
- 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

The year 2014 has seen a massive increase in the number of patients affected by Gonorrhoea. The most infected age group is between 15 and 24. This is mainly due to lack of knowledge in this age group about the disease. Here are some facts about Gonorrhoea that one must know.

Gonorrhoea Transmission
Gonorrhoea, also known as drip, is transmitted when a normal person comes in contact sexually with an infected person. Infected fluid of a mother can also pass to her newborn infant during delivery. The disease can affect both the genders.

Cause of Gonorrhoea
Neisseria gonorrhoeae bacteria cause the disease. The bacteria grow in mucus membranes and usually grow in the warm and moist areas of humans' reproductive tracts such as uterus and fallopian tube of women. These can also grow in anus, mouth as well as throat. As a matter of fact, the infection can be passed even via oral or anal sex.

Symptoms of Gonorrhoea
An infected person will develop symptoms of the disease in 2 to 14 days. Men may feel burning or painful sensation while urinating. Other symptoms are as follows:

1. Swollen and painful testicles
2. Swollen or redness at the tip of the penis
3. Penis may have a drip or discharge
4. Frequent urination
5. Recurrent soreness of throat

Females have milder symptoms of the infection. This makes it difficult to diagnose, and is sometimes misinterpreted as common vaginal yeast or other bacterial infection.

Following are a few symptoms of the disease in women:

1. Burning or painful urination
2. Frequent urination
3. Vaginal discharge
4. Soreness in throat
5. Fever
6. Lower abdominal pain
7. Pain while sexual intercourse

If the disease is not treated, infection spreads in blood stream leading to rashes, fever and even pain in the joints. Such unnoticeable symptoms make it difficult to treat.

Testing Methods of Gonorrhoea
One method is that penile or vaginal discharge samples are taken from patients and examined under a microscope by adding reactive stain. However, this is not an accurate assessment.
Another test is conducted where exposing samples are incubated. In case of infection, colony of gonorrhoea shows growth. Preliminary test may take 24 hours. Final assessment may take around three days. Samples can be from the patient's anus, joint fluid, blood, throat, vagina or tip of the penis.

Treatment
The disease is treatable under proper medical supervision. However, the bacterial resistance to Azithromycin drug has made it more difficult for treatment.

Protection
It is highly recommended to have a protected intercourse. Women of age group less than 25 need to have STI evaluation once a year.

Know All About Gonorrhoea

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

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

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?

There is a contrast between intimacy satisfaction and intimacy happiness. Happiness tends to be a byproduct of the relationship. Therefore, while it just takes one partner to be sexually satisfied, it takes two to make the conditions for sexual happiness. A key indication of sexual bliss in a relationship is a couple's capacity to endlessly rejuvenate the sexual energy between them. Consequently, the term sexual happiness depicts couples who can revive, reestablish and extend their sexual desire with each other for a very long time or even forever. Here are a few ways through which one can integrate happiness and sexuality:

Since sexual happiness is a result of the relationship, both the partners need to be happy with each other in general to achieve happiness rather than satisfaction.
Staying in shape can be very beneficial. Being sound and fit promotes better sex. Not just are fit individuals perform better sexually, but also it is proven that healthier and fit individuals have a more noteworthy longing for sex. There are numerous reasons behind this. Healthy, fit individuals are not only more joyful, but also physiologically, they are capable of producing more sex hormones due to a number of other health factors.
Enthusiasm is not found in sex; it is found in individuals. To completely grasp sexual enthusiasm, you should be completely present in the moment. As such, you should bring your psyche, body, and soul to your partner. This implies being conscious, aware, and present mentally as well as emotionally.
Decreasing or managing sex levels can also help one integrate happiness and sexuality. Life is clearly unpleasant many times, and our reaction to all the anxiety can be devastating when it comes to sexual experiences. Not only does a lot of stress or anxiety decrease the yearning for sex, it also additionally hinders sexual performance. Hence, one should vent out to their partners or try therapy or yoga for stress release.
Routine tend to repel romance and consistency cools the flames of sexual excitement and energy. To neutralize these twin constrains, you should deliberately plan and design different rituals of sexual pleasure. Indulge in customs of joy and particular actions, thoughts, activities, and exercises like back rub, animate, and stimulation of the sexual and emotional pleasures.
Being happy in general is very important. Being cheerful and idealistic is the establishment of numerous parts of a successful life. Inquiring about actions that make your partner happy are more advantageous, beneficial, and have better connections, including better and more continuous sex.
Sex is very important in a relationship for knowing and feeling that your partner still fancies you, yet having sex once a week is a practical and an achievable objective for people who tend to be very busy. A study demonstrates that regular sex additionally makes individuals more joyful than a high income.

Sexual Happiness and Satisfaction - How You Can Integrate Them?

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