Hiv without symptoms. id/qnrhg/goc-jee-advanced-notes-pdf.
For example, 75 percent of women and 50 percent of men with chlamydia have Jan 18, 2024 · An antigen/antibody lab test using blood from a vein can usually detect HIV 18 to 45 days after exposure. 78; 1. You also can develop symptoms years after having sex with someone who has Jul 13, 2023 · Human immunodeficiency virus (HIV) is an infection that attacks the body’s immune system. The blisters break and turn into sores. According to a 2017 study, only 25 percent of people with HIV will receive a positive test result Feb 20, 2024 · Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. Congestion or runny nose. Jun 23, 2020 · Professor of Medicine, Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco If half of all infected people are without symptoms at any point in May 16, 2023 · Rash. Treatment also reduces the risk of passing on the STD to a partner. The symptoms only last for a few weeks, and then you usually don’t have symptoms again for years. Jun 27, 2024 · Sexually transmitted infections (STIs) are very common among people who are sexually active. weight loss. According to the Mayo Clinic, when a person has May 16, 2023 · Sore throat. The rash can develop because of conditions caused by HIV, or it Jul 11, 2023 · Flu Symptoms vs. Feb 9, 2024 · If you get a diagnosis of HIV / AIDS, tests can help your healthcare professional learn the stage of your disease and the best treatment, including: CD4 T cell count. 3 min read. This is because HIV weakens the immune system, which makes it harder for the body to fight TB germs. This stage can last 10 years or longer. This includes talking about medications that help with symptoms. Jul 28, 2022 · Takeaway. AIDS dementia is also called AIDS dementia complex or HIV-associated dementia. reduced motor skills or coordination. This stage is called acute HIV infection. However, HIV and some HIV medicines may increase the risk of heart disease in Dec 14, 2015 · Two years ago, still without symptoms, Gary went on medication after U. You can have HIV without any symptoms. At this point the virus is moving into Jun 6, 2022 · Human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome (AIDS). blisters, sores or warts around your genitals or anus. Therefore, among persons reporting prior-year alcohol … Jan 11, 2023 · ulcers in the mouth. 23–6. 2 days ago · Why Some Infected With HIV Remain Symptom Free Without Antiretroviral Drugs. This is because HIV harms the immune system slowly, degrading it over a span of many years. Getting tested is the only way to know for sure. In the United States, vertical transmission is the most common way children under age 13 contract HIV Aug 23, 2016 · Aug 23, 2016. Jan 24, 2024 · HIV is still active and continues to reproduce in the body. CD4 T cells are white blood cells that HIV targets and destroys. Conditions that may appear with skin symptoms include Nov 17, 2022 · People with AIDS who don’t go on treatment typically survive for about 3 years. Apr 12, 2019 · HIV sometimes presents with flu-like symptoms about a month after transmission, but otherwise can go undetected for weeks, months, or years. The article describes why symptoms like these occur in males with HIV, including how they differ during Those persons who meet the criteria for treatment failure (i. Our First Story: Minnesota’s Largest HIV/STD Clinic (Red Door) 05-31-2022. Apr 22, 2024 · Conditions that can increase risk. Medications for HIV help slow the rate of immune system breakdown. Feb 9, 2024 · Symptoms. OIDP Office of Infectious Disease and HIV/AIDS Policy. Dec 27, 2022 · Untreated HIV can lead to AIDS. The nucleic acid tests (NATs) can confirm an HIV infection in 10 to 33 days. But HIV can be spread to other people — whether or not you have symptoms or feel sick. Apr 9, 2024 · Women 25 years and older with risk factors should be tested for gonorrhea and chlamydia every year. HIV weakens your immune system by destroying your T-cells until you are unable to fight off even minor illnesses. Acquired immunodeficiency syndrome (AIDS) is the most advanced stage of the disease. Early HIV symptoms generally develop within 2 to 4 weeks of transmission. Women and people AFAB who have trich and HIV are more likely to pass both diseases on to their partners. A comparison was made between individuals with and without psychiatric caseness using clinical, neuropsychological, and neurophysiological assessments. TB usually affects the lungs, but it can affect any part of the body, including the kidneys, spine, or brain. Some people have no symptoms during this stage. Severe disease. Getting tested and starting treatment early gives you the best chance of living a long life. night sweats. HIV weakens the