More infomation about PEP for HIV prevention

What it is

Post-exposure prophylaxis (PEP) is short-term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure, either occupationally or through sexual intercourse. Within the health sector, PEP should be provided as part of a comprehensive universal precautions package that reduces staff exposure to infectious hazards at work.

Why it is important

The risk of transmission of HIV from an infected patient through a needlestick where the skin is punctured by a sharp is less than 1%. The risk for transmission from exposure to infected fluids or tissues is believed to be lower than for exposure to infected blood.
The risk of exposure from needlesticks and other means exists in many settings where protective supplies are limited and the rates of HIV infection in the patient population are high. The availability of PEP may reduce the occurrence of occupationally acquired HIV infection in health care workers. It is believed that the availability of PEP for health workers will serve to increase staff motivation to work with people infected with HIV, and may help to retain staff concerned about the risk of exposure to HIV in the workplace.
There is significant debate on the need to use PEP after sexual exposure. The UN offers PEP to its staff in cases of rape when the likelihood of HIV exposure is considered high.

How it is done

The proper use of supplies, staff education and supervision needs should be outlined clearly in institutional policies and guidelines.
Regular supervision in health care settings can help to deter or reduce risk of occupational hazards in the workplace. If injury or contamination result in exposure to HIV infected material, post exposure counselling, treatment, follow-up and care should be provided. Post-exposure prophylaxis (PEP) with antiretroviral treatment may reduce the risk of becoming infected.

Prevention of exposure

Prevention of exposure remains the most effective measure to reduce the risk of HIV transmission to health workers. The priority must be to train health workers in prevention methods (universal precautions) and to provide them with the necessary materials and protective equipment. Staff should as well be knowledgeable about risks of acquiring HIV sexually, and be easily able to access condoms and confidential STI treatment services.

Managing occupational exposure to HIV

• First AID should be given immediately after the injury: wounds and skin sites exposed to blood or body fluids should be washed with soap and water, and mucous membranes flushed with water.
• The exposure should be evaluated for potential to transmit HIV infection (based on body substance and severity of exposure).
• The exposure source should be evaluated for HIV infection. Testing of source persons should only occur after obtaining informed consent, and should include appropriate counselling and care referral. Confidentiality must be maintained.
• Clinical evaluation and baseline testing of the exposed health care worker should proceed only after informed consent.
• Exposure risk reduction education should occur with counsellors reviewing the sequence of events that preceded the exposure in a sensitive and non-judgmental way.

THE FACTS AND CAUSES OF CANDIDIASIS

The Facts on Candidiasis

Candidiasis, also called thrush or moniliasis, is a yeast infection. Candida albicans is an organism that normally makes a quiet home for itself on your skin and doesn't bother anyone. We all carry this organism on our skin, in our mouth, in our gastrointestinal tract (gut), and, in the case of women, in the vagina.
Occasionally the yeast multiplies uncontrollably, causing pain and inflammation. Candidiasis may affect the skin. This includes the external surface skin and the skin of the vagina, the penis, and the mouth. Candidiasis may also infect the blood stream or internal organs such as the liver or spleen. By far the most common problems are skin, mouth and vaginal infections. It also is a common cause of diaper rash. These can be bothersome infections, but are not life threatening.
Candidiasis can kill if it reaches the bloodstream or vital organs such as the heart, but this is rare even in people with damaged immune systems and is almost unheard of in healthy people. Nevertheless, candidiasis is a constant nuisance, and sometimes a serious threat to people with AIDS and some cancer patients who lack the immune resources to fight it.

