
- 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

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!

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)

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

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

Hiv or the human immunodeficiency virus is the lentivirus which causes hiv infection and leads to acquired immunodeficiency syndrome or aids.

The symptoms of hiv vary from person to person. There are three main stages of hiv infections, where each stage has different symptoms.

Here are some facts about the three stages of hiv infections along with the accompanying symptoms.

Acute hiv infection stage
This is the first stage of hiv infection and after three to four weeks of becoming hiv infected, people experience symptoms, which are similar to flu. This flu usually does not last more than two weeks.

Symptoms include:
Fever
Rashes on the body
A sore throat
Swelling of different glands
Headache
Joint and muscle pain
Improper digestion

These symptoms appear and indicate that the body is reacting to the hiv. Infected cells circulate throughout the blood, and the immune system produces hiv antibodies in order to attack the viruses. This process is termed as seroconversion, and it takes place within 45 days of getting infected. The levels of virus in your blood are quite high during this stage.

Clinical latency stage
This is the second stage of hiv infection, which follows the early stage. This stage is also known as chronic hiv stage. During this stage, hiv is active, but is reproduced at a very low level. People in this stage may not receive symptoms related to hiv or may get mild indications.

In case of people who do not take medicines for hiv treatment, this stage lasts for a long period. Some people, however, progress faster through this stage. Medicines should be taken to keep the virus in check. During this stage, people can transmit hiv to others very easily in spite of not experiencing any symptoms. People who are on medication stay suppressed virally and have a low level of hiv in their blood, and the risk of transmission is less.

Symptomic hiv infection or aids stage
This is the third stage of hiv infection, which is characterized by severe damage to the immune system of an hiv-virus affected person. A patient is likely to have serious infections and gets bacterial or fungal diseases. The infections are termed as opportunistic infections. The patient is now said to be having aids.

The symptoms of this stage are:
Loss of weight
Diarrhoea
Sweating at night
Fevers and persistent coughing
Problems in the mouth and skin
Infections on a regular basis
Illness and development of other diseases.

Hiv infection affects the body via three stages and leads to aids in the third stage. Each stage is accompanied by several symptoms.

Stages and Symptoms of HIV Infections

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