Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?

A STD is transmitted by means of physical intimate contact and intercourse. These diseases are caused by parasites, virus or bacteria. Usually STDs are preventable provided you make the right choices concerning your sexual health. Refraining from sex isn t a feasible idea at all. But fortunately there are alternatives too to curb the menace that STDs are:

Mutual monogamy: Two people who have sex only with one another don t have any opportunity to bring a new STD into the relationship. If you and your partner have been tested and are healthy, remaining faithful to each other is a very good way to reduce your chances of contracting an STD.
Get Vaccinated: One important prevention tool against STIs is vaccination. Currently, vaccines are available to protect against infection with HPV, hepatitis A and hepatitis B. Talk to your healthcare provider to see which vaccines might be recommended for you.
Protect Yourself: Condoms work really well in stopping most STIs from being passed from an infected partner to another when they are used consistently and correctly every time a person has oral, vaginal or anal sex. Consistently and correctly means that a person makes sure they use a condom every time they have oral, vaginal or anal sex and put it on and use it the right way.
Avoid alcohol and drug use: Avoiding alcohol and recreational drug use reduces the risk of contracting an STI, having an unwanted pregnancy, or being coerced to have sex. Alcohol and drug use can reduce our ability to make good decisions. It may also make us more likely to be talked into into participating in an activity without being able to give our full consent.
Consider male circumcision: There's evidence that male circumcision can help reduce a man's risk of acquiring HIV from an infected woman (heterosexual transmission) by as much as 60 percent. Male circumcision may also help prevent transmission of genital HPV and genital herpes.
Coping and Support

It's traumatic to find out you have an STI. You might be angry if you feel you've been betrayed or ashamed if there's a chance you infected others. At worst, an STI can cause chronic illness and death, even with the best care in the world. Between those extremes is a host of other potential losses is trust between partners, plans to have children and the joyful embrace of your sexuality and its expression.

Ways to Avoid STDs

What are STDs?
STDs or STIs are infections that are caused by intimate contact that involves exchange of bodily fluids. These are also called venereal diseases and can be caused by vaginal, anal or oral sex. Most of these infections do not show any symptom initially, but they develop over time. The causative organisms can include viruses, bacteria or parasites. The signs and symptoms can be in the form of unnatural vaginal discharges, or penile discharges, or warts and ulcers in the pelvic area.

It is a very serious disease as some of those are not curable, such as HIV/AIDS or Hepatitis-B. Other diseases may include gonorrhoea, syphilis, Chlamydia etc. While there surrounds a stigma around STDs and people may feel ashamed to even go forward to ask for any help, there is nothing to be ashamed of and it is the best to seek medical attention when you feel you may have contracted a STD.

But as we know, prevention is always better than cure. Here is a list of tips that might help you prevent it in the first place:

Prevention: It is actually the cure to some diseases such as HIV and herpes
Vaccines: It can prevent you from concurring diseases such as Hepatitis- A and Hepatitis-B. It is advised to get yourself vaccinated before sexual contact to prevent the disease.
Anti-microbials: Anti-microbials such as Nonoxynol-9 can be used in the vagina to prevent any sort of venereal disease. However, the efficacy of the anti-microbials may vary depending on the efficiency in application and the type of micro-organism.
Condoms: Female or male condoms can help to prevent venereal diseases tremendously. They help to prevent the interaction of body fluids by keeping a barrier between if used properly. Otherwise the uncovered will still be susceptible to infection.
Ways to use a male condom properly:

Never reuse a condom
Always keep a certain space on the tip of the condom for the ejaculation, as it may reduce the incidence of it bursting
Be careful with the condom, if your nails are long
Flavoured condoms should only be used for oral sex as the sugar in the condoms can cause yeast infections, if used in the vagina
Do not wear the condom if it is too loose, it can come off

STDs - Ways You Can Prevent Them!

The vagina is a muscular, tubular structure of the female genital tract extending from the vulva to the cervix (the opening of the urethra). Sexual activity affects vaginal health in a number of different ways during intercourse and in the long term. A few of the varying effects and the factors responsible for these effects are listed below:

1.  Changing size of the vagina

The vagina is designed to be elastic and adjustable. So, no permanent change in size is possible but it does undergo temporary changes in sizes as effects of sex. The inner walls of the vagina enlarge during sexual intercourse and during childbirth. Tissues in the clitoris puff out and harden, this also causes an expansion in size. It takes a while to get back to its normal size.

2.  Vaginal secretion

When you are aroused during sex, the blood vessels supplying the vagina expand immediately. The blood flow increases to lubricate the vaginal walls (rugae). The rugae unfold and the space increases. These secretions are important because, women who are sexually inactive for a long time at a stretch, experience dryness that leads to urinating difficulties and rashes.

3.  Unusual discharge

Apart from natural lubricants, vagina secretes some fluids, the process being termed as 'female ejaculation'. A tiny amount of white fluid made of prostate plasma cells, is produced just before you climax and discharged with some quantity of urine. Sometimes, prostatic specific antigen (PSA) and prostatic acid phosphatase (usually found in semen) are also found in the secretion.

4.  Infections in the urinary tract

The friction caused by sexual intercourse may cause small cuts which enable bacteria to pass from the vagina to the urinary bladder through the urethra. This causes infection in the bladder, the urinary tract and the vagina. These can be avoided by using a condom or by urinating before and after having sex.

5.  Vaginal pain

A lot of women report the experience of pain and discomfort inside or around the vagina during and immediately after sex. The pain can result from repeated sex within a short period of time or reduced secretion of natural lubricants. If the pain is too severe, you should see a doctor because yeast infections or chronic vulvodynia can also be responsible for the pain sensation.

