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September 11, 2006

Living With HIV

First-Line HIV Treatment

Switching HIV Treatment

Stopping HIV Treatment

HIV Drug Resistance

Insurance HIV

Children HIV Treatment

HIV Prevention

Strange but True

• LIVING WITH HIV

Bringing HIV Meds Aboard an Airplane: Disclosure and Security
I'm traveling from the United States to the Virgin Islands and need advice on how to bring my HIV meds along without a hassle. I'd like to bring my drugs in an unmarked bag, so I won't have to disclose my HIV status to my traveling companions. Is that all right, or will I need to have the original prescription bottle with me? Also, I'm wondering whether to pack my pills or bring them in a carry-on. Now that bringing liquids aboard is banned, do I have to pack my gel-cap pills in my luggage?

• FIRST-LINE HIV TREATMENT

How to Keep Your CD4 Count on the Rise
After starting HIV treatment, my CD4 count rose from 2 to 167, and my viral load went from 100,000 to undetectable. I just switched to the new three-in-one pill Atripla (efavirenz/tenofovir/FTC); is there any way I can keep my CD4 count rising while I'm on this new treatment?

Why Is My Viral Load Slightly Above Undetectable?
I've been on HIV treatment for 10 weeks now, and although my viral load is way down, it's stayed just above undetectable (80 a month ago, 100 at last test). A resistance test showed that I'm still sensitive to all of my medications. So why am I not undetectable?

Showing Symptoms: Should I Start Therapy and Risk Side Effects?
I've been HIV positive for 10 years and haven't been on meds. In the last three years my CD4 count dropped to 250 and my viral load increased to 100,000. I've lost 18 kg (40 pounds), my lymph nodes are sometimes painfully swollen and I have intermittent diarrhea. My doc wants to put me on once-daily fosamprenavir (908, Lexiva, Telzir) + ritonavir (Norvir) + Truvada (tenofovir/FTC) -- I'm resistant to efavirenz (Sustiva, Stocrin). Is this the right time to begin treatment? Might I end up trading my current symptoms for awful side effects?

Are Some HIV Meds Better Than Others for People With PML?
A friend has just been diagnosed with progressive multifocal leukoencephalopathy (PML) -- a central nervous system disease -- and will start HIV meds soon. I understand that certain meds are better at getting into the central nervous system than others. Could these meds be particularly beneficial in my friend's case? What combination might you suggest for him?

• SWITCHING HIV TREATMENT

My New Doc Recommends Switching, but I Think I'm Doing Fine
I am coinfected with HIV and hepatitis C and am taking nelfinavir (Viracept) + Truvada (tenofovir/FTC). My HIV and hepatitis C viral loads are undetectable, my CD4 count is high (701) and rising, and my liver tests show only slight elevations. In short, I'm doing well, but my new doctor is seriously considering changing my treatment regimen. Should I go along? It seems odd to "fix" something that already works.

Are Liver/Bone Lab Abnormalities Good Reasons to Switch Treatment?
Should HIV-positive people switch treatment if they develop high liver enzyme levels and bone marrow suppression while taking Combivir (AZT/3TC) + Kaletra (lopinavir/ritonavir)? If so, what should they switch to?

Side Effects Made Me Stop My "Best" Regimen; What's the Next Step?
Ten days after starting Kaletra (lopinavir/ritonavir) + Truvada (tenofovir/FTC), red rashes appeared all over my body, especially on my shoulders and arms. My doctor told me that the rash was due to a drug-related allergy and took me off the regimen. I'm terribly upset, because I was told it was the best combination for me. What should I do now? Can I try Kaletra + Truvada again?

• STOPPING HIV TREATMENT

I'm Trading in My Meds to Improve My Life; What Do I Tell My Doctor?
My HIV meds have failed and I've had every side effect possible. I hardly even recognize myself in a mirror thanks to lipoatrophy. Hepatitis is just ridiculous, peripheral neuropathy is a pain and anemia is getting really boring -- and yet I'm still not undetectable. So I'm giving the rest of my meds to a charity that sends them to the developing world, and am going to try to live whatever time I have left in a better way. I'm not just giving up. I have fought this for 10 years, and given it everything I had. I intend to continue to do so, but want to feel better. My question is: I get along quite well with my doctor, but do you think he's likely to agree to continue monitoring my general health if I refuse meds? What would your reaction be if one of your patients made the decision I'm making?

