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Sex Workers and HIV Resistance

Published : Thursday July 7, 2016 | Posted in : General Health

Scientists have been looking into why some sex workers are resistant to HIV despite frequent unprotected sex in a country where the HIV rate is high. The women they studied did not develop HIV and researchers have previously been unaware why this is the case.

What is HIV?

Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system. This means you aren't able to fight off infections or disease so well.

It's caught by sharing infected body fluids through unprotected sex, sharing needles, or through birth and breastfeeding. There is a small risk via oral sex. It's not caught through sweat, urine or sharing utensils.

HIV is incurable but there are treatments that support individuals to live a healthy life. The earlier a diagnosis is made the sooner treatment can begin to manage the condition. HIV is not the life-limiting death sentence it was decades ago.

Often used interchangeably HIV and AIDS are not the same thing. AIDS stands for Acquired Immune Deficiency Syndrome. This is the final stage of HIV, when the immune system is so weakened it's unable to fight off illness such as pneumonia for example. People do not die of AIDS - they die from an overwhelmed immune system that can't fight off an infection.

Public Health England says 95% of the diagnosed in 2013 picked up HIV through sexual contact. Condoms are essential to protect yourself from HIV transmission.

Sex Worker Immunity Research

Scientists have been working with sex workers to study and to test preventative approaches for behavioural and vaccine studies. The women chosen for the research have interested scientists because they have not contracted HIV and have immune responses against the infection.

Researchers at the Wistar Institute now suggest that these women have changes in their immune systems and tissues that are different from how vaccines usually generate responses.

Data showed that semen exposure changed their vaginal and cervical environment to increase HIV resistance. It seems their frequent exposure may have changed their reproductive areas exposed and immune systems in three ways:

1. They had lower rates of immune activation in the blood and mucosal tissues. This is important because immune activation helps HIV spread in the body.

2. Enhanced interferon ε in epithelial cells was present. These are signalling proteins that protect the reproductive areas from infections. Researchers found that semen increased this protein in lab tests.

3. CD4 and Nucleoprin genes, needed for HIV to live and spread, were lower in the study subjects.

The study's lead author said their research 'clearly indicates that women are equipped to activate mechanisms of resistance due to sex itself'

Previous studies have also highlighted sex workers that have remained uninfected despite frequent exposure. Some long-term female sex workers in Africa for example have consistently remained negative.

HIV test

The Dangers Of Unprotected Sex

These findings do not promote the use of condom-less sex. Research is in the early stages, and simply indicates what a small number of women have experienced.

If you have sex without barrier methods of contraception then you are at risk of contracting HIV along with a host of other STIs such as:

Chlamydia

This is the most common STI in the UK, which may be due to the lack of symptoms. Many people have no symptoms whatsoever and spread the disease without knowing.

When it does create symptoms chlamydia may cause burning on urination, pain during sex and vaginal discharge. Men may experience a cloudy, watery discharge from their penis and painful testicles. Chlamydia can spread to the eyes and rectum too. It's treated with antibiotics.

Genital Warts

Genital warts are the second most common STI in England. These are small growths in the vaginal folds or on the penis caused by the human papilloma virus (HPV). Using a condom won't always stop the infection as skin on skin contact spreads these warts.

Two strains of the papilloma virus are associated with cancer, but the most common wart virus is not one of them. Your local clinic can remove warts using a special liquid or by freezing them.

Genital herpes

This virus is incurable but manageable with antivirals. Genital Herpes creates painful blisters and ulcers that come and go as flare ups but which remain dormant most of the time. When they are present urination is painful.

Gonorrhoea

Another silent infection is gonorrhoea which only shows in about 50% of women and 90% of men.

When it does show symptoms are burning on urination, yellow, green, or watery discharge, abdominal pain, bleeding between periods in women and painful testicles in men. It can affect the eyes, throat and anus too. Gonorrhoea is treated with antibiotics.

Syphilis

Syphilis presents in three stages. The first is a sore on the genitals or mouth that persists for six weeks. The secondary stage is a flu-like illness and hair loss. After a period of no symptoms this passes into the third stage which can cause blindness, heart problems and paralysis.

This is why it's so critical to see your health professional if you spot any changes in your genitals, throat or mouth areas. Syphilis is treated with antibiotics and long term penicillin.

Trichomoniasis

'Trich' is a parasite causing frothy discharge that smells of fish in women but rarely shows in men. It may cause a whitish discharge and inflamed foreskin but usually remains silent.

Trich is treated with antibiotics but is tricky to diagnose.

Pubic Lice

Lice are less common these days due to the practice of hair removal, but when the tiny creatures infest your body hair or beard they cause itching. They can be treated over the counter with creams and lotions, but if these don't work see your GP for a prescription treatment.


If you have been exposed to HIV or had unprotected sex then a screening is important because some STIs remain symptomless and cause silent damage. Most can be treated with antibiotics, but those that can't, including HIV, can still be well-managed with the right information and medication.


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