Causes of Candidiasis

You don't catch candidiasis. The yeast is already there. A number of factors can increase the chance of the yeast growing out of control. The leading cause is overuse of antibiotics. Yeast must compete for the right to live on us with various other organisms, many of them bacteria. These bacteria, which live on the skin and in the intestine and vagina, among other places, are harmless but good at fighting off yeast. When we take antibiotics to deal with less friendly bacteria, we kill off these harmless ones as well. Yeast, which is unaffected by antibiotics, moves into the vacated spots once occupied by bacteria, and starts to grow and multiply.
Steroids and some cancer medications weaken the immune system and can allow yeast to flourish. Candida albicans infections of the mouth (known as oral thrush) most often develop in people with diseases such as cancer and AIDS. They can also develop in people with diabetes or in people who have long-term irritation resulting from dentures. Taking birth control pills increases your chances of getting vaginal candidiasis. Hot weather and tight clothing are also risk factors, as they create the ideal environment for candida.
Other conditions that tend to encourage yeast include obesity and pregnancy. Yeast generally infects intertriginous areas, that is, areas where skin contacts skin. Overweight people have more folds in their skin. They also sweat more, and Candida albicans is fond of moist skin. Pregnancy causes temporary obesity and may weaken the immune system, increasing the risk of yeast infections.
Experts disagree on the question of sexual transmission. Some research has suggested that it's very unlikely for an infected woman to give a man candidiasis. On the other hand, it's not unlikely that a man could give candidiasis back to his partner once he has it. Recent research has actually found Candida albicans in the sperm of men whose partners suffered from recurrent yeast infections. You should be aware of this possibility if a yeast infection keeps coming back.

YEAST AND YEAST TREATMENT

Yeast and Yeast Treatments:

Statistics and facts about Yeast:

• Yeast is one of the largest undiagnosed causes underlying many medical problems.
• Surprisingly, more than half of the women who are self-treating yeast infections don’t actually have a yeast infection.
• Diseases mimicking yeast symptoms which should also be ruled out are bacterial vaginosis, urinary tract infections (UTI’s), vulvar vestibulitis, lichen planus, herpes, trichomoniasis, and other sexually transmitted diseases (STD’s)
• Yeast cells divide every 24 hours and feed on simple sugars.
• Yeast can burrow through the intestinal wall and into the blood stream
• Yeast is a part of our normal bowel flora.

Complaints associated with vaginal yeast include intense severe itching, redness of the external area of the vagina, cheesy and sometimes sweet-smelling discharge, burning, irritation, and even intercourse pain.
Hormonal changes, antibiotic use, illness, stress, parasite infections and other factors can upset the vaginal ecosystem, causing yeast cells to grow more rapidly than normal.
Men can contract a yeast infection if they have unprotected sexual with a partner who has a yeast infection. If both partners are not treated, they can keep re-infecting each other. Let me tell you, this is a real bummer. Men may develop genital irritation and genital itching, especially if they are uncircumcised, but usually there is no discharge.
Cancer many times has what we call “mutated yeast” as one of its core causes. What naturopaths mean by mutated is that the yeast is not a visible and obvious symptom in the body (like a vaginal yeast infection). This mutated yeast has penetrated the circulatory system and lies quietly in the entire body. Getting rid of this can be very traumatic. That is why we sometimes need to focus on detoxification and rebuilding programs so that the body will be strong enough for a yeast “die-off”. This is also why we often have to use several products in sequence to get the yeast under control and why the yeast diets are so hard to stick with. When the yeast divide, they need simple sugar. If you are not eating simple sugars the craving for them can be intense.
Some naturopaths also believe that the yeast carries in viruses and may be carried into the body itself by parasites.
The first step in getting your yeast under control is to identify that you have it. The charts below list symptoms of yeast in the different organ systems of the body and how to treat it using both natural and “real drug” treatments. This is one of those diseases where it would be very helpful to have an expert’s opinion. I feel it is money well spent to find out what the core cause of your yeast situation is so that you can rectify them. Patience is a key, here. Treating yeast takes time.
Fasting is a great way to get a jump on controlling yeast, but you will want to do this under supervision (at least phone supervision) if you have never done a “water only” five-day fast. There are some contraindications to fasting. Review the fasting handout: http://naturalhealthtechniques.com/HealingTechniques/fasting1.htm
Definitions:
Thrush (also called mycotic stomatitis and white mouth)–Yeast (candida) of the mucous membranes in children especially in the mouth and diaper area. The yeast form white spots that are raw underneath and not easily wiped off.
Candida–The common yeast in the skin, mouth, gut and vagina.
Aspergillosis–Yeast in the ear, nose and lungs. Aspergillus molds are common also in corn, peanuts, grains, dried and salted beef, cheeses, manure, and soil. If you are allergic to penicillin, this may be associated with Aspergillus sensitivities (yeast infections).
Monilia–Former name of candida.  Moniliasis is the term commonly used in medical records signifying yeast in the vagina.
Trichophyton (also known as ringworm)–Monilia yeast attacking the skin, nails and hair.
Yeast in food is known by the names–Yeast, yeast autolyzates, yeast extract, yeast malt sprout extract, tortula yeast, brewer’s yeast and baker’s yeast.
Some Common Signs of Yeast:

