HIV (human immunodeficiency virus) is a worldwide infection. In order to understand HIV and AIDS, it is important to understand the meaning behind these terms:

• HIV – human immunodeficiency virus - one of a group of viruses known as retroviruses. After getting into the body, the virus damages and/or kills immune cells. The body tries to keep up by making new cells or trying to contain the virus, but eventually the HIV wins out and progressively destroys the body's ability to fight infections and certain cancers.
• AIDS – acquired immunodeficiency syndrome - occurs when HIV has destroyed such a large amount of the body's defenses that immune-cell counts fall to critical levels that certain life-threatening infections or cancers develop.

How is it spread?

HIV is transmitted through infected cells or semen. These are the possible ways:

• Sexual contact with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum, or mouth during sex.
• The virus is spread among injection-drug users who share needles or syringes that are contaminated with blood from an infected person.
• Women can transmit HIV to their babies during pregnancy or birth, when infected maternal cells enter the baby's circulatory environment.
• HIV can be spread in health-care settings through accidental needle pricks or contact with contaminated fluids.
• Very rarely, HIV spreads through transfusion of contaminated blood or body parts. If tissues or organs from an infected person are transplanted, the recipient may acquire HIV. Donors are now tested for HIV to minimize this risk.
• People who already have a sexually transmitted disease, such as syphilis, genital herpes, chlamydial infection, gonorrhea, or bacterial vaginosis, are more likely to acquire HIV infection during sex with an infected partner.

The virus does not spread through casual contact such as:

• preparing food
• sharing towels and bedding
• swimming pools
• telephones
• toilet seats
• the virus is also unlikely to be spread by contact with saliva, unless it is contaminated with blood

Symptoms

Many people with HIV are not aware of the infection.

• Many people do not develop symptoms after they first get infected with HIV. Others have a flu-like illness within several days to weeks after exposure to the virus. They complain of:
  
  • Fever
  • Headache
  • Tiredness
  • Enlarged lymph nodes in the neck

These symptoms usually disappear on their own within a few weeks. After that, the person feels normal and has no symptoms. This asymptomatic phase often lasts for years.

• The progression of the disease varies widely among individuals. This state may last from a few months to more than 10 years.
  
  • During this period, the virus continues to multiply actively and infects and kills the cells of the immune system.
  • The virus destroys the cells that are the primary infection fighters, called CD4 cells.
  • Even though the person has no symptoms, he or she is contagious and can pass HIV to others.

AIDS is the later stage of HIV infection, when the body begins losing its ability to fight infections. Once the CD4 cell count falls low enough, an infected person is said to have AIDS. Sometimes, the diagnosis of AIDS is made because the person has unusual infections or cancers that show how weak the immune system is:

The infections that happen with AIDS are called opportunistic infections because they take advantage of the opportunity to infect a weakened host. The infections include (but are not limited to):

• pneumonia caused by Pneumocystis, which causes wheezing,
• brain infection with toxoplasmosis which can cause trouble thinking or symptoms that mimic a stroke,
• widespread infection by a bacteria called MAC (mycobacterium avium complex) which can cause fever and weight loss,
• esophageal yeast infection which causes pain with swallowing, and widespread diseases with certain fungi like histoplasmosis, which can cause fever, cough, anemia, and other problems.

A weakened immune system can also lead to other unusual conditions:

• lymphoma in the brain, which can cause fever and trouble thinking;
• or a cancer of the tissues called Kaposi's sarcoma, which causes brown, reddish, or purple spots that develop on the skin or in the mouth.

Treatment

Over the past 10 years, several drugs have become available to fight both the HIV infection and its associated infections and cancers. These drugs are called highly active antiretroviral therapy (HAART) and have substantially reduced HIV-related complications and deaths. However, there is no cure for HIV/AIDS. Therapy is initiated and individualized under the supervision of an expert physician in the care of HIV-infected patients. A combination of at least three drugs is recommended to suppress the virus from replicating and to boost the immune system. The different classes of medications include:

• Reverse transcriptase inhibitors: These drugs inhibit the ability of the virus to make copies of itself. Examples include:
  
  • Nucleoside or Nucleotide reverse transcriptase inhibitors (NRTIs).
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIS) are commonly used in combination with NRTIs to help keep the virus from multiplying.
• Protease inhibitors (PIs): These medications interrupt the virus’s replication at a later step in its life cycle, preventing the cells from producing new viruses.
• Fusion and entry inhibitors are newer agents that keep HIV from entering human cells.
• Integrase inhibitors stop HIV genes from becoming incorporated into the human cell's DNA. This is a newer class of drugs recently approved to help treat those who have developed resistance to the other medications

Antiretroviral drugs stop viral replication and delay the development of AIDS. However, they also have side effects that can be severe. They include:

• decreased levels of red or white blood cells,
• inflammation of the pancreas, 
• liver toxicity,
• rash,
• gastrointestinal problems, 
• elevated cholesterol level,
• diabetes,
• abnormal body-fat distribution, and 
• painful nerve damage.

Pregnant women who are HIV-positive should seek care immediately because HAART therapy reduces the risk of transmitting the virus to the fetus. There are certain drugs, however, that are harmful to the baby. Therefore, seeing a physician to discuss anti-HIV medications is vital.

• HIV patients should be under the care of a physician who is experienced in treating the infection. All people with HIV should be counseled about avoiding the spread of the disease. Infected individuals are also educated about the disease process, and attempts are made to improve the quality of their life.

Home Care and Other Remedies

Find a competent doctor who knows how to treat the infection and its ramifications.

