
- 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

Don't Panic !

Having unprotected sex isn't the smartest move a person can make, but it isn't necessarily the end of the world, so follow the advice below and you should be fine.

We Had Unprotected Sex And...I Think I'm Pregnant

Finding out you're pregnant can be the happiest or the scariest day of your life.

Don't wait around and bury your head in the sand saying 'it won't happen to me' and 'I'll be fine' you might not be, and then you'll find yourself in a much more difficult situation than if you'd faced the situation head on and quickly.

If the intercourse happened less than 72 hours ago, emergency contraception, the morning-after pill, can be taken as a precaution against you becoming pregnant. However, note that the sooner you take the emergency contraceptive pill, the higher its efficiency is.

We Had Unprotected Sex And...I Think I Have an STI

Check for any unusual symptoms around your genitals (vagina or penis), such as:

Pain when you urinate
Itching
An unusual or smelly discharge
Sores
Unexplained bleeding
If any consult your healthcare provider immediately

Not all STIs have visible symptoms so even if you think you're fine, after having unprotected sex, get tested!

Go For Sexually Transmitted Disease Profile Including HIV ( 1ST Month HIV RNA, 3RD MONTH HIV ELISA), HSV 1 and 2, HbsAg, HCV, Urine Routine, VDRL, etc.

We Had Unprotected Sex And...I Think I May Get HIV

Take Post Exposure Prophylactic Drugs (Anti - HIV) as soon as possible. It works when started within 72 hours and must be continued for 1 month to prevent HIV.



What If You Have Unprotected Sex?

With changing times the nature and effects of virus and bacteria are also changing and due to this, one of the biggest risks of unprotected sex is catching a sexually transmitted disease or STD. An STD can be contacted by any form of intercourse including oral, vaginal and anal sex. STDs are serious diseases that should not be ignored and require treatment and medication. Some common STDs are:
1. Chlamydia
2. Hepatitis B
3. Genital Herpes
4. Syphilis and
5. Gonorrhea 

The only way to protect yourself from an STD is to abstain from unprotected sex and always use a condom. Sometimes STD infections have no symptoms and can remain dormant for years, hence it is essential to get yourself regularly treated for STDs if you have more than one sexual partner. On the other hand some STDs have visible symptoms such as:

Skin rash
A rash in the genital area is most often a sign of STDs. This can be in the form of bumps, sores or warts. It may or may not be accompanied by itchiness. A rash caused by a STD usually results in redness and inflammation. Herpes sores may subside within a week or so but just because the rash is gone does not mean the infection has been treated. Hence even if the rash disappears before your doctor's visit, ensure you mention it. 

Painful urination
A burning sensation or pain while urinating is a symptom for a number of STDs. There may also be a change in the colour of urine. Some STDs associated with painful urination as Chlamydia, gonorrhea and trichomoniasis. However, this may also be triggered by kidney stones or a urinary tract infection. 

Painful intercourse
Pain during intercourse is one of the most overlooked symptoms of a sexually transmitted disease. While a little pain may be normal, any sudden increase in pain or new type of pain should not be ignored. This should be kept in mind especially when having intercourse with a new partner or if there is a change in sexual habits. When it comes to men's sexual health, pain at the time of ejaculation can be a symptom of a STD.

Abnormal discharge
Abnormal discharge from the vagina or penis can be a symptom of a number of infections not all of which are STDs. Strangely coloured and odorous vaginal discharge can be a symptom of yeast infections or a Sexually transmitted disease like trichomoniasis or gonorrhea. Bleeding in between periods can also be a symptom of a STD.  Abnormal discharge from the penis can be a sign of Chlamydia, gonorrhea or trichomoniasis.

Learn the Signs and Symptoms of STDs

HIV infection and AIDS (commonly referred to as HIV/AIDS) are caused by the Human Immunodeficiency Virus (HIV). HIV is transmitted sexually and through exchange of body fluids, such as blood. The HIV attacks our defense system (immune system) giving opportunity to many illnesses to attack the body. These infections (called opportunistic infections) range from common cold and diarrhea to life-threatening illnesses including uncommon pneumonias and cancers. The type, range and intensity of opportunistic infections vary with the severity of the HIV infection and the extent to which our immunity is compromised. 

