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Pathology of the: AIDS | Pathologies and health.


Diseases and conditions

  • AIDS: what is it?
  • The diagnosis of AIDS: all tests
  • AIDS: you can have a baby?
  • Fellatio and AIDS: the risks
  • AIDS: heal after a bone marrow transplant
  • AIDS and oral sex
  • Living with HIV when you are older
  • AIDS and circumcision
  • What is HIV testing?
  • Vivagel: lubricants and condoms against HIV (and AIDS)

What is AIDS?

You define AIDS (Acquired Immune Deficiency Syndrome) acquired immune deficiency syndrome, which is a serious alteration of the body's immune defenses (involves a special class of white blood cells), which occurs in individuals without any precedent in this area.

What caused AIDS?

By a virus belonging to the family of retroviruses, now commonly called HIV1 (Human Immunodeficiency Virus), but that its discovery (1984) was initially referred to as HTLV-II or LAV. It was recently discovered a second virus responsible for the disease, HIV2.

How does HIV virus on the body?

HIV enters cells, called special T-cells, destroying them and provoking a profound alteration of the immune response.

What happens to people who are affected?

Those affected are extremely vulnerable to various diseases (infections such as Pneumocystis carinii pneumonia, and cancers such as Kaposi's sarcoma), immunological normal conditions would not be able to be established. In this case, such infections are called "opportunistic infections".

What is meant by "opportunistic infections"?

Shall mean a series of infections caused by microorganisms commonly found in the environment and in the same body, which in immunologically healthy people do not cause disease, while immunosuppressed individuals find a fertile ground to take root, causing serious infections, often fatal.

How is it transmitted the AIDS virus? How can you contract it?

a) through unprotected sex with an HIV-positive person, through blood, semen, vaginal secretions;
b) through blood contact (Exchange of infected syringes, blood transfusions are not controlled);
c) for accidental exposure to infected patient to health care worker;
d) for transmission from HIV-positive mother to child during pregnancy, childbirth, breastfeeding.
The assumption was made that the saliva can transmit the virus, but so far there has been no case of AIDS through infected saliva, nor by means of other secretions such as sweat or lacrimal fluid.

It is possible the transmission of AIDS through direct reports, but non-sexual?

No. AIDS is not transmitted in any way for surface contacts and random, like touching a person or sedendole next, or swimming in the pool, or drinking in the same glass. Even the kisses, not being shown that the virus is spread by saliva, they should be harmless.

How long is the incubation period of the virus?

The duration of the incubation is very variable, and long: from six months to two years; You may also extend up to ten years. This asymptomatic phase does not correspond to the quiescent virus, as it was assumed in the past. In fact, the virus begins to multiply immediately after infection, then the immune system reacts, but ongoing viral replication in the lymph nodes.

Anyone can be infected with AIDS?

Theoretically yes. In the early years after the appearance of AIDS, some categories were particularly vulnerable:
to drug users,) the use of shared syringes;
b) promiscuous homosexuals, i.e. having many sexual partners;
c) the hemophiliacs or those forced to repeated blood transfusions or blood products (factor VIII);
d) partners, males and females, individuals living with HIV;
and those born from) HIV-positive mother.
Various preventive measures (controls on blood donations since 1985, the use of condoms, the use of autobloccantisi syringes) made it possible to restrict or, in some cases, to stop the contagion. Still remain at risk many addicts, HIV-positive individuals, partners and children of HIV-positive mother. At the time, the group most heavily exposed to infection, however, is that promiscuous heterosexuals, among whom the disease spreads mainly for lack of prevention.

What are the symptoms of AIDS?

swollen lymph nodes) simultaneously in different locations (armpits, neck, groin) that persist for at least three months in the absence of other diseases;
b) weight loss (10% of their body weight) in a short time;
c) sense of fatigue (asthenia) not related to physical activity and intake of medications;
d) fever;
and night sweats);
f) skin rashes and purple manifestations;
g) persistent diarrhea;
h) spots of recent appearance on the skin, mouth, nose, eyelids, in the anal region;
the oropharyngeal candidiasis) and/or Herpes infections persisted vesicular. These symptoms appear immunodeficiency are at an advanced stage of infection.

What you must do in the presence of these symptoms?

First, we should not panic, because these symptoms are also present in that diseases with AIDS have no relation.
For the visit and the findings, please contact specialized centers that exist throughout the country and providing all necessary assistance.

What can you do to reduce the risk of contracting AIDS?

You must use a condom during sexual intercourse and abstain from gold-genital contact. The rules cover in particular those who have casual relationships or with people you do not know the health situation. Couples, including homosexuals, who have a normal sex life, no occasional contact with strangers, and safe to be HIV negative, may continue to have relations as before, without using a condom necessarily. As regards the risk of contagion is not sex-linked, you must ensure, in the case of intravenous injection, needle and syringe are sterile.

That danger faced by members of an AIDS sufferer?

Absolutely none, as long as they do not have sexual relations with a patient or blood-blood contacts with him.

What are the chances of contracting AIDS through blood transfusions?