• Follow your doctor's instructions. Keep all of your appointments, and take your medications exactly as directed. If you get sick from your medication, call your doctor. Don't stop taking your medication or change the dosage on your own.
• Get immunizations. These may prevent infections such as pneumonia and the flu. 
• Don't smoke or use illicit drugs. These weaken your body even more.
• Eat the healthiest diet you can. Give special emphasis to fresh fruits and vegetables, whole grains and lean protein. Good nutrition is tremendously important. Healthy foods give you more energy and support your immune system. If you have diarrhea, weight loss or trouble eating you may consult with a registered dietitian. Also, because your nutritional needs are extremely high and you may not digest food well, talk to your doctor about vitamin and mineral supplements.
• Avoid foods that increase the risk of infection. These include unpasteurized dairy products, raw eggs and raw seafood such as oysters, sushi or sashimi. Cook meat until it's well-done or until there's no trace of pink color.
• Drink pure water. Boil tap water or use bottled or filtered water for drinking. If you buy a water filter, look for one that uses reverse osmosis as part of the purification process.
• Get regular exercise. Exercise helps increase your strength and energy levels and can help battle the depression that's often a part of dealing with HIV/AIDS.
• Get enough sleep.
• Take care with companion animals. Some animals may carry parasites that can cause infections in people who are HIV-positive. But that doesn't mean you should give up your companion animal.
  
  • Have someone else clean your cat's litter box or pick up after your dog.
  • If you must do this by yourself, wear latex gloves and wash your hands immediately afterward.
  • Don't feed your pets with raw meat, and make sure they have all their shots. 
  • Always wash your hands thoroughly with soap and water after petting or playing with your animals.
  • Find ways to relax. Practice your favorite activities or find new ones.
  • Keep your hands clean.
  • Wash your hands thoroughly with soap and water after using the restroom, before eating or preparing food, and after spending time in public places.
  • You might find it helpful to carry an alcohol-based hand sanitizer with you for times when it's not convenient to use soap and water.

Prevention

There is no effective vaccine against HIV. The only way to prevent infection by the virus is to avoid risky behaviors, such as sharing needles or having unprotected sex. In this context, unprotected sex means sex without barrier contraception, such as a condom. Because condoms break, even they are not perfect protection. Many people infected with HIV don't have any symptoms. There is no way to know with certainty whether a sexual partner is infected.

• Abstinence.
• Mutual monogamy
• Condoms offer some protection if used properly and consistently. Occasionally, they may break or leak. Only condoms made of latex should be used. Only water-based lubricants should be used with latex condoms.
• Do not share needles or inject illicit drugs.
• If you work in a health-care field, follow national guidelines for protecting yourself against needle pricks and exposure to contaminated fluids.
• If you have engaged in risky behaviors, get tested to see if you have HIV.
• The risk of HIV transmission from a pregnant woman to her baby is significantly reduced if:
  
  • the mother takes medications during pregnancy, labor, and delivery; 
  • her baby takes medications for the first six weeks of life, even shorter courses of treatment are effective, though not as optimal;
  • it is crucial to get tested for HIV as early as possible in pregnancy;
  • in consultation with their physician, many women opt to avoid breastfeeding to minimize the risk of transmission after the baby is born.

How to stop the spread?

• Abstinence or mutual monogamy.
• Use barrier contraception during every sexual contact.
• Do not share needles or razorblades, toothbrushes or any objects that may be contaminated with blood with other people.

 Candidiasis is also often referred to as thrush, and is a yeast infection belonging to a group of fungi containing more than 20 species. The most common type of yeast is Candida albicans, which often affects women in the form of vaginal thrush.
It can normally be found in our bodies, living harmlessly in our digestive systemand in the vaginal area of women without causing any symptoms.
A candidainfection or overgrowth usuallyoccurswhen the skin is damaged in warm, moist body areas. It can also happen when a person has a weakened immune system, and can sometimes be a result of an unhealthy diet. When there is an overgrowth of yeast, other parts of the body become infected.
Candida overgrowth tends to occur as a result of antibiotic use, hormonal changes during pregnancy or menopause, illness, or stress. Areas of the body that are often affected include the mouth, vagina, groin, diaper areas, around dentures, nail beds, underarms, under the breast, lower abdomen or skin folds. However, candidiasis may become systemic if left untreatedand will thenaffect a wide range of body functions. In systemic candidal disease, up to 75% of people may die. Even common mouth and vaginal yeast infections can cause critical illness and can be more resistant to normal treatment. Recurrent yeast infections may be a sign of more serious diseases such as diabetes, leukemia, or AIDS.

• Infection in the Vagina

Vaginal candidiasis, called yeast infection or vaginitis, is an infection of the vulva and/or vagina. It causes a smelly, thick, white-yellow discharge that might occur with itching, burning and swelling. A bad case can cause pain during walking, urination or sexual intercourse.

• Infection in the Mouth

Oral candidiasis, called thrush, involves the mouth and sometimes the throat. It can also occur without symptoms. The most common symptoms usually include discomfort of the mouth and throat, burning and an altered sense of taste (often described as "bad"). Creamy white or yellowish coatings or spots on the mouth and throat are also common. Thrush is rare if a person's CD4+ cell count is above 500, but outbreaks are more common as it drops to 100.

• Infection in the Throat

Candidiasis of the throat and windpipe, called esophageal infection, is a serious condition. It is on the list of AIDS-defining illnesses, affecting up to 1 in 5 people with AIDS. It often occurs together with thrush. Symptoms include:

chest pain

nausea

pain when swallowing
 

The esophagus may become partly blocked by coatings and spots that build up. In rare cases, bad ulcers can rupture the esophagus. Esophageal candidiasis can spread, or disseminate, into the stomach and intestines. Because esophageal candidiasis can make swallowing painful, people may not eat enough and lose weight if it's not treated promptly.

• Infection of the Skin

Candida can infect skin in the armpits, groin (including the scrotum and tip of the penis in men) and under the breasts. This is called cutaneous candidiasis. Infection can also occur around burns, cuts or catheters. It causes a bright red uneven eruption in the folds of skin. This may be coated by a white, wrinkled layer of tissue. Other symptoms include a mild burning. Fingernails and toenails can also be infected, which can be a special problem for people whose hands are often in water, like bartenders or dishwashers.

