Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

How Can We Achieve HIV-Free Generation?

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

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

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?

Chlamydia is one of the most common STD. It is a bacterial infection, caused by Chlamydia trachomatis. Occurring in both males and females, it can be transmitted via oral, genital, or anal sex. it has been dubbed as silent infection, as the affected person hardly ever presents with symptoms. It is extremely common though about 1 in 20 females in the age group of 15 to 25 can be affected. The disease, if left untreated, can cause severe reproductive issues including infertility in both males and females. Let us look at symptoms in men and women separately.

Men: About 50% of men infected with Chlamydia will go with no symptoms. It may take about 3 weeks for the symptoms to manifest and will include

    Small amounts of discharge from the penis
    Discomfort or pain with urination
    Painful, swollen, and inflamed testicles
    Burning and itching around the tip of the penis

Depending on the mode of transmission, the eyes, throat, and rectum can also be infected and there could be throat infection or conjunctivitis also.

If left untreated, Chlamydia can affect the sperm quality and lead to infertility in men in the long run.

Women: The infection is "silent" even in females and does not manifest itself with a lot of symptoms, only 30% of infected females present symptoms including:

    Abnormal, white or light yellow vaginal discharge
    Painful sex
    Bleeding or spotting in between regular periods
    Sometimes even bleeding during sex
    Burning or itching sensation around the vagina
    Severe abdominal discomfort
    Fever

In females, the infection usually travels up the urinary and reproductive tract. So, from vaginitis, it can lead to urinary tract infection, cervicitis, bartholinitis, and even pelvic inflammatory disease. If it reaches the fallopian tubes and/or the uterus, then the chances of fallopian tubes getting blocked is high. There can be scarring of the tubes and this can lead to infertility or ectopic pregnancy (pregnancy in areas other than the uterus, for example the fallopian tubes). This can be very dangerous and can be life-threatening situation too.

Pelvic inflammatory disease (PID) is a serious bacterial infection of the uterus and the fallopian tubes. Untreated Chlamydia infection often results in PID and requires antibiotics and bed rest.
Chlamydia infections have two negative sides to it, on one hand, it is difficult to detect given the absence of symptoms. On the other hand, there are serious implications leading to even fertility. It is therefore very important to prevent it. It is best to use a condom, especially with unknown partners; and in case of any doubt, one should get themselves tested and treated.

Symptoms of Chlamydia in Men and Women

Hearing that a person is HIV positive instantly makes us wary of him or her and unconsciously we may begin avoiding social interactions with them. However, HIV does not spread through the air or by water and hence there is no reason to ostracize HIV positive people. To understand how to prevent the transmission of HIV it is essential to first understand how the virus is transferred from one person to another. There are three ways in which this virus can be transmitted from an HIV positive person to another. These are:

Through blood
Through bodily fluids such as semen and vaginal or rectal fluids
From a mother to a child
Keeping this in mind, here are a few ways to prevent the transferring of HIV from one person to another:



Use only Disposable Syringes: Getting pricked by a needle that has been used on a HIV positive patient can increase your risk of suffering from the disease. Hence, insist on using a fresh needle for blood tests etc. Also ensure that the syringe and needle and destroyed after being used.
Registered Blood Banks: In case you need a blood transfusion, get blood only from registered blood banks. These blood banks need to run HIV screening tests before collecting blood and hence are guaranteed to have only HIV negative blood as opposed to local quacks.
Use a Condom: The only way to prevent the transference of HIV cells while having intercourse is by using a condom. This is essential not only for vaginal intercourse but for anal intercourse as well.
Get Tested: Today, an HIV screening test can be easily done and your results are guaranteed to be kept confidential. STDs can increase your risk of getting infected with HIV or spreading it to others. Get tested regularly for STDs and insist that your partners are checked for it as well. This is crucial if you have more than one sexual partner.
Limit the Number of Sexual Partners: The more number of people you have sex with, the higher your chance of getting infected with the virus and transmitting it to others. Remember, HIV has no overt symptoms that are visible to the naked eye.
HIV cannot be cured but it can be controlled through medication. Hence, if you suffer from this disease, follow the doctor's prescription religiously to prevent transmitting the virus to your partner. If you wish to discuss about any specific problem, you can consult a doctor.

HIV/AIDS - How To Prevent It?

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