December 20, 2011
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Dr. Bob


Each year, we scour our "Ask the Experts" forums and ask you to vote on 10 posts we feel are the "best of the worst" -- some of the oddest questions we've seen people ask about HIV that year. Bob Frascino, M.D., ("Dr. Bob"), who passed away in September, was a master at responding to these questions. To honor his intelligent, rambunctious, compassionate spirit, our "Strangest but Truest" collection this year is a tribute to him. You still have a few days left to check out the nominees (including some past favorites) and vote!


 How Can I Help My Doctor Manage Burnout?
My doctor is a great man who went into HIV/AIDS treatment back when there were AIDS wards, and has treated HIV/AIDS for the majority of his years in practice. He expressed to me, as a friend, that he now feels he's treating "age" rather than AIDS. After so many years and so much tragedy, I worry he's becoming disheartened and burned out. As a long-term survivor whom this doctor literally saved from death, what can I say to him?

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

 What Should I Do if I Want to Cleanse?
I want to do a cleanse. Are there cleanse herbs that are safe to take with HIV meds? What can I do to cleanse toxins from my body?

Nelson Vergel responds in the "Nutrition and Exercise" forum


 Brief Unprotected Penetration: What Should My Boyfriend and I Do?
I'm an HIV-positive woman with an undetectable viral load and a CD4 count of 441, and I currently take Atripla (efavirenz/tenofovir/FTC). My boyfriend is HIV negative and we've always used protection, but yesterday he penetrated me without a condom for at least 10 seconds. I'm really concerned about him getting HIV from me. When would you suggest he get tested? What else can we do?

Richard Cordova responds in the "Safe Sex and HIV Prevention" forum


 How Do I Find a Radiesse Provider Who Offers Patient Assistance?
I'm on Social Security Disability and I've run out of access to Sculptra (poly-L-lactic acid, New-Fill) treatments. Where can I go to access the other approved treatments like Radiesse (calcium hydroxylapatite, Radiance) that entail fewer treatment sessions and greater affordability?

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

Visual AIDS: Art from HIV-Positive Artists

Image from the September 2011 Visual AIDS gallery Detail from:
"Anger Management," 2003
Jerry Frost

Visit the December 2011 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery, entitled "The Sword of Damocles," is curated by Patrick Webb.


 Just Started Atripla: How Can I Alleviate Side Effects?
I started taking Atripla (efavirenz/tenofovir/FTC) a bit more than two weeks ago. Since then I've been experiencing severe dizziness, especially in the morning though lately it's been progressing through the afternoon. Moreover, a light rash and nausea appeared today. I understand I have to be patient but these symptoms are driving me crazy. Is there anything you can suggest that might help?

Keith Henry, M.D., responds in the "Managing Side Effects of HIV Treatment" forum

 Should I Switch From One 3-Drug Combo Pill to the Other?
I've been on Atripla (efavirenz/tenofovir/FTC) for about two years with very good results aside from high cholesterol and triglycerides. My doctor suggested I switch to the new one-pill-a-day regimen Complera (rilpivirine/tenofovir/FTC) to avoid these lipid-related concerns. What's your opinion on this? What do I need to know as I consider this switch?

Joseph P. McGowan, M.D., F.A.C.P., responds in the "Choosing Your Meds" forum

 Are There Different Strains of HIV?
Are there different strains of HIV? If there are, are treatment plans the same for all?

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

Connect With Others

Anyone Ever Feel Hopeless and Isolated -- Even in the "Big City"?
(A recent post from the "Living With HIV" board)

I'm a 34-year-old gay man living in New York City and I've been HIV positive for two and a half years. I'm having a harder time now than when I was first diagnosed. ... In a city like New York, you'd expect there to be a huge support network. But I haven't found that to be the case. ... There seem to be some good resources for people who have no job or housing, or for those with great jobs and fabulous health insurance -- but not for those of us who are working hard and struggling to pay for rent and insurance.

I just feel incredibly overwhelmed with no support system at all. ... I don't really have any relationship with my family, and my self-esteem is too low to deal with the "gay scene" and all the bitchy beautiful boys who are eager to reject me. And it makes me angry when people say things like, "Just be glad it isn't the 1980s," or "Anyone can get hit by a bus and die tomorrow." No one seems to understand (or care) how it really feels. ... I feel pretty hopeless right now. Has anyone else out there experienced something similar? -- cambr9

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 What Else Can I Do to Build Up Lost Muscle Mass?
I'm a 31-year-old man with an undetectable viral load and a CD4 count of 500. I currently take Norvir (ritonavir), Prezista (darunavir) and Truvada (tenofovir/FTC). I also use Androgel, which helped with my low testosterone levels. Since becoming HIV positive two years ago, I've lost muscle mass, My doctor referred me to a nutritionist and I've been exercising at least three times a week, but I'm still having trouble maintaining my weight and muscle mass, and it's beginning to show. What else can I do to improve this situation?

Nelson Vergel responds in the "Nutrition and Exercise" forum

 Can My Cat Give Me Toxoplasmosis?
I have a cat, and I'm always very careful when I change the litter box -- I wear gloves and wash my hands twice afterward. Would there still be any risk of coming into contact with the toxoplasmosis parasite via an airborne route while I change the box? Do you think I should have lab work done to check for infection?

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


 How Can I Cope With My Anxiety Over Possible HIV Exposure?
I'm a 32-year-old woman. Two weeks ago I had a weekend affair with a friend of mine. We had unprotected vaginal and oral sex, and I came home with incredible fear and anxiety. I had flu-like symptoms three days after coming home. I told my friend and he felt horrible for scaring me; he went to the clinic for an HIV test and should get his results within the next week, but now I've got a rash and I'm terrified it's due to seroconversion. I'll be getting tested soon but where I live that can't happen until 28 days after potential exposure. I don't know what would happen to me, or my 3-year-old child, if I were HIV positive. I also really do believe I have an anxiety disorder. I don't want to keep worrying about the "mights" in my life. Do you have any suggestions of first steps I can take to get help with anxiety?

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


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