I have been HIV+ since 1994 and currently asymptomatic. I am on no meds for hiv for past 2 years. viral load undect and t-4 around 300. I have 3 issues that i cant figure out what it is HIV/Depression/getting old? If you have suggestions or comments i would appreciate it. My concerns are: 1) i am tired most of the time (i still work 50+ hours a week) usually sleep bout 4 hours and wake up and then go back to sleep. BUT sometime i can sleep all day. 2)I have almost lost all desires to have sex (when there is an opportunity) It takes alot for me to get aroused, then it doesnt last long or the erection goes away before ejaculation (even during masturbation) 3) and last I have a short term memory problem. I will be doing something and then get distracted and forget what i was doing. Like walking into a room to get something and forget why you went in there. go to a store and forget what i went there for, buy something i already have ETC. Cant rember my work schedule (I have to check it the day before). That is the most frustrating part. There are post-it notes all over my office. I used to could rember everything BEFORE hiv but Now i cant rember what i did yesterday. I am 34 years old. Pretty good shape 6'2" 195#. So is it because i am getting older or could HIV be causing this. If so what kinda test does my physician need to do to determine the treatment? He is an infectious disease doctor. MY symptoms seem to be inconsistant Like i will go couple months and be fine and then I WILL be la la land for a month or so, but seems to be getting worse, the last couple times.

Hello,

Now, considering the fact that I'm 49, what makes you think 34 qualifies you for "getting old?" So, let's rule that one out right away, OK youngster?

Second, why are you working 50+ hours per week? Are you George Bush's speech coach or something?

Are you male or female? Oh, hmm, you mention you are 6'2" and 195 pounds, so I'd bet you're a guy or perhaps a woman Olympic shot putter? Your symptoms of decreased libido, fatigue, and difficulty concentrating are most characteristic of 2 conditions - hypogonadism (low testosterone) and depression. Talk to your primary care doctor or HIV specialist about these 2 possible diagnoses. A simple blood test can measure your testosterone level. It's also a good idea to check your hemoglobin, because anemia can also be associated with fatigue, mental lethargy, and decreased sex drive. If the testosterone and hemoglobin levels are normal, then I recommend you seek out an HIV-knowledgeable counselor to explore the possibilities of anxiety, stress, and depression as potential causes for your symptoms.

Finally, keep an eye on that CD4 count and viral load. If your CD4 count drops or viral load spikes, you may want to consider restarting your meds.

Hope you'll soon be out of la-la land with the post-it notes back in the desk drawer and your mo-jo back in full swing!

Dr. Bob