• Infection Throughout the Body

Systemic candidiasis is when Candida spreads throughout the body, and it can be life-threatening. Infection might include the brain, heart, kidneys, eyes, liver, genital tract and joints. This form occurs most often in people with low white blood cell counts (neutropenia). This type of infection is also called disseminated candidiasis.

Symptoms of Candidiasis (Vaginal Thrush)

Symptoms can include:

• Vaginitis
• Vaginal skin flakes
• Vaginal itching
• Vaginal burning
• Vaginal irritation
• Painful urination
• Painful intercourse
• Vaginal discharge, including lumpy white or cottage cheese-like discharge
• Local vaginal tears
• Red or tender exterior vaginal skin
• Swollen labia or vaginal lips

What does it look like?

• Oral thrush: white spots, thick, white lacy patches
• Candidal skin infections: red flat rash with sharp scalloped edges. There are usually similar looking, smaller patches nearby, known as "satellite lesions." (Rashes may cause itching or pain).
• Skin inflammation
• Small blisters
• Candidal esophagitis can cause painful ulcers throughout the GI system.
• If Candida gets into the bloodstream, a person may become sick with or without fever.
• If the infection spreads to the brain, a person may have acute changes in mental function or behavior.

How common is genital candidiasis/VVC, and who can get it?

Nearly 75% of all adult women have had at least one genital "yeast infection" in their lifetime. On rare occasions, men may also experience genital candidiasis. Yeast infection occurs more frequently and more severely in people with weakened immune systems. There are some other conditions that may put a woman at risk for genital candidiasis:

• Pregnancy
• Diabetes mellitus
• Use of broad-spectrum antibiotics
• Use of corticosteroid medications

How is genital candidiasis/VVC transmitted?

Most cases of Candida infection are caused by the person’s own Candida organisms. Candida yeasts usually live in the mouth, gastrointestinal tract, and vagina without causing symptoms. Symptoms develop only when Candida becomes overgrown in these sites. Rarely, Candida can be passed from person to person, such as through sexual intercourse.

Treatments for Candidiasis (Vaginal Thrush)

Most episodes of localized candidiasis are treatable with medicated ointments, suppositories, or mouthwash. More severe infections may be treated with oral anti-fungal medications, especially where the person may have a more serious condition such as HIV or diabetes. There are also many natural treatments forvaginal thrush, candidiasis, and other fungal infections, which include the use of herbal and homeopathic remedies.
Natural Remedies
Natural treatment for vaginal thrush has proven to be effective as well for relieving the pain and discomfort of candidiasis and for controlling candida overgrowth. There are many herbs with anti-fungal properties which may be used topically or internally to deal with the problem.
These include herbs such as:

• Cymbopogon citratus (Lemon grass)
• Calendula officinalis
• Tabebuia impetiginosa (Pau d'arco bark)

Apart from treating the fungal overgrowth itself, herbal remedies can also help to improve immune system strength, thereby helping to protect the body against future attacks. Herbal and homeopathic treatments are not only safe and effective to use, but also non-addictive and without side effects. These statements have not been evaluated by the FDA.

How to prevent Candidiasis

• Eat yogurt with live bacteria;
• Practice good oral health by brushing and flossing teeth daily;
• Wash and dry the vaginal or groin areas before dressing;
• Maintain good hygiene practices when using the bathroom;
• Increase your intake of garlic because of its anti-fungal properties;
• Avoid excessive antibiotic use;
• Avoid eating sweetened and refined foods;
• Strengthen your immune system with healthy vitamin-rich food and regular exercise;
• Reduce the consumption of sugar, dairy, wheat, caffeine, nicotine and alcohol because they help yeast to grow.

 Chancroid is a highly contagious yet curable sexually transmitted disease (STD) caused by the bacteria Haemophilus ducreyi [hum-AH-fill-us DOO-cray]. Chancroid causes ulcers, usually on the genitals. Swollen, painful lymph glands, or inguinal buboes [in-GWEEN-al BEW-boes], in the groin area are often associated with chancroid. Left untreated, chancroid may facilitate the transmission of HIV.

About half of infected men have only a single ulcer. Women often have 4 or more ulcers. The ulcers appear in specific locations.
 

Common locations in men are:

• Foreskin (prepuce)
• Groove behind the head of the penis (coronal sulcus)
• Shaft of the penis
• Head of the penis (glans)
• Opening of the penis (urethral meatus)
• Scrotum

In women:

• The most common location for ulcers is the outer lips of the vagina (labia majora).
• "Kissing ulcers" may develop. These are ulcers that occur on opposite surfaces of the labia.
• The inner vagina lips (labia minora), the area between the genitals and the anus (perineal area), and inner thighs may also be involved.

How is it spread?

Chancroid is transmitted in two ways:

• sexual transmission through skin-to-skin contact with open sore(s);
• non-sexual transmission when pus-like fluid from the ulcer is moved to other parts of the body or to another person.

A person is considered to be infectious when ulcers are present. There has been no reported disease in infants born to women with active chancroid at time of delivery.

Symptoms

Within 1 day to 2 weeks after getting chancroid, a person gets a small bump in the genitals. The bump becomes an ulcer within a day of its appearance. The ulcer:

• ranges in size from 1/8 inch to 2 inches across;
• is painful;
• is soft;
• has sharply defined borders;
• has irregular or ragged borders;
• has a base that is covered with a grey or yellowish-grey material;
• has a base that bleeds easily if banged or scraped.

Other Symptoms usually occur within 4-10 days from exposure. They rarely develop earlier than three days or later than 10 days.

• The ulcer begins as a tender, elevated bump, or papule, that becomes a pus-filled, open sore with eroded or ragged edges.
• The ulcer is soft to the touch (unlike a syphilis chancre that is hard or rubbery). The term soft chancre is frequently used to describe the chancroid sore.
• The ulcers can be very painful in men but women are often unaware of them.
• Because chancroid is often asymptomatic in women, they may be unaware of the lesion(s).
• Painful lymph glands may occur in the groin, usually only on one side; however, they can occur on both sides.
• The most common symptoms in women are pain with urination and intercourse.
• May be asymptomatic in women.