Today almost no, since from 1985 in each blood bank is carefully implemented the recognition and inactivation of viruses in the blood itself. People who received blood transfusions or blood products before that date, however, are considered at risk.

You can catch if you donate blood?

No, because all the tools are sterile and disposable.

How is AIDS?

The disease is diagnosed by the presence of some opportunistic infections and certain cancers, especially those affections which reveal a deficiency of cell-mediated immunity. With the anti-HIV test will recognize those who have come into contact with the virus and developed its antibodies (seropositive subjects). Test positivity doesn't mean illness; This can then intervene, but not necessarily.

What is the HIV test?

In search of blood serum if there are antibodies to HIV, which are produced by the organism infected by the virus. The test is called the ELISA (EnzymeLinked Immunosorbent Assay, enzyme linked immunoadsorption).

Is a safe test?

Not a hundred percent. In some cases you have "false positives", i.e. healthy individuals but the test is positive.

How do you know if the HIV is true or false?

All HIV-positive persons undergo a subsequent trial (Western blot method) that is based on the ELISA principle (identification of antibodies), but uses very purified antigens. If the subject is also positive to this test, there are no more doubts.

Do not submit for patients to Western blot test?

No, it would be too expensive. It is better to do an initial search, or screening, with ELISA method and intervene only on HIV.

The individual who had a contact at risk must immediately undergo HIV testing?

No, there is no point in testing before the contact risk is at least 4-6 weeks, because the review highlights the presence of the infection only after a period of time ranging from one to six months from such contact. During this period, called "window period", the virus – albeit not detectable – is still active and can be transmitted to other people; Therefore it is necessary and proper to take every possible precaution to avoid becoming a source of infection.

How long after last contact at risk you can be sure to not have AIDS?

The certainty of seronegativity can only be achieved by undergoing the tests after at least six months following the last contact at risk.

As you can follow the progress of the disease?

You can evaluate the relationship between blood lymphocytes CD4-type (called helper, i.e. defence) and CD8 (suppressor, i.e. of inhibition). When the disease is active CD4 decline and the relationship grows in favor of CD8. The balance between the types in course of therapy indicates the effectiveness of treatment.

There are other diagnostic tests?

Yes, the PCR technique (Polymerase Chain Reaction or polymerase chain reaction), which allows, by analyzing DNA extracted from blood cells, to determine whether the viral genome is integrated with that of lymphocytes. This test can then "recognize" the virus even within hours of infection, when the amount is minimal.

What people need to do the HIV test?

Those who belong to groups at risk, and those who are promiscuous, occasional reports commonly repeated with people at risk. It is not absolutely necessary to use the test anyway, and when you do not have reasonable grounds to suspect infection.

How a person should behave found positive?

Those who have been found HIV positive must implement preventive rules already described, not to avoid infection, but not to spread it. Diagnostic centres, they can also find all the assistance, including psychological, indispensable.

Two HIV positive individuals may have sex with each other?

Yes, but with the backing of the condom, because a new infection increases the chances of getting sick; It is good to also avoid any situation that exposes a small mucosal lesions of the genitals, mouth and anus.

Contraceptives are useful to avoid infection?

No: diaphragm, IUD, the pill, etc. are of no use. Only the condom is an effective means of prevention.

You can cure AIDS?

For some years was launched, also in Italy, the testing of a "combined" therapy, i.e. the combination of multiple drugs (usually three, two and one antiretroviral protease inhibitor) that Act on different stages of the reproductive cycle of the virus. From the results obtained so far, this therapy has proven effective in reducing the amount of HIV in the blood at levels so low that it is no longer detectable with the tests in use, but it is not yet possible to say that it is able to permanently eliminate the virus from the body.

Therapy is easy to apply?

No, absolutely. It is a long and heavy care, involving recruitment, for years, many pills several times a day and not negligible effects.
This requires, of course, the availability of the patient to sottoporvisi.

You can use the combined therapy for preventive prophylaxis?

For now, the only therapy for health care workers who accidentally come in contact with infected blood. To be effective, treatment must be started within hours of infection.

It is believed that it will be possible to eradicate AIDS?

Worldwide research of Immunologists are aimed at this goal and are held in several directions: development of drugs that are better tolerated than current, study of a vaccine for people at risk of infection, use of substances (such as cytokines) can restore the immune system. Finally, the recent discovery by researchers, Chemokines could perhaps pave the way for a future gene therapy of AIDS.

What are Chemokines?

Are proteins found on the surface of T lymphocytes and are necessary for the entry of HIV into the same cells. For a genetic defect, their production is altered in two categories of people who have a natural resistance (Genetics) to infection: the "exposed uninfected" and "long term survivor", or lungosopravviventi.

What characterizes these two categories of people?

The "exposed uninfected" are seronegative individuals who, while exposed to the virus through sexual intercourse, no symptoms of infection. The "long term survivor" are seropositive individuals for over ten years, however, do not show any symptoms of infection also.

