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!

Sadly, there is no known cure for hiv. However, it can be controlled through medication. Hiv or the human immunodeficiency virus attacks the body's immune system and over time leaves it vulnerable to a number of other diseases. In its most advanced stages, it can lead to aids. Hence, it is essential to control this virus in its early stages.

Hiv treatment is known as antiretroviral therapy or art. This involves taking a series of hiv medicines on a daily basis. Art can help hiv patients live a longer, healthier life and can also reduce the risk of hiv transmission.

The first step towards getting treated for hiv is to get tested. This can be easily done at your nearest health center and the results will be kept confidential. With hiv prevention is better than cure and hence, if you have more than one sexual partner, you must insist on them getting tested as well.

As soon as you test positive for the virus, start the treatment. Do not wait till you start feeling sick. Art can be taken by anyone at any stage of the condition. If you are pregnant, breast feeding or have been diagnosed with early hiv infection, this is all the more important.

Hiv medication works by preventing the hiv cells from multiplying and thus reduces the amount of hiv cells in the body. A low level of hiv cells gives the immune system a chance to recover and strengthen itself. A lowered hiv count also reduces chances of transferring the virus to another person.

Art involves following a regimen of a number of medicines. There are 25 hiv medicines that can be grouped under six drug classes depending on how they affect hiv cells. These include:

1. Nucleoside reverse transcriptase inhibitors
2. Non-nucleoside reverse transcriptase inhibitors
3. Protease inhibitors
4. Fusion and entry inhibitors
5. Pharmacokinetic enhancers and
6. Integrase strand transfer inhibitors

Usually, a person is prescribed 3-4 hiv medicines from a minimum of 2 drug classes. A number of factors go into deciding what form of hiv treatment is most suitable to a patient. This includes the person's individual needs, symptoms presented, potential drug interactions and possible side effects. Convenience of following the regimen and costs are also taken into account while prescribing a form of treatment to a hiv patient.

Once treatment is started, art can be proven to be effective within 3-6 months by lowering the number of hiv cells in the body.

HIV/AIDS - How Can It Be Treated?

Sexually Transmitted Diseases (STDs) are the infections that spread primarily from unprotected sexual intercourse or any kind of sexual contact. Men, like women, are equally prone to contracting STDs on having unprotected sexual intercourse; anal, vaginal or oral. Having multiple sex partners just increases the risks of it. So, you need to consult a specialist sexologist if anything these sort of things happening to you:

Common STD Symptoms in Men

Blisters on or around penis 

Spots, bumps or lesions on the penis 

Discharge (clear, white, or yellow) 

Oozing from the tip of the penis (thick or thin) 

Painful urination 

Painful ejaculation 

Itching on the tip of the penis 

Rash on the penis, testicles, or groin

Here is a list of STDs for men

Chlamydia- Chlamydia is a type of bacterial STD transmitted during oral, anal or vaginal sex with an already infected person. Some of the symptoms of Chlamydia in men are swollen testicles, penile discharge or pain while urinating.

Gonorrhea- This is another bacterial infection, majorly affecting the urethra, anus or the throat and primarily spreads through vaginal, oral or anal sex with someone already suffering from it. The symptoms are quite similar to those of Chlamydia.

Hepatitis B- Hepatitis B Virus (HBV) is the cause of the disease Hepatitis B and can cause severe inflammation of the liver. It spreads from one person to the other on coming into contact with the bodily fluids or blood of the person affected. Few signs of Hepatitis B include jaundice, vomiting, nausea, body aches, mild fever, lethargy and appetite loss.

Herpes (Simplex) - It is a viral infection caused by the herpes simplex virus (HSV) and generally tends to develop on or near to the mouth and the genitals. Primarily, herpes spreads through direct contact with the genitals or mouth of a person already diagnosed with the same.

Syphilis- Another bacterial Sexually Transmitted Disease, unprotected oral, vaginal and anal sex are the primary carriers of this disease. It is considered to be one of the most serious STDs because the risks of contracting HIV (Human Immunodeficiency Virus) get magnified once infected with Syphilis.

Human Papillomavirus (HPV) - In men, HPV is capable of causing cancers in the throat, anus or the penis. It is either passed on through skin-to-skin or unprotected sexual contact with an infected partner.

Preventing STDs

Many people can be infected with an STD without experiencing any visible symptoms. This means that practicing safe sex is crucial if you want to prevent STD infection.

The only way to completely prevent an STD is abstinence from any type of sexual contact or contact with open sores and bodily fluids of an infected person. But there are other ways to prevent STDs too.

Condoms during intercourse and dental dams or barriers during oral sex are proven effective when used correctly. Refraining from sex with multiple partners and instead opting for a monogamous sexual relationship can also help to prevent STDs. To understand it better and get treated you can always consult a sexologist.

Common STDs in Men

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

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

In most diseases, early detection of the disease is the key to control the symptoms, cure, reduce progression and improve prognosis. This holds true for sexually transmitted diseases too. As soon as there is a mild degree of suspicious of having contracted a sexually transmitted disease, it is advisable to go for a test. Most of the STDs can develop into serious complications over a period of time, ranging from infertility to even death.

Complications: Why early diagnosis is important: When left undiagnosed and untreated, most STDs progress to cause severe damage from sterility to cancer to even death. Listed below are some complications associated with each of the common STDs.

Chlamydia: If left untreated, can lead to epididymitis and testicles shrinking and infertility in males. This is a condition where there is pus formation in the scrotum. In women, it can lead to pelvic inflammatory disease which is deep-seated and unable to cure completely. This brings with it symptoms ranging from abdominal pain to uterine infections to sterility.
Syphillis: Undiagnosed syphilis can lead to blindness and deafness. It can also be passed onto the newborn and lead to severe disabilities.
Gonorrhea: If diagnosed early, it can be cured completely with antibiotics. However, if left untreated, it can lead to infertility.
HIV/AIDS: Early diagnosis can help in curtailing the disease. If detected late, then the damage is quite extensive and treatment is both expensive and cannot help restore a lot of functions. 
Symptoms of Sexually transmitted diseases: If there is a doubt of having contracted an STD, then it is very important to get tested for the same. Some of the most common symptoms are listed below.

Women: The most common symptoms in women including painful urination, burning sensation, abnormal vaginal discharge (sometimes bleeding), warts, and abdominal pain.
Men: Testicular pain, urethral pain, painful urination, pain and inflammation in the prostate, sores, fever, and abdominal pain.
Prevention: Always practice safe sexual practices. When in doubt, refrain from sex until diagnosis and treatment is complete.

Testing for STDs: Some of the standard tests include:

1. Herpes- HSV I & II - 
2. Testing HIV-- Kits and ELISA available for testing 
3. Blood test for syphilis antibodies 
4. Chlamydia and Gonorrhoea - from urine as well as swabs for culture
It is understandable that getting tested for STDs is an embarrassing situation. However, there are options available where anonymity can be maintained when getting tested for STDs. This is a wise choice to make as the risk is not just for the person affected but for the partner and in some cases even for the fetus. Early testing can help prevent complications like infertility and cancer.

STD Testing - Why You Should Never Delay?

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