How do I know if I have it?

• You have ulcers (they can be painful or painless) on vagina, rectum, penis or groin.
• These ulcers cause pain during sexual intercourse, urination and bowel movement.
• You have swollen lymph nodes.

Treatment

Chancroid can be treated with antibiotics. Successful treatment cures the infection, resolves symptoms and prevents transmission to others. A follow-up examination should be conducted three to seven days after treatment begins. If treatment is successful, ulcers usually improve within three to seven days. The time required for complete healing is related to the size of the ulcer. Large ulcers may require two weeks or longer to heal. In severe cases, scarring may result. Partners should be examined and treated regardless of whether symptoms are present.

Prevention

• Abstinence (not having sex);
• Mutual monogamy (having sex with only one uninfected partner);
• Latex condoms for vaginal, oral and anal sex. Latex condoms may protect the penis or vagina from infection, but does not protect other areas such as the scrotum or anal area. Chancroid lesions can occur not only in genital areas that are covered or protected by a latex condom, but may also occur in areas that are not covered or protected by a condom. Latex condoms, when used consistently and correctly, can reduce the risk of chancroid, genital herpes, syphilis, and genital warts, only when the infected areas are covered or protected by the condom.

If chancroid is present, avoid contact with the infected area to prevent the chance of spreading the infection to other parts of the body.

How To Stop the Spread?

• Washing carefully before and after sexual intercourse in to clear away the bacteria from your body.
• Practicing safe sex (Remember that open sores may appear on the areas that are not protected by a condom).
• Limiting your number of sexual partners and not going back and forth between them.
• Having sex with one faithful partner.

 Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium Chlamydia trachomatis, which can damage a woman's reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur "silently" before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man.

In pregnant women, there is some evidence that untreated chlamydial infections can lead to premature delivery. Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns.

How is it spread?

Chlamydia is transmitted though sexual intercourse (including such form of sex as oral, anal, vaginal) with the infected partner. Chlamydia also can be transmitted from an infected pregnant woman to a baby during vaginal childbirth.

The greater the number of sex partners, the greater the risk of infection. Because the cervix (opening to the uterus) of teenage girls and young women is not fully matured and is probably more susceptible to infection, they are at particularly high risk for infection if sexually active.

Since chlamydia can be transmitted by oral or anal sex, men who have sex with men are also at risk for chlamydial infection.

Symptoms

Chlamydia is known as a "silent" disease because about three quarters of infected women and about half of infected men have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.
 

In women, the bacteria initially infect the cervix and the urethra (urine canal), symptoms (if any) may include:

• an abnormal vaginal discharge
• burning sensation when urinating
• When the infection spreads from the cervix to the fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have:
  • lower abdominal pain
  • lower back pain
  • nausea
  • fever
  • pain during intercourse
  • bleeding between menstrual periods
     

Chlamydial infection of the cervix can spread to the rectum.
 

Men might have:

• a discharge from their penis
• burning sensation when urinating
• burning and itching around the opening of the penis
• pain and swelling in the testicles though these symptoms are uncommon
   

Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause:

• rectal pain
• discharge
• bleeding
   

*Chlamydia can also be found in the throats of women and men having oral sex with an infected partner.

Treatment

Chlamydia can be easily treated and cured with antibiotics. All sex partners should be evaluated, tested, and treated.

• Persons with chlamydia should abstain from sexual intercourse until they and their sex partners have completed treatment, otherwise re-infection is possible.
• Women whose sex partners have not been appropriately treated are at high risk for re-infection.
• Having multiple infections increases a woman's risk of serious reproductive health complications, including infertility.
• Retesting should be encouraged for women three to four months after treatment. This is especially true if a woman does not know if her sex partner received treatment.

Prevention

• Abstinence (the most trusted and safest method)
• Long-term mutual monogamy with a healthy, tested partner
• Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia.
• Annual chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women.
• Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles could mean an STD infection.
• If a woman has any of these symptoms, she should stop having sex and consult a health care provider immediately.
• Treating STDs early can prevent PID (Pelvic inflammatory disease).
• Women who are told they have an STD and are treated for it should notify all of their recent sex partners (sex partners within the preceding 60 days) so they can see a health care provider and be evaluated for STDs.
• Sexual activity should not resume until all sex partners have been examined and, if necessary, treated.

How to stop the spread?

• Limit the number of sex partners;
• Notify all recent sex partners;
• Cease sexual activity for the treatment period and resume only after fully healed;
• Regular medical tests and check ups to detect re-infection;
• Get your partner tested and treated;
• Mutual-monogamous relationship;
• Barrier contraception (latex condom).
   

Gardnerella’ is a bacteria that can cause vaginal infection. This bacterium has been known as ‘haemophilius’, and has also been implicated in a condition called ‘non-specific vaginitis’ or ‘bacterial vaginosis’ Gardnerella is not harmful but can be quite irritating. In men, Gardnerella can go undetected and therefore pass from partner to partner. If a partner has Gardnerella, the male partner must be treated. Condoms should be used to prevent another infection. In pregnancy, proper detection and treatment can often prevent preterm labor and delivery.

Symptoms

Symptoms depend on the amount of bacteria present. While a small amount may cause no symptoms, a moderate to large amount may cause:

• itching
• burning
• pain during intercourse
• grey-yellow discharge
• foul odor (fishy, musty)
• soreness of the vulva and/or vagina

Symptoms may be mild, moderate or severe or Gardnerella may have been identified on a Pap smear or swab without you noticing any changes.

Is Gardnerella sexually transmitted?

Like ‘thrush’, gardnerella organisms prefer to live in the moist environment of the vagina. They are not necessarily sexually transmitted, however, it is possible to acquire or pass on such an infection through sexual contact.