The diagnosis of AIDS: all tests

HIV testing is generally known as an AIDS test. In reality, however, this is an incorrect statement. In fact, the test is used to detect whether a person has developed HIV antibodies. Remember that AIDS is only the terminal stage of HIV infection.
HIV testing is generally known as "AIDS test". In reality, however, this is an incorrect statement. In fact, the test is used to detect whether a person has developed HIV antibodies. It's good to remember that AIDS is only the terminal stage of HIV infection.

What is an ELISA test?

The ELISA is a test of immune response, a laboratory examination performed on blood, to diagnose infectious diseases. The term derives from the English word ELISA-Enzyme-Linked ImmunoSorbent Assay enzyme-linked immunosorbent assay using enzimodipendenti antibodies.

What is the window period?

When HIV enters the body, antibodies anti-HIV, not formed immediately. The window period is the span of time during which you have been infected but is not, yet, the seroconversion. This time, in summary, you are, again, become HIV positive because they do not have formed the anti-HIV antibodies. During this phase, the ELISA test is negative and, therefore, based only on it, to diagnose HIV, the infection can not be detected.
The window period lasts an average of:
• 4-6 weeks in the case of older generation ELISA test
• 22 days with the ELISA test, currently in use in most laboratories
anyway to get a result that can be considered definitive need to wait 3 months before the event at risk. However, for safety reasons, we generally recommend that you repeat the test at 6 months.

What is the Western Blot test?

The Western Blot is a confirmatory test that helps identify, through blood, the presence of specific antibodies against different virus. This examination is typically used as confirmation of infection.

How to test?

The ELISA test, done privately, has a modest cost. On the contrary, however, at public facilities can be made anonymously and free of charge, typically without the doctor's request.
The test can be performed:
• public and private facilities where you make withdrawals
• departments of infectious diseases of public hospitals
• health centres for sexually transmitted diseases

Who should test?

Persons belonging to a group at high risk should undergo the tests. It is worth noting that, often, HIV infection is asymptomatic. In some cases, you may experience skin disorders, Seborrheic Dermatitis, emaciation, diarrhea, fever, oral candidiasis. Other infections that can accuse patients, infected with HIV, are represented by herpes simplex or herpes zoster, tuberculosis, salmonellosis. The test is voluntary, and because it runs, you need your explicit consent.
The decision to take the test is yours: take your time to deal with it peacefully. Remember, though, that early diagnosis could help you more choice when considering a course of treatment, if any,.

AIDS: you can have a baby?

You can give birth to a healthy child if one of the spouses is HIV-positive. The risk of contamination of the partner or child is the main problem. The medically assisted procreation (PMA) offers some solutions.
In France, in May 2001, after much waiting, a Ministerial Decree defined the possibilities and conditions of treatment of HIV-positive couples. Today a dozen hospitals (including three in Paris) can satisfy this desire for motherhood. Waiting lists are therefore less long, although sometimes you have to wait a few months.
In Italy, the Decree of the Ministry of health of the 4/11/2008 (G:U: 4/30/2008) updated as required by law 40/2004. This decree introduced the ability to use the techniques of medically assisted procreation (PMA) for couples where the male is the bearer of sexually transmitted viral diseases, in particular HIV and hepatitis B and C, recognizing that such conditions are comparable to the cases of infertility for which redress is granted to PMA. In these cases there is a high risk of infection to the mother and the fetus, resulting in unprotected sex with the HIV-positive partner.

A shorter treatment

Since triple-drug therapies were introduced, several couples in which one partner is HIV positive manifest their desire to become parents. In this case, the main problem is certainly the risk of transmission between partners (horizontal transmission) Human Immunodeficiency Virus (HIV) and the risk of mother-to-child transmission (vertical transmission). The medically assisted procreation (PMA) can be a solution for these couples called "serodiscordant".
Such couples must meet the essential conditions of the PMA (stable couple married or common-law partner for more than two years, psychological support, etc.) and at the same time not have to bring a therapeutic failure or uncontrolled infection. Otherwise, the project of prospective parents is usually postponed until you have reached a satisfactory level of effectiveness of the treatments.
Finally, the treatment is different depending on whether:
• both men to be HIV-positive;
• whether the woman was HIV-positive;
• both partners are HIV positive.

When the man is HIV positive

This is the most common case today in France and in Italy, where the number of men infected than women is threefold. The main objective is therefore to avoid contamination of the partners. In the years ' 80 artificial insemination with donor sperm (IAD) represented an alternative with the advantage of having a risk of transmission of zero. For couples who instead wanted a biological filiation in the early 90 's had been tried the natural method, then abandoned.
Today the technique is to select a fraction of sperm in which the virus cannot be detected. Although antiretroviral therapies are able to reduce the viral load (number of copies of the virus in a milliliter of blood) to irrilevabili levels in the blood, sometimes the virus remains in the ejaculate. The spread of antiretroviral drugs at the level of the genital system differs considerably depending on the molecule used. Sometimes, then, you vary the treatment.
The choice of resorting to medically assisted procreation is, therefore, based on the results of biological and virological analysis, but also on the basis of any fertility problems: intrauterine insemination (IUI), in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI).