• Autoimmune diseases
• Burning sensation during urination
• Chronic body aches
• Chronic Fatigue Syndrome
• Constipation
• Depression
• Endometriosis
• Fibroid cysts
• Fibromyalgia
• Headaches
• Itching of the rectal opening
• Leaky Gut Syndrome
• Manic depression
• Multiple Chemical Sensitivities Syndrome (MCSS)
• Pain during sexual intercourse.
• Poor memory
• PMS
• Redness, swelling, and/or cracking of the vulvar skin
• Sugar craving
• Terrible fatigue
• Thick, white, possibly curd-like vaginal discharge
• Vaginal irritation
• Vaginal itching

Signs of Yeast in the Gastrointestinal Tract (gut):

• Belching or regurgitating
• Coated tongue
• Constipation alternating w/ diarrhea
• Cramping
• Diarrhea
• Distention or stomach pains
• Frequent heartburn
• Gas
• Growling/Gurgling noises
• Hemorrhoids
• Itching anal area
• Sore gums or tingling
• Sour Stomach
• Unusual sensation on tongue
• White area on gums
• White on corners of mouth

Signs of Yeast in the Respiratory Tract:

• Asthma
• Bronchitis
• Chronic cough
• Earaches
• Halitosis
• Pneumonia
• Postnasal drip
• Runny nose
• Sinusitis
• Sneezing
• Sore throats
• Stuffiness
• Swollen eyes/face

Signs of Yeast in the Skin:

• Chronic skin blemishes
• Dry skin
• Eczema
• Foul body odor
• Fungal growths on skin or nails
• Hives
• Itching
• Psoriasis
• Rashes
• Smelly feet/underarms

Signs of Yeast Surrounding Menstrual Cycles:

• Bladder problems (increased frequency/burning)
• Chronic bladder problems after pregnancy
• Concentration, reasoning and memory problems
• Cramping
• Decreased interest in sex
• Depression or bizarre emotions
• Depth perception is off
• Excited or anxious
• Feelings of clumsiness
• Helplessness
• Irritable
• Itching without discharges
• Light-headed or dizzy before period
• Lost of self confidence
• Mild hearing loss
• Nervous
• Night blindness or vision blurred
• Noises sound “too loud”
• Overly sensitive to odors
• Personality changes
• PMS
• Salty or metallic taste in mouth
• Secondary bacterial infections due to scratching
• Some loss of taste/smell
• Sore burning or itching vagina
• Vaginal discharges (may be in the past)
• Weight gain due to water retention

Signs of Yeast in the Musculoskeletal system:

• Acute pain in the joints before rainy or damp weather
• Arthritis
• Inflammation of the joints
• Stiff joints

Signs of Yeast in the Nervous system:

• Anxiety
• Change in sleep patterns (insomnia or excessive sleep)
• Depression
• Exhaustion or the feeling of “not being right”
• Feelings of fogginess or “spaced out” feelings
• Memory loss
• Migraine, sinus or tension headaches
• Multiple Sclerosis
• Uncontrollable crying

