October 26, 2011
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LIVING WITH HIV/AIDS


 Would Boosting My Testosterone Help Increase My Sex Drive?
I'm a long-term HIV survivor in my mid-40's. My viral load is undetectable and all my other numbers are great except my testosterone level, which used to be high-normal but is now right in the middle. I'm in good physical shape but my sexual drive and sensation continue to drop from year to year. It seems too early in life for this to happen to me. My doctor doesn't want me to start testosterone replacement therapy just yet, but do you think it would help my sex drive? Do you have any other ideas?

Nelson Vergel responds in the "Nutrition and Exercise" forum


 Diagnosed With HIV on Top of Existing Anxiety: It Wasn't the End of the World!
I was diagnosed with HIV 20 months ago. I'm taking Norvir (ritonavir), Prezista (darunavir) and Truvada (tenofovir/FTC) and tolerating it well, though it took me over a year to get my viral load undetectable and my CD4 count up to 720. Before I was diagnosed I was dealing with severe panic attacks, and after trying many anxiety meds I saw a hypnotherapist. I learned to recognize and deal with anxiety, and I haven't had a panic attack since. My point is that becoming HIV positive and dealing with anxiety do not have to be the end of the world. I know when I was down-and-out dealing with this I thought for sure I would never get better. But I did, and I hope other readers will too.

David Fawcett, Ph.D., L.C.S.W., responds in the "Mental Health and HIV" forum


MIXED-STATUS COUPLES


 After All These Years, How Can I Ask My Poz Partner to Use Condoms?
My husband is HIV positive and has been for the nine years we've been together. We found out while I was pregnant with our first child. I had an HIV test immediately and it came back negative. My husband's doctor told us that because my husband's viral load was undetectable, we could enjoy a normal sex life. My husband took this advice to heart and doesn't use any precautions. We have a second child who also tested negative (I was also negative at that time). It's been four years since I had a test and I'm scared to take another. I feel we should use condoms, but my husband thinks we've been doing this for so long that it's obvious I can't get HIV from him. What can I do?

David Fawcett, Ph.D., L.C.S.W., responds in the "Mental Health and HIV" forum


BODY SHAPE CHANGES & HIV/AIDS


 I Can't Afford More Sculptra: Can I Use Radiesse Instead?
I've been getting Sculptra (poly-L-lactic acid, New-Fill) injections once a year after having six initial sessions for facial wasting, and it's worked great for me. However, my doctor just informed me that I won't be eligible to get more vials of the product through the Sculptra patient-assistance program for two more years. I'm nervous that waiting two years for a "tune up" will take away all the work that has been accomplished. My doctor's office also has an assistance program for Radiesse (calcium hydroxylapatite, Radiance). How well does Radiesse work, and how long does it last? Is it OK to go back and forth between Sculptra and Radiesse given the restrictions of the programs?

Gerald Pierone, M.D., responds in the "Facial Wasting" forum


the ultimate unscheduled event

Dr. Steve and Dr. Bob
"You, Dr. Bob's global online family, have suffered an immeasurable loss," writes Steven Natterstad, M.D. ("Dr. Steve"). In this blog post, Dr. Steve writes about the life and loss of his husband and partner for 18 years -- our amazing friend and online expert Dr. Bob. Dr. Steve also shares the details of Dr. Bob's final hours.


HIV/AIDS TREATMENT


 Should I Switch From My Current Regimen to the New 1-a-Day Pill?
I've been HIV positive for 16 years. My viral load is undetectable and my T-cell count is 680. I take Truvada (tenofovir/FTC) and Viramune (nevirapine) and was wondering if there would be any benefit in switching to Complera (rilpivirine/tenofovir/FTC). Aside from taking the extra tablets daily, what's the disadvantage of Viramune compared to the new medication in Complera?

Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum


 Trying to Quit Smoking: Will Nicotine Pills Interact With My HIV Meds?
I take Norvir (ritonavir), Prezista (darunavir) and Truvada (tenofovir/FTC), and unfortunately I smoke. I want to quit and bought nicotine pills to help me do so. But now I'm suddenly scared that these pills might interact with my HIV drugs. Are we 100 percent sure it's safe to take both at the same time?

Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum


OTHER HEALTH ISSUES & HIV/AIDS


 Feeling Run-Down: Would Human Growth Hormone Injections Help?
I'm a 46-year-old man with an undetectable viral load and a T-cell count of about 500, and I take Isentress (raltegravir), Norvir (ritonavir) and Reyataz (atazanavir). I have at times felt run-down and tired. My friend is a nurse who works for a clinic that prescribes injectable human growth hormone (HGH) to HIV-positive clients. Do you think using HGH would have any benefits to my overall health?

Nelson Vergel responds in the "Nutrition and Exercise" forum


 What Are the Dangers of Using Poppers While on HIV Meds?
I have a patient on Atripla (efavirenz/tenofovir/FTC) who also uses poppers. I've suggested that he refrain from recreational drug use but he is persistent. What are the potential effects of using this product while taking HIV meds?

David Fawcett, Ph.D., L.C.S.W., responds in the "Mental Health and HIV" forum


Visual AIDS: Art from HIV-Positive Artists

Image from the October 2011 Visual AIDS gallery Detail from:
"Listening to Myself: Closed," 2002
Richard Sawdon Smith


Visit the October 2011 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery, entitled "Stereopsis," is curated by Andrew Blackley.

UNDERSTANDING HIV/AIDS LABS


 Is an Elevated CD8 Count Good or Bad?
After a year on Isentress (raltegravir) and Truvada (tenofovir/FTC), my viral load is undetectable and my CD4 count has gone from 400 to an average of 680. However, my CD8 count remains high and my CD4/8 percentage averages at 32. What does this mean?

Mark Holodniy, M.D., F.A.C.P., C.I.C., responds in the "Understanding Your Labs" forum


HEPATITIS C TRANSMISSION


 Do Sexually Active Couples Need to Worry About Hepatitis C Transmission?
My husband has hepatitis C. Should I be tested?

Barbara McGovern, M.D., responds in the "Hepatitis and HIV Coinfection" forum



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