When the woman is HIV positive

The prevention of transmission of infection to the partner does not necessarily require a PMA. If there are fertility problems, the couple can also practice autoinseminazioni in respect of their privacy. The sperm is collected in a clean container or a free condom and spermicides is immediately injected into the bottom of the vagina using a syringe or a pipette.
The main problem is to prevent mother-to-child transmission and reduce the toxicity of antiretroviral therapy on the fetus. To reconcile these two goals, today the team specializing in HIV and the midwife team have many molecules. Caesarean section is no longer mandatory if the viral load is undetectable to the end of pregnancy and if the treatment was followed properly until delivery. If treatment was not optimal, postnatal prophylaxis in children (generally limited to administration of Azidotimina-AZT-for six weeks) will be intensified. In addition, breastfeeding risk is eliminated by the use of powdered milk.
Without the administration of any type of treatment, the risk of contamination is approximately 20%. However, this percentage has been reduced to less than 1-2% by combining appropriate antiretroviral therapy. In France, about 1,500 births per year from HIV positive mothers, 20 cases of transmission are reported due to lack of treatment rather than an actual therapeutic failure. However, currently do not have reliable data regarding the long-term toxicity of antiretroviral therapy taken during pregnancy on children.

The special cases

Couples in which both partners are HIV positive may resort to medically assisted procreation at specialized centers. Such a choice can be made in case of infertility of the couple or for fear of contamination with new virus strains. The treatment of these couples will be made in the manner mentioned above.
In the case of co-infection with the hepatitis C virus, in humans is the test for detection of hepatitis C in sperm. In 70% of patients the viral load is undetectable in the ejaculate. Otherwise, you should select a fraction of semen virus free. As for the hepatitis B virus, you should vaccinate uninfected partners regularly. The hospitals involved in the PMA in patients at risk do not necessarily viral even HIV-hepatitis B co-infection.
According to the 2004 report on the treatment of people infected with HIV, "the results in terms of pregnancy are better than those of couples generally treated with PMA, because they show that nearly half of couples can hope to realize their dream of becoming parents." In the case of male infertility, a good alternative is the insemination of sperm from anonymous donor (not HIV, hepatitis B and hepatitis C). You can then always think to seek adoption, although its suitability in fact remains very difficult.

Fellatio and AIDS: the risks

The risk of transmission of the AIDS virus during fellatio is known for many years now. The extent of this risk, however, was not yet quantified.
Fellatio is often associated with other sexual practices, it has not been easy to highlight its link with HIV infection. Early detection tests now enable to reduce the time between infection and the time when this is encountered. Now it is therefore easier to identify practices that could be the source of infection. Also, being more widespread use of condoms for vaginal and anal intercourse, it is easy to study groups of subjects such as risk behaviour only fellatio without a condom.

AIDS and fellatio: an underestimated risk

A recent us study so discombobulated old convictions *. Was conducted on homosexual 102 recently infected with HIV. In at least 7.8% of cases, the source of the contamination would have been the practice of fellatio without a condom. The risk is therefore far from being negligible, particularly since, for prudence, the authors failed to take account of all those cases in which other practices may be at the origin of HIV. Therefore, it is highly likely that it is an underestimated risk. The majority of men considered thought that the chance of being infected during an oral report to be very poor if not nonexistent. In view of the serious risks associated with vaginal and anal intercourse, prevention campaigns have focused primarily on the need to use condoms to these practices. While the fellatio was often considered "at risk". This situation has developed the belief that the risk of infection were almost non-existent. This is not the case and this American study.

The condom: the only weapon for AIDS prevention

This study emphasizes the need to use condoms to orogenitali relations. For now the data that helps explain precisely how the virus is transmitted. The American study highlights the risk to the individual who performs fellatio but there is nothing that allows you to assert that those who receive no risks nothing. Of course, swallowing semen is a higher risk, but it is useful to know that the preorgasmico liquid (Cowper's secretion of Garcia that humidifies the Glans on erection much before ejaculation) can be a carrier of HIV.
We must not forget that a few drops of semen can leak even before ejaculation. Some research has also shown that the foreskin can be a reservoir for HIV. The gums increase the risk and is not recommended to brush your teeth before practicing fellatio.
The condom is the only way to mitigate risks. For convenience, use condoms lubricated. There are flavored versions (vanilla, strawberry, etc.) that may make the use of condoms for the person who performs fellatio.

AIDS: attention to other oral caresses

No other orogenitali reports (cunnilingus or analingus, i.e. lick sex or the anus of partners) are risk free. However, data are lacking to define with precision the modes of transmission and their degree of risk. Be aware, however, that the AIDS virus may be present in vaginal secretions and menstrual blood is infectious. As for fellatio, avoid brushing your teeth before intercourse to avoid weakening the gums. To reduce these risks and avoid any direct contact between the mouth and mucous membranes, can use a dental dam. It is a latex sheet square shape where you need dentists to create the operating field. You can buy it in pharmacy or some sex shops. Alternatively, you can use a condom cut lengthwise.

