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My Dr wont allow me to start meds
Mar 23, 2011

Once again thank you for your response. I previously wrote about my diagnosis. My numbers were 6 weeks ago were 607 -CD and 14000 -VL. I got my numbers again today 580-CD 10000 -VL. Can you please comment about it. My hubby who was negative when i tested positive took another blood test tooday and we are waiting by end of week to know his status. My doctor still doesnt think i need meds, i suggested that to her because i would like to significantly reduce the viral load. And for the sake of my marriage we need to start having sex with my husband, with a condom on ofcourse. We are also considering having a child in the near future. What do you suggest?

Response from Dr. Frascino

Hi,

I would suggest you have a heart-to-heart conversation with your HIV physician specialist, discussing exactly the reasons you want to start antiretroviral treatment now. Personally I feel your reasons are valid and would have no reservations about starting you on combination antiretroviral medications immediately. In fact there is increasing evidence suggesting that perhaps every HIVer should be started on treatment no matter what their CD4 count or viral load may be. The basic logic is that early intervention decreases the risk of damaging immune activation/inflammation and preserves immune function. Immunologically this makes a lot of sense; however, we do need to balance these potential benefits with the potential side effects and toxicities of antiretroviral therapy.

In addition to this early intervention strategy, you also have another compelling reason to begin treatment as part of a magnetic couple.

If your doctor continues to disagree, I'd recommend you consider finding another HIV specialist with whom you can work more cooperatively. You are not being unreasonable (or unwise) in your desire to begin treatment now.

Good luck.

Dr. Bob

Zero sex drive Mar 12, 2011

Thanks Dr Bob for the great work on this forum........i was diagonised positive in Jan 2011, my CD count is at 607 and 14000 VL.Probably infected in 2006,been faithful to my partner since we got married in 2007. I just took another test 3 days ago, still waiting results. I am still not on meds because my Dr says am still in the safe zone. My spouse is negative, my biggest worry now is that we have not had sex since i was diagonised. He is very supportive and we are still in love as before, but i have no desire for sex whatsover, am afraid this might affect our marriage....He has not suggested sex but am thinking maybe he is just holding back wondering what my reaction will be.please advice.

Response from Dr. Frascino

Hi,

Sorry to hear about your recent diagnosis. No sex or no desire for sex certainly could (and usually does) ruin a marriage. I'd suggest you talk to your HIV specialist about this problem. He will perform the appropriate medical workup to see if there is a physical or hormonal cause of your problem. If this is unrevealing, the problem may be psychological, such as fear of infecting your partner or guilt-related, etc. Counseling, perhaps couples counseling, and/or psychotherapy could help if that's the case. Communication is very important in all relationships, and it's absolutely essential for magnetic couples. I'd suggest you and your spouse read through the information in the archives of this forum where you will find a chapter devoted to magnetic couples. You may want to consider some of the harm-reduction strategies discussed, such as having a dose of PEP available for accidental exposures, PrEP for the negative partner, or even your starting antiretroviral therapy early to decrease the risk of transmitting the virus.

Regarding your spouse, you mention he's HIV negative, but you were only diagnosed in January 2011. Your spouse will need HIV testing out to six months from the last potential exposure (unprotected sex) to confirm his negative status.

Good luck to you both.

Dr. Bob



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