Microbicide & Safe Sex (11)

Pubic Lice

Pubic Lice also called crab lice or "crabs," pubic lice are parasitic insects found primarily in the pubic or genital area of humans. Pubic lice infestation is found worldwide and occurs in all races, ethnic groups, and levels of society.

Pubic lice usually are found in the genital area on pubic hair; but they may occasionally be found on other coarse body hair, such as hair on the legs, armpits, mustache, beard, eyebrows, or eyelashes. Pubic lice on the eyebrows or eyelashes of children may be a sign of sexual exposure or abuse.

Pubic lice have forms: the egg (also called a nit), the nymph, and the adult.

Nit: Nits are lice eggs. They can be hard to see and are found firmly attached to the hair shaft. They are oval and usually yellow to white. Pubic lice nits take about 6-10 days to hatch.

Nymph: The nymph is an immature louse that hatches from the nit (egg). A nymph looks like an adult pubic louse but it is smaller. Pubic lice nymphs take about 2-3 weeks after hatching to mature into adults capable of reproducing. To live, a nymph must feed on blood.

Adult: The adult pubic louse resembles a miniature crab when viewed through a strong magnifying glass. Pubic lice have six legs; their two front legs are very large and look like the pincher claws of a crab. This is how they got the nickname "crabs." Pubic lice are tan to grayish-white in color. Females lay nits and are usually larger than males. To live, lice must feed on blood. If the louse falls off a person, it dies within 1-2 days.

Microbicide & Safe Sex (8)

HIV/Aids
Persons initially infected with HIV may develop an "acute retroviral syndrome" characterized by fever, lymph node enlargement, and flu-like symptoms. If symptoms are present, they clear spontaneously, but all infected persons, both with and without symptoms, remain infected and infectious to others indefinitely. The incubation period is highly variable, averaging about a decade, but ranging from a few months or years to possibly longer than two decades. When sufficient damage to the immune system has been sustained, measured either by laboratory cell counts of the Thelper cells or by onset of opportunistic infections, the patient is said to have AIDS. Common manifestations of HIV infection include tiredness, lymph node enlargement, fever, weight loss, and yeast infections of the mouth and vagina.

HIV infection is diagnosed by laboratory detection of evidence of infection, usually identification of HIV-specific antibodies in a blood, oral fluid, or urine specimen. AIDS can be diagnosed in HIV-infected persons in several ways, based on either laboratory evidence of immunodeficiency (lowered levels of CD4+ cells), or clinically by onset of any one or more of a specific list of opportunistic diseases. Opportunistic diseases are those that occur only, or most severely, in patients whose immune systems are impaired. The most common opportunistic diseases in AIDS patients are Pneumocystis carinii pneumonia, Kaposi's sarcoma, toxoplasmosis of the brain, tuberculosis and other mycobacterial infections, and severe herpes, cytomegalo virus, and yeast infections.

How the AIDS Virus Works?
The AIDS virus weakens the immune system (“immune deficiency”), allowing other infections to ravage the body. These infections are called “opportunistic” because they take advantage of the opportunity to live where the body’s immune system would normally destroy them. It’s when these opportunistic infections strike that the person is said to have AIDS.

Microbicide & Safe Sex (6)

Hepatitis B

Hepatitis B is a virus that infects the liver. Most adults who get hepatitis B have it for a short time and then get better. This is called acute hepatitis B.
You can have hepatitis B and not know it. You may not have symptoms. If you do, they can make you feel like you have the flu. But as long as you have the virus, you can spread it to others.
Sometimes the virus causes a long-term infection, called chronic hepatitis B. Over time, it can damage your liver. Babies and young children infected with the virus are more likely to get chronic hepatitis B.

Hepatitis B is caused by the hepatitis B virus. It is spread through contact with the blood and body fluids of an infected person.
You may get hepatitis B if you:
==> Have sex with an infected person without using a condom.
==> Share needles (used for injecting drugs) with an infected person.
==> Get a tattoo or piercing with tools that were not cleaned well.
==> Share personal items like razors or toothbrushes with an infected person.
==> A mother who has the virus can pass it to her baby during delivery. If you are pregnant and think you may have been exposed to hepatitis B, get tested. If you have the virus, your baby can get shots to help prevent infection with the virus.
You cannot get hepatitis B from casual contact such as hugging, kissing, sneezing, coughing, or sharing food or drinks.

Many people with hepatitis B do not know they have it, because they do not have symptoms. If you do have symptoms, you may just feel like you have the flu. Symptoms include:
# Feeling very tired.
# Mild fever.
# Headache.
# Not wanting to eat.
# Feeling sick to your stomach or vomiting.
# Belly pain.
# Diarrhea or constipation.
# Muscle aches and joint pain.
# Skin rash.
# Yellowish eyes and skin (jaundice). Jaundice usually appears only after other symptoms have started to go away.
Most people with chronic hepatitis B have no symptoms.