immune system, increasing the risk of TB in people with HIV. Genital herpes symptoms. Providers can also tell patients how to lower the risk of transmitting herpes to sex partner (s). People who take HIV treatment as prescribed may never move into Stage 3 (AIDS). Chills. Feb 4, 2016 · Depression is not just sadness. The loss of CD4 cells makes it difficult for the body to fight off infections, illnesses, and certain cancers. An HIV-infected child is usually diagnosed with AIDS when the immune system becomes severely damaged or other types of infections occur. Primary infection, also called acute HIV. unusual vaginal bleeding. The greater the spread of infection in the brain, the worse the dementia symptoms become. May 6, 2024 · The human immunodeficiency virus (HIV) was first identified in 1983 and has since claimed approximately 40. thrush in the mouth. HIV targets the body’s white blood cells, weakening the immune system. joint pain. Both viruses MHAF Minority HIV/AIDS Fund. Some illnesses (sometimes called opportunistic infections) occur more often and are more severe in people with HIV. Hepatitis C (HCV) and HIV are two chronic viral infections that affect millions of people in the United States. issues thinking clearly. It is a serious consequence of HIV infection and May 7, 2024 · The higher the set point (the relatively stable virus levels that occur after primary infection), the more quickly the CD4 count decreases and the greater the risk of opportunistic infection, even in patients without symptoms. During this time, the HIV is multiplying and spreading inside your body. HIV targets immune cells for entry into the body. The initial symptoms are followed by a stage called clinical latency, asymptomatic HIV, or chronic HIV. e. 87, respectively), having a low social support for psychological symptoms (3. No test can detect HIV immediately after infection. 2. After these symptoms disappear, HIV may not cause symptoms for many years. People with HIV. HCV affects the liver while HIV targets the immune system. If you or someone you care about has HIV, understanding HIV basics and what to expect can help you keep Oct 3, 2021 · A person may experience no symptoms during the chronic HIV infection phase. HIV destroys cells in your immune system called CD4 cells or T cells. These HIV antibodies generally do not reach levels high enough to detect by standard blood tests until 1 to 3 months following infection, and may take as long as 6 months. Some of these symptoms are very common and can occur due to many conditions other than COVID-19, the disease caused by the coronavirus called SARS CoV-2. CDC does not recommend herpes testing for people without symptoms in most situations. People living with HIV will look and Mar 25, 2021 · HIV can raise resting energy expenditure (REE) or the number of calories burned at rest. Often, there are no symptoms during this stage. Jul 11, 2024 · The early symptoms of HIV can look like the flu or lots of other illnesses. This is the body’s natural response to HIV infection. Prevent illnesses. Some people may not Jun 13, 2019 · No. 28 and 3. According to the Centers for Disease Control and Prevention (CDC), in 2021, over 53% of the people in the United States diagnosed with HIV were aged 50 and older. diarrhea. Complications include sepsis and organ failure. Asymptomatic HIV infection. vision loss. difficulty focusing. Blog. The human immunodeficiency viruses ( HIV) are two species of Lentivirus (a subgroup of retrovirus) that infect humans. difficulty speaking clearly. HIV stands for human immunodeficiency virus. Many other things can also cause these symptoms. 4 days ago · Upper respiratory tract infection symptoms (cough, rhinitis, sore eyes, and myalgia or muscle pain) Blistering rash and erosions on the face, trunk, limbs, and mucosal surfaces. However, the research, development, and widespread availability of highly active antiretroviral therapies (ARTs) have helped contain the HIV pandemic How HIV is transmitted. Retrieved July 18, 2024 from www. Obsessive compulsive behaviors, such as washing your hands or obsessive worry about May 31, 2024 · These symptoms may come and go within two to four weeks. You can get HIV if you have anal or vaginal sex with someone who has HIV without using protection (like condoms or medicine to prevent HIV). The risk of getting HIV depends on the type of exposure or behavior, such as sharing needles or having sex without a condom. swollen glands. The symptoms of HIV and AIDS vary depending on the person and the phase of infection. During this stage, there are no symptoms of HIV infection. body rash. May 29, 2024 · Some oral symptoms are: White patches on your tongue, inner cheeks, the roof of your mouth, or throat. If