Health News resources and information

Coming to terms with a difficult decision, like how to cope with an unplanned, unwanted pregnancy is an intensely personal experience. No one can tell you how to do it. Ultimately a person has to make a decision that is right for her. She should not be having an abortion because she feels that someone else would prefer it that way; she is the person who should be uppermost in her concerns.

She does not have to make the decision on her own. Many women find that talking things through makes it easier, but choosing a person to share those thoughts with is the difficult part, particularly if you do not want anyone to know. A friend or relative may be helpful, but there are also trained counsellors at many centres who are available to help women in this situation.

If a woman does decide to have an abortion she may experience emotional reactions.

Dealing with your emotions about having an abortion can sometimes be difficult. It may be that the abortion coincides with a difficult time in a relationship, or increases tensions within a family. If a woman does not want anyone to know about it this can place greater stress on her. She may be worried about what effect an abortion may have on her relationship with her partner, or her family. Any number of added factors can compound her feelings.

Sometimes the partners of women who have had abortions find it useful to discuss their feelings, and some abortion clinics and counsellors provide this help if it is needed.

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This is the big one. ‘AIDS’ stands for ‘Acquired Immune Deficiency Syndrome’, and HIV is the name of the bug which causes the disease: ‘Human Immunodeficiency Virus’. If this book had been written fifteen years ago, AIDS would not have even rated a mention, because as far as we knew, it didn’t exist. It has, unfortunately, made its presence felt in no uncertain terms.

One reason that HIV has made such an impact on our lives is that it kills people. Infection may not cause symptoms initially, but there is, at the moment, a 100 per cent death rate among infected people, although the time between infection and death may be relatively long. In some studies in developed countries, only 50 to 60 per cent of infected people have become ill after ten years. Treatments have been found, and are still being developed to increase the length of time an infected person remains well. It is hoped that an effective treatment may one day change the course of this disease. Until then we can only hope to beat it by preventing its spread, relieving the suffering of the people it affects, and continuing to look for an effective cure.

The disease was first noticed in the early 1980s. In Australia and the United states it was initially predominantly found in homosexual and bisexual men (and they still account for the majority of infected people in Australia), intravenous drug users (the second biggest group here), and people who had been given infected blood and blood products. (This was before the Blood Bank knew about it. Now all blood is screened before being given, and the risk of getting infected blood is considered minuscule.) The disease has spread to varying degrees in different populations. In some developing nations, for example in parts of Africa and Asia, the rate of HIV infection among the general population is alarmingly high; men, women and children are infected in enormous numbers, and the proportion is increasing. This illustrates that the virus has the ability to be spread through heterosexual intercourse (the main route of transmission world-wide), and poses a great threat if we do not change our patterns of behaviour. The routes by which the virus is spread are:

• sex. It is in semen and vaginal secretions.

• blood and blood products. This includes sharing intravenous needles and syringes, as they are contaminated with blood.

• from a mother to a baby, either during pregnancy or childbirth.

Many people are concerned that traces of the virus have been reported in saliva (spit), but it appears that the amount is so small that it would take a bucketful, literally, to transmit the virus (and it is not often that one sees a bucketful of spit, fortunately). The possibility exists that it may also be found in breast milk. There is no evidence that it is spread though non-sexual social contact, like touching, kissing, sharing cups, etc.

The virus can be spread through oral, vaginal or anal intercourse. The skin can act as a weak barrier to transmission of the bugs, but microscopic breaks and small cuts in the skin can speed up transmission, and make it easiest for the bugs to get through. This is why more physically traumatic intercourse, like anal intercourse, is thought to spread the virus so well. Similarly, if there are other infections around which have helped to break down the skin’s barrier, like ulcers or sores in the genital region (like herpes or syphilis) or cervical infections (like chlamydia and gonorrhoea), the rate of transmission is probably higher. This may contribute to the very rapid transmission rate in developing countries and communities where heterosexual spread is more apparent than in developed societies to date. The rate of all sexually transmitted diseases is higher in underprivileged communities, and AIDS in particular is sweeping through parts of Africa with ferocity.

HIV causes damage by affecting the body’s immune (infection- and cancer-fighting) mechanisms. This means that the person who carries the virus will eventually lose the natural defence mechanisms which ward off disease. This leaves the person susceptible to other bacterial, fungal and viral infections and some cancers, one or more of which will eventually lead to death.

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The temperature method. A further guide to recognizing the riming of ovulation is to monitor the body temperature. Interestingly there is a tiny increase in a woman’s ‘basal’ (usual) temperature following ovulation. This is in the range of 0.2 to 0.6?C, and if a woman takes her temperature (via a thermometer in either her mouth or her vagina), she may be able to recognize this change, and know that ovulation has probably occurred. She should abstain, as outlined above, but as it is a ‘retrospective’ reading, she may find that the ovaries have fired off sooner than her calendar predicted, and in fact she is closing the gate after the sperm have bolted (so to speak).

The mucus method. The mucus (the dear sort of normal discharge in the vagina) changes under hormonal conrrol during the cycle. About ovulation time there is more clear, thin mucus. After ovulation it becomes stickier and tacky. Women may use this change as a further sign that ovulation has taken place. While it may be useful as an adjunct to other methods, it is not all that reliable as the mucus viscosity is also affected by such things as semen and infections.

Of course all these useful signs of ovulation can be helpful when trying to become pregnant, too. Simply try harder during the ‘fertile’ time. Some researchers have developed home ovulation detection kits, which may be useful to some women as another means of assessing if ovulation has taken place. These are probably more use to women trying to get pregnant rather than avoiding it.

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