HIV and associated diseases
If you have HIV, you are at higher risk for diseases such as tuberculosis (TB), sexually transmitted infections (STIs) – which includes the human papillomavirus virus (HPV) that causes cervical cancer, as well as hepatitis C (HCV).
At Right to Care, we want to help you prevent infection and make sure you know how to lower your risk of getting infected with these diseases on top of your HIV.
We suggest that you:
- Test for HIV, TB, STIs and hepatitis C
- People who inject drugs are particularly susceptible to hepatitis C,
- Get onto treatment if you test positive for any these and
- Stay on your treatment by collecting your monthly medicine and taking it as prescribed.
Common symptoms
Symptoms of STIs, cervical cancer and HIV can include:
HIV – what you need to know
What is HIV?
HIV is the human immunodeficiency virus. This virus attacks the immune system, our body’s natural defence against illness. If HIV is left untreated, a person’s immune system will get weaker and weaker until it can no longer fight off infections. This can be life-threatening.
The most important target for the human immunodeficiency virus is CD4 cells in the body. CD4 cells are white blood cells that prevent or fight infection from viruses, bacteria, fungi and parasites, as well as some cancers. HIV infection destroys CD4 cells, making the body weak when attacked.
In addition to killing important CD4 immune cells, HIV can:
- affect the body’s organs, such as the nervous system and the kidneys,
- cause weight loss,
- night sweats and
- diarrhoea.
Antiretroviral treatment (ART) prevents this from happening.
Who is at risk?
Everyone is at risk of contracting HIV, but some people are more at risk than others.
Young girls and women
Right to Care sees many new HIV infections in adult girls and young women. We encourage young people need to test for HIV before they begin their exciting journey into adulthood.
Gender based violence is at a crisis point in South Africa, and takes place all over the world. When women are disempowered and fearful:
- they are unable to insist that their partner wears a condom and
- they are more at risk of becoming infected with HIV and/or sexually transmitted infections (STIs).
HIV is passed from mother to child during pregnancy, labour and delivery, or breastfeeding. This is why women must test for HIV and get onto treatment before they become pregnant.
Men
While women have to seek healthcare services during pregnancy, childbirth and after childbirth, men tend to avoid seeing a doctor. Some men have told us they are scared of testing. We tell men why they shouldn’t be afraid and we encourage them to test for HIV and to circumcise.
Unfortunately:
- some men are HIV positive but don’t tell their partners and
- too many men are still suffering and dying from advanced acquired immune deficiency syndrome (AIDS).
Right to Care is therefore working with healthcare facilities to encourage men to seek healthcare services. The presence of male healthcare workers is helping men feel more relaxed when they get to a healthcare facility, which means they agree to test and get onto treatment if necessary.
Key populations
Key populations, identified by UNAIDS as ‘female sex workers, men who have sex with men (MSM), and injecting drug users, have the highest risk of contracting and transmitting HIV. Yet they also have the least access to prevention, care, and treatment services because their behaviours are often stigmatised and even criminalised.’
Symptoms of HIV
Initially you may experience flu-like symptoms. Other symptoms can include:
Aching muscles and tiredness
Diarrhoea
Fever
Headache
Night sweats
Sore eyes and sensitivity to light
Sore throat
Swollen glands
Skin rash
Ulceration of the inside surface of the mouth and genitals
After experiencing initial symptoms, many people don’t have any other symptoms for many years, even though they are living with HIV.
This is why Right to Care wants everyone to test for HIV.
Testing for HIV
When you go for an HIV test at your healthcare facility, you will be counselled before the test. This is to prepare you for a negative or a positive result. You will be counselled after the test as well.
If you are negative, your healthcare worker will remind you how to stay negative.
If you test HIV-positive:
- you will be provided with ART
- your healthcare worker will talk to you about managing your condition
- you will be closely monitored
- you must attend follow up appointments and you must adhere to your treatment
- regular blood tests will be done to make sure the amount of human immunodeficiency virus in your body is going down. When your doctor or nurse talks about your viral load, they mean the level of the human immunodeficiency virus in your body.
Antiretroviral treatment (ART)
ART is used to treat HIV. The drugs do not kill or cure the virus. If taken as prescribed, ART can suppress the HIV virus to undetectable levels which, in turn, also means that your HIV is untransmissible (you cannot infect anyone). However, ART will never entirely eliminate HIV from your body.
ART provides protection from passing on the HIV virus providing you:
When your viral load is undetectable, there is too little virus in your system for you to pass it on to anyone else. This is also called viral suppression. Achieving viral suppression will mark a highlight in your treatment journey, but, do not stop taking your ART. You will remain HIV-positive even if the virus cannot be detected. By taking your treatment, you will stay healthy, prevent illness and live longer.