AIDS: heal after a bone marrow transplant

A bone marrow transplant in a patient 42 years seropositive, edited in 2007 by a German team of leukemia, has made no longer detected the AIDS virus. The announcement of this discovery occurred in November 2008, considered a few time, led to a scientific publication in the journal Blood. Despite being amazing, this "healing" is met with caution from experts.
It was announced in 2008: Timothy Brown, an American man of 42 years living in Germany, from 10 years, HIV was forced two years ago to stop any treatment against the virus to undergo a bone marrow transplant. Following the transplant, the patient is not only cured of leukemia, from which he was suffering, but also seems to no longer exist any trace of the Aids virus.
To succeed in this undertaking, the team of hematologist Eckhard Thiel, Charity hospital in Berlin, had the brilliant idea to choose a particular donor for the bone marrow transplant: a person carries a genetic mutation, mutation of the CCR-5 receptor is present in almost 1% of Caucasian population and that seems to confer to individuals who are carriers immunity against HIV (or at least a much slower evolution toward the stage of AIDS).
Doctors hoped that this would allow bone marrow transplant healing from leukemia, but also to eliminate HIV infection.
The findings published in the medical journal Blood are very promising. At the end of the treatment, the patient presents with immune cells rates similar to those of an uninfected person. In addition, the cells produced are carriers of the mutated gene and, consequently, become resistant to HIV infection. Three years later, researchers have not found any re-infection, the viral load is undetectable, suggesting a real healing.
However, the reservations expressed in 2008 on the possibility to see the virus hidden in the "tanks" (fabrics that can survive in very limited quantities) are always topical. The other fear is that the virus could mutate and use roads other than the CCR5 receptor (another co-receptor, CXCR4 baptized specifically) to infect the cells of the immune system. But three and a half years away, and after the restoration, immunologic (CD4 repopulation of the donor) blood level, but also marrow digestive tract level, these results are extremely encouraging.
Today, the main concern reserves the technique employed, very risky and difficult to apply General:

-In the context of cancer care, the patient was subjected to chemotherapy, radiotherapy and immunodepressivo treatment, before undergoing a bone marrow transplant first and then a second, 13 days later, following a recurrence of leukemia. Timothy Brown developed a neurological complication, which gave him a temporary blindness, memory problems and, according to friends, even a personality change.
The compatible HLA marrow donations are already very hard to find (in fact, it is rare to find a compatible donor: there is 1 chance in 1 million that two people picked at random can be compatible), if you add as a condition that the donor is also carrying a mutation that allows a natural resistance to HIV, the situation becomes even more difficult ... unless you can modify the genetic heritage of grafting stem cells.
-Bone marrow transplantation remains an extremely heavy treatment with serious risk of complications (graft reaction against the host, infections or liver problems ...). Finally, this type of treatment plan to spend several weeks in cleanroom. The mortality rate after a bone marrow transplant is more significant than that of HIV-positive patients taken care in developed countries.
Finally, this encouraging medical procedure will not be extended to the 33 million people infected worldwide, and that the risk of complications, the difficulty of finding suitable stem cells and resulting costs. However, the healing of this patient confirms the key role played by the CCR-5 receptor in HIV transmission and the development of the disease. These results should revive the track in front of gene therapy against HIV, in order to introduce HIV-resistant gene in stem cells, before they can be implanted. But even if this new search path, the cost of treatment should initially be limited to patients in rich countries in lack of care.

AIDS and oral sex

A survey reveals that more than a third of our net surfer believes that practicing fellatio condom does not entail risks. Although known for many years, the risk of transmission of the Aids virus is often underestimated. Yet this kind of relationship would be responsible for about 8 percent of infections.
The risk of transmission of HIV through oral sex is not non-existent. Some British and American studies suggest that this kind of relationship is the cause of many more cases than you think.

An underestimated risk

For a long time researchers have had to confront a real puzzle: how to separate the risk associated with oral reports from other sexual practices? The spread of the use of condoms, especially in the gay community, however, allowed to examine more specifically this practice as the only risky behavior.
Studies conducted since 1998 have come to the conclusion that, although uncommon, contagion through oral sex are not negligible.
The findings of a survey carried out among the homosexual community of London between 1996 and 1998, the most significant have made it possible to establish an initial evaluation. About 494 seropositive patients, 6% thought to have been contaminated through oral sex.
Subsequently, presented at the 7th Conference on Retroviruses and opportunistic infections, more results have come in upset because believed until then. Researchers from the prestigious Center for Diseases Control and Prevention (CDC), in collaboration with the Hospital of the University of San Francisco, examined 102 HIV positive homosexuals, of which 8 were found to be infected after an oral sexual intercourse (i.e. about 8%). "We didn't expect to find so many cases of infection through oral sex," said Frederick Hercht, co-author of the study.
Prevention campaigns have focused on vaginal transmission and anal, which represents 90% of infections. However, it seems that today the transmission through oral sex is not negligible and that is higher than you think, especially due to the spread of fellatio without a condom. Cases have also been reported of contagion for cunnilingus or analingus.

