Dear Drs,

I am an HIV+ male in my 40's. It's always been difficult for me to distinguish between aging and HIV or med related side effects. Having been diagnosed in '85, I've been on all sorts of drug combinations. I am currently on Reyataz, Norvir, Viread and Epivir. I've been experiencing dramatic hair loss (without a family history of baldness) but what is most troubleing is that my genitals, both my penus and testicle, have been shrinking over the past two years or so. I've also noticed that my seminal output has been dramatically reduced. I've consulted my doctor and he doesn't seem very concerned. Are these changes simply due to age, or is there evidence of HIV or HIV-meds-realated side effects. I was infected at 21, I've now been living with HIV longer that I lived with out it, and although I'm HIV+ I feel I deserve to have a healthy satisfing sex life. Can you help?

LG

Have you had a good hormonal (thyroid, testosterone) evaluation? Have you be seen by an HIV friendly urologist? HIV meds can aggravate the type of problem you are experiencing as can other medications and medical conditions. Most HIV specialist are quite amendable to evaluating that important problem and seeking a solution. Saying that aging is the cause is not very satisfying and not usually the case. KH