Right to Care will help you:
We are here for you. To speak to us you can send a WhatsApp or ‘please call me’ to 079 851 2490.
Tuberculosis (TB) – what you need to know
South Africa has one of the highest rates of tuberculosis (TB) worldwide. TB is an infectious disease usually caused by a tuberculosis bacteria. It is estimated that about 80% of the South African population is infected with TB bacteria. TB generally affects the lungs, but can also affect other parts of the body.
Sometimes people have TB but do not have symptoms. This is called latent TB. The highest prevalence of latent TB, estimated at 88%, has been found among those aged 30-39 living in townships and informal settlements. About 10% of latent infections progress to active TB which, if left untreated, kills about half of those affected.
There are many different types of TB, but the most common one is TB of the lungs.
TB spreads easily. When a person with active TB in the lungs
Drug-resistant TB
Drug-resistant TB is just as infectious as ordinary TB and anyone can get drug-resistant TB, even if they have never been on treatment before.
How to protect yourself
Those that don’t have TB must protect themselves. One of the main ways to do this is to open windows at home, at work and when using public transport and taxis.
Move away from people who are coughing.
If you know someone with TB, wait until they are better before having close contact with them and make sure they don’t cough near you.
Remember:
- TB is not a death sentence but is a very serious disease if left untreated.
- TB is not a lifelong disease and with treatment, it is curable.
Who is at risk?
Some people are more at risk for TB than others such as:
- young children,
- the elderly,
- pregnant women and
- people with HIV, diabetes or cancer.
People living in overcrowded, poorly ventilated areas are particularly at risk. When families and friends live together in small closed rooms they become more vulnerable to TB. People living in informal settlements, prisons, mines or orphanages tend to be at a higher risk of getting TB.
Symptoms of TB
Common symptoms of TB are:
- coughing,
- chest pain,
- loss of weight,
- loss of appetite,
- coughing up blood,
- sweating at night,
- tiredness,
- weakness,
- shortness of breath and
- difficulty in breathing.
If you answer yes to these 5 questions then you must get tested for TB at any healthcare facility.
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Have you been around anyone who has been diagnosed with TB?
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Have you had a cough for more than three weeks?
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Have you had any unexplained weight loss?
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Do you have heavy night sweats?
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Are you extremely tired?
Test for TB
If you have symptoms you must test at your nearest healthcare facility. If someone you know has symptoms, tell them to test for TB. If you know someone with TB, you must also get tested. People who have TB and are not on treatment are more likely to pass the illness on to others. They will also become very ill without treatment.
Go to your nearest healthcare facility. The nurse will ask you to cough into a bottle and this will be sent to laboratory. You will have results after about 72 hours.
Treating TB
If you are diagnosed with TB, you will be given medication and instructions on how often to take your treatment. Doctors prescribe antibiotics to kill the bacteria that cause it. You’ll need to take them for 6 to 9 months. You must stay on your medication, follow your healthcare worker’s advice and return to your clinic for regular check-ups.
Do not interrupt your treatment. Talk to the healthcare worker at your clinic or hospital about what may prevent you from taking your treatment.
The medications you take and how long you’ll have to take them, depends on what works to eradicate your TB. Sometimes, antibiotics used to treat the disease don’t work. Doctors call this drug-resistant TB. If you have this form of the disease, you may need to take stronger medication for longer.
TB and HIV
People who are HIV-positive are more likely to develop TB than those without HIV. If you are HIV-positive and have had contact with someone who has TB, or if you have symptoms, you must get tested for TB.
Sexually transmitted infections (STIs) – what you need to know
What are STIs?
STIs are infections that are passed on during unprotected sex with an infected partner. This includes vaginal, anal or oral sex. Some STIs can be passed on by just skin-to-skin contact. Common STIs include:
- gonorrhoea,
- chlamydia,
- genital herpes,
- genital warts,
- syphilis and
- hepatitis
You may not have any obvious symptoms if you have a STI.
To avoid getting an STI, use a condom with your partner/s.
STI symptoms
Symptoms can include:
- Sores or lumps on the vagina, penis or anus,
- Clear, white, yellow or green discharge coming out of the penis or vagina. This discharge is often smelly,
- Pain in the lower abdomen,
- A burning feeling when you urinate,
- Itching and/or redness around the penis or vagina,
- Pain when having sex,
- Painful or swollen testicles and
- Swollen glands, particularly in the groin area.