AIDS is the last stage disorder of the HIV infection. Though there is no complete cure for the HIV-infection till date - despite thousands of scientists across the world working on it, spending countless hours of research involving billions of dollars - there has been tremendous progress in medicare improving the quality of life of the HIV-infected, in extending their life-span to almost normal levels and in preventing mother-child transmission. 

The key factors in extending the life-span, and in keeping good immunity and good health are 

balanced and nutritious diet

regular physical exercise

correct, consistent and lifelong use of the prescribed medicines

periodic medical checkups

staying psychologically positive and strong

good family support and

good lifestyle habits.

The last one involves maintaining good personal hygiene, avoiding smoking (active as well as passive), alcohol, recreational drugs, unhygienic and disease-prone environments and sedentary life style. Those who follow these will guidelines certainly have better prognoses. 

Diet:

A nutritious diet is of utmost importance to the HIV-infected, as adequate nutrition contributes to the development of the immune system, prevents malnutrition and wasting, achieves and maintains optimal body weight and strength, enhances the body s ability to fight opportunistic infections, helps delay the progression of HIV, improves the effectiveness of drug treatments, and improves the quality of life. 

Ensure that the food contains adequate macronutrients, that is, carbohydrates, proteins and fat, otherwise the patient may end up with - protein-energy malnutrition, manifesting itself in the weight loss and wasting that is typical of AIDS patients.

As per WHO, an HIV-infected person has additional nutrient requirements: 10-15 percent additional energy intake and 50 to 100 percent increase in protein intake as compared to a non HIV-infected person.

Consuming micronutrients (especially Vitamins A, B6 and B12, iron and zinc) is important for building a strong immune system and fighting infections.

Try and maintain a daily diet containing rice/roti, vegetables, legumes, and fruits which provide you energy and micronutrients. Choose foods that are low in saturated fat, trans fat, and cholesterol.

Eat at least two servings of fish each week. Oily fish, which contain omega-3 fatty acids, are best. If you cannot eat fish, you can also get omega-3 fats from omega-3 eggs, walnuts, flax seeds.

Better avoid fast foods.

Living with HIV/AIDS: Diet, Nutrition, and Food Safety

Sexually Transmitted Diseases (STDs) are infections that you can get from having sex with someone who already has the infection. The causes of STDs are bacteria, parasites, and viruses. These infections often do not cause any symptoms, and can still be passed unknowingly from the infected partner to the other. However, some common symptoms include genital itching, lesions, flu / fever like symptoms and feeling pain / pressure in the lower part of the stomach.

There are many kinds of STDs including Chlamydia, gonorrhea, genital herpes, syphilis and HIV.

The important thing to understand and know is that these STDs can be prevented.

3 ways of preventing STDS are:

1. Precautions before having sex

There are some things you can do to reduce your risk of contracting STDs before having sex. This include:

  Limiting the number of sexual partners
  Talking honestly with partners about your sexual history
  Getting tested, along with your partner, before having sex
  Getting timely vaccination against HPV and HBV

If you have been diagnosed with an STD you should tell your partner about it and also explicitly ask your partner if they have had an STD.

2. Practice safe sex

Use a latex condom every time you have sex and use a water-based lubricant. If your sex life involves intercourse, anal or vaginal, make up your mind to never have sex without a condom. If you or your partner is at a high risk of STDs, be consistent about barrier use during oral sex as well. Avoid sharing towels or underclothing to reduce the risk of an STD. Check the expiration date of the condom and make sure that it has an air bubble, which shows it has not been punctured. Dispose the condom properly and never reuse it.

3. Don't drink Alcohol or use drugs before having sex

It's impossible to make responsible choices about your sex life under the influence of drugs or alcohol. When you are under the influence of any one of them, you are not in your mind and are likelier to choose a partner you wouldn't have picked otherwise. In that case, you may be at a higher risk of contracting an STD. Also, if you are on birth control pills and you vomit, the pills could lose some effectiveness.



3 Ways You Can Prevent STDs (Sexually Transmitted Diseases)

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

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