•  LIVING WITH HIV

How Do I Tell "The One" That I Have HIV?
I just found out I'm HIV positive, and started informing past and present sex partners so they can get tested too. But one of the guys I have to tell could possibly be "the one" I've been looking for. How do I tell him, and how do I deal with the possibility of being rejected solely because I'm HIV positive?

•  HIV TREATMENT

Is "Almost" Undetectable as Good as Completely Undetectable?
I've been HIV positive for 20 years now, and try to stay off meds as much as possible. I've taken 3 breaks from treatment, each at least a year long, mostly to get over bad side effects. I've been taking a new combination for 6 months now, and I'm actually quite happy with it: There seem to be minimal side effects and my CD4 count is 520. However, my viral load hovers around the 50 line; my doctor and I can't say that it's "undetectable," which seems to be the goal with any HIV medications. But does it really matter? Should I worry about this continued low level of detectability or just chalk it up to the variability of the virus?


How Soon Will I Need to Start HAART?
How close am I to needing to start treatment? I'm 49 years old, and have been HIV positive for about 8 years. My CD4 count has been holding in the high 200s or low 300s, and lately my viral load has fluctuated from about 8,000 to nearly 20,000. Aside from some muscle pain in my arm, I feel like I'm in good health. I'm taking a regimen of daily supplements and have changed my diet to lower my cholesterol.


What Do You Know About DAPYs?
I've been reading a lot about experimental HIV meds called DAPYs. What's the status of those drugs, and how much longer must research be conducted before they become available?


Restarting Treatment and Avoiding Lipodystrophy
After 7 years of taking Combivir (AZT/3TC) and nelfinavir (Viracept), I became resistant and stopped treatment in December 2002. Since then, my CD4 count has stayed around 380, but my viral load is creeping up -- it's now at 25,000. I have a history of hepatitis B and am a recovering alcoholic. If my labs continue on their current trend, my doc says that I'll need to restart treatment within the next year. Given my history, what regimen would you recommend that has minimal side effects and does not cause lipodystrophy?


Rotating Work Shifts and a HAART Regimen
I'm about to join a clinical trial for a new HIV medication. According to the protocol, I might have to take efavirenz (Sustiva, Stocrin) as part of my regimen. I know efavirenz is a good drug, but I'm a nurse and I work on rotating shifts. I don't mind taking it at bedtime, but what do I do when I have to work a night shift?

• DRUG INTERACTIONS

HAART and Antidepressants: Should I Be Worried?
I'm taking the antidepressant dosulepin (dothiepin, sold in the United Kingdom under several brand names). If it doesn't work, I might switch to fluoxetine (Prozac, Sarafem). I'm also going to start HAART soon; will my HIV meds interact with my antidepressants? My first regimen will be 3TC (lamivudine, Epivir), AZT (zidovudine, Retrovir) and nevirapine (Viramune).


Do Efavirenz and Nevirapine Have the Same Drug Interactions?
For 6 years, I had been taking a HAART regimen of Combivir (AZT/3TC) and indinavir (Crixivan), along with fluoxetine (Prozac, Sarafem) to treat my depression. Eventually, I switched the indinavir for efavirenz (Sustiva, Stocrin) because of high cholesterol and fat problems. But the efavirenz interacted badly with my fluoxetine, and since then, I haven't been able to find a depression treatment that works. Now I'm taking Combivir with nevirapine (Viramune); is it safe to take an antidepressant with this med, or will it react the same way efavirenz did?


Options After Bactrim/AZT Interactions
My wife started HIV treatment 6 weeks ago, when her CD4 count was 83 and her viral load was 2,071. She's also taking double-strength co-trimoxazole (Bactrim DS, Cotrim DS, Septra DS, Sulfatrim) to prevent pneumocystis pneumonia. She recently reported a decline in white blood cells, which her doctor is sure has happened because of an interaction between the co-trimoxazole and the AZT (zidovudine, Retrovir) she's taking. Should she switch off the AZT -- and if so, switch to what? Or should she wait for another CD4 test to see if her count has risen?

• HIV/HAART-RELATED HEALTH PROBLEMS

How Can I Lessen Wild Dreams From Efavirenz?
I've been on efavirenz (Sustiva, Stocrin) since September 2003 and continue to have wild dreams. Unfortunately, not the sexual ones as many have claimed, but intense, action-drama, movielike ones. I wake up exhausted every morning; it feels like I've been living the dreams. Can I suppress this side effect with diet or other methods? Zolpidem (Ambien) seems to work, but I don't want this to be a constant remedy. My regimen is working well, so I don't want to switch.


Preventing Muscle Breakdown After Workouts
For the past 2 years, physical activity -- especially weightlifting -- causes my body to crash after a workout. Last weekend, for instance, a few hours after a tough workout my body couldn't even carry me and I had muscle tremors. I went to the hospital and the only thing they could find was that the level of creatine kinase was at 2,200. The doctors concluded it was muscle breakdown, and that HIV alone can't cause that. What can I do to prevent more damage? Do I have to cut all exercise?


Men and Yeast Infections: How to Treat?
Is there an over-the-counter cream to treat male yeast infections? Can a man use a woman's over-the-counter cream for such an infection?


Treatment for "Acute" Hepatitis C Infection
I may be in the "acute" phase of hepatitis C infection; I'm waiting for blood test results to confirm it. I understand that the cure rate for hepatitis C is nearly 100% if I start treatment as soon as possible. Is this true? What's the best way to treat it?


Fat Problems on HAART in a Person Living in Africa
I live in Africa. When I was diagnosed with HIV in 2003, my CD4 count was 176; after starting a combination of 3TC (lamivudine, Epivir), d4T (stavudine, Zerit) and nevirapine (Viramune), it went up to 396, and I was feeling great. Three months ago, though, I began losing weight, my breasts enlarged and I have wasting in my arms, legs and face. My last CD4 count showed a drop to 376. What's happening to me?


Diagnosing and Treating Anemia
How does someone know if they are anemic, and what's the best treatment?

•  HIV TESTING & TRANSMISSION

Undetectability and HIV Testing
Would someone who has an undetectable viral load still test positive for HIV?


Can Clothing Provide HIV Protection?
A stripper wearing only her underwear rubbed herself against my penis, though I was fully clothed at the time. Is there still a risk of HIV infection if she was positive?

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