hi, micheal, i was once your student a few years ago. i think you gave me an A(SMILE). however a few years ago (5) i feel in love and let a man who said we'd be together forever infect me.I,m finally getting ready to have my dream come true and am about to get my SRS in thailand this summer. I'm also going to get breast implants. But is this going to kill me any faster than i'm already going? to be honest i feel i'd rather be dead than not go ahead w/ the surg. I,ve already been castrated w/ no noticeable side-effects

The question you ask about whether SRS will kill you faster than you are "already going" concerens me because it shows how you feel about having HIV. It sounds like you have not made the necessary psychological and emotional adjustments for learning how to live with HIV instead of thinking that you are dying from AIDS. This mental head set is crucial for all people living with HIV to make in order to have a reasonable quality of life. I find this a very serious problem for anyone, but especially someone going through the major life changing processes of sexual reassignment surgery.

Since I am not a doctor I really do not have any knowledge about what effects if any SRS has on the body's immune system, on progression of HIV disease or how any of the hormones that you will need to take might interact with any antiretroviral therapy you may be taking. I think that you really need to discuss these important concerns with qualified medical professionals.

Michael Shernoff, MSW