the infection is not treated, it becomes chronic HIV infection. As the immune system deteriorates, complications begin to develop. Some people infected by HIV get a flu-like illness within 2 to 4 weeks after the virus enters the body. Painful or burning urination. Worldwide, TB is one of the leading causes of death among people with HIV. Most often, HIV causes flu-like symptoms about 2 to 4 weeks after being infected. During this time, the virus makes copies of itself fast. 74; 1. AIDS is the disease caused by the damage that HIV does to your immune system. Because HAD symptoms may Jan 29, 2015 · Answer: Your risk for HIV is extremely low, so fears about contracting the virus seem extremely unrealistic. The risk of passing the disease to sexual partners is high. Asymptomatic HIV infection is the second stage of HIV/AIDS. Cotton-like Feb 4, 2023 · An antibody/antigen test can technically detect HIV in as little as 18 days, or about 2. Other HIV symptoms include fever, swollen lymph nodes and rashes. Symptoms of HIV infection sore throat. These symptoms can include fever, headache, tiredness, and enlarged lymph glands in the neck and groin area. Having sex with someone who has HIV without using a condom or taking medicine to prevent or treat HIV. Stage 2: Chronic HIV Infection. This makes it easier to get sick with diseases like tuberculosis, infections and some cancers. STI symptoms might include: Sores or bumps on the genitals or in the oral or rectal area. Apr 5, 2024 · FRIDAY, April 5, 2024 (HealthDay News) -- People with HIV could have an increased risk of heart disease even if they aren’t suffering any symptoms related to their infection, a new study finds Feb 14, 2023 · Symptoms of AIDS include: persistent high fevers of over 100°F (37. But for people with compromised immune systems, like those living with HIV, the fungus may spread quicker than the immune Mar 26, 2024 · People with HIV have an increased chance of developing severe symptoms from common infections. htm. Fever is usually one of the first symptoms of HIV. Later HIV/AIDS symptoms. The most common symptoms of genital herpes is a group of itchy or painful blisters on your vagina, vulva, cervix, anus , penis, scrotum (balls), butt, or the inside of your thighs. long-lasting diarrhoea. Aug 10, 2021 · Heart disease is caused by the buildup of plaque inside the blood vessels (called the coronary arteries) that carry blood to the heart. Even without HIV treatment, people usually remain in fairly good health for several years. This is often called the asymptomatic stage and it can last for several years. So, even people who have the symptoms of HIV infection may think Mar 20, 2024 · memory loss. Once seroconversion is over, most people feel fine and don’t experience any symptoms. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom or HIV medicine to prevent or treat HIV), or May 7, 2024 · After the first symptoms disappear, most patients, even without treatment, have no symptoms or only a few mild, intermittent, nonspecific symptoms for a highly variable time period (2 to 15 years). Diarrhea. This stage may last a few days to several weeks. A NAT can usually detect HIV 10 to 33 days after exposure. In stage 3 HIV, the body’s immune system is badly damaged and vulnerable to opportunistic infections. Aug 4, 2021 · Inactive TB is called latent TB infection. With an early diagnosis and effective treatments, most people with HIV will not develop any AIDS-related illnesses and will live a near-normal lifespan. [37] Jan 13, 2023 · HIV ( human immunodeficiency virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. If you get an HIV test after a potential HIV exposure and the result is negative, get tested again after the window period for the test you took. You can also get HIV from sharing needles, syringes, or other drug injection equipment (for example, cookers) with someone who has HIV. severe chills and night sweats. Receiving adequate treatment that results in viral suppression stops the progression of immune dysfunction Oct 28, 2014 · white spots or unusual blemishes in and around the mouth. Sore Jul 27, 2023 · According to UC San Diego Health, 90% of people living with HIV experience skin symptoms and changes at some stage of the disease. Within 2 to 4 weeks after infection with HIV, about two-thirds of people will have a flu-like illness. 4 million lives worldwide (as of 2022). For example, although there is no cure for HIV, HIV medicines can prevent HIV from advancing to AIDS and reduce the risk of HIV transmission. During this stage, the virus keeps multiplying in the body and the immune system slowly weakens, but the person has no symptoms. pneumonia-like symptoms. Dry cough. But even without noticeable symptoms, an HIV-positive person can still pass the virus on to others. 