October 16, 2012
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Living With HIV

 How Can I Safely Gain Muscle?
I'm 30 years old with an undetectable viral load on Atripla (efavirenz/tenofovir/FTC). I lift weights, bike and swim regularly. I'm in the normal weight range for my height, but I would like to gain more muscle. I was considering meal replacement products like creatine, but they all seem to have issues associated with them. I was also wondering if there are some supplements in the market I should avoid in light of my HIV med regimen. What do you suggest?

Nelson Vergel responds in the "Nutrition and Exercise" forum

 Where Can We Find Support for Our HIV-Positive Teenager?
Our 17-year-old son told us this spring that he's HIV positive. We were able to find him excellent medical care and he's doing a super job taking his medications. We can see that he would benefit from connecting with peers with HIV. Do you have any recommendations for where to find such groups, or age-appropriate counseling?

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

More Questions About Living With HIV/AIDS:

Mixed-Status Couples

 Can My Poz Partner and I Safely Enjoy Urine-Related Play?
My partner is a 50-year-old gay man who has been HIV positive for 28 years. He has an undetectable viral load and is fully adherent to his HIV med regimen. I'm also 50, HIV negative, and we have a rich sex life. We do not have sex with other men. Recently, we both started getting into piss play and I started drinking his piss and am really enjoying it. Is it safe for us to continue to have fun in this way? What are the potential risks?

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

 Is My Man Putting His Life on the Line by Marrying Me?
I am a 29-year-old female and I was recently diagnosed HIV positive. I've been with my guy for the last three years, and we were planning to get married next summer. He still wants to marry me, but I'm hesitant. I don't want to be the weight in our marriage; I want us to be able to have healthy children; I don't feel comfortable having sex, even with condoms. If I marry him, would I be morally obligated to share my diagnosis with his family, when I haven't even told mine yet? What if I end up feeling indebted to him because he put his life on the line to profess his love to me?

Shannon R. Southall responds in the "Safe Sex and HIV Prevention" forum

Visual AIDS: Art from HIV-Positive Artists

Image from the October 2012 Visual AIDS gallery Detail from:
"Flowers," 1969
Joe Brainard

Visit the October 2012 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery, "Notes on a Steady Decline," is curated by Steven Evans.

Insurance, Workplace & Legal Concerns

 Who Can Gain Access to My Health Information?
I am very concerned about keeping my HIV status confidential. If a person living with HIV uses their insurance card for doctor visits and prescription medications, obviously their health insurance company will know they're being treated for HIV. Does that mean an employer could potentially find out that information? Also, do life insurance companies have access to HIV test results that are reported to the health department? Who has access to information about my HIV status?

Jacques Chambers, C.L.U., responds in the "Workplace and Insurance Issues" forum

Body Shape Changes & HIV/AIDS

 Will Switching Meds Make a Difference in My Facial Wasting?
I've begun experiencing lipoatrophy in my cheeks. A good diet, supplements and working out have had no impact on this problem. I recently had PMMA (Articol, Artefill, Metacrill, polymethyl-methacrylate) injections, although have yet to see benefit. I've been on Truvada (tenofovir/FTC) and Viramune (nevirapine) for about three years, but Truvada has been part of my regimen for about seven years. Would making a switch in regimens help at all?

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

HIV/AIDS Treatment

 What About This Study on Sustiva and Brain Damage?
As someone who has been on Atripla (efavirenz/tenofovir/FTC) for over four years now, I was most concerned after reading the study that says that Sustiva (efavirenz, Stocrin) may be toxic to neurons in the brain. I've been lucky with none of the side effects as far as fogginess, anxiety, vivid dreams, high cholesterol and triglycerides. In fact I have been undetectable for the entire time with a CD4 count of 1,275. Should I consider changing my medication?

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

 Can I Go Back to My Last Regimen if Switching Meds Doesn't Work?
I've been HIV positive for more than two years and doing well on Norvir (ritonavir), Prezista (darunavir) and Truvada (tenofovir/FTC). My viral load is undetectable and my CD4 count is currently above 750. I recently saw my specialist and mentioned I'd be interested in trying Complera (rilpivirine/tenofovir/FTC) as it's just one pill a day as opposed to four. She agreed to switch me over and also said if this doesn't work out I could try Stribild (elvitegravir/cobicistat/FTC/tenofovir). My concern is that if I don't tolerate either pill, would it be possible to go back to my current meds?

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

Connect With Others

Newly Diagnosed Mom of 5: Now What Do I Do?
(A recent post from the "I Just Tested Positive" board)

I'm not really sure how or where to start ... I was diagnosed yesterday. ... I had two lymph nodes removed a month ago thinking I have cancer and when those tests came back benign they started testing EVERYTHING and come to find out ... well, I'm HIV+. It wasn't what I was expecting and I actually had no idea that an HIV test was one of the blood tests they were running so I was completely blindsided. I feel so broken. I really never thought about this as a possibility. Not to pass any judgment (but show my own ignorance) I thought because I wasn't an IV drug user or promiscuous it wouldn't happen to me. I've read so many stories that are quite the opposite: moms, wives, grandmothers, fathers ... people like me. ...

I can't breathe at times, I start crying thinking of my kids (putting my 5-year-old twins on the bus was torture today) ... I just don't know how I'm ever going to make it... If I didn't have kids I might lay in bed and die. ... Now what? And does anyone suffer from pain? I feel like I've been hit by a bus. Can anyone relate? -- redheadmom

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Other Health Issues & HIV/AIDS

 On a Path to Healing: What Kind of Therapy Should I Pursue?
I recently completed an 18-week group therapy program. In the program I took a long, intensive, painful look into my childhood, and realized how it impacted my behavior as an adult. There were several traumatic events in my life, and I was able to realize that these traumatic events and my unstable family life contributed to me contracting HIV. However, now that the group therapy is done I feel lost and hopeless. I went from 18 weeks, four hours a day of daily support, to nothing. I am trying to use my new coping tools but it isn't going well. I'm considering more therapy but not sure what type of therapy would suit me at this point. Do you have any suggestions?

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

 How Do I Decide Whether to Treat Hepatitis C Now?
I'm 59 years old and in great shape. I've been HIV positive for 20 years with a current CD4 count of 1,365. I acquired hepatitis C two years ago. I'm having a liver biopsy next Friday. I was due to start treatment with Incivek (telaprevir) plus interferon and ribavirin last month, but decided to get the biopsy first to ascertain the extent of damage to my liver. Would you recommend basing my decision to start treatment on biopsy results, or waiting for the interferon-free therapy that will most likely become available next year? What other factors should I be considering?

Lynn E. Taylor, M.D., F.A.C.P., responds in the "Hepatitis and HIV Coinfection" forum

Understanding HIV/AIDS Labs

 How Are My Pregnant, HIV-Positive Wife's Initial Lab Results?
My wife is 13 weeks pregnant and was just diagnosed HIV positive when tested at 8 weeks. At week 10 she broke out with shingles. Anecdotal evidence -- a survey of friends with kids -- showed two friends had gotten shingles while pregnant and I presume they are HIV negative. Anyway, after finishing a cycle of antivirals for the shingles, her lab test results showed a CD4 count of 374, a CD4 percentage of 30 and a viral load of 7,000. Obviously, she will start meds immediately because she's pregnant. But as far as the progression of the virus, is she in relatively OK shape?

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

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