Gardnerella is often present in the vagina without causing any problems. If the other bacteria (‘lactobacilli’), which normally live in the vagina and keep the vagina acidic (pH between 3.5 and 4.5), are disturbed, the vagina becomes alkaline. This tends to favor the overgrowth of gardnerella organisms.

What causes the vagina to become alkaline?

• Antibiotics may kill off the lactobacilli. This can also lead to overgrowth of yeast organisms causing ‘thrush’ (also called ‘monilia’ or ‘candida’).
• Lack of estrogen (e.g. around the time of menopause) or a change in the estrogen/progesterone balance.
• Stress and diet may possibly affect hormonal balance.
• Frequent intercourse may affect the pH of the vagina (semen and vaginal lubricating fluid are both alkaline. Menstrual blood is also alkaline).

What does Gardnerella overgrowth cause?

Under normal conditions the vagina sustains a natural balance of bacteria, however this balance can be disturbed and if harmful bacteria over populates, Bacterial Vaginosis develops. Overgrowth of Gardnerella may be responsible for this condition and as such BV is also known as Gardnerella Vaginalis. A decrease in the good bacteria such as Lactobacilli, which keeps the vagina slightly acidic, will also allow overgrowth of the bad bacteria.

Contracting Bacterial Vaginosis

Though it is understood how BV develops, it is more of a mystery as to how the imbalance of bacteria occurs to begin with.
It is known, however, that BV can affect all women and that factors suspected of raising the risk of developing BV include:

• multiple sexual partners
• oral sex
• douching (rinsing of the vagina)
• stress

BV does not appear to be a sexually transmitted condition though it seems to develop as a result of sexual activity. This can include non-penile penetration such as toys or fingers. It can develop just as easily if a woman has had only one sexual partner or uses protection at all times.

Treatment Options

Always seek professional medical advice about any treatment or change in treatment plans.

• Antibiotics
• Antibiotic cream
• No treatment - some conditions without symptoms, such as those found only on a routine Pap smear, may not need treatment.

Prevention

Because it is not fully understood as to how exactly bacterial vaginosis is contracted, prevention of BV involves reducing the risk of developing it.

• safe sex with condoms;
• Avoid douching;
• Abstinence;
• Limiting number sexual partners;
• Cleaning sex toys before use in the vagina.

 Genital warts are the most common sexually-transmitted disease caused by a virus. Genital warts or venereal warts are the most easily recognized sign of genital human papillomavirus (HPV) infection. Many people, however, have a genital HPV infection without genital warts. Over 100 types of HPVs have been identified; about 40 of these types have the potential to infect the genital area.

• Around 90% of genital warts are caused by two specific types of the virus (HPV-6 and -11), and these HPV types are considered "low risk," having a low cancer-causing potential.
• Other HPV types have been strongly associated with premalignant changes and cervical cancers in women. HPV-16 is responsible for about 50% of cervical cancers, and types 16, 18, 31, and 45 together account for 80% of cancers.
• Common warts are not the same as genital warts and are caused by different HPV types that infect the skin.

Genital warts affect both men and women. In children younger than three years, genital warts are thought to be transmitted by nonsexual methods such as direct manual contact. Nevertheless, the presence of genital warts in children should raise the suspicion for sexual abuse.

Genital warts, sometimes referred to as condyloma acuminata, are:

• soft, moist flesh-colored or gray growths found in the genital area and anal region of both men and women which appear within weeks or months after infection.
• They sometimes appear in clusters that resemble cauliflower-like bumps, and are either raised or flat, small or large.
• The size may range from less than one millimeter across to several square centimeters when many warts join together.
   

How are they spread?

The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity. Once cells are invaded by HPV, a latency period of months to years may occur.

The number of genital warts usually rises during pregnancy, which makes vaginal delivery difficult, because warts can bleed easily and infect the newborn, which poses the threat of contracting recurrent respiratory papillomatosis (RRP). This is a life-threatening disease of the respiratory tract. The papillomas or warts appear and spread quickly, sometimes dangerously blocking the child's airway.

Symptoms

• painless bumps, itching, and discharge.
• Rarely, bleeding or urinary obstruction may be the initial problem when the wart involves the urethral opening (the opening where urine exits the body.)
• Warts in more than one area are common.
• There may be a history of previous or concurrent sexually transmitted diseases (STDs).
• In women, genital warts have a similar appearance and usually occur in the moist areas of the labia minora and vaginal opening. Lesions visible on the outer genitals warrant a thorough examination of the vaginal canal, cervix, and anorectal area. Most vaginal warts occur without symptoms. Rarely, women may experience bleeding after sexual intercourse, itching, or vaginal discharge.
• In men, genital warts can infect the urethra, penis, scrotum, and rectal area. The warts can appear as soft, raised masses with a surface that can be smooth (on the penile shaft) or rough with many fingerlike projections (anal warts). Others may appear pearly, cauliflower-like, or rough with a slightly dark surface. Most lesions are raised, but some may be flat with only slight elevation above the skin surface. Infection with HPV may be dormant or undetectable, with some lesions hidden by hair or in the inner aspect of the uncircumcised foreskin in males.

Treatment

There is no single treatment that is effective in eliminating warts and preventing them from coming back.

• Cryotherapy: This technique freezes the wart using liquid nitrogen or a "cryoprobe."
• Laser treatment: This treatment is used for extensive or recurrent genital warts. It may require local, regional, or general anesthesia. The laser physically destroys the HPV-induced lesion. Disadvantages include high cost, increased healing time, scarring, and potentially infectious viral particles in the air caused by the laser plume.
• Electrodesiccation: This technique uses an electric current to destroy the warts. It can be done in the office with local anesthesia. The resulting smoke plume may be infectious.
• Medications
• Surgery: Surgery may be performed as an office procedure with local anesthesia. It is usually done when the warts are small in size and number. Of all the treatment techniques, it has the highest success rate and lowest recurrence rate. Initial cure rates are 63%-91%.
• After treatment, patients should routinely visit their doctors for a check up, tests and new or alternative treatment.