22; 1. Middle-aged people living with HIV were more likely to have early signs of heart disease, with thicker blood vessels placing strain on the heart. Symptoms of initial (primary) HIV infection usually last from 3 to 14 days. Smooth, red areas on the back of your tongue. ScienceDaily. Repeat testing may be needed. The only way to know if you are infected with HIV is to get tested. For the HIV-negative partner, receptive anal sex ( bottoming ) is much riskier than insertive anal sex (topping ). itchy genitals or anus. During this period, the person might have no reason to suspect they have HIV, but they can spread the virus to others. A person with HPV can pass the infection to someone even when they have no signs or symptoms. This number is staggering, and if left unchecked, HIV could become a global health crisis. white spots in the mouth. Even without visible sores, herpes increases the number of immune cells in the lining of the genitals. You also could have HIV without any symptoms. Early HIV symptoms can include: Fever. Jun 6, 2022 · Human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome (AIDS). STI testing, prevention, and treatment should be part of regular HIV care for sexually active people. Early HIV is the beginning stage of HIV, right after someone gets the virus. Pregnant people can pass HIV to their baby 3 days ago · While the symptoms of HIV are largely the same for both males or females, signs of HIV that affect males include erectile dysfunction, penile ulcers, and breast tissue growth. Hormone Aug 10, 2021 · A few weeks after getting HIV, many people have flu-like symptoms, which may last days or weeks. If you are sexually active, you can get HPV, even if you have had sex with only one person. People who have both HIV and TB should Visna-maedi virus. Though you might feel well at this stage, the virus is active, infecting new cells, making copies of itself and damaging your immune system’s Mar 12, 2024 · Yes, anyone can get HIV, including older people. If not treated, TB disease can cause death. Viral Suppression. Also, even if you have a flulike illness from HIV, it's usually pretty difficult to tell it apart fromthe flu. 26 You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It attacks and starts to destroy There's currently no cure for HIV, but there are very effective drug treatments that enable most people with the virus to live a long and healthy life. For Gary, deciding to go on antiretroviral therapy was “a tossup. Sore throat. It is also called acute HIV. sciencedaily. It is one cause of dementia in people infected with HIV. fever. Staying up to date on routine screenings and vaccines can help you prevent infection or severe disease. HIV weakens the body’s ability to fight other infections, and without treatment people will become more susceptible to other severe illnesses such as tuberculosis, cryptococcal meningitis, bacterial infections and some cancers including lymphomas and Kaposi’s sarcoma. Other symptoms can include: tiredness. These symptoms may last for a few days or for weeks. lack of interest in activities once enjoyed. The asymptomatic stage of HIV. Acute HIV infection (Stage 1) progresses over a few weeks to months to become chronic or asymptomatic HIV infection (Stage 2) (no symptoms). Fever, chills, muscle aches, tiredness, swollen glands, and a sore throat can also be symptoms of other common viral and bacterial infections May 21, 2024 · Syphilis and HIV infection. pain when peeing. . As a group, people aged 55 years and older in the United States have the lowest incidence of estimated new HIV infections. STIs—also commonly referred to as sexually transmitted diseases (STDs When initially infected, many people have no noticeable symptoms, but within 1 to 4 weeks, fever, rashes, sore throat, swollen lymph nodes, fatigue, and a variety of less common symptoms develop in some people. Symptoms can include prolonged feelings of hopelessness, apathy, social isolation, anxiety, insomnia or excessive sleeping, loss of sex drive, loss of appetite or excessive eating, and the inability to enjoy activities or people that you usually find enjoyable. Headache. nausea. Aug 26, 2021 · There is no cure for STDs caused by viruses, but treatment can relieve or eliminate symptoms and help keep the STD under control. A baseline HIV genotype (blood test) can be ordered if the HIV viral load is > 500 copies/mL; availability of this Symptoms of a sexually transmitted infection (STI) can include: an unusual discharge from your vagina, penis or anus. Without treatment, HIV can gradually destroy the immune system, causing health May 4, 2024 · See a healthcare provider if you have symptoms of HIV