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[Gerald Weiß]

Sometimesthings don't feel right "down there." One common cause is vaginitis. This means that your vagina (birth canal) is inflamed. It might be swollen, itchy, or sore. It might even smell strange or make an unusual discharge (liquid). If your vulva (the outside part of your genitals, including the labia and clitoris) is also affected, it is called vulvovaginitis.

Bacterial vaginosis (BV). A healthy vagina has a balance of many different kinds of bacteria, yeast, and other microbes. But sometimes, the balance gets upset, and one microbe grows too much. BV happens when there's too much of one bacteria, usually Gardnerella vaginalis bacteria. It can cause a grayish white discharge with a strong fishy smell.

Candida or "yeast" infection. Candida yeast is a type of fungus. Small amounts of this fungus live in your mouth, digestive system, and vagina. This is perfectly normal and healthy. But too much can cause itchiness and discharge that looks and feels like cottage cheese.

It can be hard for even an experienced doctor to tell the difference. Many types of vaginitis have similar symptoms, and you could have more than one at the same time. Meanwhile, some might not cause any symptoms.

It's especially important to take care of vaginitis when you're pregnant. That's because it can cause health problems for your baby. For example, babies whose mothers had BV during pregnancy are at a higher risk of being born too early and too small.

Yeast infections are an overgrowth of the yeast that you normally have in your body. BV happens when the balance of bacteria is thrown off. With both conditions, you may notice a white or grayish discharge.

How can you tell them apart? If there's a fishy smell, BV is a better guess. If your discharge looks like cottage cheese, a yeast infection may be to blame. A yeast infection is also more likely to cause itching and burning, though BV might make you itchy, too.

Antibiotics. Antimicrobial drugs, including antibiotics, are medicines that kill germs. Antibiotics kill unfriendly germs, but they also can kill friendly germs. When you take antibiotics for a urinary tract infection or other illnesses, they can kill the friendly germs in your vagina. This leaves extra room for other microbes to grow.

Keep yourself clean and dry. But doctors don't recommend vaginal sprays or heavily perfumed soaps for this area. Douching may cause irritation, too, and, more importantly, could hide or spread an infection. It also removes the healthy bacteria that do the housekeeping in your vagina. Douching is never recommended.

Vaginitis is when your vagina becomes itchy, swollen, or inflamed. You also might notice discharge that feels, smells, or looks different than usual. It can be caused by infections, irritation from chemicals, imbalances in the vaginal flora, or hormone changes. If you have vaginal irritation or unusual discharge, talk to your doctor right away.

Always talk to your doctor about what is causing your vaginitis and how to treat it. Although some mild cases can go away on their own, many require medication. Leaving vaginitis untreated can cause other problems, like raising your risk of STIs.

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The U.S. Food and Drug Administration today approved Descovy (emtricitabine 200 mg and tenofovir alafenamide 25 mg) in at-risk adults and adolescents weighing at least 35kg for HIV-1 pre-exposure prophylaxis (PrEP) to reduce the risk of HIV-1 infection from sex, excluding those who have receptive vaginal sex. Descovy is not indicated in individuals at risk of HIV-1 infection from receptive vaginal sex because the effectiveness in this population has not been evaluated.

According to the Centers for Disease Control and Prevention, 38,739 people received an HIV diagnosis in the U.S. in 2017. To confront this epidemic, President Trump announced an initiative, Ending the HIV Epidemic: A Plan for America, in his State of the Union address on February 5, 2019. This opportunity to eliminate new HIV infections in our nation seeks to provide our hardest-hit communities with additional expertise, technology and resources required to address the HIV epidemic. The aim is to reduce new infections by 75% in the next five years and by 90% in the next ten years, averting more than 250,000 HIV infections in that span.

PrEP, or pre-exposure prophylaxis, is an HIV prevention method in which people who do not have HIV take medicine on a daily basis to reduce their risk of getting HIV if they are exposed to the virus. Descovy for PrEP should be used as part of a comprehensive strategy, including adherence to daily administration and safer sex practices, including condoms, to reduce the risk of sexually acquired infections.

