October 31, 2012
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Living With HIV

 How Do You Tell a Child About Her Mother's AIDS Diagnosis?
I've been raising my granddaughter since she was 4 years old; she is now 11. She has no contact with her father and limited, supervised visits with her mother. I was just informed that her mother has AIDS, and the doctors say she won't live much longer. How do you explain about HIV/AIDS to an 11-year-old who doesn't yet know anything about sex? What would you suggest?

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

Mixed-Status Couples

 How Risky Is Unprotected Sex in a Stable, Serodiscordant Couple?
I'm looking for realistic advice or opinions, and I hope you can help me with both. I have been HIV positive for over 25 years. My viral load is undetectable and has been so for several years. My CD4 count is likewise stable and above 500. My partner is a non-practicing bisexual, HIV-negative man. Our sexual relationship roles never vary: I'm the passive (receptive) partner in anal sex and the active (insertive) partner in oral sex; my partner is anal active and oral passive. We are completely monogamous and our commitment to each other is very strong, but so is our desire to have the sexual intimacy condoms do not afford us. How risky would it be for us to have unprotected anal sex?

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

Insurance, Workplace & Legal Concerns

 Is There Help Out There for My Out-of-Pocket Expenses?
After a recent major heart attack, I'm faced with a lot of medical bills. I have insurance, but I owe $5,000 out of pocket. Do you know if there is any way to get help with these expenses? Where might I start looking?

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

 Can I Be Deported Because of My HIV Status?
I know HIV has been removed from the list of conditions for which a person can be banned from entry into the United States. I'm an HIV-positive person from outside the U.S; I'll be claimed by my sister, a U.S. citizen, as a participant in a family reunification immigration program. Are you sure I cannot be denied entry into the country on the basis of my HIV status, or deported once I arrive in the U.S.? What HIV-related concerns might complicate my green card application?

Christa Douaihy, Esq., responds in the "Legal Issues and HIV" forum

Visual AIDS: Art from HIV-Positive Artists

Image from the October 2012 Visual AIDS gallery Detail from:
"Godiva 4 & 5," 2002
Chuck Ramirez

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.

HIV/AIDS Treatment

 Would I Do Better on the New "Quad" Pill?
I've been on HIV meds for 12 years, doing very well for the most part. My viral load is undetectable and my CD4 count is in the 500s. I'm currently taking Atripla (efavirenz/tenofovir/FTC). My doctor wants me to switch to the new one-a-day pill, Stribild (elvitegravir/cobicistat/FTC/tenofovir, nicknamed "Quad" while in development), because he feels it might help lower my cholesterol and triglyceride levels. What's your opinion?

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

 Is My HIV Med Regimen Safe for Pregnancy?
I've been living with HIV for over 14 years. I've had an undetectable viral load for six years, my CD4 count is above 1,000, and I'm now pregnant. I take Norvir (ritonavir), Reyataz (atazanavir) and Truvada (tenofovir/FTC, sometimes known as Tyricten in its generic form). Are these meds safe for my baby, or should I consider switching? Will I need to take AZT (zidovudine, Retrovir) during my delivery?

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

 Could My Stomach Pains Be Caused by Atripla?
I've been on Atripla (efavirenz/tenofovir/FTC) for almost three months now. Currently my CD4 count is 304 and my viral load is undetectable. Ever since I started taking it I've been getting severe stomach pains whenever I exercise or otherwise exert myself. It usually happens when I haven't eaten anything during the day by 3 p.m. I'm a student, 25 years old, and I'm not the breakfast type. Could this be the reason? Or is this some sort of side effect from the Atripla? Is there a component of the regimen that's most likely the culprit?

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

Other Health Issues & HIV/AIDS

 How Can I Control My Lipid Levels Without Drugs?
I've been taking HIV meds for 10 years and I also have chronic hepatitis B. My triglyceride levels are high and have actually increased in the past six months. I take omega-3 and green tea supplements daily and I've started taking L-carnitine, but nothing seems to be helping. I'm in my 20s and my doctor won't put me on lipid-lowering medication. I'm skinny, and if I start to diet and exercise I'm afraid I might vanish. What else can I do?

Nelson Vergel responds in the "Nutrition and Exercise" forum

 Is There a Connection Between My ADHD and HIV?
I've been HIV positive for 23 years; I also have attention deficit hyperactivity disorder (ADHD). It seems to be getting worse as time goes on. My CD4 count is 530, my viral load is undetectable and I was originally given an AIDS diagnosis in 1995. My psychiatrist doesn't think there's a correlation; then again, adult ADHD is not a very old science. Has any research been done on HIV and ADHD?

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

Connect With Others

Will I Have What I Want in Love?
(A recent post from the "Gay Men" board)

I want to find a man that I can love and receive love from in return. I want to lie next to a man and feel his body next to mine. I want to take him in my arms and hold him tight. I want to kiss him. I want to love him. I want to give him pleasure. I want to bring him to heights of ecstasy. I want to cuddle with a man before a raging fire. I want to sip wine with him in a romantic restaurant. I want to call him during the day just to hear his voice and see how his day is going. I want to come home to him and feel complete. I want ... I want ... I want ...

Will it ever happen with me having HIV? Can anyone else relate to this feeling? Have you found love while positive? I want to know ... -- njpozdad

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Understanding HIV/AIDS Labs

 Anxious to See if Meds Are Working: Should I Be Tested Again?
I'm a 63-year-old man who tested HIV positive this past May. My initial viral load was 497,000, my CD4 count was 173 and my CD4 percentage was 16. After a month on Atripla (efavirenz/tenofovir/FTC), my viral load was 3,050, my CD4 count was 234 and my percentage was 23. The second month showed continued though modest improvement. Another month has passed, but the doctor doesn't want to see me again until December. I'm anxious for an undetectable viral load and I want to make sure Atripla is still working. Should I have my CD4 count and viral load checked again now? What other health tests should my doctor be giving me?

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

HIV & Hepatitis Testing

 What Could Have Caused My False-Positive Hepatitis C Test?
I recently had a false-positive hepatitis C test. I had the basic screening which showed a positive result, but my genotype and RNA tests indicated I didn't have hepatitis C. I had a high level of the liver protein AFP while I was pregnant, and jaundice during delivery. I also take allergy shots. All my liver function tests are negative but I have a fatty liver on ultrasound. Is there something in my medical history that could explain this false-positive test result?

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

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