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Change meds for job?
Mar 2, 2007

I am 35, HIV+ since 1999, with CD4 350, VL undetectable, on Sustiva and Kivexa with no side effects. Am going for interview for flight attendant position. Do you think I should change meds for this type of job (which could have odd hours)? Would it be problematic to be taking Sustiva at a time that would be my normal bedtime but the middle of my shift as a flight attendant. And, do you think that an HIV+ person should even be doing a job like this? I know it's a physically demanding job with irregular hours. It is, however, my dream job and I don't want my disease to prevent me from achieving my goal. I feel healthy (fabulous actually), and the thought of working as a flight attendant makes me so happy, but, I don't want to jeapordize my health. What do you think? Also, do you think an employer would be able to determine my HIV status through a medical check even though it's illegal for them to actually do the test. Basically, is there another way they can test my health to make an educated guess that I am positive? Thanks, by the way, for all the great things you do here.

Response from Dr. Pierone

Kivexa is also known as Epzicom and is a combination of Ziagen (abacavir) and Epivir (lamivudine). Sustiva is normally taken at bedtime because it may cause a variety of neuro-cognitive side effects such as drowsiness, unsteadiness, and poor concentration. These side effects typically occur when Sustiva is first started, but generally improve or resolve with time. There is a great deal of variability in the rate and severity of this adverse event among people. Some people will continue to experience a "hang-over" effect of Sustiva in the morning after a nighttime dose, even after years of use. Others can take Sustiva in the morning, go to work, and not miss a beat.

So in your case the decision to switch really depends on how well you are tolerating the Sustiva. If you don't have these neuro-cognitive problems then it is a non-issue. Even if you do get them it doesn't mean you have to switch though. Flight attendants have to sleep on some sort of schedule so simply take the medications before your retiring.

There is no reason that you cannot pursue your goal and it will not jeopardize your health. I have taken care of HIV-infected patients who have worked as flight attendants as well as commercial pilots so the demands of a busy travel-related job are not out of reach by any means.

The laws protecting employees from workplace discrimination vary from country to country. But airlines do not, to my knowledge, test potential employees for HIV infection by direct or indirect methods.

Thanks for posting and best of luck!



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