A simple blood test can tell your  if you have the hepatitis B virus now.
The Home Bio Hepatitis B test is an easy to use, accurate and reliable assay that will detect antibodies to the hepatitis B virus present in whole blood, serum or plasma.
The test is easy to use and the result is available within minutes – in the privacy of your own home.
Our test kits are the same as those used by doctors and other healthcare professionals to screen for infection with hepatitis. The test is specific for hepatitis B and has an accuracy greater than 99.8%.
You simply prick your finger, using the lancet provided, and transfer a few drops of your blood to the test cassette with the dropper provided. The easy to read result will develop after ten minutes and you will learn your hepatitis B status.

Microbicide & Safe Sex (1)

In this first decade of the 21st century the various risks connected with having sex have (alas) increased.
The figures for HIV, chlamydia and gonorrhoea are all going up. This is almost entirely because so many people – whether they're heterosexuals or homosexuals or 'bi' – don't practise safe sex.

One way to have safer sex is to only have one partner who has no sexually transmitted infections and no other partners than you.

But, this isn't always the safest kind of safer sex. That's because most people don't know when they have infections. They are very likely to pass them on without knowing it.

Another other reason is that some people aren't as honest as they should be. In fact, about 1 out of 3 people will say they don't have an infection when they know they do, just to have sex. So most of us have to find other ways to practice safer sex.

Another way to practice safer sex is to only have sex play that has no risk — or a lower risk — of passing STDs. This means no vaginal or anal intercourse. Many of us find that great sex is about a lot more than a penis going in a vagina or anus. It is about exploring the many other ways you and your partner can turn each other on. Not only is it a way to discover new sexual pleasures, it's also safer.

Safe Sex:
- Reduces our risk of getting a sexually transmitted disease (STD)
- Using condoms and/or microbicide makes vaginal or anal intercourse safer sex
Although condoms provide the best form of protection for people who are sexually active, using a microbicide will be much safer than nothing for women for whom condom use is unlikely or impossible.

For some women and men, the contraceptive effect of condoms is a major deterrent to use; developing both contraceptive and non-contraceptive microbicides is important. Providers can counsel patients on the use of microbicides in conjunction with condoms for added protection, and as a "backup" method when condom use cannot or does not occur.

More about Microbicides

Microbicides for sexually transmitted diseases are pharmacologic agents and chemical substances that are capable of killing or destroying certain microorganisms that commonly cause human infection (for example, the human immunodeficiency virus).

Microbicides are a diverse group of chemical compounds that exert their activity by a variety of different mechanisms of action. Multiple compounds are being developed and tested for their microbicidal activity in clinical trials. Microbicides can be formulated in various delivery systems including gels, creams, lotions, aerosol sprays, tablets or films (which must be used near the time of sexual intercourse) and sponges and vaginal rings (or other devices that release the active ingredient(s) over a longer period). Some of these agents are being developed for vaginal application, and for rectal use by those engaging in anal sex.

Although there are many approaches to preventing sexually-transmitted diseases in general (and HIV in particular), current methods have not been sufficient to halt the spread of these diseases (particularly among women and people in less-developed nations. Sexual abstinence is not a realistic option for women who want to bear children, or who are at risk of sexual violence. In such situations, the use of microbicides could offer both primary protection (in the absence of condoms) and secondary protection (if a condom breaks or slips off during intercourse). It is hoped that microbicides may be safe and effective in reducing the risk of HIV transmission during sexual activity with an infected partner.

Microbicide & Herpes (2)

Genital herpes is one of the most prevalent sexually transmitted infections worldwide and is the most common cause of genital ulcers. Despite increased public awareness and the initiation of efforts to prevent transmission, the prevalence of herpes simplex virus (HSV) type 2 continues to increase.

What makes HSV so difficult to control is that most sexual and perinatal transmission occurs during unrecognized or asymptomatic shedding. The impact of genital herpes as a public health threat is amplified because of its epidemiological synergy with HIV/AIDS. Thus, there is an urgent need for novel prophylactic methods, such as topical microbicides designed for genital application, to prevent both HSV and HIV transmission.

In summary, genital herpes is a critical global health priority because of its devastating impact on young adults and infants and its association with the HIV/AIDS epidemic. Topical microbicides that block transmission at the mucosal surface may provide a realistic method of intervention for worldwide distribution. Currently, there are several candidate drugs being advanced to clinical trials that block both HSV and HIV infection by inhibiting binding and entry in vitro.

