing a doctor regularly for a pelvic exam, Pap test, and testing for sexually transmitted infections (STIs) is a vital part of your healthcare. During your visits be sure to tell your care provider about any menstrual changes, irregular discharge, itching, or pain you have during sex or while going to the bathroom.

Pelvic exams

A pelvic exam is an external and internal inspection of your labia, vagina, anus and reproductive organs for signs of infection or disease. Because HIV weakens your immunity, you can get infections or diseases that might be difficult to get rid of. Regular exams can keep track of your health and treat problems as soon as they’re found.

The external exam
During an external exam, the outer genital area is looked at for any abnormalities. Sores, moles, lesions, cuts, swelling, inflammation, and/or warts are recorded. The doctor might also apply pressure to the abdomen in order to see if any areas are tender.

An external pelvic exam can show signs of:

  • yeast infections
  • HPV, or human papillomavirus
  • syphilis
  • gonorrhea
  • herpes

The internal exam
An internal exam includes looking for any signs of infection (unusual discharge, a strong smell, sores or blisters), looking at the cervix, feeling the placement and size of the uterus and ovaries, and collecting a small sample of cervical cells during a Pap test. If you are showing any signs of infection, a swab may be taken to send to the lab for diagnosis.

Pap tests or smears

A Pap test (or smear) helps to diagnose the health of the cells in your cervix, including checking for signs of cervical cancer. During a Pap test (or Pap smear), a speculum is inserted into the vagina to hold the vaginal walls open. Next, a cotton swab is inserted and rubbed over the cervix, collecting cells and fluid samples. This sample is sent to a lab and you’ll hear about the results in a couple of weeks if anything is abnormal.

If a Pap test result shows any abnormalities, you may be advised to have a repeat Pap or go on to further testing like a colposcopy. An abnormal result is common, so don’t panic: it may be as simple as a yeast infection. Follow up!

The suggested frequency of your Pap tests will depend on your current health and your ongoing Pap test results. Your doctor might want to see you again in three months to repeat the test, or might say that every six months to a year is okay. Following your advised Pap test schedule is one of the most important things you can do to stay healthy.

Sexually Transmitted Infections

Everyone who has been sexually active (even if it’s been a while) can be affected by sexually transmitted infections (STIs), some that are curable and some that aren’t. There’s a whole bunch of them, including:

  • Chlamydia
  • Herpes
  • Gonorrhea
  • Vaginosis
  • Syphilis
  • HPV

HIV can make these infections hard to treat. Some sexually transmitted infections can become life threatening (such as pelvic inflammatory disease) if they go untreated, so have regular pelvic exams and seeing a doctor if you experience any of the following, including during sex or urination:

  • Pain
  • Itching
  • burning
  • discharge (with or without a smell)
  • sores, blisters, irritation

Some STIs don’t cause symptoms you’d really notice, which makes regular pelvic exams and STI testing very important.

You’re worth it. Get tested.

For more information: CATIE offers good information and follow up help on all treatment issues related to HIV.

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