Article Abstract:
HIV infected women should be closely monitored for the diagnosis and treatment of gynecological diseases. Cervical intraepithelial neoplasia is common and may be resistant to certain treatment in HIV infected women. These women should undergo regular Pap smears and colposcopic testing when their HIV is first detected. Pelvic inflammatory disease may also be more common in HIV positive women and may require hospitalization for effective treatment. Women with HIV infection also tend to have menstrual problems, including absence of menses, excessive bleeding, and irregular cycles. Sexually transmitted diseases increase the risk of HIV infection, and HIV infection may progress differently in the presence herpes simplex virus. The relationship between vaginal infections and HIV infection is unclear, however. HIV infected women should be examined carefully for such infections. The best contraceptive methods for HIV infected women may be both a condom or diaphragm and birth control pills or tubal ligation.
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Article Abstract:
Health care personnel should devote attention to the diagnosis and treatment of gynecological diseases in women with HIV infections. The percentage of women infected with HIV increased from 3% to 12.5% of all HIV cases between 1981 and 1993. A 1995 review article discusses gynecological diseases in this population. HIV infected women have a high risk of developing cervical intraepithelial neoplasia (CIN) which may become severe or develop into cervical cancer. Contrary to one study and the 1995 review article, PAP smears, rather than colposcopies, may be the most practical means of screening HIV infected women for CIN. HIV infected women with severe pelvic inflammatory disease (PID) should be hospitalized. Vaginal candidiasis that is resistant to treatment may be common in HIV infected women. Thus women with PID or resistant vaginal cadidiasis should be encouraged to undergo HIV testing.
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Article Abstract:
HIV-infected women with very low CD4+ T cell counts are more likely to develop gynecologic complications. Researchers compared Pap smears of 185 women with T cell counts between 200 and 500 and 67 women with T cell counts below 100. Women in the latter group were less likely to have a normal Pap smear and more likely to have squamous intraepithelial lesions (SIL), which is a precursor of cervical cancer.
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