Gynecologic care of women infected with HIV.

Abstract

Gynecologic diseases are commonly encountered when caring for HIV-infected women especially those with greater degrees of immunosuppression. HIV infection may affect the occurrence or clinical severity of a variety of gynecologic conditions. This article reviews specific issues related to the provision of gynecologic care and contraception for women infected with HIV. It presents studies on the prevalence and incidence of gynecologic diseases as well as several recommendations for prevention and treatment of the diseases. These include lower genital tract neoplasia invasive cervical cancer pelvic inflammatory disease menstrual disorders sexually transmitted diseases (STD) and vaginitis. When recommending contraceptive use by women infected with HIV these issues should be considered: 1) risk of increased HIV/STD transmission; 2) effect of the contraceptive on the course of HIV infection; and 3) acceptability of the method to sexual partners. In general most gynecologic conditions in women infected with HIV will respond to standard therapy but require increased vigilance for treatment failure. Although some will require multiple courses of treatment or use of innovative treatment methods all HIV-infected women deserve careful evaluation for and treatment of gynecologic diseases.