I'm a practical nurse, positive for four years, no serious problems, buffalo hump noted a few months ago, not sure what to do, I feel ugly, my fat has developed mostly in abdominal area and back, what should I do, surgery perhaps or is there any other way to rid of this?

You don't mention which HIV meds you are on (if any) and what your HIV status and treatment history is. That bears on the issue of whether a change in meds might help some. There is a growth hormone study now open in the US looking at whether that costly intervention can help. I have had some patients have decent results with surgery (though often needs to be repeated). Sometimes patients seem to do better with aggressive diet and exercise intervention as well as hormone optimization (such as testoterone replacement in men). Alas, for some patients I have run out of options and am awaiting new understanding about why this is happening and how to best intervene. KH