Natural Treatments for Yeast:
Treating yeast is tough, because many times the man and woman pass yeast back and forth from one to another. It can be harbored in the vaginal tract and in the male urethra or prepuce. When one partner is treated, it is often a temporary fix as that partner just gets reinfected the next time the couple has intercourse. It’s best to treat both partners at the same time.
With as many treatments for yeast on the market, none of them will work unless you can get the load down in your system enough that it doesn’t overpower the other gut flora. Yeast is a part of our normal bowel flora. You can’t ever totally get rid of it, but you can prevent it from controlling your life.
Acidic douches restore the natural pH of the vagina:

• Use 2 tablespoons of white or cider vinegar, or the
• Juice of half a lemon, or
• One teaspoon Vitamin C powder,

Per quart of water. Use every day to treat mild infections, or in combination with other treatments for more severe infections.
Note: Vinegar is not to be used for Blood Type O people as any vinegar is on the Avoid List.
Retention douches made of bentonite clay, Pau D’Arco tea, yogurt, tea tree oil and Goldenseal used as a douche two times a day for seven to 10 days.

• Bifidophilus bacteria
• Boric acid–protect labia w/ Vitamin E oil if irritation occurs
• Candida vaccine
• Caprylic acid
• Dioxychlor
• Essential Fatty Acids
• Fasting (5 days, water only)
• Fiber increase in diet
• Gentian violet
• Hydrogen peroxide
• Immune Stimulation formula
• Lactobacillus acidophilus
• Multi-vitamin
• Multi-mineral supplement
• Mycological Immune System Stimulator
• Nutribiotic Grapefruit seed extract
• Ozone Therapy
• Photoluminescence
• Potassium sorbate
• Probiotics
• Yogurt (Plain of course!)
• Zinc

Herbs used for Yeast:

• Ashwaganda
• Barberry
• Bentonite Clay
• Berberis (Oregon Grape root)
• Cinnamon
• Echinacea (orally)
• Fennel
• Garlic vaginal suppository
• German chamomile
• Ginger
• Goldenseal root
• Horopito (AKA Psuedowintera colorata)
• Herbal douches
• Kyolic (aged garlic)
• Licorice
• Mathake
• Oregano
• Pau D’Arco AKA: Taheebo, La Pacho (Tincture is best)
• Rosemary
• Tanalbit (a Tannic Acid medication)
• Tea Tree Oil soak a tampon with diluted tea tree oil and keep it in the vagina overnight.
• Thyme

Allopathic Medicine “Real drugs” used for yeast:

• Amphotericin B (Fingizone)
• Antifungal creams or suppositories inserted directly into the vagina.
• Astroglide or Slippery Stuff to prevent irritation
• Butoconazole
• Clotrimazole
• Diflucan–have your sexual partner treated, use condoms in the meantime
• Diflucan–taken by mouth, every third day for two weeks
• Diflucan–taken by mouth, up to 200 mg., in a single dose
• Femstat 3
• Fluconazole (Diflucan)
• Gyne-Lotrimin
• Itraconazole  (Sporanax)
• Ketoconozole  (Nizoral)
• KY Jelly to prevent irritation
• Lidocaine gel for painful irritation
• Miconazole
• Monistat
• Mycelex
• Nizoral (Ketoconozole)
• Nystatin
• Sporanax (Itraconazole)
• Terazole
• Terconazole
• Tioconazole

Note: Some yeast medicines make latex condoms and diaphragms weak and more likely to break. If you use a condom or diaphragm, ask your pharmacist or health care provider which medicine you should use.
To relieve vulvar itching, try making a paste of slippery elm powder and a little water, and then apply as needed. Another option is to keep aloe vera juice in the fridge, and then soak a cotton pad in it and apply it to your vulva as needed.
Note: Slippery elm or aloe will only relieve itching, though, and won’t kill yeast, so they must be combined with an antifungal treatment to really stop the problem.
Causes of Yeast and Factors that may disturb the vagina’s balance include:

• Adrenal insufficiency
• Allergic reactions to spermicidal creams and gels
• Amalgam fillings (mercury/silver)
• Antibiotic treatments (esp. broad-spectrum)
• Birth Control Pills
• Cancer therapies (chemo and radiation)
• Condom allergies (to lubrication or latex)
• Detergent allergies
• Diabetes
• Eating spoiled, moldy, live yeast containing foods
• Food allergies
• High carbohydrate intake, especially refined sugars and alcohol
• History of “jock itch”
• History of athlete’s foot
• History of past yeast infection
• History of ringworm
• Hot weather
• Inadequate sleep
• Intravenous drug users using dirty needles may inject the yeast directly into their bloodstream or deep tissues.
• New sexual partner
• Non-ventilating clothing
• Oral contraceptives
• Panties without cotton crotches
• Pantyhose (synthetics directly next to skin)
• Pollen allergies
• Pregnancy
• Repeated intercourse over a short period of time
• Scented toilet paper
• Semen allergies
• Sexual intercourse w/ infected partner
• Situations which increase moisture and warmth suitable for fungal growth
• Spermicidal jelly allergies
• Steroids
• Stress
• Suppressed immune system (including leukemia and HIV)
• Too much junk food
• Unprotected genital contact
• Use of corticosteroid medications
• Use of devices implanted in the skin
  • Urinary catheters
  • IV ports
• Washing vagina with soap (OK to wash labial area)

Dietary factors influencing and exacerbating yeast:

• Alcohol
• All simple sugars
• All suspected food allergens
• Cheeses
• Dairy (except if cultured)
• Dried fruits
• Melons
• Peanuts

Foods commonly containing yeast:
Yeast is a fungi that is high in folic acid. Yeast produces enzymes that convert sugar to alcohol and carbon dioxide.

• Bakery products
• Barbecue sauce
• Catsup
• Cheeses of all kinds
• Corn grits
• Dried fruit
• Enriched cornmeal
• Farina
• Fermented brews (beer/wine)
• Flavor enhancers
• Hot dog/hamburger buns
• Meat fried in cracker crumbs
• Milk fortified w/ vitamins
• Mushrooms
• Pretzels
• Rolls
• Truffles (the mushroom, not the candy)
• Vinegars

Other Rule outs for Yeast Infection:

• Bacterial vaginosis.
• Herpes
• Lichen planus
• Trichomoniasis
• Urinary tract infections (UTI’s),
• Vulvar vestibulitis
• Other sexually transmitted diseases (STD’s)

Ways to prevent yeast infections:

• Antibiotics can also cause a yeast infection, since they kill or decrease normal flora. If you need to take antibiotics, you can ask for an anti-yeast prescription, or you can buy over-the-counter creams or suppositories.
• Avoid feminine deodorant sprays and douches–They irritate the vulva and vaginal areas
• Avoid tight-fitting clothing
• Check for an underlying disease, such as AIDS or diabetes.
• Consider changing your birth control pills
• Discontinue bath soaps
• Don’t douche unless instructed by a physician.
• Don’t use deodorant tampons
• Don’t wear pads or panty-liners beyond the length of your period.
• During sex, make sure that no body part contacts the area around the anus, and then goes in the vagina or around the vaginal opening. This can happen easily and inadvertently. His penis may be brushing up against the your anus during foreplay.
• Eat a healthy, low-sugar, low-grain diet
• Get enough sleep
• Have your partner wash his penis prior to having intercourse
• If you go swimming, get out of your swimsuit as soon as possible.
• Limit sugar intake
• Menstrual blood raises the vaginal pH, causing the number of yeast cells to decrease because they can’t grow in the pH present during menstruation.
• Pat yourself dry before getting dressed with an unscented clean tissue or a towel.
• Use a non-hormonal form of birth control, as hormone levels are factors in yeast infections.
• Wear cotton underwear rather than synthetic
• Wear loose-fitting cotton clothing
• Wear skirts, dresses or other open ended clothing without underwear, whenever practical.
• Wipe after using the toilet from the front to the back
  Wipe from front to back after urination and bowel moveme