Prevention

In 2006, an HPV vaccine (Gardasil) was approved by the FDA for use in girls and women, aged 9-26. This vaccine has been shown to be safe and 100% effective in preventing infection with the four most common HPV types (6, 11, 16, and 18) in women who have had no previous exposure to the virus. However, it is less effective in women who have already been infected with HPV, and it does not protect against all types of HPV infection.
Other tips on prevention include the common rules of prevention against any other STD:

• Abstinence
• Barrier contraception
• Limited number of partners or mutual monogamy
• Simple hygiene such as shower before and after sexual intercourse

How to stop the spread?

• Inform any recent partner(s)
• Use barrier contraception
• Cease sexual activity during time of treatment
• Remember that birth-control pills do not protect you from STDs, thus having multiple partners requires barrier contraception even if birth-control pills are taken
• Do not touch the warts since they are highly infectious
• Limit your number of partners or practice monogamy
• Take the necessary precautions to prevent trauma to the area, which can result in bleeding.
• Because the warts themselves are infectious, avoid touching them. Do not pick or squeeze the warts.

 Gonorrhea is a sexually transmitted disease (STD). It is caused by the bacteria Neisseria gonorrhoeae that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacteria can also grow in the mouth, throat, eyes, and anus.

How is it spread?

Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread from mother to baby during delivery.
People who have had gonorrhea and received treatment may get infected again if they have sexual contact with a person infected with gonorrhea.
Any sexually active person can be infected with gonorrhea. In the United States, the highest reported rates of infection are among sexually active teenagers, young adults, and African Americans.
If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. This can cause:

• Blindness
• joint infection
• a life-threatening blood infection in the baby

Treatment of gonorrhea as soon as it is detected in pregnant women will reduce the risk of these complications. Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary.

Symptoms

Some men with gonorrhea may have no symptoms at all. However, some men have signs or symptoms that appear two to five days after infection; symptoms can take as long as 30 days to appear. Symptoms and signs include:

• a burning sensation during urination
• a white, yellow, or green discharge from the penis
• sometimes painful or swollen testicles
   

In women, the symptoms of gonorrhea are often mild, and most women who are infected have no symptoms. Even when a woman has symptoms, they can be so non-specific as to be mistaken for a bladder or vaginal infection. The initial symptoms and signs in women include:

• a painful or burning sensation during urination
• increased vaginal discharge
• vaginal bleeding between periods
   

Women with gonorrhea are at risk of developing serious complications from the infection, regardless of the presence or severity of symptoms.
 

Symptoms of rectal infection in both men and women may include:

• discharge
• anal itching
• soreness
• bleeding
• painful bowel movements
   

Rectal infection may also not cause any symptoms. Infections in the throat may cause a sore throat but usually causes no symptoms.

Treatment

Several antibiotics can successfully cure gonorrhea in adolescents and adults. However, drug-resistant strains of gonorrhea are increasing in many areas of the world, including the United States, and successful treatment of gonorrhea is becoming more difficult. People with gonorrhea should be tested for other STDs.

• It is important to take all of the medication prescribed to cure gonorrhea.
• Although medication will stop the infection, it will not repair any permanent damage done by the disease.
• People who have already been treated can get the disease again if they have sexual contact with someone who is infected with gonorrhea.
• If a person’s symptoms continue even after receiving treatment, he or she should return to a doctor to be reevaluated.

Prevention

• Abstinence
• Latex condoms
• Mutual monogamy
• Any genital symptoms such as discharge or burning during urination or unusual sore or rash are a signal to stop having sex and to see a doctor immediately.

How to stop the spread

• Refrain from sexual activity for the period of treatment
• Use barrier contraception
• Limit the number of partners
• Notify recent partners about the diagnosis
• Regular medical check ups may be helpful in detecting any STD sooner. Timely treatment can prevent complications.

 Hepatitis causes inflammation of the liver. It can be caused by one of many things — including a bacterial infection, liver injury caused by a toxin (poison), and even an attack on the liver by the body's own immune system.
Although there are several forms of hepatitis, the condition is usually caused by one of three viruses: hepatitis A, hepatitis B, or hepatitis C virus.
Some hepatitis viruses are able to mutate, change over time and can be difficult for the body to fight. In some cases, hepatitis B or C can destroy the liver, and a person may need a liver transplant to survive.

Hepatitis A

Hepatitis A is highly contagious, but is NOT transmitted sexually. Hepatitis A is actually considered to be less destructive than some other hepatitis viruses due to the fact that it rarely leads to permanent liver damage. Within a few weeks, the symptoms go away on their own, and the virus is no longer present in the system.
Once someone has recovered from a hepatitis A infection, that person has immunity to the virus, and he or she will probably never get it again. People can also be vaccinated for hepatitis A.

Hepatitis B

Hepatitis B is a more serious infection. It may lead to a condition called cirrhosis (permanent scarring of the liver) or liver cancer, both of which can lead severe illness and death.

• This infection has 2 phases: acute and chronic.
  
  • Acute (new, short-term) hepatitis B occurs shortly after exposure to the virus. A small number of people develop a very severe, life-threatening form of acute hepatitis called fulminant hepatitis.
  • Chronic (ongoing, long-term) hepatitis B is a viral infection that lasts longer than 6 months. Once the infection becomes chronic, it may never go away completely.
  • About 90-95% of people who are infected are able to fight off the virus before it reaches the chronic stage. Only about 5-10 percent of adults infected with HBV (Hepatitis B Virus) go on to develop chronic infection.
• People with chronic HBV infection are called chronic carriers. About two-thirds of these people do not themselves get sick or die of the virus, but they can transmit it to other people. The remaining one third develops chronic hepatitis B, a disease of the liver that can be very serious.

The liver is an essential organ that the body needs for survival. Its most important functions are:

• Filtering many drugs and toxins out of the blood;
• Storing energy for later use;
• Helping with the absorption of certain nutrients from food;
• Producing substances that fight infections and control bleeding;

How is it spread?