Other AIDS transmitted through oral sex

The British Department of health has decided to launch a new prevention campaign. Based on the conclusions of a study, English-speaking authorities think that citizens should be informed about the hazards and decide for themselves the level of risk considered acceptable. AIDS, however, is not the only risk. Other sexually transmitted diseases such as syphilis, gonorrhea, hepatitis B, genital herpes can be spread through oral sex.
Thus, several outbreaks of syphilis in Europe (Manchester, Dublin, Paris, Oslo, etc.) have made it possible to identify oral sex as a risk factor. Extensively researched, Manchester's case has highlighted the impotence of overseas health authorities-in Sleeve stop despite prevention campaigns.
Oral reports seem to represent an important risk factor also in the transmission of chlamydia and herpes.

Condoms and prevention

Higher risks are associated with oral cumshots in the mouth of the partners, but also the liquid preorgasmico (secretion that is tasked to humidify the penis in erection) can be a carrier of HIV. Also from the penis can slide a few drops of cum even before ejaculation.
Good oral hygiene reduces the risks of oral transmission, but brush your teeth before oral intercourse produces the opposite effect. Certain infections or diseases of the oral cavity can help the AIDS virus contamination. Also, rinse the mouth before or after an oral report would tend to reduce security rather than increase it, because this eliminates the protective substances naturally present in the mouth.
The only way to protect yourself from sexually transmitted diseases is the use of condoms. Know that there are flavoured condoms without lubricants and specifically designed for oral sex.

Fellatio, cunnilingus and tumor

The human papilloma virus (HPV), which was recognized a role in most cases of cervical cancer, is now being called into question as well as for cancers of the mouth and oropharynx. A team of international agency for research on cancer (IARC) in Lyon has recently conducted a study in order to search for the presence of human papilloma virus in tumors of the oral cavity. Doctors have known for a long time that this type of cancer is caused primarily by cigarette smoking and alcoholism, but for some cases, there were no apparent explanation.
The IARC team has therefore conducted a study in nine countries. The results are interesting. The human papilloma virus have been found in nearly 4% of cancers of the mouth and over the 18% of tumors of the oropharynx. In 95% of cases it was HPV 16 strain more frequently involved in cervical tumors. This virus has been found in tumors of smokers than in people who claimed to have had several sexual partners or to practice fellatio or cunnilingus.
You will need to perform additional research in order to demonstrate that these sexual practices are actually responsible for these infections. Don't panic, though, alcoholism and smoking are responsible for 90% of cancers of the oral cavity.
The human papilloma virus are part of the great family of sexually transmitted diseases and how best to limit the risks, so the use of condoms.

Living with HIV when you are older

Before the arrival of tritherapy in 1996, the problem was to survive the virus VIH et non of age with it, but now there are concerns for the future, with isolation and loneliness for some age-related diseases, the appearance of the body, the desire that turns off, not to mention the fear of poverty for those who have had a bumpy career path and for which the HIV virus and fatigue played a role of amplifiers difficulties.
The testimonies collected by the Association AIDES worldwide reflect the variety of possible directions and questions: even though it is not all black, some words hurt.
"I no longer have sexual relations from 2007, and since I am now too thin is beautiful and the problem solved" said Matilda (55 years old, HIV positive from 27) that, like others, confides her fear to infect someone, fear of rejection and the difficulty of using condom consistently. Sometimes this "block" that hampers the new encounters and pushes to close itself dates back to the discovery of one's HIV status, twenty years earlier.
For Vincenzo, 52 years old, HIV-positive from 24, which is in danger of being evicted from his apartment because of debts, "what I anguish isn't HIV but the precariousness".

HIV and older people, especially men

The DGS interviewed a sample of 54 subjects, most of whom are between the ages of 60 and 70 years. It is a male population (only 23% of women, compared to 35% in the population under the age of 60 years), characterized by a situation better on average than those with less than 60 years: have indeed experienced a period economically beneficial (work, etc.) and when they contracted the virus could already count on an "economic situation" (in the case of the youngest at least 30-35 years).
Those who have worked for their entire lives can benefit from an adequate pension and often have their own accommodation; the resources of the majority of the women interviewed, however, are significantly more fragile.
In the vast majority of cases, this generation could benefit from a system of efficient and competitive social protection: health insurance guarantees a feeling of security against future, as emerges from the study.
Among the measures put in place should mention the training for the staff of EPADH commissioned to accommodate AIDS patients and psychological support for people in distress situations, such as women infected by her husband, has since died.
AIDES also interviewed 52 people aged between 50 and 71 years in relation with the Association, whose members are mostly under the age of 60 years. The survey revealed that the majority live on less than 1000 euros per month, then under the poverty line. And according to topics with more than 50 years who responded (300) the survey "HIV, hepatitis, and you?", conducted in 2010, only 30% have a job and less than one third live in a lodging property. One in five gave up at least once on a visit to the family doctor for cost reasons, and one in three at a visit to a specialist.

AIDS and circumcision

A study initiated by the National Agency for AIDS research proves the protective effect of circumcision on the risk of HIV infection. The observation of over 3300 men in Orange Farm, South Africa, showed a decrease by 57% to 61% of the rate of new infections in men circumcised than uncircumcised men. According to Prof. Auvert, lead author of the study, these results encourage us to quickly give way to circumcision programs in Africa.

