
- hiv testing in pregnancy should be done early so as standard care can be taken for the pregnant women.


- this hiv testing must be repeated in the third trimester, usually before 36 weeks of gestation. This should be done in women with hiv-seronegative and also in pregnant women who are at a high risk of developing hiv infection.


- expedited hiv tests should be performed at the time of delivery and labor and this is a must in women who have not been documented for hiv. The results of the test should be available in one hour of the test and the testing should be available 24 hours. In case the results are positive then, infant postnatal antiretroviral and intrapartum drug prophylaxis should be started immediately.


- women who have not been able to be tested for hiv at the time of labor and delivery are suggested expedited screening for hiv. Their screening can be done immediately postpartum or their babies should undergo screening. In case the infant and mother, both are positive, then infant antiretroviral drug prophylaxis should be started immediately. These mothers should avoid breastfeeding their babies, until the supplemental hiv tests are negative. In infants with positive hiv, prophylaxis should be discontinued and antiretroviral drug therapy should be started.


- in case of acute hiv infection during pregnancy, that is in the intrapartum period, or during breast feeding, initial testing can be performed with an antigen/antibody combination immunoassay. If the supplemental test is negative, then an additional test which is the virologic test (dna, rna) are necessary for the diagnosis of the hiv infection.
- if the mother is hiv positive then this information must be documented in the infant's medical record and also communicated to the infants care provider.
The knowledge of an antenatal maternal hiv infection allows the:
- women with hiv infection to get the correct antiretroviral therapy along with prophylaxis for the infections which might occur due to the immunocompromised state of the body. This also prevents and decreases the risk of transmission to their partners.
- when there is provision for antiretroviral therapy for the mother during pregnancy and labor along with antiretroviral drug prophylaxis for the baby there is less risk of perinatal transmission of the hiv.
- the hiv infected women should be counseled for a cesarean delivery. The option of an elective cesarean reduces the perinatal transmission of the hiv.
- the hiv women should be counseled about the risk of breastfeeding.

Identification and Management of Perinatal HIV Treatment

Most of us are affected by diseases, which spread through physical contact, but most of us do not consider it important to get them checked, due to which they turn into major ailments. Sexually transmitted diseases (stds) are infections, which are transmitted through any kind of sexual contact. The organism that causes the disease is transmitted from one person to the other during sex intercourse. Sometimes stds can be asymptomatic (no symptoms or signs)

Here are some stds that you should be informed about:

1. Gonorrhoea: genital infection caused by bacteria is called gonorrhoea, its symptoms include 

 Bloody vaginal discharge
 Painful urination
 Heavy period bleeding
 Anal itching

2. Chlamydia: bacterial infection in the genital tract is called chlamydia. Chlamydia is usually difficult to diagnose, its symptoms include

 Pain during urination
 Pain in lower abdomen
 Vaginal discharge
 Painful intercourse
 Bleeding between menstrual cycles

3. Syphilis: the bacterium treponema pallidum causes syphilis, its symptoms include

 Rashes
 Sores in the mouth, anus or vagina
 In later stages, it causes nerve and organ damage

4. Genital herpes: the herpes simplex virus (hsv) causes herpes. Signs and symptoms include-

 Small red bumps or ulcers in the anal, genital and other areas
 Itching or pain around the genital area, thighs and buttocks

5. Human papillomavirus (hpv) and genital warts: genital warts are caused by hpv. It infects the genital tract. Hpv has been linked to cervical cancer, its symptoms include

 Small swellings in the genital area
 Itching
 Bleeding during sex

6. Chancroid: chancroid is a bacterial infection. The bacterium haemophilus ducreyi causes chancroid, its symptoms include

 Development of red bumps on the skin folds covering the genitals
 Pain during urination
 Burning sensation during bowel movement

7. Ectoparasitic infections: ectoparasitic infections are caused by small parasitic bugs like mites or lice. The parasites usually affect the hair or skin. Scabies and crabs are common parasites that cause such infections. They both cause intense itching and visible rashes.

8. Human immunodeficiency virus (hiv) and acquired immunodeficiency syndrome (aids): the virus that causes aids is called hiv. It can spread through blood, vaginal fluids, semen and breast milk. Unprotected sex or sharing needles with an infected person is how the disease spreads. It includes symptoms, such as

 Slight fever
 Fatigue
 Muscle aches
 Weight loss.

Most Common STDs in Women

An STD is transmitted by means of physical 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:

Abstain: The most effective way to avoid STIs is to abstain from sex.
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 reduce 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 participating in an activity without being able to give our full consent.
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   trust between partners, plans to have children, and the joyful embrace of your sexuality and its expression. If in doubt, don't hesitate to visit a skin specialist or a physician.

STDs - 5 Ways You Can Avoid Them

People who suffer from human immunodeficiency virus, commonly known as'hiv, are known as hiv positive people. The virus is the agent of aids that is currently incurable. Hiv is known to alter the human immune system and makes people much more susceptible and vulnerable to diseases and infections. 

Body fluids such as semen, blood, breast milk, vaginal fluids etc. Of an infected individual contains the virus, which can be passed from one person to another during blood-to-blood and/or sexual contact. Hiv positive women may even pass on this virus to their children during pregnancy, delivery or by breast feeding them. Hiv is also transmitted during oral, anal or vaginal sex, by contaminated hypodermic needles and by blood transfusion. 

