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September 25, 2006

Living With HIV

First-Line HIV Treatment

• LIVING WITH HIV

Should I Bother Going Back to School?
I've been positive for two years and recently went back to college. I've heard that the average lifespan for an HIV-positive person is 10 to 15 years, so I wonder if I'm wasting my time trying to get my degree. Should I just enjoy the time I have left?

My Numbers Are Good. Should I Worry About the Future?
I'm doing well on HIV treatment, but I'm constantly worried about my future. Since I started treatment two years ago, my CD4 count has gone from 32 to 366 and my viral load dropped to less than 40. Still, I'm really anxious about treatment failure, developing resistance and lipodystrophy. Am I right to be worried?

• FIRST-LINE HIV TREATMENT

Will My Side Effects Ever Go Away?
Soon after I take my meds (Combivir [AZT/3TC] + efavirenz [Sustiva, Stocrin]), my mouth feels heavy and turns slightly red. Also, I'm having trouble falling asleep. My doctor says these side effects will go away. Is this true? What can I do in the meantime?

Can Tuberculosis Treatment Blunt the Effect of HIV Meds?
I have tuberculosis and HIV. My CD4 count went from 4 to 96 within six months of starting HIV treatment, but my viral load climbed from 2,500 to 48,000. Could my tuberculosis treatment have caused this?

CD4 Count Barely Budging, Even on Meds. Is There Hope?
Since I started treatment, my CD4 count has barely risen, from 55 to 61. I feel so healthy and fit that I thought my count would be much higher by now. Is it time to write my will, or is there still a chance I can beat this disease?

My CD4 Count Is 850. When Should I Start Treatment?
I was diagnosed with HIV in March. My CD4 count is 850 and my viral load is 3,500. My doctor says the earlier I start meds, the better, and he wants me to take Atripla (efavirenz/tenofovir/FTC). Do you agree that I need to start treatment now?

Sudden, Sharp CD4 Drop: Have My Meds Stopped Working?
I've been on Combivir (AZT/3TC) + efavirenz (Sustiva, Stocrin) for five years. My viral load has been undetectable for a few years, and my CD4 count has been around 1,200. Then, at a recent doctor's visit, my CD4 count dropped to 600. My doctor says fluctuation is normal, but that's a big drop! Does this mean my regimen is failing?

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• HIV DRUG RESISTANCE

How Do You Pick the Right Drugs When You're Resistant to Everything?
I was diagnosed 22 years ago and I'm highly resistant to all currently available meds. My CD4 count is 100 and my viral load is 750,000, up from 50,000 a month ago. How do I pick the right meds for my next regimen? Would any meds from my old regimens be effective? What about new meds in the pipeline?

Restarting Meds After a Treatment Interruption
I have been off meds for almost two years and now it's time to start again: My CD4 count is 200 and I have a viral load of 40,000. In the past, I've taken regimens that have included d4T (stavudine, Zerit), ddI (didanosine, Videx), nevirapine (Viramune) and tenofovir (Viread). These regimens always kept my CD4 count up and my viral load undetectable, but a resistance test back in 2003 showed that I was resistant to a good number of meds. What are my options now?

Are My Treatment Options Really as Limited as My Doc Says?
I have been positive for more than 20 years. Lately, my viral load has been doubling every few months; it's now 47,000, and my CD4 count is at 150. My last phenotype test showed I was resistant to many HIV meds. My doctor says my only option is to take T-20 (enfuvirtide, Fuzeon) + TMC114 (darunavir, Prezista). Are there definitely no other meds I can consider?

• HEALTH INSURANCE & HIV

How Can I Get Health Insurance if I Quit My Job?
I'm thinking about leaving my job. If I do, my boss will drop me from my group health plan right away, and I don't think I'll be able to even ask about COBRA coverage. Should I buy an individual plan? Can my boyfriend put me on his plan?

What Does "Pre-Existing Condition" Really Mean?
I just got a new job and signed up for their health insurance, even though it doesn't cover pre-existing conditions. Can the insurance company use the "pre-existing condition" clause to refuse to pay for my HIV-related doctor visits and lab tests?

Can I Transfer My Health Insurance Without Declaring My HIV Status?
I am self-employed, healthy and do not require meds for my HIV. I need to switch my health coverage from California to Florida, where I now live. The health insurance company doesn't know I have HIV. Can I transfer my policy to Florida without having an HIV test?

• HIV TRANSMISSION

Was It Risky to Have Protected Sex at a Gay Sauna?
I'm a "straight" bloke who's attracted to men. I recently had protected anal sex at a gay sauna. After I got home, I noticed a speck of blood on my towel from my anus. I've had diarrhea for eight days and my lymph nodes are throbbing. Should I be worried about HIV? I'm scared to have sex with my girlfriend. I don't want to pass anything on.

Feeling Sick After PEP -- Does That Mean I Have HIV?
I had unprotected, receptive anal sex with a man whose HIV status I don't know. At the end of a month-long course of post-exposure prophylaxis (PEP), I have a fever, sweats, sore throat, fatigue and swollen glands. Do my symptoms mean the PEP didn't work?

• STRANGE BUT TRUE

Does Drinking Urine Slow HIV Progression?
My mom researches alternative therapies, natural medicine and all kinds of crazy things. I read something with her the other night that said proteins in the urine of pregnant women will block the progress of HIV. Could this be true?

Can I Get HIV From a Soap Dispenser?
How long can HIV survive in a soap dispenser at home or in a public bathroom?

Save the Date! Join Dr. Bob on Sept. 27 for a Live Chat on Fatigue and Anemia

At 6 p.m. Eastern Time (3 p.m. Pacific) on Wednesday, Sept. 27, The Body's Dr. Bob Frascino will answer your questions about fatigue and anemia in a live chat! Click here for more info on the chat, or to sign up for an e-mail reminder shortly before the chat is scheduled to start.

Art From HIV-Positive Artists

Image from the September 2006 Visual AIDS Web Gallery

"Single Gardenia," 2005;
Joel Carlson

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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