Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?

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

With changing times the nature and effects of virus and bacteria are also changing and due to this, one of the biggest risks of unprotected sex is catching a sexually transmitted disease or STD. An STD can be contacted by any form of intercourse including oral, vaginal and anal sex. STDs are serious diseases that should not be ignored and require treatment and medication. Some common STDs are:
1. Chlamydia
2. Hepatitis B
3. Genital Herpes
4. Syphilis and
5. Gonorrhea 

The only way to protect yourself from an STD is to abstain from unprotected sex and always use a condom. Sometimes STD infections have no symptoms and can remain dormant for years, hence it is essential to get yourself regularly treated for STDs if you have more than one sexual partner. On the other hand some STDs have visible symptoms such as:

Skin rash
A rash in the genital area is most often a sign of STDs. This can be in the form of bumps, sores or warts. It may or may not be accompanied by itchiness. A rash caused by a STD usually results in redness and inflammation. Herpes sores may subside within a week or so but just because the rash is gone does not mean the infection has been treated. Hence even if the rash disappears before your doctor's visit, ensure you mention it. 

Painful urination
A burning sensation or pain while urinating is a symptom for a number of STDs. There may also be a change in the colour of urine. Some STDs associated with painful urination as Chlamydia, gonorrhea and trichomoniasis. However, this may also be triggered by kidney stones or a urinary tract infection. 

Painful intercourse
Pain during intercourse is one of the most overlooked symptoms of a sexually transmitted disease. While a little pain may be normal, any sudden increase in pain or new type of pain should not be ignored. This should be kept in mind especially when having intercourse with a new partner or if there is a change in sexual habits. When it comes to men's sexual health, pain at the time of ejaculation can be a symptom of a STD.

Abnormal discharge
Abnormal discharge from the vagina or penis can be a symptom of a number of infections not all of which are STDs. Strangely coloured and odorous vaginal discharge can be a symptom of yeast infections or a Sexually transmitted disease like trichomoniasis or gonorrhea. Bleeding in between periods can also be a symptom of a STD.  Abnormal discharge from the penis can be a sign of Chlamydia, gonorrhea or trichomoniasis.

Learn the Signs and Symptoms of STDs

According to the tenets of Ayurveda, HIV is primarily a disease involving low immunity which is considered the most vital sap of the body. Immunity is in charge of providing both mental and physical strengths required to cope up with the foreign bodies that cause unwanted changes in the human body. When the immune system gets disrupted, the individual becomes susceptible to a host of infections and disorders. There are incessant numbers of bacteria and viruses in the environment, and some of them are highly contagious which can easily cause an infection.

Ayurveda has numerous highly effective therapies to combat HIV exposure. There is a sector of Ayurveda specifically dedicated to boosting immunity and vitality in the body with the help of herbs, minerals, and practice of Ayurvedic techniques. The treatment first aims to detoxify the body and strengthen the immune system which improves the immune system with the help of certain "rasayanic" techniques.

How is HIV exposure treated through Ayurveda?
The first step of HIV exposure treatment through Ayurveda is having nourishing food and leading a positive life supported by well-meaning friends and relatives. The patient can also take part in some physical exercises which don't cause any strain to the fragile health condition. Engaging in comfortable yet fruitful activities can help in strengthening good tendencies and stimulating appetite as well.

Then the patient will have to take some Ayurvedic tonics along with rejuvenators that can boost immunity levels and eliminate the toxins from the body. This is particularly done through emesis, purgation, and enemas. The medications which are given at this stage are neither drastic nor very harsh for the body so that they can be digested without any difficulty.

In the third stage of treatment, appropriate medications will help in purifying the blood, and this is where the role of liver corrective measures come to the fore. The patient has to take preparations with medicated ghee and soups that can alleviate the signs and symptoms of HIV exposure. There is no scope of consuming spicy and oily junk foods as they can take a toll on the patient s liver. Medicated alcohol may have to be used to aid in the digestive procedure and removal of blockages in the flow of energy.

Participating in physical activities on a daily basis is important. In case the patient is too weak to exercise or even run, then steaming can be helpful. This is very crucial since it is believed in Ayurveda that heated blood can weaken and sometimes destroy the virus involved in HIV.

There are some herbal cum mineral compounds which are helpful for subsiding the conditions of HIV exposure. It is important to consult with an expert who can evaluate your condition and help in healing the signs and symptoms that you are suffering from.

HIV Exposure - How Ayurveda Can Help You Manage It?


- 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 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?

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