The HIV (human immunodeficiency virus) is a critical disease. This virus invades a person's immune system which is the body's defense against infections such as viruses and bacteria. The immune system doesn't work properly and becomes deficient once attacked by HIV. One social acknowledgement to HIV that has gained enough recognition is the HIV counselling due to the crucial need to counsel the patient about sexual behavior and the risks associated with it. 

Importance of HIV counselling 
The human immunodeficiency virus has become an epidemic in nature and has reached to a distressing proportion worldwide as it is in its third decade. Thus, counselling becomes remarkably crucial part of the treatment. 

HIV prevention counselling is a significant mode of behavioral invasion particularly in the deficiency or lack of an effective curative treatment or vaccine. HIV counselling varies from other forms of counselling sessions. Apart from being a health obstacle, the disease is equally overwhelming for the family as well as people around you. family. It is also connected with endless and intense human suffering which stimulates multiple emotional responses. Such reactions involve self-denial, grief, fear, loss, anxiety, anger, annoyance, depression self-blaming, pity, self-condemnation isolation and suicidal thoughts. 

Also, the risk of passing the virus to the partner during sexual activity is high and the patient must be aware of safe sex and the risks associated with unprotected sex. Hence, counselling becomes paramount. 

Counselling session s information Self-care counselling: 
The patient must be well informed about the disease and should be supported in embracing attitudes, actions, and beliefs which will defend and serve as a protective shield to the body s immune system. Improving, enhancing, and transforming nutrition is required. A few other things that are emphasized are, encouraging physical activity, avoiding objects, actions, and events that threaten the body, overcoming anxiety and stress that compromise the psychological, mental, physical and welfare of the body, and seeking and giving support for self-care. 

Types of counselling: 

Patient centered counselling: It changed the focus of counselling from a single informative one to one that concentrated on a patient s circumstances and needs. This involved active listening, to render better support and managing client's particular prevention needs. 
Risk reduction counselling: This includes examining client s awareness about sexual activity and their feelings.Using their current HIV knowledge as an appealing tool, the limitations they have for protected sex is discussed. A better understanding is ensured in the patients so that unsafe behaviors can be avoided. 
Grief counselling: People who are contaminated with HIV have an elevated risk of acquiring depression. Counselling helps you to deal with any emotional outburst. 
Aims of counselling in HIV infection-

Prevention is the first purpose of HIV counselling. It decides whether the lifestyle puts that individual at a higher risk. Helping to recognize and distinguish the definitions of high-risk behavior. The counselling contributes to behavioral change and also aims at working with the person and his family to obtain and sustain that change in approach and behavior.

HIV Counselling - Why It Is Important To Get It?

An STD or sexually transmitted disease is usually an infection which spreads from one person to another during sexual contact. Some STDs can also be transferred through touch, since they spread by skin contact. People hardly like to talk or discuss about STDs, but it is very important to rule out the possibilities of STD. Whether one likes it or not, if STD testing is ignored, then it can lead to long term consequences.

Why STD Testing is Important

Often STDs have no signs and symptoms, and the only way to know that are you suffering from an STD is to get tested for it. So it is a good idea to get yourself tested, as you never know if you might have STD even though you don't show symptoms. Also, when STDs are diagnosed, most of them can be cured.

Consequences of Not Getting Tested

If one has STD and is not getting tested for the same, then it could lead to health problems which can cause permanent damages or might prove to be fatal. Some of the problems are:

1. Undiagnosed and untreated STDs can lead to damaged reproductive system, leading to sterile men and women. 
2. Chlamydia, if untreated can lead to epididymitis and shrinkage of testicles and infertility in men. It also leads to pelvic inflammatory disease. But good news is, it can be treated easily.
3. Syphillis can make a person blind and deaf, and can also be passed on to babies. 
4. Gonorrhea, which can also be treated easily with antibiotics, can lead to infertility or death if untreated. 
5. Even HIV/AIDS if diagnosed in early stages can enable the patient to lead a normal life and does not mean only death, contrary to conventional perceptions.  

