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LIVING WITH HIV/AIDS
 What Kind of Support Group Is Right for a Senior Living With HIV?
I'm 68 years old, I've been HIV positive since the mid-'80s and have done relatively well living with HIV. I have avascular necrosis, which has pretty much destroyed both my hips, as well as stage IV lung cancer. I was referred to a mental health provider who handles people living with HIV/AIDS, but they don't work with seniors. It seems that once you pass 65, you are supposed to be dead, healed or not in need of mental health services. Someone suggested a geriatric group in a distant part of my city. Do I just forget about the AIDS part of my situation?
David Fawcett, Ph.D., L.C.S.W., responds in the "Mental Health and HIV" forum
MIXED-STATUS COUPLES
Diagnosed With HPV: Do I Need to Stop Having Anal Sex?
I'm a 44-year-old gay man who's been taking Atripla (efavirenz/tenofovir/FTC) for the past three years, with an undetectable viral load and no side effects. I eat very well, exercise regularly, don't drink and have never smoked. I'm also in a "magnetic" monogamous long-term relationship and always practice safer sex. However, I recently learned that I have several strains of human papillomavirus (HPV). I haven't developed anal cancer, but after all my hard work at taking control of my health this latest news has stressed and slightly depressed me. Is there anything else I can do to prevent anal cancer? Should I avoid anal intercourse altogether?
Robert J. Frascino, M.D., responds in the "Safe Sex and HIV Prevention" forum
HIV/AIDS TREATMENT
Is It Safe for Me to Start Treatment Without a Genotype Test?
I was recently diagnosed with HIV and have just had my first lab tests. Because my viral load was very low, a genotype test for drug resistance couldn't be performed. My doctor seems to be in favor of starting treatment early. Is it safe to start HIV meds without genotype test results?
Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum
What Can I Do to Prepare for a Tropical Vacation?
I've been taking Truvada (tenofovir/FTC) and Viramune (nevirapine) for 10 months. I'm going to the Dominican Republic later this month, and I'm supposed to take anti-malaria medications for the trip. Are there any interactions between certain anti-malaria drugs and my HIV meds? What else can I do to prepare for my trip, health-wise?
Joseph P. McGowan, M.D., F.A.C.P., responds in the "Choosing Your Meds" forum
My Nephew May Be Dying: Can I Help Him Help Himself?
(A recent post from the "My Loved One Has HIV/AIDS" board)
My nephew is 24 years old and has been HIV positive since he was 9 years old. He's been staying at an HIV/AIDS house since June 1 because he needed care I couldn't give him. He hasn't taken his meds for 1 1/2 years because he says it messes with his head, but he has lost so much weight and he looks bad ... I was told if he doesn't take his meds he could die. If he starts taking his meds again, would it be possible for him to live longer? How can I help get him to take them? -- rlsunshine
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OTHER HEALTH ISSUES & HIV/AIDS
Should My HIV/Hepatitis C-Coinfected Friend Be Smoking Pot?
My friend is HIV and hepatitis C positive. He said his doctor told him it was OK to smoke pot daily as long as he doesn't drink alcohol. What do you think?
David Fawcett, Ph.D., L.C.S.W., responds in the "Substance Use and HIV" forum
What's the Risk of Long-Term Prednisone Use?
I have an undetectable viral load and 350 CD4 cells, and I take Intelence (etravirine), Isentress (raltegravir), Norvir (ritonavir), Prezista (darunavir), Ziagen (abacavir) and blood pressure meds. For the past year I've had a persistent, itchy rash. My doctor thinks it's a side effect of one of my meds but isn't sure which one. Small doses of prednisone take the rash away, but when I stop the prednisone the rash always comes back. For how long can I take the prednisone? Will it mess with my immune system?
Keith Henry, M.D., responds in the "Managing Side Effects of HIV Treatment" forum
UNDERSTANDING HIV/AIDS LABS
Are High Viral Loads Common in Recently Diagnosed Individuals?
I was diagnosed with HIV six months ago. My initial CD4 count was 256 and my viral load was nearly 2 million! I've never heard of anyone with a viral load that high. My doctor seemed to think it could be the spike that's often seen with a recent infection, but he's never seen a viral load that high either. It concerns me that I may have an aggressive strain of HIV. Are these numbers common with a recent infection or could they indicate something more serious?
Keith Henry, M.D., responds in the "Managing Side Effects of HIV Treatment" forum
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