Circumcision as AIDS strategy?

The protective effect of circumcision on the risk of HIV infection has been demonstrated in numerous studies scope. Three large-scale essays attest to this protective effect: the first dates back to 2005 (French study conducted in South Africa), the results of which were later confirmed in Kenya (in 2007) and Uganda (2007). All these works have shown that the risk of being infected by HIV in circumcised men had decreased from 50% to 60%.
Since 2006 it is estimated that the implementation of programmes promoting circumcision over the next ten years could prevent 2 million new cases of HIV and about 300,000 died from Aids in sub-Saharan Africa. In 2008, researchers have estimated that the cost of a circumcision campaign in 14 countries in the region to 919 million dollars, compared to the benefits that would result, would be economically viable.
Decreasing the number of people infected, the budget would fall to antiretroviral treatment. A calculation on 20 years suggests that, in this way, in 14 Countries of the study could save 2 billion dollars. In view of these results, the World Health Organization and UNAIDS from 2007 recommend adult circumcision as additional prevention strategy against HIV in communities most affected by HIV in which circumcision is uncommon.

The protective effect to humans

From where come this protective effect? It would depend on the nature of the inner wall of the foreskin: a delicate permeable mucosa consists of numerous dendritic cells, immune cells are very sensitive to HIV. Circumcision would therefore significantly reduce the surface permeable to viruses, and even the remaining skin to cheratinizzarsi (i.e. hardening) and become more waterproof. However, even if circumcision can actually reduce the risk of infection, this is not enough to protect men during sexual intercourse.
It remained therefore to demonstrate how these data could be transposed into real life, resulting in a reduction in the incidence (rate of new infections) and prevalence (proportion of infected people) of HIV infection among men. IAS Conference of 2011, there have been reports some preliminary results of the study 12126 Anrs (Bophelo Pele). Today researchers confirm these findings in the journal PLOS Medicine. It is therefore the first scientific publication that demonstrates the efficacy of male circumcision to reduce the risk of being infected.
Conducted between 2007 and 2011, this study consisted in offering free circumcision and medical volunteers to all men between 15 and 49 years in a population of 110,000 adults in the shantytown of Orange Farm, South Africa. Were performed over 20,000 circumcisions, accompanied by an extensive program of information and prevention. Among the population of slums was recruited a sample of 3,338 people.
These have responded via anonymous questionnaire questions about their sexual habits and were invited to perform a diagnostic test of the HIV virus. Included a screening tests that can determine, in the case of HIV, if the infection was recent.

Significant reduction in HIV transmission

The results allow to prove membership of men in this practice and its protective effect: the proportion of men circumcised for Mysterio went from 12% at the beginning of the study to 53%; has reached 58% among those aged between 15 and 29 years. It is important to note that sexual behaviors, especially condom use, do not differ depending on whether the men are circumcised or not. This results in a significant decrease in both the prevalence and the incidence of HIV infection in circumcised men.
Researchers believe that, in the absence of voluntary program, in the population examined the spread of HIV would be higher than the 19%. With a more pronounced effect among younger people, whose broadcast was 28% higher among those aged between 15 and 29 years. In parallel was observed a decrease in the number of recent infections among circumcised men. Circumcision is so associated with a reduction from 61% to 57% in the proportion of new infections. For Prof. Auvert, these findings are important for two reasons.
On the one hand confirm the efficacy of circumcision practised on a population scale in significant reduction in HIV transmission among men of that population. The other shows that you can accomplish this in just a few years, even in populations where circumcision is not a usual practice. The study continues in order to know the effect of circumcision on reducing the risk of infection in the general population, and particularly among women.

Voluntary circumcision

This study provides one more argument to accelerate the start of voluntary circumcision programs, especially in sub-Saharan Africa, where most of the 2.2 million people infected each year with HIV in the world.
Prof. Delfraissy, of Anrs Director, believes that given the impact observed in this study to reduce the risk of HIV acquisition in men circumcised, the circumcision generalization must be more than ever a priority of public health in Eastern and southern Africa.
In this way the formation of qualified public structures remains a key challenge. But even in this case there has been progress and some initiatives, especially in Zimbabwe by Population Service International, made it possible to optimize the voluntary circumcision programs.

What is HIV testing?

HIV, or human immunodeficiency virus, a retrovirus is transmitted during sex or from mother to child during pregnancy, and in some cases through breastfeeding, or in case of accidental exposure to infected blood by the medical staff. An early diagnosis allows to prevent HIV evolve into AIDS.

What is HIV?

HIV (Human Immunodeficiency Virus) is the virus of AIDS (acquired immunodeficiency syndrome) and belongs to the family of retroviruses, of which there are two categories: HIV-1 and HIV-2. Is a sexually transmitted disease and contamination may appear some signs (usually towards the 15th day after the filming): fever, rash, fatigue, diarrhoea.

