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May 8, 2006

Living With HIV

Having a Baby

HIV Treatment

HIV Drug Resistance Rescue Therapy

Clinical Trials

Complications of HIV HIV Meds

Questions From HIV-Affected People

HIV Transmission Prevention

Strange but True

• LIVING WITH HIV

Marijuana and HIV: A Bad Combination?
My partner's been positive for nearly five years now. He sometimes has trouble with depression and sleeping. Recently he's been smoking a lot of pot -- about one eighth of an ounce every couple of days. I'm worried. I thought about mentioning it to his doctor, but since it's illegal, I didn't want to put his doc in a difficult position. Is smoking pot going to affect his HIV?

Is Liposuction a Safe Way to Deflate My "Spare Tire"?
I'm a 25-year-old gay male who's been living with HIV for three years. I have a "spare tire" of fat around my waist (unrelated to HIV or meds) that I haven't been able to get rid of, despite working out for the past two years. Is liposuction a safe option for me, or would a plastic surgeon not want to do such a procedure on an HIV-positive person?

• HAVING A BABY

Pos-Guy, Neg-Gal Couples Can Have Healthy Babies!
I've read many questions in these forums written by magnetic couples who are worried about conceiving a baby when the man is positive and the woman is negative. I just wanted to let everybody know that we were able to do so -- my wife (who is still negative) gave birth to a healthy, HIV-negative baby girl. My family is living proof: It is possible!

• HIV TREATMENT

HIV Meds and Viral Load: How Antiretrovirals Keep the Virus Down
When I was diagnosed three years ago, my viral load was around 700,000, and I was told I'd been infected for more than a decade already. I started treatment with Combivir (AZT/3TC) + efavirenz (Sustiva, Stocrin), and now my viral load is undetectable. If HIV meds don't actually kill HIV, how can my viral load go down that low? And if it can become undetectable, why can't I be cured completely?

Why Are My Lab Numbers so Much Worse This Month?
After an upward trend, my lab numbers suddenly took a nosedive last month -- my CD4 count dropped from 380 to 206, while my viral load went from undetectable to 48,000. All of my test results are coming from the same lab. I just started treatment in September, and I've never missed a dose. Why would my numbers change so much so quickly?

Is Gene Therapy the Next Big HIV Treatment Breakthrough?
I recently read a newspaper article about an experimental HIV treatment method in which researchers are trying to use stem cells to make a person's blood resistant to HIV. The article made it sound like this strategy was actually working, but how likely is it to be a breakthrough treatment for HIV? Could it ever replace antiretrovirals?

In addition to Dr. Eric Daar (who answered the question above), Dr. Bob Frascino also recently chimed in on the gene-therapy issue. You can read Dr. Bob's response by clicking here.

To read the newspaper article referred to in this question, click here.

• HIV DRUG RESISTANCE & RESCUE THERAPY

Heavily Drug Resistant and Almost Out of Options
I went through many HIV treatment regimens in the 1990s, thanks to a drug-addiction problem. Although I've been sober for four years now, I've developed resistance to virtually every HIV medication. My CD4 count is extremely low; I'm lucky not to have gotten sick yet. People keep recommending I join a clinical trial for a new drug, but I live in Minnesota, and many trials don't include my area as a study site. What options do I have?

Has My New Rescue Regimen Stopped Working?
Since January I've been in a study of two HIV meds in development (TMC114 [darunavir] and TMC125 [etravirine]), which I'm taking along with T-20 (enfuvirtide, Fuzeon) and Truvada (tenofovir/FTC). My viral load was high and my CD4 count was very low when I started. I initially responded well to my new regimen, but my latest labs show that this trend has stopped. Is this something I should be worried about, or is there still a chance my new regimen will keep working?

• CLINICAL TRIALS

Leg Pain, Abacavir and "Blinded" Clinical Trials: What Are My Rights?
I'm in a "blinded" HIV treatment study comparing Epzicom (abacavir/3TC) and Truvada (tenofovir/FTC, Kivexa). Because the study is blinded, I don't know which of the two drugs I was prescribed. Two weeks after I started, though, I developed severe leg pain -- one of the symptoms of abacavir hypersensitivity reaction. I was taken off meds, and am now feeling better. I've read that abacavir should never be restarted if someone had an allergic reaction to it, but I don't even know if I received abacavir in the first place. How can I ensure that when I restart treatment, I won't be placed back on the Epzicom arm again?

• COMPLICATIONS OF HIV & HIV MEDS

Testosterone Replacement Therapy: Which Is the Best?
Dear Dr. Bob: You seem pretty set against HIVers using DHEA for fatigue or depression, even though a lot of people promote it. What's so bad about it? Also, do you have any thoughts on which is the better brand-name testosterone replacement product: AndroGel or Testim?

Was I Right to Stop All My Meds After Developing a Rash?
Ten days after I started a new regimen of efavirenz (Sustiva, Stocrin) + Epzicom (abacavir/3TC, Kivexa), I woke up with an itchy rash on my upper body. I called an emergency hotline, and the doctor I spoke with told me to stop taking my HIV meds immediately. I did so, but I haven't seen my HIV doctor yet -- I don't have an appointment until later this week. Did I do the right thing? By stopping my meds so suddenly, could I develop resistance to them?

Stopping a Med Because of Acne
I'm taking Combivir (AZT/3TC) + efavirenz (Sustiva, Stocrin) + tenofovir (Viread). Although my viral load is undetectable, I'm getting terrible breakouts on my face, especially my forehead and nose. I suspected the Combivir was to blame, so I stopped taking it. Was this a bad idea? The acne has worsened since I stopped the Combivir; what can I do?

• QUESTIONS FROM HIV-AFFECTED PEOPLE

What Can We Do to Help an Old Acquaintance With AIDS?
Today, out of the blue, one of my husband's old army buddies called. He said he's had AIDS for many years, has no contact with his family, has no money and is out of meds. We can't give him any money, and we live halfway across the country from him. What can we possibly do to help?

• HIV TRANSMISSION & PREVENTION

Can My HIV-Positive Son Infect My Family?
I was searching my son's room for recreational drugs when I found his HIV medications. He's been acting strangely recently, but I certainly didn't expect he had HIV. My son is 19 years old, and I have three younger kids, the youngest of whom is only nine. Does his HIV infection put the rest of my family at risk? Should I ask him to move out?

How Might Circumcision Protect Someone From HIV?
I had never heard of the concept of circumcision for HIV prevention before I read about it in these forums. How would this work, and why would it be a good idea?

Will Successful HIV Treatment Make a Person HIV Negative?
I know someone who tested positive for HIV eight years ago, and has been taking HIV meds ever since. He says he got retested for HIV recently and that the new test came back negative. Is this possible?

Is Unprotected Sex Safer if It's With a Transsexual?
Am I still at risk for HIV if I have unprotected sex with a person who has undergone a complete sex change (from male to female)?

• STRANGE BUT TRUE

Can HIV Eat a Uterus? (And Other Digestion Questions)
My girlfriend and I have been having sex without a condom. I was diagnosed with HIV last year; she knows about my status, and is afraid that the virus will eat up her uterus. Is this something she should be concerned about? My girlfriend also likes to give me oral sex. If she swallows my semen, will her stomach acid eat the HIV and protect her from infection?

Art From HIV-Positive Artists

Image from the May 2006 Visual AIDS Web Gallery

"Self-Portrait: Entrapment with Twist," 2002; Luna Luis Ortiz

Visit the May 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The May gallery is entitled "The 'Me' You See"; it's curated by Reed Massengill, a widely published writer and photographer who specializes in male nudes.

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