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August 24, 2004

Questions About HIV Treatment

Workplace & Insurance Issues

Mixed-Status Relationships

Doctors, Drug Companies and Activism

HIV/HAART-Related Health Problems

Coinfections

HIV Transmission

Strange but True

• QUESTIONS ABOUT HIV TREATMENT

When to Stop Treatment During Acute Infection
A week ago -- two months after I was infected with HIV -- I started taking Combivir (AZT/3TC) and Kaletra (lopinavir/ritonavir). I hate it already. The side effects are minimal, but I feel like I'm taking some really nasty poisons when I don't have to. Would it be OK to stop treatment next week? My last CD4 count was 340 and my last viral load was 435,000.

What's the Next New HIV Drug?
I noticed that some HIV drugs were recently approved in the United States as combinations of existing drugs. When will we see another new drug for HIV approval, and what will it be?

Sudden Viral Load Jump After Infection
When I was diagnosed in February, my viral load was 31,000. Two months later, it was 29,000. But I just got back my results for July, and suddenly my viral load is up to 117,000. Is it normal to have such a rapid increase months after my diagnosis? Does it mean I should begin treatment?

Can Nevirapine Be Used Again After a Rash?
A friend of mine had to stop taking nevirapine (Viramune) due to rash, but he doesn't think he did the usual two-week "ramp-up" period people normally do to acclimate to it. Taking efavirenz (Sustiva, Stocrin) instead isn't an option; he already switched off of it because of the side effects. Should he try taking nevirapine again, or is it too risky?

• WORKPLACE & INSURANCE ISSUES

What Can My Previous Employer Tell My Next One?
According to Texas law, how much can my previous employer disclose to a prospective employer about why my last job was terminated? My understanding is that they can only answer three questions: (1) Did I work there? (2) How long did I work there? (3) Am I eligible for re-hire?

Breach of Privacy by a Health Insurance Company
My health insurance company admits it sent my medical records to a third party without my consent. What are my options?

• MIXED-STATUS RELATIONSHIPS

What Are the Risks With a Positive Partner
I am an HIV-negative gay man and recently meet an awesome guy who told me up front that he is HIV positive. I'd like things to advance between us, but I have reservations about having sex with him. We'd use protection, of course, but what are the relative risks of being the giver as opposed to the receiver?

How Do I Tell My Partner I Have HIV?
I'm an HIV-positive woman who has met a wonderful HIV-negative man. We've had protected sex, but I haven't told him I'm HIV positive, and I feel so guilty. I know the risk of HIV transmission from a woman to a man is low, but I realize I have to tell him. What's the best way to bring the issue up?

• DOCTORS, DRUG COMPANIES AND ACTIVISM

The Impact of Doctor/Drug Company Relationships
How much does the relationship between a particular doctor and the companies that manufacture HIV meds affect the choice of treatment the doc will recommend to a patient? Why is it that HIV drugs are so expensive?

In South Africa, a Need for Doctors Who Fight Stigma
I'm from South Africa, and was inspired by a speech you recently gave about how important it is for doctors to get more involved in AIDS activism. I believe that if doctors in South Africa were to help remove the stigma of HIV and provide hope to the affected and infected individuals in our country, we would probably have fewer infections than we do now, since HIV-positive people would disclose their status and encourage others to get tested.

• HIV/HAART-RELATED HEALTH PROBLEMS

Switching Kaletra for Fosamprenavir?
My doctor cut the 3TC (lamivudine, Epivir) out of my 3TC + Kaletra (lopinavir/ritonavir) + tenofovir (Viread) regimen, but I still have neuropathy, high triglycerides and gastrointestinal problems. I'm considering switching my regimen completely -- to a regimen containing fosamprenavir (Lexiva, Telzir) and ritonavir (Norvir) -- but what other drugs should I take with them to improve my side effects? If the new regimen doesn't work, can I switch back to Kaletra?

I Don't Want to Be Yellow!
Are there any treatments for high bilirubin levels in people with HIV and hepatitis C? I'm very yellow and hate the way I look! All my other labs are good. I'm taking 3TC (lamivudine, Epivir), atazanavir (Reyataz), ddI (didanosine, Videx), ritonavir (Norvir) and tenofovir (Viread) for HIV, and ribavirin (Copegus, Rebetol, Virazole) and peginterferon alfa-2b (PEG-Intron) for hepatitis C.

• COINFECTIONS

Can an STD Impact My CD4 Count and Viral Load?
I'm HIV positive and was recently infected with syphilis after my partner's condom broke. Since then, my CD4 count has fallen and my viral load is rising. Is this typical when you get a sexually transmitted disease (STD)?

Hepatitis C Testing in Infants
My wife tested positive on a hepatitis C antibody test, but has tested negative several times on other tests. We asked to have our newborn baby tested as well -- the result came out positive. Does our child have hepatitis C or not?

• HIV TRANSMISSION

Female-to-Male Transmission: Does It Take More Than One Exposure?
Is it true that it's more difficult for a man to contract HIV from a woman than vice versa, and that to become infected a man usually needs repeated exposures?

Addicted to HIV Testing
I've been tested for HIV 30 times over the past five years for many different exposures, the latest being when I accidentally kissed someone on the eye. How can I break this cycle of anxiety and testing?

An HIV-Obsessed Surgeon
I'm an orthopedic surgeon who's a bit of a hypochondriac when it comes to HIV. I've had a host of different symptoms over the past couple of years and am worried. I admit I've never engaged in high-risk sex, and I have obsessive-compulsive disorder and anxiety problems, but do you think there's a chance I'm infected?

• STRANGE BUT TRUE

My Psychic Says I Might Have HIV
I talked to my psychic about my last sexual encounter -- protected anal sex and unprotected oral sex with a male model -- and he says I may have gotten HIV. Is he right?

Ask Nelson Vergel About:
NUTRITION AND EXERCISE

HIV positive and looking for advice on healthier living through nutrition and exercise? Ask Nelson Vergel, who for the past year has done an amazing job answering questions in The Body's Nutrition and Exercise forum. Nelson is leaving our forum at the end of this month, so take advantage of his expertise while there's still time!

ART FROM HIV-POSITIVE ARTISTS

Untitled, 1990; David Wojnarowicz (in collaboration with Phil Zwickler and Rosa von Praunheim)

Visit the August 2004 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.

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