If you notice any of these go to your nearest healthcare facility.
Not all STIs will give you symptoms. So if your partner is experiencing symptoms or if you have had unprotected sex, go and get checked.
Many people feel scared to ask for help, as they find it embarrassing and worry about the stigma attached to STIs. Do not ignore symptoms of STIs. Get treated to protect your future health, and in the case of pregnant women, the health of your baby.
Symptoms of cervical cancer
Symptoms tend to appear only after the cancer has reached an advanced stage. They include:
Prevention
The HPV vaccine provides almost 100% protection against HPV 16 and 18. Speak to your healthcare worker about the vaccine.
Pap smears are vital to pick up cervical cancer early. Because it develops slowly over time, women have many opportunities to be screened and treated. Having a pap smear alone does not prevent cancer. Patients must come back for their results so that abnormal pap smears can be dealt with. Ask your healthcare worker how often you should have a pap smear. It will depend on your age and risk profile.
Women must take care of themselves and prevent getting HPV by:
- Having the HPV vaccine,
- Having regular pap smears,
- Delaying sexual activity for as long as possible and
- Using condoms.
If you develop cervical cancer, there are different ways to treat it. Your doctor will consider the kind of cervical cancer you have and how far it has spread. You may be referred to a specialist, an oncologist who deals with cancer.
Treatments include:
- surgery,
- chemotherapy and
- radiation therapy.
Treating STIs
The sooner you get treatment for an STI, the easier it is to treat. Delaying treatment can cause problems.
STIs can be caused by:
- Bacteria,
- Parasites and
- Viruses
The type of STI you have will inform the treatment you get at your healthcare facility. Take your treatment as described. Do not stop the medicine when the signs and symptoms go away. This can lead to the infection coming back again, or becoming resistant to the treatment, making it more complicated to treat.
HPV is an STI
Cervical cancer is the leading cause of cancer death among South African women. The primary underlying cause of cervical cancer is the human papilloma virus (HPV). HPV is the most common STI and there are more than 100 types of the virus. Type 16 and type 18 cause 70% of cervical cancers.
An HIV positive woman is five times more at risk to develop cervical cancer because:
- HIV suppresses her immune system and
- makes her vulnerable to the HPV virus.
It takes 10 to 15 years for cervical cancer to develop in healthy women. For a woman with a weakened immune system due to untreated HIV infection, it can take only 2 to 5 years.
Nicknamed the ‘silent killer’, cervical cancer’s symptoms don’t appear until it reaches an advanced stage.
Risk factors for cervical cancer
These can include:
Hepatitis C – What you need to know
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). It can damage the liver and cause serious illnesses and even death in a small percentage of people.
You can get infected through contact with an HCV-infected person’s blood or body fluids. This is why people with HCV are also vulnerable to HIV.
A major risk factor for both HIV and HCV infection is injection drug use. Sharing needles or other drug injection equipment increases the risk of contact with HIV- or HCV-infected blood.
Infection with both HIV and HCV is called HIV/HCV coinfection. HIV may cause chronic HCV to advance faster.
Many HCV-infected individuals are unaware that they are infected which drives new HCV infections.
Early diagnosis and getting people onto treatment is critical for preventing the spread of HCV.
Symptoms
Initial infection with HCV has relatively few symptoms but nearly 80% of those infected will go on to develop a chronic infection. After several years, this can lead to cirrhosis of the liver or liver cancer which are very serious conditions.
Protection
The best protection against HCV is to never inject drugs. People, including those with HIV, can also reduce their risk of HCV infection by using condoms during sex.
If you do inject drugs, always use new, sterile needles and don’t reuse or share needles, syringes or other injection drug equipment.
Treatment and support
Unlike HIV, HCV can be cured though a 12-week treatment programme of direct acting antivirals (DAAs). If you have HIV and HCV you can be treated for both infections.
People who inject drugs can be stigmatised when they try and get help at healthcare facilities. Some healthcare workers feel patients should ‘get clean‘ before they receive healthcare services. But this is wrong. If you are someone who injects drugs, you have needs and rights. It is critical that you get HCV testing and treatment if you are diagnosed with HCV.
To help people who inject drugs, Right to Care works with a range of partner organizations in some areas to:
- provide access to clean needles and syringes,
- offer opioid substitution therapy and
- support patients with other harm reduction methods.
We have worked with people who inject drugs in:
- South Africa through our Global Fund programme as well as in
- Myanmar and the Ukraine where we showed how testing and treating people for HIV and HCV can be made more affordable and give patients the best chance of successful recovery.
