Pelvic Inflammatory Disease (PID) & HIV

Pelvic Inflammatory Disease (PID) & HIV

Pelvic inflammatory disease (PID) is a very serious condition that can result from untreated vaginal or cervical infections. If left untreated, bacteria can spread from the vagina or cervix, through the uterus and fallopian tubes, and into the ovaries and surrounding tissues. PID causes serious damage to the reproductive tract and can be fatal. Chlamydia and gonorrhea are the most common causes of PID.

Pelvic inflammatory disease often leads to scarring in the fallopian tubes, which blocks them and prevents fertilization. Indeed, PID is a major cause for infertility in women of reproductive age. Even if fertilization occurs, the scarring is likely to interfere with the fertilized egg's passage to the uterus. If this occurs and the egg remains embedded in the fallopian tube, an ectoptic (also known as tubal) pregnancy results. Ectopic pregnancy can result in the loss of the fetus and is the major cause for pregnancy-related deaths among women in the United States.

PID affects about one million women in the United States every year, and as many as 7–22% of these women may be infected with HIV. Women who have HIV are more susceptible to infections in the lower genital tract, which increases the risk for developing PID.

Further, PID is likely to be more severe and more difficult to treat in women with HIV because HIV impedes the immune system's efforts to fight the infection. Treatment for PID normally involves a strong course of antibiotics and women who have HIV are more likely to need surgical treatment.

Main symptoms of PID include fever, increased vaginal discharge, and lower abdominal pain that tend to persist and range from moderate to severe. Bleeding between periods and/or irregular periods, nausea, and frequent, painful urination also may occur. In many cases, patients have no symptoms and may not even be aware that PID is developing.

Because gynecological infections are one of the first and most common problems in women who have HIV, and because they can lead to PID if left untreated, it is essential that patients have regular Pap smears to screen for vaginal and cervical infections.

Also, it's recommended that women who are infected with HIV do not use an IUD (intrauterine device) as a method of birth control, because this device provides a direct route to the pelvic organs and easy access for bacteria.