Doctor's Column: I am HIV positive, what is the best contraceptive to use?

Dear doctor, Iam a person living with HIV but married. Which is the best contraceptive can I use?
Mwajuma

Dear Mwajuma, I wonder why you are asking when you are supposed to be using condoms. They are recommended for every sexual encounter between an HIV infected person and others whether they have or do not have the virus.

Consult your doctor who will counsel you and your partner in choosing the best contraceptive method for yourselves. Please talk to your doctor who will advise you on the best contraceptive for you since what is good for one person with HIV may not be the best for another.

If you are a living with HIV but not taking antiretrovirals (ARVs), you can use most types of contraception. But whether you are using ARVs or not, generally, condoms rank high.

Apart from protecting against pregnancy, they are also effective in preventing spread of HIV and other sexually transmitted infections. Sexually transmitted diseases increase the likelihood of worsening HIV infection.

That said, diaphragms which are not commonly used in Uganda but usually used with the spermicide (nonoxynol 9) are not recommended because the spermicide is more likely to increase HIV transmission though originally it was thought to protect women. Note also that one may get a more dangerous strain of HIV, which may resist drugs.

Antiretroviral drugs affect most hormonal contraceptives, meaning that women who are taking HIV treatment will not get the same level of protection against pregnancy from the contraceptive pill, implant, and emergency contraception (the ‘morning after’ pill).

However, the Intrauterine Device , also known as the coil, just like the condom is unaffected by antiretroviral drugs and ranks second best provided you or your sexual partner have no other sexual partner(s).

Dear doctor, I have a baby who keeps gnashing his teeth. I have done all the rituals to cleanse what they told me could be the cause, that my wife cheated on me, but to no avail. What drug can make him stop doing this?
James Bond Balaaga, Kamuli

Dear James, bruxism (grinding of teeth) in children often occurs during sleep and is usually from unknown causes though it may be blamed on poor alignment of the top and bottom teeth,or as a way to ease the pain from teething and nervous tension or anger.

Some children with other medical conditions (such as cerebral palsy) or pinworm infestation may also grind their teeth. A child is, however, more likely to grind his teeth if the parent did or does the same and then it is also more likely to talk in its sleep. Though even adults grind their teeth, the problem usually starts around three years and by six years it has stopped.

Usually though, the sound may be bothersome to other family members, grinding is usually harmless save for some headaches, earaches and sore jaws it may cause. In some cases, this may wear down teeth making them sensitive especially if grinding is serious or chronic.

Most children outgrow bruxism by the time they reach adolescence. But in case it is serious, a dentist may prescribe a special night toothguard as one grows permanent teeth at around six years of age.

Relaxing a baby before bedtime may help relieve stress and give a child better sleep without grinding the teeth. If this does not help, you may need to see a doctor (paediatrician) for further evaluation.

So, it is unlikely that your wife’s cheating is the cause of bruxism. You need a doctor to evaluate related problems like stress and a dentist to check out for complications instead of seeking drugs for your baby, which are not likely to help.