Symptoms of STD

While, gonorrhea, chlamydia and human papilloma virus (HPV) have no symptoms, the common symptoms of STDs might vary. 

1. In women, the common symptoms are pain and burning sensation during urination, blood in vaginal discharge as also abnormal vaginal discharge, abdominal pain, blisters, warts, and swollen glands. 
2. Men often experience inflammation of the testicles, prostate, sores, fever, urethral discharge and pain during urination.

If these symptoms are observed, it is vital to get tested for STDs. Also the best way to protect your partner is not to practice unsafe sex and to refrain from the same until diagnosed and treatment is complete.
 
Getting yourself tested for STD is also beneficial, as it can prevent against complications like cancers and infertility. The standard STD panel of tests consists of Herpes IgG antibody and HIV antibody blood tests, along with a blood test for syphilis antibody and DNA urine test for gonorrhea and Chlamydia.

The Dangers of Putting Off STD Testing

Gonorrhea : Disease + Symptoms

Gonorrhea is a contagious disease that can affect both men and women. It is caused by a bacterium called Neisseria gonorrhoeae that can easily grow in the mucus membranes of the human body.

It is mostly transmitted when an uninfected person gets in sexual contact with an infected person. It can also be spread when a mother's infected body fluids come in contact with her newborn during childbirth.

It is a common infection and the symptoms vary for both men and women. The symptoms are:

Symptoms in Women:

- White or greenish-yellow vaginal discharge
- Burning sensation while urinating
- Pain in the lower abdomen and in the pelvic region
- Occurrence of Conjunctivitis
- Spotting or light bleeding after sexual intercourse
- Bleeding between periods
- Vulvitis

Symptoms in Men:

- White or greenish-yellow discharge from the penis
- Swelling and pain in the testicles
- Burning sensation while urinating

The symptoms come to notice usually within 2 to 10 days of the infection in case of women and it takes approximately 14 days for them to be recognized in the case of men. However in a few cases, the symptoms may take as long as 30 days to appear or they may appear so negligibly that they are hardly noticeable if they occur at all.



Gonorrhea is Contagious. But is it Only Sexually Transmitted?

HIV or the human immunodeficiency virus is a retroviral agent that causes the immune system of the body to weaken and lead to cause the acquired immune deficiency syndrome (AIDS). It is now treatable. Research is being conducted all over the world to formulate a targeted drug therapy for combating this life-threatening disease. No vaccine is available, which renders the world population highly susceptible to contract the infection.

HIV infection spreads from an infected person through contact with certain bodily fluids like blood and semen. Spread from one human being to another is called as transmission of HIV. Mother to child transmission, i.e. perinatal transmission is also common. Healthcare and hospital staff are at a great risk of occupational transmission. Other causes of transmission include sharing intravenous drug equipment, needle prick injury, organ transplantation and artificial insemination. Since vaccination and targeted drug therapy for remission are not available, prevention strategies play an important role in curbing the spread of infection.

A three-level prevention strategy is implemented for HIV infection.

Primary prevention- Activities that focus on prevention of uninfected people being infected.
Secondary prevention- Aimed at the provision of proper health care and behavioral facilities for HIV infected people like lifestyle changes, welfare rights advice, anti-discrimination measures.
Tertiary prevention- Aimed at minimizing the symptoms of an infected person; includes the provision of prophylactic drugs and complementary therapies.
The risk avoidance approach for transmission of HIV infection includes certain measures like practicing mutual monogamy & delayed sexual activity in the young population. Safe and appropriate use of syringes and needles is advised. Unnecessary blood transfusions should be completely avoided. Routine screening of HIV antibody should be done.

Risk reduction approach propagates the mandatory use of condoms during sexual intercourse. Sexually transmitted diseases should be treated to avoid the risk of transmitting infection. Sterile syringes should be used. If blood transfusion is necessary, then blood transfused should be evaluated well to meet the quality standards.