Effects Of Frequent Sex On Vagina 

Female infertility is considered as the inability of conceiving. As per WHO it is described as the inability to be pregnant, maintain and carry forward a pregnancy to its full term. It is often of two types:

    Primary Infertility: This is the inability to give birth to a baby either due to the inability to become pregnant or maintain a pregnancy, which includes stillborn and miscarriage.
    Secondary Infertility: This refers to the inability to give birth when there is already a live birth or the woman was pregnant.

The causes of infertility can vary from being acquired or genetic. However, following factors are largely responsible for infertility:

    Genetic: Some genes can lead to mutation leading to infertility like, in case of BMP15 gene there is a hypergonadotrophic ovarian failure which causes infertility.
    Acquired: This is caused by factors like age, smoking, sexually transmitted diseases, obesity, body weight, eating disorders, diseases like diabetes, thrombophilia and also radiation and chemotherapy.

The treatment for infertility usually depends on the cause, age, duration of time for which a person has been infertile and preference of the patient. Infertility is believed to be a complex disorder and the treatment involves a huge amount of physical, financial and psychological commitments. All this also requires a lot of time. Some women might need just a minimum of two therapies to attain fertility while others might require different treatment before they can conceive.

Treatment is largely aimed to restore the fertility either by means of medication and surgery or help in reproduction with the help of some procedures.

Fertility Restoration through medication

This is the main treatment for women who are infertile because of ovulation disorders. These drugs include:

    Gonadotropins: These are injected to stimulate the ovaries. Drugs like Menopur, Repronex, Follistim AQ, Gonal-F, Bravelle restore the production of eggs, while Ovidrel and Pregnyl are used for maturing the eggs and for their release.
    Clomiphene citrate: This is taken orally and stimulates ovulation by releasing more Follicle Stimulating Hormone and Luteinizing Hormone from the pituitary gland.
    Metformin: This is used in females who have PCOS and also when insulin resistance plays a major role in infertility.
    Bromocriptine: Used when the infertility is caused due to excess prolactin production.
    Letrozole: This also induces ovulation

Fertility Restoration through surgery

Surgical procedures can amend the problem of infertility. However, these treatments are very rare these days owing to the success of other fertility treatments. These include:

    Tubal ligation reversal surgery: In case a tubal ligation has been performed it can be reversed by reconnecting the tubes again through surgery.
    Hysteroscopic surgery: This corrects or removes the abnormalities that cause infertility. This surgery can correct the shape of the uterus, remove endometrial polyps and improve chance of getting pregnant.
    Tubal surgeries: In case of blocked fallopian tubes laproscopic surgery can be performed to dilate the tubes, removed blockages or create a new opening.

Assistance in Reproduction through techniques

The most common used techniques for reproduction assistance are:

    Intrauterine insemination or IUI: In this about million healthy sperms are put in the uterus at the time of ovulation.
    Assisted reproductive technology: In this mature eggs are retrieved from a woman and this is then fertilized with sperms in a dish in the lab. Once the fertilization is done the embryo is placed in the uterus for further development. IVF is the most common and effective assisted reproductive technology. This procedure takes place over weeks with several blood tests and hormone injections.

Dealing with infertility is not easy and can be emotionally and physically draining. To cope with the various tests and treatments of infertility one should be fully prepared, eat a healthy diet, exercise reach out for help and support of family and friends and look for other options like a donor egg, adoption or no children.

Treatments of Infertility

The female reproductive organ is an area of the human body where many microbial organisms inhabit together and it is a necessary requirement for its health. These organisms may include fungi and bacteria and play important roles individually in maintaining the pH levels (the acidic and alkaline balance) levels of the vagina. However, when one of these, especially the fungi go out of balance and begin to propagate, it results in a vaginal yeast infection.

Symptoms
A yeast infection or vaginal candidiasis is a fungal infection that causes extreme itchiness of the vulva (which is the opening of the vagina) and the further insides of the vagina as well. It may result in a white discharge from time to time and causes vaginal inflammation. Some of the other symptoms are:

Pain in the vagina akin to a burning sensation while urinating or when having sex
Rashes in the vagina
General soreness and pain
White odorless discharge, which is thick in consistency
Colorless watery discharges can occur as well
Swelling and redness near the vulva or the vagina in general
Causes
The type of fungi that causes vaginal yeast infections is the  candida fungus . Usually, this fungus is present within the vagina, but is kept in check by the Lactobacillus bacteria. These are bacteria naturally present within the vagina and secrete acids, which keep the fungi in check. However, when the levels of bacteria are reduced, it will cause the levels of fungi to increase causing a yeast infection.

Risk Factors
The below mentioned factors can aggravate the risks of this disease:

Problems brought on by diabetes
A compromised immune system
Pregnancy may also disturb the balance
Starting to use or stopping the use of oral contraceptive pills
Hormone therapy
Usage of antibiotics that may kill off lactobacillus bacteria within the vagina
Generally, yeast infections are not considered to be sexually transmitted, although yeast infection could be spread through sexual contact as well.

The primary treatment includes a course of anti fungal oral medication to lessen the levels of the fungi within your vagina. It could be supplemented with vaginal creams, which may reduce the itching and the inflammation. If you have recurrent infection multiple times within a year, then you may have to go for a longer course of treatment and correct the underlying conditions that may be causing it.

Vaginal Yeast Infection - 6 Signs You are Suffering from it

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