Mentioned below are a few issues that a hiv positive woman have to face apart from discrimination and stigma, fear of infecting their children or partners, violence and abandonment. 

1. Menstrual disorders: changes in menstrual cycles are frequently reported by hiv infected women. However, menstrual dysfunctions are due to varied reasons that aren't directly related to the disease. Although most of the hiv positive women suffer from amenorrhea i. E. The unusual absence of periods, it is not just due to hiv but also because of weight loss or immunosuppression. 
 
2. Contraception: it is very important that the contraception a hiv positive woman chooses not only acts as birth control, but also to prevent the transmission of sexually transmitted diseases and hiv. Although condoms do not provide exceptional pregnancy prevention, they are excellent at preventing transmission of the hiv virus. Permanent sterilization is usually the most chosen contraceptive method for hiv serodiscordant couples.

3. Surgical complications: hiv positive women are at a higher risk of undergoing gynecologic surgery. This is because they are more vulnerable to pelvic infectious disease that requires surgical intervention. There is also a greater risk of developing vulvar cancer in hiv positive women. 

4. Fertility: there has been an increase in the number of seropositive women contemplating pregnancy and childbirth. Most couples resort to assisted reproduction to lower the risk of horizontal hiv transmission. Studies show that undergoing hiv treatment and having an undetectable viral load is helpful in preventing the transmission of hiv. It is important to consult a medical expert if you are unable to get pregnant after at least 6 months of trying. Fertility problems are more common in hiv positive women than hiv negative women.

Issues for HIV Positive Women

A couple of decades ago, medical professionals believed that a lot of females could not climax at all. There are a number of reasons for this. It is easy for the male to know when he has achieved an orgasm, which usually happens with ejaculation, which is quite evident. For the females, on the other hand, it is not so evident. It is a perceived feeling and while the media showcase it in a particular way, reality is far moved from it.
There are various reasons why it is very difficult to pin this down. Orgasms are not just an elusive feeling for the woman, it is an elusive topic for the medical professionals too. Read on to know some of the common causes (more beliefs or notions) about this and some simple but effective ways of managing this.
- Private topic: Girls are very shy compared to boys and both their exposure to sex education and discussion about this is limited compared to boys. We might tend to think of it as common in India alone, but this is true across a vast number of countries. We are not alone! This shyness continues into their later years too, and unless transformed by the partner, it may continue to be a topic that is shunned.
- Purpose: Sex is more deemed as a form of procreation rather than for sex. Therefore, while sex is necessary for conception, orgasm is not. This is one more reason (strange but true) that orgasm is very elusive for a woman.
- Psychological factors: It could be guilt from past relationships or fear of past abuse. It could be fear of losing control or fear of coming across as vulnerable. For any of these reasons, women can have difficulties climaxing during the act.
In men, the causes are more defined and physical in nature and include erectile dysfunction, premature ejaculation, retrograde ejaculation, and delayed ejaculation.
Whatever the cause of the problem, the first step in coping up with the issue is to acknowledge the issue. Being a private topic, this is not something that is going to draw the person towards medical help. However, this needs to be discussed frankly with the partner or with the doctor. Getting the partner involved removes a lot of psychological barriers (guilt, fear, anxiety, etc.) This would result in natural ironing out of issues, improving the performance of both the people involved.
If that does not happen, seeking professional help, be it medical help to correct physical issues or counselling, is the next suggestion. A frank discussion will do wonders, and what was once elusive can be well within your reach.

The Elusive Orgasm - Causes and Coping!

STDs or STIs are usually transmitted from one person to another through body fluids while being in a physical relationship. Herpes, Chlamydia, HIV and gonorrhea are some of the common STDs you may be susceptible to. These diseases are extremely unpleasant and usually cause long term health issues. Sometimes they might even be fatal. Here are a few ways you could use to prevent yourself from getting affected with STDs:

    Abstinence: The best and most certain way of preventing STDs is practicing abstinence. Although abstinence from any type of sexual activities including oral, vaginal or anal sex is a surefire method of prevention, it is not a very realistic method to do so. If you don't want to practice abstinence, make sure you educate yourself about other prevention methods.
    Single partner: Practicing monogamy in terms of sex is the safest kind of sexual activity. Make sure both you and your partner get tested for any STD. If you and your partner are not suffering from any STD and you both agree to practice monogamy with each other, then you automatically cut down on the risk of suffering from STDs.
    Talk: Talk to your sexual partner about his/her sexual health. Inform him/her about yours as well. Avoid having sex with someone who does not inform you with his or her sexual health information.
    Avoid taking drugs or alcohol: Try not to get drunk or take drugs before having sex. They reduce inhibitions which actually tend to make you reckless. You tend to become more adventurous and do not keep the sexual hygiene in mind at that time. Using a condom in the influence of alcohol and drugs can also result in a condom failure. Be sober enough before you have sex.
    Do not indulge with a person with symptoms: If someone shows symptoms of suffering from any kind of STD, do not indulge in any sexual activity with him or her. Refrain from having sex with him or her until he or she is treated by a doctor.
    Take precaution: Use different forms of protection while having sex to prevent pregnancy as well as STDs. But you have to realize the fact that these forms of protection are not full proof and always have a slight percentage of risk embedded in them.

Be extremely careful before you indulge in any type of sexual activity with anyone. After all, your health is in your hands.

How To Best Prevent Yourself from STDs or STIs

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