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January 9, 2006

Living With HIV

HIV Treatment

Drug Resistance

HIV Treatment-Related Health Problems

Health Insurance HIV

Strange but True

• LIVING WITH HIV

Should I Stop Taking Ecstasy and Special K?
I'm a club-drug user newly diagnosed with HIV. My doc said I don't need HIV meds yet, because my CD4 count is 851 and my viral load is 9,890. The drugs I use are Ecstasy and Special K; I know they're dangerous to take while on HIV treatment, but since I'm not on treatment yet, are they still safe? Are club drugs more dangerous for HIV-positive people than HIV-negative people?

Is There Any Point in Saving for My Retirement?
I've been HIV positive for six years; during that time, I've been on a few different treatment regimens, with mixed success. My latest regimen has worked well and my health is great, but my CD4 count won't climb out of the 300s and my viral load has never quite gotten down to undetectable. Lately, I've become very depressed: I'm very driven in my career and my life, but feel like I am just wasting my time by putting money away for my retirement and laying a foundation for the future. Since I have never achieved total viral suppression, does that mean that, even though I look great and never had an HIV-related illness, I can expect to die an awful death in 10 years with my family around me saying, "I told you so?"

Dear Dr. Bob: How Did You Get HIV?
Dr. Bob, I've been reading your responses to people in the "Fatigue & Anemia" forum for a long time now, and am so moved by your compassion, patience and understanding. I just recently read in one of your posts that you have HIV yourself. I hope you're not offended by this question, but how on Earth did you become infected?

HIV and the Law: Don't You Have to Disclose Before Sex?
Dear Dr. Bob: I recently read a post in your forum from a man who said he was HIV positive and repeatedly had unprotected anal sex with another man, but hadn't yet told this partner about his status. Why didn't you tell the guy that it's illegal for him to do this in the United States, and that he could be sued for not disclosing?

• HIV TREATMENT

First-Line Treatment for Someone With Full-Blown AIDS
It took only a year and a half for me to go from newly HIV positive to having full-blown AIDS. Now I'm starting my first HIV treatment regimen: atazanavir (Reyataz) + ritonavir (Norvir) + Truvada (tenofovir/FTC). Is this a good choice? What do I need to know about side effects and dosing issues?

AIDS and Treatment Concerns
My uncle has been diagnosed with advanced AIDS (his CD4 count is only 9), and is now taking seven different meds to manage his health, including the HIV meds Kaletra (lopinavir/ritonavir) + Truvada (tenofovir/FTC). Is this a good regimen for somebody in his condition? Can it interact with any of the other meds he's taking? What's my uncle's prognosis?

Taking HIV Medications While on Methadone
My partner is taking methadone to help him recover from drug abuse. He has full-blown AIDS, and just started taking the HIV treatment regimen abacavir (Ziagen) + efavirenz (Sustiva, Stocrin) + tenofovir (Viread). Is it OK for my partner to take these meds while he's on methadone therapy?

Ten Years of Combivir-Only Treatment: Is It Time for a Change?
I've been taking Combivir (AZT/3TC) with no other HIV meds since I was diagnosed in 1995. My CD4 count has been in the 700s almost the entire time, and my viral load has been low but detectable (never above 5,000) for years now. I'm in excellent health, although I'm beginning to notice some changes in my face that could be lipoatrophy. My doctor says that, because none of his other patients are taking two-drug therapy anymore, I should switch to a three-drug regimen of efavirenz (Sustiva, Stocrin) + Truvada (tenofovir/FTC) to see if that can bring my viral load down to undetectable. What do you think?

• DRUG RESISTANCE

Temporary Viral Load Spike: Does It Mean I'm Resistant?
After being undetectable for two years, I had a spike in my viral load -- it was 554 in October and 2,514 in November. My CD4 count was unchanged at 880. My doctor decided to stop my regimen and do a resistance test. He hasn't been able to do the test, however, because since November my viral load has fallen below 400! What's going on here? My doctor now insists that I should remain off treatment and that we should check my CD4 count and viral load in a few months, but I feel jittery about not taking HIV meds. What do you think?

If I've Never Taken HIV Meds, Can I Still Be Resistant to Everything?
I was recently diagnosed with HIV, and am waiting for the results of a resistance test. I know that drug resistance is a growing problem. What are the odds that I've been infected with a strain of HIV that's resistant to all common HIV meds?

Interpreting Resistance Test Results
A recent resistance test found that I was resistant to virtually all protease inhibitors, some NRTIs and no NNRTIs. How do I choose a new regimen based on these results? Does the fact that I'm on hemodialysis (a procedure to "clean" the blood using a dialysis machine) change my HIV treatment options?

• HIV & TREATMENT-RELATED HEALTH PROBLEMS

Low Testosterone While on HIV Meds
During a recent blood test, my doctor found that I had very low testosterone levels. I've been feeling tired and depressed lately, and my sex drive has dropped. Could my HIV meds be causing all this, or is it HIV itself? How can I get back to normal?

Mental Problems for HIVers
What are the most common mental problems in people with HIV?

• HEALTH INSURANCE & HIV

Group Health Plan: Can My HIV Meds Cost Other Employees Their Coverage?
I work for a company with less than 50 employees. We recently got a group health plan. I'm worried that if I start taking HIV medications, my company's health plan rates will skyrocket and other employees might lose their coverage. Can this sort of thing happen?

My Guardian Manages My Health Insurance; How Can I Keep My HIV a Secret?
I'm a newly diagnosed 23-year-old who has a legal guardian. Neither he nor my family knows I have HIV, and I'd like to keep it that way for now. However, my health insurance is currently provided by a company that my guardian owns. If I start taking HIV medications, can he find out because he's the one who oversees everything? Could I get my HIV meds covered by simultaneously enrolling in another program with a different insurance company?

• STRANGE BUT TRUE

A New Year's Meal, a Bloody Tongue and a Crawling Virus
On New Year's Eve, I went to a bar with some friends for some food and drinks. One of my friends bit his tongue while eating -- so hard that it drew blood! Is it possible that some of the HIV in his blood floated through the air, landed on my food or in my drink, or crawled on the table and got onto my fork?

An Unexpected Steam Room Encounter for a Married Man
I'm a married man with a problem: When I went to the steam room of my gym the other day, the guy beside me gave me a hand job, and then the guy in front of me gave me oral sex. I had no idea this gym was frequented by so many gay men! Do you think I just put myself at risk for HIV?

Art From HIV-Positive Artists

"Subway Dancer #3";
John Lesnick

Visit the January 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! This month's gallery is entitled "Compassion, Responsibility and Independence"; it's curated by a group of 16 teenage photographers who completed a summer program at New York University's Tisch School of the Arts.

Will You Pass the Test?
(100 Bucks Says You Will)

Looking for a little extra pocket change? Take The Body's monthly HIV/AIDS Knowledge Quiz for a chance to win a $100 cash prize. You may also learn some things about HIV that you didn't already know!

How can you get in on the action? Easy: Just take our five-question quiz. Answers to all five questions can be found on The Body. A particularly good place to look for answers is in recent editions of our weekly e-mail updates.

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