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Health Information:

Sexually Transmitted Diseases
Learn more about how to prevent and heal your body from these diseases:

   Venereal Diseases
   Bacterial Vaginosis
   Human Papilloma Virus
   Anal Warts

Shaving Prevention
Prevent pubic shaving sores that lead to open gateways for STDs.

   Razor Burn
   Ingrown Hair

Pap Smear
Pap smear test can detect early signs of HPV and help prevent cervical cancer.

   Pap Smear

Vaginal Yeast Infection
Yeast infections seem to be only rarely passed from one person to another through sexual contact.

A male partner of a woman with a yeast infection usually will have no symptoms, but some men may get an itchy rash on the penis.

   Vaginal Yeast Infection

 

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HIV
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What is HIV? What is AIDS?
The human immunodeficiency (im-myoo-no-duh-fish-in-see) virus (HIV) causes AIDS, the acquired immunodeficiency syndrome.

There are different types of HIV. Most people have HIV-1, but there are many strains (types); a person can become infected with more than one strain.

HIV attacks the body's immune system (natural defense system against disease) by destroying one type of blood cells (CD4 cells) that helps the body fight off and destroy germs.

CD4 cells belong to a group of blood cells called T-cells that also help the body fight disease. In the body, HIV gets into these cells, makes copies of itself, and kills the healthy cells.

Then the body can't fight germs anymore. When HIV takes over enough CD4 cells or causes serious infections (that don't normally make a healthy person sick), a person then has AIDS.

The progression from HIV to AIDS is different for everyone-some people live for 10 years or more with HIV without developing AIDS, and others get AIDS faster.

How HIV is spread
HIV is spread through some of the body's fluids. HIV is in:

  • blood

  • semen

  • vaginal fluids

  • breast milk

  • some body fluids sometimes handled by health care workers (fluids surrounding the brain and spinal cord, bone joints, and around an unborn baby)

HIV is passed from one person to another by:

  • having sex (vaginal, anal, or oral) with a person who has HIV

  • sharing needles with a drug user who has HIV

  • during pregnancy, birth, or breastfeeding if a mother has HIV

  • getting transfusions of blood with HIV, which is rare in the United States

HIV is NOT spread by:

  • sitting on toilet seats

  • hugging, handshakes, or closed-mouth kissing (there is a small chance of getting HIV from open-mouthed or "French" kissing if there's contact with blood)

  • sharing food or drinks

  • donating blood

  • working with or being around some with HIV

  • using phones

  • getting bug bites

  • tears

  • swimming in pools

HIV is affecting more women.
Each year, HIV infection rates are rising in women, especially in women of color. Women are contracting HIV mostly through sexual contact with men. The second most common way women are getting HIV is through injection drug use. Consider these statistics:

  • African American and Hispanic American/Latina women make up less than one-fourth of all U.S. women, yet account for more than three-fourths (78%) of AIDS cases.

  • HIV is the leading cause of death for African American women between the ages of 25 and 44.

  • The rate of HIV infection is seven times higher in Hispanic American/Latina women than in White women.

  • HIV is beginning to rise in American Indian and Alaska Native communities. New cases of AIDS are higher for American Indians and Alaska Natives than for Whites and Asian Americans/Pacific Islanders, but lower than African Americans and Hispanic Americans/Latinos.

HIV symptoms
Many people have no symptoms when they first get HIV-some have no symptoms for years. It varies from person to person. But some people get a flu-like illness within a month or two after first getting HIV. The flu-like symptoms- fever, headache, fatigue (being a lot more tired than usual, and all the time), swollen lymph nodes (glands in the neck and groin)-often go away within a week. Even if there are no symptoms, HIV can still be passed to another person.

Also keep in mind that HIV is never diagnosed by the symptoms. You may have the symptoms below but not have HIV. These symptoms may be caused by something else. To find out if you have HIV, you'll need to get a test. If you find out you have HIV, there is no cure but there are ways to help keep you healthy.

It's important to remember that HIV is active inside your body, even when you don't have symptoms. As the HIV infection spreads throughout your body, you'll start to feel sick. For many people, the first symptom they notice is large lymph nodes (swollen glands) that may be enlarged for more than 3 months. Other symptoms that follow may include:

  • being very tired (fatigue)

  • quick weight loss

  • fevers

  • night sweats

  • headache

  • nausea

  • vomiting

  • diarrhea

  • sore muscles

  • mouth ulcers

  • sore throat

  • rash

There are also other symptoms that are more common, serious, and harder to treat in women with HIV:

  • vaginal yeast infections

  • other vaginal infections such as bacterial vaginosis and STDs like gonorrhea, chlamydia, and trichomoniasis

  • pelvic inflammatory disease (PID) or infection of a woman's reproductive organs

  • menstrual cycle changes, like not having periods or having heavy and constant bleeding

  • human papillomavirus (HPV) infections that cause genital warts and can lead to cervical cancer

As the immune system continues to weaken, other diseases and infections can develop that affect your eyes, digestive system, kidneys, lungs, skin, and brain.