The safety and efficacy of Descovy for PrEP were evaluated in a randomized, double-blind multinational trial in 5,387 HIV-negative men and transgender women who have sex with men and were at risk of HIV-1 infection. The trial compared once daily Descovy to Truvada (emtricitabine, tenofovir disoproxil fumarate, 200 mg/300 mg), a daily fixed dose combination of two drugs approved in 2012 to prevent the sexual acquisition of HIV; participants were followed for 48 to 96 weeks. The primary endpoint was the rate of HIV-1 infection in each group. The trial showed that Descovy was similar to Truvada in reducing the risk of acquiring HIV-1 infection. The most common adverse reaction in individuals without HIV who were taking Descovy for PrEP was diarrhea.

There is a boxed warning for individuals who take Descovy who also have hepatitis B virus (HBV) to be aware of the risk of exacerbations of HBV in those who discontinue products with emtricitabine or tenofovir disproxil fumarate, and which may occur in individuals who discontinue Descovy. Descovy for HIV-1 PrEP is contraindicated in individuals with unknown or positive HIV-1 status and should only be prescribed to individuals confirmed to be HIV-negative immediately prior to initiating and at least every three months during use.

Descovy was FDA approved in 2016 in combination with other antiretoviral drugs to treat HIV-1 infection in adults and pediatric patients. The FDA granted the approval of Descovy to Gilead Sciences Inc.

A vaginal yeast infection isn't considered a sexually transmitted infection. But, there's an increased risk of vaginal yeast infection at the time of first regular sexual activity. There's also some evidence that infections may be linked to mouth to genital contact (oral-genital sex).

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Candida albicans is the most common type of fungus to cause yeast infections. Yeast infections caused by other types of candida fungus can be more difficult to treat, and generally need more-aggressive therapies.

WHO today recommended that the dapivirine vaginal ring (DPV-VR) may be offered as an additional prevention choice for women at substantial risk[1] of HIV infection as part of combination prevention approaches.

The DPV-VR is a female-initiated option to reduce the risk of HIV infection. To properly use the ring, it must be worn inside the vagina for a period of 28 days, after which it should be replaced by a new ring. The ring is made of silicone and is easy\r\n to bend and insert. The ring works by releasing the antiretroviral drug dapivirine from the ring into the vagina slowly over 28 days.

Two Phase III randomized controlled trials found that using the DPV-VR reduced the risk of HIV infection in women and long-term use was well-tolerated. The Ring Study demonstrated an HIV reduction of 35% among women using DPV-VR, and the ASPIRE study\r\n a 27% reduction in risk.

The DPV-VR is intended to reduce the risk of acquiring HIV during vaginal sex for women who are at substantial HIV risk as a complementary prevention approach in addition to other safer sex practices. It can be offered alongside oral PrEP as a choice\r\n for women who do not want or are unable to take a daily oral tablet. While contraceptive vaginal rings have been available for several years, the DPV-VR is the first vaginal HIV prevention product. Research is under way to develop a vaginal ring that\r\n includes both contraception and HIV prevention.

The Guideline Development Group outlined implementation considerations and research gaps to be considered in rollout of this product. These included addressing the provision of the DPV-VR as part of comprehensive services; ensuring women\r\n are offered full information in order to make an informed choice about the benefits and potential risks when considering to use the ring; adolescent girls and young women may need more support during\r\n initiation and for continuation; acceptability among women from key population groups; additional adherence support and demand creation; training and support for providers to\r\n understand and be able to offer this new product; further information on safety in pregnancy and breastfeeding and cost-effectiveness.

WHO stresses that when providing HIV prevention services for women it is important to provide these alongside other services including the offer of other HIV prevention choices, STI diagnosis and treatment, the offer of voluntary partner services, HIV\r\n testing and links to antiretroviral therapy for all women who test positive, and a range of contraception options. Services must also be provided for women who experience intimate partner violence and health care workers need training to provide services\r\n that are respectful and inclusive of women in all their diversity.

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