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!

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!

Chlamydia is a Sexually Transmitted Disease. It is generally found in men and women under the age of 25. Researchers have found that in the United States about 2.9 million individuals develop this disease every year. 

Here are things that you must know about the disease:

What is it all about?
It is caused due to bacterial infection and is transferred sexually. You can be infected with disease by having vaginal, oral or anal sex with the patient. You must be aware of the fact that you can develop chlamydia even if your partner doesn t ejaculate inside your vaginal tract. If you had suffered from this disease in the past, you can still get it again by having unprotected sex with an infected person.

What are the symptoms of this disease?
There aren t any obvious symptoms for this disease. Most of the patients show no sign of developing this disease. Thus, you never get to know when you were infected actually. However, some patients do reflect some symptoms after 4 to 5 days of infection. These symptoms include abnormal penis or vaginal discharge and painful, burning urination. Men can also develop a bleeding rectum.

How do you know for sure that you are infected?
Well, you can get yourself tested to confirm about the infection.

What happens if you don t get treated?
If the patient doesn t seek medical help, he or she is posing threat to his or her health. Women may develop pelvic inflammatory diseases, infertility or ectopic pregnancy. In men, it can cause pain and fever as the infection spreads along the tube carrying sperm.

Is there any treatment?
This disease is curable. But it is important to avoid sexual contact with anyone during the period of treatment or medication. First, you need to undertake the test to confirm the infection. You shouldn t have sex for seven days after the treatment is over. It is advisable to get yourself tested thrice in a year.

Chlamydia - Things You Must Know About It!

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?

Any kind of dysfunction points to the issues experienced during any stage of the cycle of physical issue that prevents the participants from experiencing any kind of satisfaction from the intimate activities. Though the researches imply that sexual problems are common all across the globe; 43% of women along with 31% of men are affected by some sort of dysfunction; however, it is something that most people are hesitant to talk about. But thankfully enough, most cases of sexual problems can be effectively treated, and can be prevented from occurring again, by sharing your concerns with a qualified doctor. You should consider visiting the doctor along with your partner.

What leads to sexual problems?
Sexual problems can be caused either due to physical or psychological reasons. Many medications and clinical conditions can cause a variety of sexual dysfunctions, and these physical conditions include heart and vascular disease, high levels of blood sugar and blood pressure, any kind of neurological disorder, chronic diseases of the kidneys, liver and lungs, and hormonal imbalances. In addition to this, the side effects stemming from any medicine, including antidepressant drugs, can cast a harmful impact on the sexual desire and its normal functioning. On the other hand, psychological causes refer to the stress caused due to work pressures, anxiety, depression, excessive concern about sexual performance, feelings of guilt, and relationship problems.

What are the common sexual problems?
What leads to sexual problems can cause a wide variety of issues in both men and women. While erectile dysfunction is most commonly found in men, vaginal dryness is the most common issue in women. Sexual dysfunction can take a variety of forms, and it is not plainly confined to the dysfunction or simple disinterest in sex, which is commonly termed as lack of sex drive. It can also involve pain while having sex or an inability to maintain the erection or experiencing pain while getting an orgasm. There are some people who experience excruciating pain during intercourse, which is often accompanied with a burning sensation.

All couples have the right to enjoy a happy and healthy sex life, which can be considered a crucial aspect of any relationship. So, if you are having any kind of difficulty that is interrupting your lovemaking, it is imperative to speak with your doctor to get the right diagnosis, and discuss openly with your partner to find out the ideal solution of your sexual problems.

Sexual Problems - Things That Can Lead to It

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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