Diagnosing AIDS
The Centers for Disease Control and Prevention (CDC) define AIDS as being infected with HIV and

  • having less than 200 CD4 cells per cubic millimeter of blood (Healthy adults have CD4 and T cell counts of 1,000 or more.)

    OR

  • having at least one of the health problems common in people with AIDS, some of which are called opportunistic infections (OIs) (like wasting syndrome [from HIV], recurrent pneumonia, or invasive cervical cancer). These are problems that usually don't make a healthy person sick. People who have AIDS can have severe OIs, which can be fatal because their bodies can't fight them off.

Listed below are health problems common in people with AIDS:

  • coughing and shortness of breath

  • seizures

  • lack of coordination

  • hard or painful to swallow

  • hard to think and remember things

  • severe and persistent diarrhea

  • fever

  • loss of vision

  • nausea, stomach cramps, and vomiting

  • weight loss

  • feeling very tired all the time

  • severe headaches

  • diarrhea

  • coma

  • pneumonia

  • cancers of the skin or immune system

Getting Tested
Even though there's no cure for HIV, it's important to get tested for it. If you find out that you have HIV, there are drugs that can slow down the progress of the virus, help you feel better if you have health problems from HIV, and keep you from getting some HIV infections. If you are pregnant, you also will be able to help prevent passing HIV to your baby. You can tell your sexual partners if you have HIV and protect them from getting the virus.

When you have HIV, your body makes antibodies (disease-fighting proteins) to fight the virus. The tests for HIV do not look for the virus, but actually measure these antibodies. There are several types of HIV tests:

Blood. This is the most common test. Blood is drawn to find the antibodies your body makes to fight HIV. The results are usually available between a few days and two weeks.

Urine. The patient gives a urine (pee) sample to find the antibodies in your urine. The results are usually available between a few days and two weeks.

Oral (mouth). You put a pad between your cheek and gum for two to five minutes. It finds the antibodies in the blood vessels in your cheek and gum. It is sent to a lab for results and you'll receive the results in 5 to 7 days.

Rapid tests. These are tests that give you results quickly. There are 2 types: blood tests and oral (mouth) tests. For the blood test, blood is taken from your finger, and you can get your results in 20 to 60 minutes. For the oral test, a pad is used to swab your gums. Results are ready in 20 minutes. Tests approved by the Food and Drug Administration (FDA) are OraQuick Rapid HIV-1 Antibody Test, OraQuick(R) Rapid HIV Antibody Test for use with oral fluid, Reveal HIV-1 Antibody Test, and Single Use Diagnostic System for HIV-1.

Home Access test. You place drops of blood rom you finger onto a card. You then mail the card to the lab. You receive a number that you use to call for results. There is only one home test approved by the FDA: Home Access Express HIV-1 Test System. It takes three to seven days to get test results. You can buy the test online or at the drugstore.

There are many places to get tested: freestanding HIV testing centers, health departments, hospitals, private doctors' offices, and clinics. To find a testing site in your area, call the CDC National AIDS hotline at 800-CDC-INFO (232-4636). There are also tests that you can find on the Internet and take by yourself at home. However, the FDA has not approved any of these HIV test kits you use at home. Many of these tests give the wrong results.

Confidential verses anonymous testing
If you're concerned about giving your name, you can get tested without giving your name. This is called "anonymous" testing. When you get an anonymous HIV test at a testing site, they record a number or code with the test result, not your name. A counselor gives you this number at the time you take the test. Then you return to the testing site or call and give them your number or code to learn the result of your test.

If you get the test from your doctor, you can ask that the information be confidential. This means the results may be shared only with people allowed to see your medical records. With confidential testing, state health departments may also have access to your test results.

HIV Treatments
If you need help finding an doctor, call the CDC National AIDS hotline at 800-CDC-INFO (232-4636). This hotline will either point you to a specific provider or to resources in your area where you can get health care, like a clinic. Your doctor will talk to you about your health, and you'll get a physical exam. If you found out about your positive result over the phone from a counselor at a mail-in testing company, follow-up with an doctor to talk about your result.