CD4-Guided Treatment Breaks: Smart or Stupid?
Is it safe to stop taking HIV medications when your CD4 count is high, and then restart when your CD4 count drops to a certain level? I keep hearing conflicting stories about whether these "CD4-guided" treatment interruptions are safe.

• HIV DRUG RESISTANCE

What Does "Complete" Resistance Really Mean?
If a phenotypic resistance test says that I have "complete" resistance to an HIV medication, can it still work against some of the virus in my body?

Can I Become Protease Inhibitor Resistant While I'm Not Even on Meds?
I've been on an HIV treatment interruption for almost two years. My doctor recently gave me a genotypic resistance test, and it found that my NNRTI resistance had vanished, but that I've suddenly gone from being susceptible to protease inhibitors to resistant to almost all of them! I haven't had unprotected sex during my treatment break, so I couldn't have acquired a new strain of HIV that way. What could be going on? If I need to restart treatment, what regimens should I consider?

• INSURANCE & HIV

Student Health Insurance "Continuation": How Does This Affect COBRA and HIPAA?
I am a graduate student with HIV. My school's health insurance policy offers a 12-month "continuation privilege" after a student leaves, but the policy doesn't mention COBRA, which is what usually kicks in to ensure continuous coverage between an old insurance policy and a new one. Is it possible that a student insurance plan doesn't have to offer 18 months of COBRA if it offers this 12-month continuation privilege? After the 12-month period ends, is the process the same for applying for coverage under HIPAA?

Converting Group Life Insurance to an Individual Plan
I heard that I can convert my group life insurance to an individual plan within 30 days of termination of employment. I was also told that, if I do so, I won't have to prove that I'm "insurable," which can be a huge hassle for someone with HIV. Is this true? How does the conversion process work?

• CHILDREN & HIV TREATMENT

How to Deal With High Cholesterol/Triglycerides
My 12-year-old son is doing well on a regimen of abacavir (Ziagen) + d4T (stavudine, Zerit) + Kaletra (lopinavir/ritonavir), but he has high cholesterol and triglycerides, and I'm very worried about the health of his heart. What can you recommend? His doctor doesn't want to switch therapy, since his CD4 count is high and his viral load is undetectable.

• HIV PREVENTION

Taking HIV Meds After Exposure to Prevent Infection
If my partner's condom breaks and I'm exposed to pre-cum or cum, could antiretroviral therapy prevent me from getting HIV? How soon would I have to take it?

Why Did I Receive the "Wrong" Kind of PEP?
After having unprotected sex with an HIV-positive man, I went to a clinic and was prescribed d4T (stavudine, Zerit) + ddI (didanosine, Videx) as a post-exposure prophylaxis (PEP) regimen. When I wrote to this forum a few days ago, I learned that this combination is not considered a good option for PEP. Now I'm wondering why a PEP specialist at a university hospital would recommend an inferior regimen. Should I trust this clinic in the future?

• STRANGE BUT TRUE

A Close Encounter With a Bum on a Bike
Three hours ago, I was walking on the sidewalk, and a bum hit me from behind with his bike. We both fell down, and my knees hit the ground, causing minor abrasions. I am 100% sure that the bum did not have any contact with my abrasions, but his head may have hit mine, and I have acne. Is it possible he could have bled on my acne, putting me at risk for HIV?

Can Masturbating in the Shower Give Me HIV?
I'm 15 years old and started masturbating a year ago. I like to take very hot showers when I masturbate to reduce the risk of getting HIV, but then I started wondering: What if HIV is in the shower water itself? Could it get into my urethra and infect me that way?

Exclusive Images From
AIDS 2006

Image from The Body's AIDS 2006 Photojournal

A tile from The Peace Tile Project. Students from Africa, India and the United States contributed tiles for display on one of the walls in the Youth Pavilion of the Global Village. Each tile tells a unique story about HIV, whether it be combating stigma, advocating for safe sex or supporting women.

The Body's exclusive AIDS 2006 Photojournal features dozens of images of the many people, protests and unique sights of the XVI International AIDS Conference. From world leaders to HIVers living in the developing world; from press conferences to protests; and from the conference center to downtown Toronto, we give you a glimpse of what it was like to attend the largest gathering on HIV in history.

Art From HIV-Positive Artists

Image from the September 2006 Visual AIDS Web Gallery

Untitled (Boy in a Dress), 1997;
Ferenc Suto

Visit the September 2006 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! The September gallery is entitled "Do You Remember the First Time?"; it's curated by Jeffrey Walkowiak, co-director of the Sara Meltzer Gallery in New York City.

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