Dr young,first let me say you guys do an invaluable service to us hivers,thanks.Been postive for 6 tears and due to a lack of insurance have nt had a cd4 count done but ive monitored my total wbc count and absolute lymphocyte total.My numbers last year were such 4.1 total wbcs,my lymphocytes were 980,hemogoblin 15.8,hemacrit 46.8,and platelet was 190.all were in normal range according to the reference range.Last month my numbers went to 1523 lymphocytes,hemo. 14.8, hemacrit 43.8 ,platelet count 221.Can you tell me how i might be holding up.Should i consider therapy or im i doing ok.Have a job opportunity with bene s .in near future.Been self employed for 6 yrs.thx

There are many ways to obtain adequate HIV care in the US even without health insurance, due to the Ryan White Care Act, and in other countries. You should enroll in a federally qualified health center (FQHC) or public hospital in your state in the US, or a public facility in another country, and get the proper diagnostic tests done. Also, there are self-insurance health pools these days that may allow you to get benefits for $1-200/yr that are worth exploring. Note also that the Ryan White Care Act provides treatment at no or minimal cost to the individual. You can also access this information via the many NGO HIV advocacy agencies in your state.

In general, a total lymphocyte count below 1200 is an indication for treatment, but its too crude a tool to be useful for monitoring ART. I urge you to have two plans - one for if and when you get employment with benefits, and a second in case you don't. Recent data suggest that the average life expectancy for a man of 35 years is 69 years if they are treated before they develop AIDS, and only 49 years if they receive treatment after they become ill with AIDS. Don't let any more time go by and allow the risk of this possibility to increase - you don't have to, in spite of being unemployed.

I will give you the name of one such NGO in Chicago, in case you need a name: Test Positive Aware. This group publishes an HIV resource directory every year in Chicago, and they could direct you to the appropriate agency in your state if necessary.