If HIV infection is suspected, anti-retroviral drug therapy should be started.
The only universally approved method of HIV transmission during sexual activity is the use of condoms.
Pharmaceutical methods for prevention and treatment include antibiotic drug therapy for sexually transmitted diseases, anti-retroviral drugs for infected individuals, pre and post-exposure prophylaxis and use of low space dead syringes.
Pre-exposure prophylaxis is advised for people who are at a higher than average risk of contracting the infection.
Drug therapy consisting of a combination of Tenofovir and Emtricitabine is prescribed, one per day.
Visit the physician at regular intervals and routine screening is done. Post-exposure prophylaxis is considered to be effective if the treatment is started within an hour of exposure, to effectively reduce the risk of seroconversion. A drug combination of Emtricitabine, Tenofovir and Raltegravir is given.
Social initiatives are undertaken to spread awareness and educate people regarding AIDS. Behavioral change and acceptance of social message is necessary to benefit from the social initiatives. Sex education, LGBT sex education and awareness, safe injection use programs, needle exchange programs, safe sex practice education are some social strategies implemented.
Prevention of transmission of HIV from mothers to children involves anti-retroviral drug therapy during pregnancy and post birth in the newborn child. Breastfeeding is avoided and bottle feeding is advised.

HIV Transmission - How Can It Be Prevented?

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

HIV: QUICK FACTSIntroductionThe human immunodeficiency virus (HIV) is a subgroup of retrovirus (lentivirus) that causes HIV infection. After a period of time, this infection leads to what is called acquired immunodeficiency syndrome (AIDS).

Epidemiology

According to the Centers for Disease Control and Prevention (CDC), from 2010-2015, the estimated rate of HIV infection in all 50 US states decreased from 14.2 per 100,000 population in 2010 to 12.3 per 100,000 population in 2015. In 2015, 39,513 individuals were diagnosed with HIV infection. From 2010 to 2014, the annual number of new HIV infections decreased by 9%.

Virology HIV-1 and HIV-2 are retroviruses in the Retroviridae family, Lentivirus genus. They are enveloped, diploid, single-stranded RNA viruses with a DNA intermediate.Upon entry into the target cell, the viral RNA genome is converted into double-stranded DNA by an enzyme, reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase. HIV contains three retroviral genes, namely gag, pol, and env.

Gag gene: Encodes group-specific antigen; the inner structural proteins
Pol gene: Encodes polymerase; it also contains integrase and protease
Env gene: Encodes the viral envelope, the outer structural proteins responsible for cell-type specificity. Glycoprotein 120, the viral envelope protein, binds to the host CD4+molecule
Pathophysiology

HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells and leads to cellular immune deficiency. This results in the development of opportunistic infections and neoplastic processes.

Mode of Transmission
Sexual intercourse: Unprotected sexual intercourse; especially receptive anal intercourse and different sexual partnersContact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids infected with the virus.Spread from an infected mother to her infant through breast milk. An HIV-positive mother can transmit HIV to her baby both during pregnancy and childbirth due to exposure to her blood or vaginal fluid.

Signs and Symptoms There are 3 categories of infection 

Category A: Asymptomatic HIV infection without a history of symptoms or AIDS-defining conditions
Category B: HIV infection with symptoms that are directly attributable to HIV infection
Category C: HIV infection with AIDS-defining opportunistic infections
Investigation

A high-sensitivity enzyme-linked immunosorbent assay (ELISA) should be used for screening.

Management

Start with antiretroviral therapy (ART) in all HIV-infected adults ready to start therapy. 
CD4 count is no longer a criterion for starting the therapy.
Use of nucleoside reverse transcriptase inhibitors and protease inhibitors.
For refractory cases, during the failing treatment regimen and before switching therapy, use rapid confirmation, perform resistance testing and reevaluate.

HIV - Quick Facts Need To Know!

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