and think you may have been exposed to HIV. Early HIV Infection. You have AIDS when you get dangerous infections or have a super low number of CD4 cells. Many long-term nonprogressors have not wanted to do so. , depending on history of sexual activity and on findings of neurologic examination, either repeat treatment Bothersome symptoms potentially related to drinking are commonly reported by people with and without HIV (PWH/PWoH). Anal sex is the riskiest type of sex for getting or transmitting HIV. genital or anal May 20, 2023 · Stage 1: Acute HIV Infection. Without treatment, the tertiary phase of syphilis may lead to several complications decades after infection. But remember: people who don’t have HIV can also get any of these – they can be the signs of other illnesses. [3] Jun 24, 2024 · When the immune system is compromised, it becomes easier for viruses, fungi, bacteria, parasites, and other causes to trigger a rash. Some people may have no symptoms. A weakened immune system may leave someone more open to Feb 20, 2024 · Testing allows a healthcare provider to talk with patients about what to expect in the future. malaise. Personal Stories. Fatigue. Without treatment, this second stage of the natural history of HIV infection can last from about three years [35] to over 20 years [36] (on average, about eight years). Anyone who has sex is at risk of acquiring one, including people with HIV. Even if you have no symptoms, HIV infection becomes AIDS when your CD4 T cell count dips below 200. The only way to know for sure is to take an HIV test. Then the infection will progress to AIDS. 43–7. Everyone who is pregnant should be tested for syphilis, HIV, hepatitis B, and hepatitis C starting early in pregnancy. Without HIV treatment, this stage may last a decade or longer, or may progress faster. 6 weeks. For this reason, the Centers for Disease Control and Prevention (CDC) recommends that HIV-positive women and people AFAB get tested for trich at least once a year. muscle pain. That’s why some doctors also call it “asymptomatic HIV infection” or Apr 7, 2023 · Early symptoms of HIV may be mild and easily dismissed. HIV attacks and destroys the infection-fighting CD4 cells ( CD4 T lymphocyte) of the immune system. , signs or symptoms that persist or recur or a sustained [>2 weeks] fourfold or greater increase in titer) should be managed in the same manner as persons without HIV (i. However if they remain without treatment, after a few years they may begin Apr 25, 2020 · HIV symptoms tend to fluctuate depending upon the level of virus in the body and the various complications it causes. New loss of taste or smell. Active TB is called TB disease. Oct 13, 2010 · Yes, you can have any sexually transmitted infection and have no symptoms. Apr 24, 2020 · Even without symptoms, HIV can still be present in the body and can still be transmitted. However, even if people with HIV feel healthy, the virus is still affecting their bodies. an increase in herpes or cold sore outbreaks. HIV is a retrovirus that infects cells of the human immune system (mainly CD4-positive T-cells and macrophages—key components of the cellular immune system) and destroys or impairs their function. You might have these other symptoms too: burning when you pee if your urine touches the herpes sores. When you have a fever your body temperature increases above a normal range, and often results in sweating, chills and shivering. ” Jun 14, 2022 · HIV is most often transmitted by. Infection with this virus results in the progressive depletion of the immune system, leading to Early HIV infection often causes no symptoms, and must be detected by testing a person's blood for the presence of antibodies—disease-fighting proteins—against HIV. Without CD4 cells, your body has a hard time fighting off AIDS is the most advanced stage of HIV infection. ulcers on the genitals. The virus initially disables or destroys these cells without causing symptoms. While there is no cure for HIV infection, it can be treated using antiretroviral drugs, which work by stopping the replication of the virus. Mar 12, 2024 · Early symptoms. However, the relationship between bothersome symptoms and level of alcohol use is often not appreciated by patients or providers. If it is not treated, eventually the virus will weaken your body's immune system. Oct 27, 2023 · Your HIV test result reveals only your HIV status. 