You will have tests to figure out if and when you should start treatment. Some tests may include:

  • blood count

  • blood chemistry profile

  • hepatitis B

  • hepatitis C

  • viral load test (amount of HIV in your blood)

  • CD4 cell count (number of cells in your blood that fight infection)

  • syphilis

  • TB skin test

  • toxoplasma antibody test

  • gynecologic exam (with Pap test and pregnancy test)

Treatment will slow down the disease
There is no cure for HIV/AIDS, but there are medicines that slow down the disease. The U.S. Food and Drug Administration (FDA) has approved a number of drugs for treating HIV. Because each HIV drug can't work by itself, patients must take a combination of drugs. When drugs (usually more than three every day) are taken together, it's called highly active antiretroviral therapy or HAART. Sometimes, it is also called a "cocktail" or "cocktail therapy." HAART treatment helps people with HIV live longer and have fewer opportunistic infections (OIs). Treatment lowers the amount of HIV virus in the blood.

Because you may be taking a lot of medicines, tell your doctor if you're using any recreational drugs, alcohol, herbal remedies, over-the-counter medicines, or methadone. These other drugs could interact with your HIV medicines and hurt you. In particular, women should tell their doctors if they're taking birth control pills. Some HIV drugs can make the birth control pill less effective.

There are different classes of drugs used to treat HIV. In order to treat HIV, you may need to take more than one of these drugs every day:

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs) prevent HIV from making copies of itself:

  • Epzicom (Abacavir/Lamivudine)

  • Emtriva, FTC, Coviracil (Emtricitabine)

  • Truvada (Emtricitabine, Tenofovir DF)

  • Retrovir� (zidovudine [zye-DOE-vue-deen]) [AZT, ZDV]

  • Hivid� (zalcitabine [zal-SITE-a-been]) [ddC]

  • Ziagen� (abacavir [a-BAK-a-veer] sulfate) [ABC]

  • Videx� (didanosine [di-DAN-oe-seen]) [ddl], Videx EC

  • Zerit� (stavudine [STAV-yoo-deen]) [d4T]

  • Epivir� (lamivudine [la-MI-vyoo-deen]) [3TC]

  • Combivir� (lamivudine/zidovudine)

  • Trizivir� (abacavir sulfate/lamivudine/zidovudine)

  • Viread� (tenofovir [te-NOE-fo-veer] DF)

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) prevent HIV from making copies of itself:

  • Rescriptor� (delavirdine [de-la-VIR-deen] mesylate)

  • Viramune� (nevirapine [ne-VYE-ra-peen]) [NVP]

  • Sustiva� (efavirenz [ef-FAH-ver-enz]) [EFV]

Protease Inhibitors (PIs) block a protein that HIV makes to stop HIV from making copies of itself and infecting healthy cells:

  • Reyataz, ATV (Atazanavir)

  • Lexiva, FPV (Fosamprenavir)

  • Norvir� (ritonavir [rit-ON-uh-veer])

  • Crixivan� (indinavir [in-DIN-a-veer])

  • Agenerase� (amprenavir [am-PREN-a-veer])

  • Viracept� (nelfinavir [nel-FIN-a-veer] mesylate)

  • Kaletra� (lopinavir [low-PIN-a-veer]/ritonavir [ri-TOE-na-veer])

  • Fortovase� (saquinavir [sa-KWIN-a-veer]), Invirase

Fuse Inhibitors work outside of the cell to keep HIV from infecting healthy T-cells:

  • Fuzeon� (enfuvirtide)

When to start treatment

Talk to your doctor about when to start treatment. The time to start treatment is different for everyone because there are many factors to consider.

  • Damage to the immune system. Starting treatment early may protect the immune system from weakening.

  • Readiness to start treatment. You will need to take all of the drugs exactly how your doctor tells you to, without missing any doses. Since one drug isn't strong enough to fight HIV alone, you will have to take several drugs every day.

  • Managing side effects. You will probably have side effects from the drugs that you need to be ready for.

  • Treatment options. Early treatment can help the body�s immune system stay strong. But if someone doesn�t have symptoms and takes treatment at that time, it�s possible that resistance to the drugs can develop. This problem can limit treatment options when symptoms begin.

  • Participation in clinical trials. Some clinical trials require that a person hasn�t started treatment.

