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February 19, 2008

Mixed-Status Couples

HIV Treatment

Complications of HIV HIV Meds

Hepatitis

Understanding Your Labs

Pos-Pos Couples

HIV Transmission

Strange But True

• MIXED-STATUS COUPLES

The Swiss Say Some HIVers Can Have Unprotected Sex; Are They Right?
Swiss researchers recently released a statement saying that HIV "cannot" be transmitted from an HIV-positive man with an undetectable viral load to his HIV-negative sex partner, given that a number of conditions are met, including that the HIV-positive man is in a monogamous relationship and has no other sexually transmitted diseases. Do you support this claim? Is it really OK for some magnetic couples to have unprotected sex?

My Boyfriend Is Negative and I'm Afraid of Infecting Him
I'm freaked out about the risk of infecting my negative boyfriend. He is aware of my status, but he insists on giving me blow jobs without using condoms. We've been together more than three years and we are in love -- in fact, we are going to get married next year. We enjoy our sex life, but every time we are naked, the only thing I have in my mind is HIV. My mind tells me that we have to end our relationship. If we continue this way, he will be infected. "No condoms, no sex, no relationship!" But my heart won't listen; I want to be with him forever. What should I do?

• HIV TREATMENT

I Forgot to Take My Once-a-Day Pill!
I went to sleep last night without taking my daily dose of Atripla (efavirenz/tenofovir/FTC), and I won't be able to take another dose until tonight. That's a full day without HIV meds! Have I put myself at risk of developing resistance?

Should I Skip My Meds When I Drink Wine?
When I have a glass or two of red wine, is it OK to skip my HIV meds?

Can My Doctor Refuse to Start Me on HIV Meds?
I realize my CD4 count is high (700) and my viral load is low (15,000), but I recently started dating someone who's HIV negative, and I want to reduce my risk of HIV transmission to him as much as possible. My doctor keeps telling me that HIV meds are "not recommended" for me right now, but can he actually prohibit me from starting treatment?

CD4 = 400: Time to Start Meds?
I was recently diagnosed with HIV. My CD4 count is 400 and my viral load is 30,000. My doctor has put me on Bactrim (which protects against PCP pneumonia), but I'm debating whether to start HIV meds as well. What do you think?

Can I Drink Any Grapefruit Juice While on Sustiva?
I know that there's an interaction between grapefruit and Sustiva (efavirenz, Stocrin), but I love grapefruit juice! Would it be OK to drink it just once in a while?

• COMPLICATIONS OF HIV HIV MEDS

Ziagen and Heart Attacks: Should the Risk Make Me Switch?
I'm currently taking Ziagen (abacavir), but my health care provider is wondering whether I should switch. A major study recently found that Ziagen increases a person's risk for heart attack. Although I'm reasonably fit, I already have some risk factors: I'm a 40-year-old man with high cholesterol and high blood pressure. Do you think I should switch from Ziagen to another HIV medication?

Lowering Triglycerides With Supplements
I've tried taking fenofibrate (Tricor, Lipanthyl) to lower my triglycerides, but it doesn't work well and has annoying side effects. Are there any supplements I can try?

HIV Meds and Pre-Diabetes
Since I began taking Epzicom (abacavir/3TC) and Sustiva (efavirenz, Stocrin), my blood sugar has increased to the point where I'm now borderline pre-diabetic. Could my meds be causing the higher glucose levels? What can I do to avoid developing diabetes?

• HEPATITIS

Hep C and Fisting: What's the Connection?
I like to think I'm well informed, but I don't understand how the sexual practice of fisting increases a person's risk of getting hepatitis C. Could you explain?

My Hep C Treatment Worked; Can I Safely Drink Alcohol?
My husband and I both had hepatitis C, but we responded well to treatment. If we drink two or three glasses of wine in the evening, are we putting ourselves at risk for a hep C rebound or further liver damage?

• UNDERSTANDING YOUR LABS

Why Isn't My CD4 Count Higher?
My viral load has plummeted since starting HIV meds, but my low CD4 count has barely budged. What's going on?

Why Wasn�t the Lab Able to Complete My Drug Resistance Test?
A drug resistance test I took this December came back with a strange result. The report said the test couldn't be performed, and gave two possible reasons: Either I had "insufficient virus" (not possible; my viral load was 61,000) or there was an "inhibitory substance" in my blood (I don't do drugs). What's going on?

Different CD4 Counts, Different Folks
Why do people who were infected with HIV at the same time have different CD4 counts?

• POS-POS COUPLES

Can We Ditch the Condoms?
My boyfriend and I are both HIV positive, but I'm the only one on meds. If we're in a committed, monogamous relationship, do we have to have safe sex? If we have unprotected sex and my HIV is resistant to my meds, is there a risk of passing that drug-resistant virus on to him?

• HIV TRANSMISSION

Why Should People Support Needle Exchange?
I have a hard time condoning the idea of setting up centers where injection drug users are given clean needles. Sure, that clean needle might save a life by preventing HIV. But that same needle could also be used to inject a fatal overdose. How can needle exchange programs be justified given that risk?

• STRANGE BUT TRUE

A New Drink in the Hotel Wet Bar
When I opened up my hotel room refrigerator, I found a condom partly filled with some sort of fluid. I dumped the liquid in the sink, then wrapped the condom in paper and threw it away. If there was HIV-infected semen in there, could I have put myself at risk?

From the "Ask the Experts" Forums

I'm a 42-year-old gay man, and have been in a monogamous relationship with an HIV-negative man for 18 years. I was probably infected in the late 1980s, but by the time I was diagnosed, my CD4 count was 170 and my viral load was through the roof. I honestly thought my life was over. But I immediately began therapy, and within a month my viral load was undetectable and my CD4 count had risen to over 500. It's now up to 1,300!

I really don't know why I have been so lucky, but I just want to let others know that there can be hope. I have an excellent doctor who always listens to my questions, however petty, and the support of a great partner as well as half a dozen friends and family with whom I chose to share my diagnosis. I have, thank God, remained in excellent health and maintained full-time employment in a very stressful job. I have been 100% adherent, to the half hour, with all my meds and have never missed a dose. I place my meds where I can see them, in the same place, at the same time, every day. This has become a total habit and is as natural to me now as getting in the shower in the morning!

I don't want to preach and I know I have been one of the lucky ones, with excellent results and as yet no side effects, but I really believe that the key thing is adherence. Eight years ago, I honestly would never have believed I would still be here. Don't give up, and never be afraid to ask your medical providers any questions or queries you have.

--Liam

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Art From HIV-Positive Artists

"Floaters," 2003; Max Greenberg

Visit the February 2008 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery, entitled "Looking Up Lyrics," is curated by Becca Albee.

The Most Bizarre
Posts of 2007 in our
"Ask the Experts" Forums

Our readers have spoken, and we have a winner! (Or loser, depending on how you look at it.) Hundreds of people voted in TheBody.com's first annual "Strangest but Truest" survey, in which we nominated 10 of the most bizarre posts to grace our "Ask the Experts" Forums in 2007.

It was a very close contest. To find out which post won the most votes, and to see a full breakdown of votes in the survey, click here.

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