Toxoplasmosis. Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. Approximately 80 percent of all adults have been infected with T. gonda at some point in their lives, and most healthy people experience no symptoms or problems from this infection. However, in people with AIDS this infection can reactivate and cause problems in the central nervous system, such as encephalitis and pockets of infection in the brain. A blood test can tell whether or not someone has been infected and therefore whether he or she is at risk of the T. gondii infection reactivating as the HIV infection progresses.

Trimethoprim/sulfamethoxazole is the medication of choice; alternatives are pyrimethamine and dapsone.

Tuberculosis. Skin testing for tuberculosis will tell if a person has been exposed to the disease in the past. This is a particularly good idea for HIV patients, because a reactivation of the tuberculosis can occur as the immune system declines. If a skin test is positive, the medication isoniazid is recommended to kill the bacterium and prevent the disease from occurring.

Mycobacterium avium Complex Infection. When the T-helper-cell count falls below 50, about 30 percent of people with AIDS will develop infection with this organism. Symptoms include fever, night sweats, weight loss, and stomach pain. Three medications that have proven effective in treating this infection are clarithromycin, azithromycin, and rifabutin.

Fungal Infections. Fungal infections are very common among persons with AIDS, and they include cryptococcal meningitis and fungal infections of the esophagus and mouth. Fluconazole has been shown to prevent these infections; however, because it interacts with other medications that are commonly used to treat HIV infection, it is recommended that fluconazole be used only to treat active infections and not to prevent potential infection.

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The hepatitis C virus is the most common cause of what used to be called “non-A, non-B” hepatitis, a term formerly used to describe viral hepatitis that was not caused by hepatitis A or B. Hepatitis C is a major health concern in the United States and around the world, and it is the most common cause of chronic liver disease in the United States.

The hepatitis C virus has only recently been recognized as a cause of viral hepatitis, and a test to screen blood for it has been available only since 1990. Because it has been identified only recently, hepatitis C is not clearly understood in the way that hepatitis A and B are. Much research is currently under way, however, and new information is emerging rapidly.

Several types of hepatitis C virus have been recognized so far, each with a slightly different genetic makeup. A person may have infection with one or several types. Although the symptoms the viruses cause are similar, their response to treatment with medication (alpha-interferon) differs, and their degree of infectiousness may also differ. The most common types in the United States are hepatitis C types 1 (a and b), 2, and 3. Type 4 is more common in northern and central Africa and the Middle East, whereas type 5 is seen in South Africa and types 7, 8, and 9 in Vietnam.

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Chlamydia infection of the eye usually produces redness, itching, and pain in the lining of the eyelids, this infection is called conjunctivitis.

A man or woman who becomes infected with chlamydia in the anal area after receiving anal intercourse from someone who is infected may develop a mucous rectal discharge, rectal bleeding, diarrhea, and pain with bowel movement. Or there may be no symptoms.

Finally, the throat can also be a site of infection with chlamydia, usually in someone who performs oral sex on a man who is infected. Men who perform oral sex on women are usually not at high risk, since there is no direct contact with the cervix, which is the usual site of infection in women. Kissing is not a risk factor for chlamydia. Although throat irritation can occur with chlamydia throat infection, when someone has a chlamydia infection of the throat.

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Talking about sex can be very difficult, so many people—regardless of their gender, age, or sexual orientation—avoid the subject altogether. For example, a recent American Social Health Association survey of women attending college showed that although 81 percent, on entering into a sexual relationship, asked their partner how many partners he had had in the past, only slightly more than half asked if he had ever had a sexually transmitted infection or had ever had unprotected sex. Fewer than a third asked whether their partner had ever had a same-sex partner or had ever used intra- venous drugs. And these are the findings on how women behaved when they knew their partner. fairly well before entering into the sexual relationship. When women were entering into a new sexual relationship with a casual partner, even fewer of them asked these important questions. Finally, although about 85 percent of the women in this study were sexually active, fewer than half of them used any method to protect against sexually transmitted infections, and about a quarter had never had a pelvic examination.

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Lice. Pubic lice, also known as “crabs,” are tiny bugs that infect the pubic hair and sometimes the hair under the armpits and the eyelashes. They can but do not always cause itching. A person with lice may also notice tiny blood spots on their underwear, resulting from the openings in the skin where the lice have bitten.

Scabies. Scabies causes itchy bumps and small lines (which are the burrows of the mites that cause the infection) on the body in a characteristic pattern. Most often, these are seen in the genital area, around the beltline, in the armpits, and in the webs between the fingers. The itching is usually worse at night and after a shower.

Trichomoniasis. The itching resulting from a trichomonas infection can range from mild to severe. The discharge is usually thin and yellow-green in color. There may also be a strong, fishy odor.

Warts. Warts are usually small, hard, flesh-colored bumps that can occur anywhere in the genital or anal area. They may also be cauliflower-like in appearance. Although warts usually don’t produce any accompanying symptoms, about 20 percent of people with warts experience itching, which is usually mild.

Yeast. Yeast infections—usually caused by the fungus Candida albicans—can occur at any time of the year, but they occur more often in the warmer months. Often there is itching, which can range from mild to severe, as well as a thick, white, clumpy discharge. If the inflammation is severe or if a woman scratches in the genital area, there may be breaks in the skin as well. A woman who has recently taken an antibiotic is more likely to develop a yeast infection, since the antibiotics temporarily diminish the quantity of the normal vaginal bacteria and allow yeast to overgrow.

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