Whether blockade of entry will be sufficient to prevent sexual transmission or whether a combination strategy targeting multiple steps in the viral life cycle will be required is not yet known. Importantly, before embarking on large-scale clinical trials, more extensive evaluation of candidate microbicides, including assessment of the impact on innate defences, is warranted. Assessment of the safety and mucosal response to microbicides should be accrued from several different models including cell and organ cultures, animal models and, most importantly, pilot clinical studies.

((Excerpt of)Topical microbicides for the prevention of genital herpes infection: Marla J. Keller, Ana Tuyama, Maria Josefina Carlucci and Betsy C. Herold)

A topical microbicide that silences two genes can safely protect against genital herpes infection for as long as one week, according to a joint study by researchers at the Albert Einstein College of Medicine of Yeshiva University and Harvard Medical School.

Microbicide actions

Microbicides can act in various ways. Microbicides can be nonspecific, moderately specific or highly (exclusively) specific to HIV. The nonspecific and moderately specific agents are often active against a variety of sexually transmitted microorganisms (e.g., chlamydia and herpesvirus) and may have a contraceptive effect. The HIV-specific agents interact directly with one or several steps of the infection or replication cycle of HIV.

Nonspecific microbicides
The nonspecific microbicides consist of buffering agents and of detergents or surfactants that include nonionic, anionic or cationic compounds. The detergents destroy the viral envelope by solubilizing membrane proteins. However, this nonspecific mechanism of action may also disrupt the cell membranes of the vaginal and cervical epithelium and cause erosions and lesions, leading to an increased risk of HIV infection.

Moderately specific microbicides
Moderately specific microbicides mainly comprise  macromolecular linear anionic polymers. Linear polyanions are active against HIV, HSV and in some cases demonstrate inhibitory activity against human papillomavirus (HPV), Neisseria gonorrhoeae and Chlamydia trachomatis. They block viral entry into cells through electrostatic interactions with the viral envelope proteins and, in some cases, host cell receptors. The lack of potency of linear polyanions for HIV and the ability of semen to further abrogate anti-HIV activity, may in part explain the lack of in vivo efficacy of these microbicides. In addition, adherence to product use and transmission via anal receptive sex, which would not be prevented by a vaginally applied microbicide, are other considerations.

Highly specific anti-HIV agents
HIV-specific microbicides should preferentially block the viral infection cycle before the viral genome gets
incorporated in the target cells as proviral DNA.

Targeting viral entry seems the most promising method, preventing virus particles from entering its susceptible cells and, as shown or expected for most entry inhibitors, also preventing transmission of the virus from virus-infected cells to uninfected cells or transmission of dendritic cell-captured virus to lymphoid cells, or both.

About Personal Water Based Lubricant

Lubricant is a substance, typically fluid, that is used to reduce friction during sexual activity. Water-based lubricants are specifically those fluids or gels that are made from a base of water and typically a cellulose solution. A water-based lubricant is water soluble and can therefore be fairly easily washed off. The earliest and still most prevalent forms of personal lubricants are water-based, though newer forms of oil-based and natural lubricants have come onto the market.

Because they are water-based, such lubricants can have a tendency to dry out during use. This can be remedied to some extent by applying more of the lubricant or by applying a small amount of water to the area. A water-based lubricant will dry on its own and be absorbed into the skin or dissolve after use, leaving only the residue of the other ingredients. Because a water-based lubricant can dry out it is usually best to reapply during use to prevent a buildup of friction that can cause injury such as blistering or skin irritation.

Microbicides and women

Microbicides are substances capable of reducing the transmission of HIV and other sexually transmitted pathogens when applied vaginally.Evidence from many settings strongly suggests that many women will find microbicides easier to use than condoms and that they can be used when condom use is not possible. This has raised the concern that women might abandon condoms in favour of microbicides. Indeed, the fear of 'condom migration' has been a major barrier to the widespread endorsement of microbicides as a potential method of HIV prevention.

Despite such high HIV-efficacy, there is substantial evidence that in many settings levels of consistent condom use is low, especially within primary partnerships. Studies show that even after directed intervention, the percentage of couples that achieve consistent condom use seldom exceeds 20-30%, except where individuals know that one partner is HIV infected. Success in increasing the consistency of condom use has been greatest among sex workers and other vulnerable groups, but even here, many sex workers do not use condoms consistently with their non-commercial, primary partners.

Even when condoms are used consistently they may be used incorrectly. The immense gap between the numbers requiring protection and those using condoms consistently and correctly could potentially be filled by microbicides.

With AIDS vaccine efforts at an impasse, microbicides -- virus-blocking gels inserted into the vagina before sexual intercourse -- have risen from their own string of setbacks to once again offer hope of preventing HIV infections, at least in women.

