Doc, can I get HIV from my positive wife?

Dr Flo,
I have been married for the past two years. When my wife conceived, we went for normal antenatal clinics and she was found to be HIV positive, but I was negative. I have been tested several times since then and I am still negative. I have tested more than four times in a year. Is there a possibility of becoming positive as we are still together? My child is negative. 
DM

Dear DM,
You are in a HIV discordant relationship, where one person is HIV positive and the other person is HIV negative. As long as there is sexual intercourse, the risk of HIV transmission is still there. However, there are different ways of reducing your risk of transmission. One of them is for your partner to take their medication as instructed and, therefore, becoming virally suppressed, which reduces the chances of her transmitting the virus to you or to a child if she is pregnant or breastfeeding. This means that the number of viruses in her body is very low because the virus is being suppressed by the medication. Another way of reducing the risk of transmission is by using condoms consistently and correctly. Another way is for you to use pre-exposure prophylaxis (Prep). This is anti-retroviral medication that is taken every day to prevent HIV. You are also advised to take a test every three months, since you are constantly exposed to HIV. At the clinic where your wife gets HIV care, if it is a comprehensive clinic, you should be able to get support and advice concerning your situation. There are many couples in HIV discordant relationships, and many comprehensive care clinics have support groups for these couples.

Dr Flo,
I am a 28-year-old man and I have a problem with my urinary system. Sometimes when passing urine, I feel like I am burning. Please advise me on the matter.
Richard

Dear Richard,
The burning sensation when you are passing urine most likely means that you have an infection. It may be due to gonorrhoea, chlamydia, trichomonas or infection by other types of bacteria which you may have acquired from sexual contact.
If it is not treated, the symptoms may actually reduce with time, though the infection is still present. The danger with this is that the infection can spread to the testicles and the rest of the reproductive tract and in the long run, can lead to infertility. The infection can also spread to the rest of the body, causing serious illness. Any time you have unprotected intercourse, you can spread the infection to your partner. In women, this can lead to infection in the reproductive tract and pelvic organs and can also lead to fertility problems.
Less common causes of these symptoms include kidney stones, bladder stones, prostatitis (inflammation of the prostrate) and, very rarely, bladder cancer.
You need to have the urine and any discharge present examined. It would also be advisable to do an STI screen, a chlamydia test, including HIV test. You will be given antibiotics to treat the infection, depending on the results. Abstain from sexual intercourse until you have completed treatment, and you have been retested and found to be cured. Any partners you have had in the past three to six months also need to be treated, for their own health’s sake, and also to prevent re-infection to you.

Dr Flo,
I am a teenage girl who cannot seem to control how I eat. The urge grows whenever I see food. I cannot resist food. Whenever it is meal time, I finish up a plateful of food and can go for up to four rounds and still eat more. I now look like an expectant woman. I am also overweight, almost obese. I recently fell from the sofa to the floor and injured my backbone and it has been painful ever since. I cannot stand it anymore and the overeating and weight gain makes me feel depressed. My self-esteem is low. Help me.
Eve

Dear Eve,
You are suffering from binge eating disorder. It is characterised by eating a larger amount of food than what most people would eat in a similar time frame and a sense of lack of control during the episode either over the eating itself, or the what or how much is being eaten. During the binge eating episodes, you may eat faster than normal, you may eat until you are uncomfortably full, you may eat large amounts of food when you are not physically hungry, you may eat alone because of feeling embarrassed about how much you are eating and you feel guilty, disgusted or depressed afterwards.
Binge eating disorder is a serious disorder that causes a lot of psychological distress and also has serious health implications, like being overweight, sleep problems, digestive problems, menstrual irregularities, joint pains, hypertension, diabetes and heart disease. It is caused by a combination of genetic, biological, psychological, behavioural and social factors.
Binge eating disorder is manageable and you can be able to overcome it. To manage it, you need to see a counsellor or a psychologist or a psychiatrist for individual, group and family therapy. You may also be started on some medication to manage the depression and anxiety. You also need to visit a nutritionist, so that you can know what your body needs for you to be healthy. You also need to start exercising, preferably with the help of a personal trainer, if you are able to.
It is important that you talk to someone about the issue; do not try to handle it alone. Once you start on a treatment plan, stick to it. Do not try to diet or go on weight loss programmes, stick to what the nutritional counsellor and your doctor advise.

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