Hepatitis B is transmitted from person to person through blood or other bodily fluids (sexual contact), as well as through needles. People who inject drugs also are at risk of becoming infected if the needles they use were not sterilized.
You cannot get hepatitis B when:

• Being sneezed or coughed on
• Hugging
• Handshaking
• Breastfeeding
• Eating food or drinking water
• Casual contact (such as an office or social setting)

Symptoms

Half of all people infected with the hepatitis B virus have no symptoms.

• Symptoms develop within 30-180 days of exposure to the virus. The symptoms are often compared to flu.
  
  • Feeling tired (fatigue)
  • Nausea and vomiting
  • Itching all over the body
  • Pain in the liver (on the right side of the abdomen,
    under the lower rib cage)
  • Jaundice - A condition in which the skin and the
    whites of the eyes turn yellow in color
  • Urine becomes dark in color (like cola or tea).
  • Stools are pale in color (grayish or clay colored).
  • Appetite loss

Treatment

• Acute hepatitis B usually does not require medical treatment, except when very severe symptoms such as vomiting or diarrhea occur. These symptoms are treated to restore fluids and electrolytes. There are no medications that can prevent acute hepatitis B from becoming chronic.
• If you have chronic hepatitis B, you should see your health care provider regularly.

Prevention

• Practice safe sex.
• Men who have sex with men should be vaccinated against both hepatitis A and hepatitis B.
• If you inject drugs, don't share needles or other equipment.
• Don't share anything that might have blood on it, such as a razor or toothbrush.
• There is also a risk of infection if you are planning to get a tattoo or body piercing. You can become infected if the artist or piercer does not sterilize his/her needles and equipment, doesn’t use disposable gloves, or doesn’t wash his/her hands properly.
• Healthcare workers should follow standard precautions and handle needles and sharps safely.
• If you are pregnant or think you might be pregnant, tell your health care provider if you have any of the risk factors for HBV infection.

How to stop the spread

• People with HBV should not share razors or toothbrushes with others.
• Practice of safe sex, including use of barrier contraception.
• Do not share needles or other sharp tools with other people.

Hepatitis C

Like hepatitis B, hepatitis C can lead to cirrhosis or liver cancer. Hepatitis C is the most serious type of hepatitis — it\'s now one of the most common reasons for liver transplants in adults.

How is it spread?

• Like hepatitis B, the hepatitis C virus (HCV) is transmitted from person to person through blood or other body fluids.
• Through sharing drug paraphernalia.
• Through unprotected sex with an infected partner.
• HCV also can be passed from mother to unborn child.
• Re-using instruments or sharp tools in a medical environment, without appropriate cleaning between patients.

Virus cannot be transmitted by:

• shaking hands
• kissing
• hugging

Symptoms

When the virus enters the body, you may feel the following:

• Fatigue
• Loss of appetite
• Muscle aches
• Fever
• Yellowing of the skin or eyes (jaundice) is rare at this early stage of infection.
• HCV also has adverse effects on the liver, which may become serious and/or chronic over time.

Treatment

Treatment may include medication, injections, or even liver transplants. See your doctor if you have any concerns, and get tested for HCV and other STD’s regularly.

Prevention

• Do not share or reuse needles.
• Use barrier contraception (condoms) to limit the risk of HCV and other sexually transmitted diseases.
• Mutual-monogamy
• Abstinence

How to stop the spread

• People with HCV should not share razors or toothbrushes with others.
• It is critical that physicians and clinics follow manufacturer's directions for sterilizing/cleaning instruments and make sure that disposable sharp instruments be discarded properly.

 Herpes is the name of a group of viruses that can cause painful blisters and sores. There are several types of herpes viruses, some of the more prevalent ones are discussed below. Genital herpes, oral herpes and CMV are the viruses that can be categorized as STD’s.

Genital Herpes

Genital herpes is a sexually transmitted disease (STD) caused by herpes simplex viruses type 1 (HSV-1) or, more commonly, type 2 (HSV-2). Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection.

Symptoms

Most people infected with HSV-2 are not aware of their infection. The first herpes outbreak usually occurs within two weeks after the virus is transmitted, and the sores typically heal within two to four weeks. When signs do occur:

• they typically appear as one or more blisters on or around the genitals or rectum
• the blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur.
• another outbreak can appear weeks or months after the first, but it is almost always less severe and shorter than the first outbreak.
• although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.
• Other signs and symptoms during the primary episode may include a second crop of sores and flu-like symptoms, including fever and swollen glands.
• However, most individuals with HSV-2 infection never have sores, or very mild signs that can be mistaken for insect bites or a skin condition.
• People diagnosed with their first outbreak of genital herpes can expect to have several (typically four or five) herpes outbreaks (symptomatic recurrences) within a year.

How is genital herpes spread?

Genital herpes is spread through contact with an infected person, and can enter your body through a break in your skin or through the skin of your mouth, penis or vagina, urinary tract opening, cervix or anus. Herpes is most easily spread when the infected person is having an outbreak. However, it can be spread at any time, even when the person who has herpes isn’t experiencing any symptoms.

• Genital herpes is usually spread from one person to another by having sex, including oral sex.
• Herpes can also be spread from one place on your body to another, such as from your genitals to your fingers, then to your eyes or to other parts of your body.
• Herpes can also be spread from a mother to her baby when she gives birth.

Treatment

There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks. In addition, daily suppressive therapy for symptomatic herpes can reduce transmission to partners. See your doctor for a treatment plan if you feel you may have been exposed.

Prevention

• Abstinence or mutual monogamy
• Latex condoms reduce the risk of getting herpes
• People with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present.
• It is important to know that even if a person does not have any symptoms he or she can still infect their partner.

How to prevent the spread?

• Abstinence
• Barrier contraception
• Refrain from sexual activity for the time of outbreaks

Oral Herpes

Oral herpes is an infection caused by the herpes simplex virus. The virus causes painful sores on the lips, gums, tongue, roof of the mouth, and inside the cheeks. It also can cause symptoms such as fever and muscle aches.
Herpes simplex is a DNA virus that causes sores in and around the mouth. Two herpes subtypes may cause these sores.