Tested for HIV

AIDS (acquired immunodeficiency syndrome) is the consequence of HIV (human immunodeficiency virus), which is diagnosed by detection of antibodies in the blood, antibodies that appear 2-12 weeks after the contamination. It is possible that for several years a seropositive person does not present any symptom of the disease, although it is contagious (e.g. in case of sexual intercourse, through contact with contaminated blood products or transplacental transmission from mother to child). HIV testing may be performed for free in a pickup Center anonymous and free HIV tests.

How does the levy for the test?

Venous blood is taken, usually at the bend of the elbow. You don't need to be fasting. You may need to do a second picker control. In France the HIV test is required for anyone wishing to make a donation of blood, semen, tissues or organs. The confidentiality of the test and results is absolute.

HIV test results

The test is made with two different techniques (2 ELISA test or ELISA test 1 et 1 quick test):
• If the search with the two techniques is negative, the subject is HIV seronegative. In the case where a risk of contamination, in order to consider the result as a permanently negative analysis can be repeated once a month in the months following the 3 possible contamination.
• If any of the tests, or both, are positive, prompted another pick for a confirmatory test, the Western blot test (confirmation test). A test is considered positive if 2 gp41, gp 120 antibody or gp 160 are associated with at least one precursor protein antibody p55, p24, p17 p40 or enzyme or protein p66, p51 or p31.
• If the test is positive confirmation, subject to HIV seropositivity is confirmed.
• It is possible that the second test results no doubt: in this case you may require a new test after one month to determine if the outcome depends on a real doubt seroconversion, started right around the time of the first withdrawal, or if it is a negative reaction, or the subject is seronegative (in this case the result no doubt can be due to a non-specific reaction with other antibodies without any connection with HIV).

Pathological changes related to HIV contamination

The risk of contamination with HIV increases in case of Pathology such as syphilis, hepatitis B and C or the anoproctite.

Vivagel: lubricants and condoms against HIV (and AIDS)

It does not matter if you are hetero or homosexual, HIV, the human immunodeficiency virus that can lead to AIDS, remains one of the greatest risks of unprotected sex. Transmitted primarily through sexual contact, they are different tools that provides medicine to prevent infection. If the condom is still the best weapon to prevent HIV, you can choose to use concurrently with this useful barrier as well as other products, like gels, including protective Vivagel. What are? How to use?
Of all the sexually transmitted diseases, AIDS remains one of the most feared, although today do not have the mortality of his debut. To cause HIV or human immunodeficiency virus, which is transmitted through contact with infected blood, semen and vaginal fluid or from mother to fetus. Once in the body, is integrated into the DNA of a host cell, where it can remain inactive for a few months as years before they start to multiply invading other cells and resulting in full-blown AIDS immunodeficiency.
In the 90 's lethal, today, thanks to antiretroviral therapy schemes, the medicine can keep the virus under control and to prevent the emergence of the disease, but never eradicate the virus from the body. Aside from medications, an HIV-positive patient can lead an existence serena and become a parent. If the seropositive mother with caesarean section and an appropriate treatment can reduce the risk of contagion for the future unborn child to less than 2%.
For men, on the other hand, you can resort to sperm washing, which guarantees safety for both mother and child. However, prevention remains the best weapon against HIV, and thankfully this bow arrows continue to increase.

Disease prevention: condom

A condom is always the best shield not only to unwanted pregnancies but also for all sexually transmitted diseases. Remember that sexual relations are those most at risk, where the likelihood of a microlesione is higher than in vaginal intercourse, but that women become infected more easily than men. The most common are latex condoms, but if either partner was allergic to this material there are also synthetic LaTeX, material created specifically to avoid adverse reactions, or if they are also found in polyurethane, propylene and sensoprene.
With the same capabilities not LaTeX reduce sensitivity, in these cases it is necessary to make sure the size of condoms because of their less elasticity. Another option is the Femidom, the female condom, usually made of polyurethane, already equipped with a lubricant. This type of condom has the advantage of being able to be placed before you begin intercourse, thus avoiding to interrupt the intimacy of the couple.

Condoms and lubricants

The lubricants have no power to prevent the transmission of HIV, although recent studies have disproved the hypothesis that could favor him. Was expected, in fact they made female genital mucous membranes more susceptible to the virus, but a study of 2012 has denied this possibility. Certainly, however, we must pay attention to the type of used lubricant because it might undermine the protective barrier provided by the condom. If you use a latex condom, you can only use watery lubricants, while that in polyurethane, which is masculine or feminine, even oily ones are fine.
The use of lubricants may be still useful to slide better the penis during sex, especially anal, avoiding condom breakage, as the strength of the latter is extensively tested.

Lubricants and prevention: Vivagel

The latest addition to the fight against HIV is Vivagel product from Starpharma. This is an antimicrobial gel able to inactivate virus rate close to 100%, as claimed by the manufacturer. This gel would be effective not only for HIV, but also against other sexually transmitted diseases such as the dreaded human papilloma virus. In addition to the cream, the drugmaker has joined as a lubricant for condoms to provide double protection to its users.
We must not forget that the condom offers protection close to 100% but not complete, so a pharmacological aid might be a good solution to increase the safety of sex. The Vivagel, however, is currently only available in Australia and in Japan, and there is no date for his arrival in Italy.


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