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March 5, 2007

Living With HIV

Pregnancy HIV

HIV Treatment

Complications of HIV HIV Meds

HIV Transmission

HIV Treatment in Developing Countries

Strange but True

• LIVING WITH HIV

Can I Ever Lead A "Normal" Life Again?
Six months ago, I had a CD4 count of 2. Now, after starting HIV meds, my CD4 count is 52. I also just got released from the hospital after almost dying (I was diagnosed with immune reconstitution syndrome). If I take good care of myself from now on, is it possible for me lead a "normal" life? Can I expect to be alive 15 years from now?

To Disclose, or Not to Disclose: One Person's Opinion
I'm surprised to read these forums and see so many people asking whether or not they should disclose their HIV status to their partners. It's not a question of whether or not you should -- you must disclose. By keeping your HIV a secret, you put your partner at risk for HIV and yourself at risk for legal repercussions and serious remorse. Some will argue that the negative partner is just as responsible for avoiding HIV infection, but pos folks are responsible for being honest.

Nursing and HIV Disclosure
Are HIV-positive registered nurses required to tell their employers, coworkers or patients about their status?

Another Way to Pay for HIV Meds After Losing a Job
In reply to a question about paying for HIV meds after losing a job, an expert said that HIVers in the United States who can't afford drugs can get help through their state's AIDS Drug Assistance Program. I'd like to point out that HIVers may be eligible to receive help paying for insurance as well as HIV meds themselves. All 50 states offer insurance premium assistance for people with HIV who have lost a job. The rules vary by state, but these programs all offer HIVers financial help so that they can continue getting the coverage they were offered by their employers.

• PREGNANCY & HIV

Risks and Benefits: Getting Pregnant the Old-Fashioned Way
I've been HIV positive for 10 years and my wife is negative. In 2004, we decided to try to have a child -- but our insurance company, which supposedly covers assisted conception, refused to help us. We decided to take a chance and try to get pregnant via unprotected sex. We now have a healthy, HIV-negative, 2-year-old boy. My wife remains negative as well. I'm not saying this method works for everyone, and you're taking a risk if you try it, but it was sure worth it for us.

What HIV Meds Can I Take During Pregnancy if I Already Have Multidrug Resistance?
I'm resistant to almost every HIV medication except Kaletra (lopinavir/ritonavir). My current CD4 count is 246 and hasn't topped 350 since I started treatment. I want to have a child someday; are there any HIV meds that are safe for me to use during pregnancy?

• HIV TREATMENT

My Meds Are Failing, What Should I Do?
HIV and me go back a long way, but since I started taking meds in 1995, I've been in good health. However, I'm now showing resistance to all of the current classes of HIV meds. Over the past year, my meds have begun to fail, and my CD4 count has been declining: It's now 288. My doctor is urging me to try Fuzeon (enfuvirtide, T-20), but I want to avoid it as long as possible. Can I afford to wait around for the new drugs (e.g., maraviroc and MK-0518 [raltegravir]) to become available? What other options do I have?

Should I Stop Taking Meds If I Have Multidrug Resistance?
I'm resistant to a lot of HIV meds, and I wonder if and how I should pursue treatment. Is there any benefit to taking meds I'm resistant to, or should I just wait until new drugs are available? What are the benefits of the reduced viral fitness of drug-resistant HIV? Can drug resistance be reversed?

• COMPLICATIONS OF HIV & HIV MEDS

My Side Effects Went Away; Does That Mean My Meds Have Stopped Working?
I have been on my current regimen of Kaletra (lopinavir/ritonavir) + Truvada (tenofovir/FTC) for about two years. Immediately after starting, I experienced nausea, diarrhea and headaches, but now the side effects have vanished. My CD4 count is around 500 and my viral load is undetectable, but I'm scared the lack of side effects means my meds aren't working as well anymore. Could that be true, or has my body just gotten used to them?

Can Atripla Cause Darkened Veins?
I tested positive more than two years ago, and I'm now taking Atripla (efavirenz/tenofovir/FTC) to keep my HIV in check. My CD4 count is above 700 and my viral load is undetectable. Over the last couple of months, the veins in my palms and the bottoms of my feet have become a lot more noticeable. They look darker, especially when I shower, and other people have started to notice. Could Atripla be causing this?

My CD4 Count Is High, So Why Do I Have Abscesses?
I'm HIV positive, and my CD4 count is nearly 1,000. In addition, I have never developed any opportunistic infections. In the last six months I've developed six abscesses on my body. One swelled my face so badly that I could barely swallow. What's going on?

My Doctor Doesn't Believe I Have Kaposi's Sarcoma!
My doctor has made some mistakes in the past, and I'm wondering if she's making another one now. I recently developed a hard, reddish-purple, scaly bump on my left shoulder. When I showed it to my doctor she barely gave it a glance. I worry that the spot is Kaposi's sarcoma. Should I push my doctor to take another look at it? I was diagnosed with AIDS seven years ago, but my CD4 count is now up to 500.

• HIV TRANSMISSION

A Concerned Teacher and an HIV-Positive Preschooler
I've just learned that one of the students in the preschool class I teach is HIV positive. I don't want to treat her differently than the other children I'm caring for, but I do want to make sure I'm taking appropriate precautions. How can I keep all of my kids safe?

• HIV TREATMENT IN DEVELOPING COUNTRIES

Drug Resistance in Zambia
I'm a doctor working with HIV-positive people in Zambia. One of my patients is a 15-year-old boy. He's been on HIV meds for almost 10 years and has become resistant to a wide range of drugs. His CD4 count is extremely low, and even with his current drug regimen, his health continues to worsen. What can I do? It's very difficult to get the meds that may work against his drug-resistant HIV, and even if we could get them, the costs are prohibitive.

• STRANGE BUT TRUE

A Hot Dog Situation That Nobody Would Relish
I enjoy putting hot dogs in my booty sometimes, but now I'm concerned. I usually buy packaged hot dogs and boil them to be sure they are sterile. However, I recently bought a hot dog from a street vendor because I was on the road in a big city and there was no nearby grocery store. If the vendor had HIV, is there any way I could have become infected?

Is Crystal Meth a Good Addition to an HIV Regimen?
My friend has been alternating doses of an HIV medication, Sustiva (efavirenz, Stocrin), with "doses" of methamphetamine. His viral load is now undetectable, and he thinks crystal meth is responsible for his improvement. Is that possible?

Art From HIV-Positive Artists

Image from the March 2007 Visual AIDS Web Gallery

"It Is Beautiful There," 1992;
Arnold Fern

Visit the newly launched March 2007 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery is entitled "Camp Tales: The Art of Arnold Fern and Marc Lida"; it's curated by Jonathan Weinberg, Ph.D., a painter, author and art historian.

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