Identifying a microbicide that works even partially could have a huge effect. Almost half of the more than 33 million people living with HIV worldwide are women; in sub-Saharan Africa, the figure is 60%.Abstinence and condoms have been the only proven ways to prevent or reduce the spread of HIV among adults. Circumcision lowers the risk for men, and already-existing AIDS drugs are used prophylactically to reduce mother-to-child transmission during birth or breast-feeding.

Things to Consider Before You Buy Vaginal Lubricants

Vaginal lubricants are available in a variety of products containing various ingredients.
It's important for women to read the label of a vaginal lubricant and buy only water-based vaginal lubricants.
Petroleum-based lubricants can harbor bacteria in the vagina and lead to infection, as well as cause damage to latex condoms rendering them ineffective against unplanned pregnancy and STDs.

Many times women believe that vaginal lubricants or moisturizers are only for women going through menopause and experiencing vaginal dryness; however, normal estrogen fluctuations often cause vaginal dryness creating the need for extra vaginal lubrication.

Vaginal dryness often occurs during:
• the menstrual cycle,
• pregnancy,
• childbirth,
• nursing,
• times of emotional stress,
• and when using a condom.

The Best Type of Vaginal Lubricant
There are several different types of vaginal lubricants available over-the-counter, as well as estrogen-based creams available by prescription.
Vaginal lubricants come in tubes, bottles, and as vaginal suppositories.
Which product works best for your situation is mostly a matter of personal preference.

Microbicide Q & A (2)

Who is working on microbicide research and development?
Virtually all microbicides research to date has been conducted by non-profit and academic institutions or small biotech companies. Research is financed by charitable foundations along with government grants. These public funds also support basic science, social and behavioural research, and clinical study infrastructure that contribute to microbicides research and development. Large pharmaceutical companies have not invested significantly in this area, this is mostly because their income would be minimal.

Why do we need microbicides if we will finally have an HIV-vaccine?
No method or technology will "solve" the AIDS pandemic. We must implement all existing prevention methods --such as behavior change, voluntary counselling and testing, STI diagnosis and treatment, extensive access to male and female condoms, and anti-retroviral interventions-- as well as extend our collection of resources and technologies. Microbicides will probably be accessible and available sooner than an HIV-vaccine. Even after a safe and effective vaccine is discovered, vaccines and microbicides will have different, complementary roles to play in an integrated, multi-faceted global HIV prevention strategy.

Would a microbicide also protect the male partners of HIV positive women?
Lots of candidate microbicides currently being examined are widely anti-microbial and may provide protection against a variety of sexually transmitted infections, including HIV.  By neutralising pathogens in both semen and vaginal secretions, these products will give bi-directional protection; that is, will help protect men and partners. This will give HIV positive people a way of minimizing their partner's risk of HIV exposure during intercourse --as well a way of reducing their own risk of re-infection.
Microbicides will also provide valuable back-up protection to couples who use them with condoms. If the condom slips or breaks, the microbicides can provide both partners added protection from possible infection.

Why would a man want to use a microbicide instead of a condom?
Lots of men dislike using male condoms, regardless that they are excellent barriers against infection and unintended pregnancy. Objections include perceived decrease in pleasure, difficult maintaining an erection, interruption of spontaneity and decrease of the intimacy associated with skin to skin contact. Even before the spread of HIV/AIDS resulted in higher concern about STIs, these factors influenced men's attitude towards condoms. Largely, they account for the popularity of non-condom methods of contraception.
However, non-condom methods of STIs prevention do not yet {exist|be found}. Even when microbicides reach the market, it is unlikely that they will meet the efficacy of male and female condoms for HIV prevention. Logically, it is advisable to keep a virus from coming into contact with one's body than it is to try to eliminate it once it is there.
But, for men and women who don't use condoms regularly, microbicides will offer an essential risk reduction option. Using even a partially effective microbicide will provide significantly more protection than using nothing at all.

Microbicides benefits

- Will provide women an easy way to minimize their personal risk of infection when they cannot insist on   condom use.
- May provide bi-directional protection for men sex with partners who are HIV positive or have STIs.
- Helps protect the wellness of children by helping to lower their parents' risk of infection.Prevent from HIV and STIs while still allowing you to conceive a child.
- Help protect your future children from being born with HIV and/or other STIs.
- Provide you with extra resources for making safe, informed reproductive choices.
- Offer protection against both unwanted pregnancy and diseases.
- Offer a contraceptive alternative that is non-hormonal, non-irritating, and will not interfere with intimate contact.
- Be usable with condoms or hormonal contraceptives for back-up protection.
- Provide contraceptive safety and minimize risk of infection when condoms are not being used.
- Enable you to enjoy sex with less fear of becoming infected.
- Provide lubrication thereby enhancing sexual pleasure and enjoyment.
- Be applied before sex to avoid interruption