78–7. Symptoms during this relatively asymptomatic period may result from HIV directly or from opportunistic infections. During this time, HIV continues to be active and causes damage to your immune system. This stage is also called chronic HIV infection or clinical latency. STDs can have a range of symptoms, including no symptoms. Low calorie intake is one of the main reasons for HIV weight loss, but REE can hasten weight loss. red, brown, pink, or purplish blotches on or under Apr 5, 2024 · FRIDAY, April 5, 2024 -- People with HIV could have an increased risk of heart disease even if they aren’t suffering any symptoms related to their infection, a new study finds. While some people experience symptoms of an infection, like discharge, burning, or itching in the genital area, other people can have a sexually transmitted infection and have no symptoms at all. Risk factors include having new partners, multiple partners, or a partner who has an STI. a May 27, 2015 · Out of 290 patients, 202 (70%) had typical HIV symptoms and 74 (25%) had atypical symptoms; only 14 individuals (5%), seven in the acute category and seven in the recent category, had no symptoms of early HIV infection. Sep 19, 2023 · The disease manifestations can be divided into 3 stages: acute HIV (first 2-4 weeks), chronic HIV (middle stage, which can last months to years, with no symptoms at all, although the immune system Apr 18, 2022 · Even without treatment, many people in this stage don’t notice any HIV-related symptoms for 10 years or more. This provides a way for HIV to enter the body. Although some people do have a flulike illness around the time they get infected, many do not. The antigen/antibody tests do so in 18 to 45 days. warts in your mouth or throat, but Oct 28, 2015 · Symptom 1: Fever. Jan 27, 2022 · Muscle or body aches. Without treatment, it usually takes about 10 years for someone with HIV to develop AIDS. HIV encephalopathy is an infection that spreads throughout the brain. Drugs most commonly associated with SJS and TEN in people with HIV include: Anticonvulsants. tiredness. health officials advised that everyone with HIV start therapy immediately rather than wait until they hit certain viral load and T cell levels. 8°C) diarrhea that lasts for longer than a week. If left untreated, the virus Feb 24, 2021 · Candida live in the mouths of most people without causing any symptoms. Headache or muscle aches. People with HIV are more likely than people without HIV to become sick with active TB disease. AIDS is the most serious stage of HIV, and it leads to death over time. May 11, 2023 · In clinical latency, the virus is living in a person and causes few or no symptoms. People may not have any symptoms or get sick during this phase but can transmit HIV. ART can reduce the level of virus to such low levels in the body that the immune system will function normally, and a person living with HIV can enjoy good health, provided they adhere to treatment and the treatment remains effective. Launching #NHASeverywhere. com / releases / 2008 / 08 / 080812064347. This is not unexpected given that the most common reason to be in the study was presentation with suggestive symptoms. Fever is often accompanied by other mild symptoms, such as fatigue, swollen lymph glands, and a sore throat. S. Swollen glands. One year after infection, HIV usually has no symptoms. lumps or skin growths around your genitals or bottom (anus) a rash. nausea, abdominal cramps, and vomiting. Aug 16, 2016 · Even without antiretroviral treatment, most HIV-positive people have no symptoms for several years after contracting HIV. At this stage most people develop symptoms from opportunistic infections, symptoms can include: night sweats. That's why sexually transmitted infections may go unnoticed until a person has complications or a partner is diagnosed. swollen glands in the groin, neck or armpit. Mouth sores. Nausea or vomiting. Stage 3: AIDS. Over time, they cause acquired immunodeficiency syndrome (AIDS), [1] [2] a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Syphilis increases the risk of acquiring HIV infection by approximately two-fold, as well as of other STIs, such as gonorrhoea, chlamydia, genital herpes, among others. May 28, 2021 · Other factors that increased the likelihood of presenting severe menopausal symptoms, after adjustment for menopausal status, were the current or past use of drugs for both psychological and urogenital symptoms (OR 2. HIV is not necessarily transmitted every time you have sex or share needles, syringes, or other drug injection equipment (for example, cookers). Mar 15, 2021 · Without intervention, the rate of transmitting HIV during pregnancy is about 15 to 45 percent. Feb 15, 1997 · The psychiatric caseness of HIV-seropositive individuals without AIDS and seronegative controls was assessed using a standardized clinical interview (Present State Examination). Pain or soreness in your mouth. Risk factors for heart disease, such as high blood pressure or smoking, are the same for people with HIV and people without HIV. mb jp jb bf ch kb hk rn ib ny