If you are new to HIV drugs, some drugs may be better to take before others
The National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health (NIH), released a study about which drugs are better for people who are starting treatment. Taking a combination of zidovudine (AZT, ZDV), lamivudine (3TC), and efavirenz (EFV) provide the greatest benefit to people who have not been treated in the past, compared to the other combinations they tested. Researchers also found that after 48 weeks on the initial regimen, about 10 percent of individuals taking ZDV, 3TC and EFV experienced failure, as opposed to the other three-drug regimens, in which approximately 30 to 40 percent of people experienced failure. They also found that health problems caused by the drugs occurred more often in people who began treatment with didanosine (ddI) and stavudine (d4T) than in those who began treatment with ZDV and 3TC. They had more problems like nerve damage and inflammation to the pancreas. Leading researchers now recommend that HIV treatment should not begin with regimens that contain both ddI and d4T.

HIV/AIDS drugs cause side effects
Despite the beneficial effects of HAART, you can get side effects from the drugs. These are some side effects:

  • nausea

  • vomiting

  • diarrhea

  • weakness

  • dizziness

  • headache

  • rash

  • fever

  • liver problems

  • diabetes

  • losing fat in some parts of your body of your body and getting it in other parts (face, legs, arms, buttocks, breasts, neck, stomach)

  • high cholesterol

  • more bleeding in patients with hemophilia

  • decrease in bone density

HIV treatment can be hard because of side effects and having to take so many drugs. Before you starting taking HIV drugs, talk to your doctor about side effects you may have, ways to feel better, if/when they will go away, and how long they'll last.

Stick to your treatment
HIV drugs can be hard to take. You may need to take a lot of them, and they often cause side effects that are hard to manage. But it�s so important that you take all of them as your doctor tells you to. People who take their medicines most of the time, but not all of the time, face a high risk of drug resistance. This means that the drugs may not work as well in fighting the virus. Patients who can�t take one drug may be able to find another one that works, but will then be faced with managing the side effects of the other drug. Here are some ways to stick to your treatment:

  • Know your options and what to expect. Talk to your doctor about all treatment options and drug side effects.

  • Think about why you might have a hard time with treatment. For example, it might be too hard to take all the drugs when you're supposed to take them. Talk to your doctor about these barriers and making your treatment plan fit your lifestyle. For instance, it might be helpful to take medicine when you get out of bed in the morning.

  • Plan your meals. Some drugs have to be taken with food. Plan when you'll eat so you take the right drugs with the right amount and type of food.

  • Write down information about the medicines. This includes drug name, when to take it, how much to take, and if you take it when you're eating or on an empty stomach. Don't leave your doctor's office until you understand how to take your drugs.

  • Organize your medicines. Use daily or weekly pill boxes (or even egg cartons).

  • Don't forget! Use timers, alarm clocks, or pagers to remind you to take your medicines. You could even write it in your planner.

  • Plan ahead. Weekends and holidays make it harder to remember to take your medicines. Figure out a plan ahead of time so you won't forget. If you're traveling, keep medicines with you, just in case your checked luggage is lost.

  • Get refills on time. Don't miss a dose!

  • Write down the problems you have with the drugs. It will help you remember and track your problems.

  • Tell your doctor right away if you have side effects or other problems. Don't wait. Work with your doctor to make your treatment plan work for you � you might be able to change your treatment so it's better for you.

  • Talk to people who can help you cope. This process is no easy task. Talk to people who can help you get through this. It is important not to isolate yourself � reach out to those you love. Think about joining a support group to talk to other people with HIV.

Is treatment working?
There are ways to know if your treatment is working. Your doctor will consider these factors:

  • viral load (amount of HIV in your blood)-the lower, the better. HIV isn't detectable at less than 50 copies/ml.

  • CD4 cell count (number of cells in your blood that fight infection)-the higher, the better able you are to fight HIV infection

  • recent health history

  • results from physical exams

Even if the treatment is working and the amount of HIV in your blood is so low that that the tests can't find it, you still have HIV or AIDS. You can still give HIV to other people. Keep using condoms, and don't share drug needles.

Taking a drug holiday
If you take medicines for HIV/AIDS, you may feel like the drugs are running your life. It�s tough to take all of the medicines when you�re supposed to, some with food, some not. The medicines� side effects can make you long for a break from treatment. Researchers are trying to figure out if there are certain times when you can stop your therapy or take the least amount of drugs to give you and your body a break.

The National Institute of Allergy and Infectious Diseases (NIAID) conducted a study of people who had drug-resistant HIV (a type of HIV that does not get better with medicines) and detectable virus in their blood to find out if breaks in their treatments would help them. Unfortunately, it didn�t work for this group. SMART is another government-funded study that is now looking into this possibility. Even though there is no conclusion yet about the safety of breaks from HIV medicines, some doctors are already letting their patients take a break, while closely watching their CD4s and viral loads. Other doctors are against it; they think a break will put too much of a strain on the immune system. Talk to your doctor about how to best maintain your health and quality of life.