• Herpes simplex virus, type 1 or herpes-1, which causes 80% of cases of oral herpes infections
• Herpes simplex virus, type 2 or herpes-2, which causes the rest.

Stages

• Primary infection: The virus enters the skin or mucous membrane and reproduces. During this stage, oral sores and other symptoms, such as fever, may develop.
  • The virus may not cause any sores or symptoms. This is called asymptomatic infection.
  • Asymptomatic infection is twice as common as the disease with symptoms.
• Latency: From the infected site, the virus moves to a mass of nervous tissue in the spine called the dorsal root ganglion. There the virus reproduces again and becomes inactive.
• Recurrence: When encountering certain stresses, emotional or physical, the virus may reactivate and cause new sores and symptoms.

What does it look like?

• Pain, burning, tingling, or itching occurs at the infection site before the sores appear.
• Clusters of blisters emerge and break down rapidly and, when seen, appear as tiny, shallow, gray ulcers on a red base.
• A few days later, they become crusted or scab over, and appear drier and more yellow.

Symptoms

Incubation period: The amount of time between contact with the virus and the appearance of symptoms, the incubation period, is 2-12 days. Most people average about 4 days.
Duration of illness: Signs and symptoms last 2-3 weeks.

• Fever
• Tiredness
• Muscle aches
• Irritability
   

Oral sores: The most intense pain caused by these sores occurs at the the onset and may make eating and drinking difficult.

• The sores may occur on the lips, the gums, on the front of the tongue, the inside of the cheeks, the throat, and the roof of the mouth.
• They may also extend down the chin and neck.
• The gums may become mildly swollen and red and may bleed.
• Lymph nodes in the neck often swell and become painful.
• For people in their teens and 20s, herpes may cause a painful throat with shallow ulcers and a grayish coating on the tonsils.

How is it spread?

People can be infected with herpes by touching infected saliva, mucous membranes, or skin.

Treatment

• Medication for fever and muscle aches.
• Drink plenty of fluids to prevent dehydration.
• A topical anesthetic may be prescribed to relieve pain.

• See your doctor if you think you’ve been infected, for a diagnosis, or if you are experiencing painful or uncomfortable symptoms.
• Cases that may require hospital admission:
  • Severe local infection
  • Infection has spread to other organ systems
  • People with weakened immune systems
  • Dehydrated individuals who need IV hydration
  • Infants younger than 6 weeks

Prevention

Avoid touching saliva, skin, or mucous membranes that have sores.

How to stop the spread?

• Do not kiss anyone until treatment period is over.
• Do not touch skin, or mucous membranes that have sores.

Cytomegalovirus (CMV)

Cytomegalovirus (CMV) is a common virus that is part of the herpes family of viruses. Like most other herpes-type viruses, once a person is infected with CMV it will remain dormant in the body for the rest of his or her life. Currently, here is no cure for CMV. A possible vaccine is currently being researched and used in clinical trials.

Types of CMV

The three main types of CMV infections are:

• Acquired (or primary) CMV: a CMV infection that is contracted for the first time.
• Reoccurring CMV: a previously dormant CMV infection that reoccurs due to a weakened immune system.
• Congenital CMV: a CMV infection that develops in pregnancy and can affect the unborn baby.

Unlike other viral infections, CMV causes no, or very few, symptoms. Most people will be unaware that they've developed an infection. See your doctor regularly to check if you’ve been exposed, and to get the necessary treatment in a timely manner.

 Human papillomavirus (HPV) consists of a group of more than 100 related viruses. They are called papillomaviruses because certain types may cause warts, or papillomas, which are benign (non-cancerous) tumors. The HPVs that cause the common warts that grow on hands and feet are different from those that cause growths in the throat or genital area. Some types of HPV are associated with certain types of cancer. These are called high-risk, oncogenic, or carcinogenic HPVs. Low-risk HPV can cause genital warts. Warts can form weeks, months, or years after sexual contact with an infected person.
Genital HPV infections are very common and are sexually transmitted. Of the more than 100 types of HPV, more than 30 types can be passed from one person to another through sexual contact. Although HPV is usually transmitted sexually, doctors cannot say for certain when an infection occurred.

Symptoms

Most infected people are not aware they have this infection. Currently, there is only a test for cervical cancer but not for HPV infection. Usually infection goes away by itself without causing any health problems. However, HPV infection sometimes persists for many years, with or without causing cell abnormalities. This can increase a woman’s risk of developing cervical cancer.
Genital warts indicate that HPV infection may be present.

How is it spread?

Human papillomavirus is transmitted through sexual contact. Having many sexual partners is a risk factor for HPV infection.

Very rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery. In these cases, the child can develop RRP, or Recurrent Respiratory Papillomatosis.

Treatment

Although there is currently no medical cure for human papillomavirus infection, the lesions and warts these viruses cause can be treated. Methods commonly used to treat lesions include:

• cryosurgery (freezing that destroys tissue);
• LEEP (loop electrosurgical excision procedure, the removal of tissue using a hot wire loop);
• conventional surgery.

Similar treatments may be used for external genital warts. In addition, some drugs may be used to treat external genital warts. See your doctor if you think you may have been infected. Only a physician can prescribe the correct medication and treatment.

Prevention

• Vaccines (against some of the most common types of HPV). These vaccines are given in three shots. It is important to get all three doses to get the best protection. The vaccines are most effective when given before a person's first sexual contact, when he or she could be exposed to HPV.
  • Condoms may lower the risk of HPV. HPV can infect areas that are not covered by a condom - so condoms may not fully protect against HPV.
• Abstinence or Mutual monogamy.

How to stop the spread?

• Have regular Pap tests which show the changes that are caused by HPV (your doctor may advice you on when to start testing and how often you should do it)
• Abstinence