August 31, 2009
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MIXED-STATUS COUPLES


 Availability of PEP for Negative Partners in Mixed-Status Couples
I'm the negative pole of a relatively new magnetic couple. We're considering having a starter kit for PEP (post-exposure prophylaxis) on hand, especially when traveling internationally. In general I have good communication with my partner and we've agreed that we need to have a set of sexual habits that keep things within mutually accepted safety limits. He arranged for us to meet with his HIV specialist, but surprisingly this rather prominent doctor had not heard of PEP. Although I assured him I understood that the goal would be never to have to use it, he didn't seem to understand why I wanted something like that on hand and has not made it available to us. Am I being reasonable in thinking it would be a good thing to have in this situation, and can you advise me how to get it? My partner currently takes Truvada (tenofovir/FTC) and Viramune (nevirapine) and has an undetectable viral load on this regimen, but I don't know if his regimen has varied due to resistance at some point.


 Mixed-Status Couples: How Often Should the Negative Partner Get Tested?
I have been dating an HIV-positive man for the past year. He has brought total joy into my life. My question is: How often should I get tested for HIV? We practice safer sex, except during oral sex.


 Partner and I Newly Diagnosed: Why Are Our CD4 Counts Different?
My partner and I were diagnosed last week and had our first test results today. My CD4 count is 240 and my partner's is 780. Why are our CD4 counts so different? I'm very worried that I will have to start HIV meds straight away, but I'm wondering if there is another way that I can increase my CD4 count. Do you think my CD4 count will rebound in a few weeks?


Also Worth Noting: HIV Retreat: Spots Open at September Weekend for Gay Poz Men!

Shadowcliff Lodge

There are still some spots left for the Teratment Educat10n Network (TEN) and Strength in Numbers (SIN) mountain weekend for gay HIV-positive men at Shadowcliff Lodge in Grand Lake, Colo.! It's a three-day social weekend from Thursday, Sept. 10, through Sunday, Sept. 13. Cost for the weekend (rooms and meals) is $149. More detailed information (and the link to sign up) is available at: www.mounTEN-SIN.blogspot.com. Note: There are some really cheap airfares to Denver right now. For a list of other upcoming HIV retreats, click here.
WHEN TO START HIV TREATMENT


 Recently Diagnosed: When to Start Treatment, and With What?
I got the bad news last night: viral load of 67,000; antibody test indeterminate, but expecting that to be positive soon. I had a good meeting with my new case manager. The question for me is: When should I start treatment? My gut feeling is to start right away. If I can knock my viral load back down, then let's go for it, I say. Atripla (efavirenz/tenofovir/FTC) seems to be the popular HIV med right now. One pill a day seems doable and the side effects seem manageable. I realize I'm going to have to start taking better care of myself overall. So my plan is: start ASAP with Atripla, get in better shape, hope for the best. Please let me know what you think my next steps should be.


 Starting Treatment in Brazil: How Do My Options Sound?
Since I was diagnosed, my CD4 count has dropped from around 570 in January 2008 to 369 in June 2009, and my doc expects to start me on HIV meds soon. I live in Brazil and was lucky enough to get a resistance test as part of a volunteer study. My test results showed that I cannot be treated on efavirenz (Sustiva, Stocrin). This was good to know since guidelines down here normally recommend starting on AZT (Retrovir, zidovudine), 3TC (lamivudine, Epivir) and efavirenz. I asked not to take AZT due to my concern about lipodystrophy. However, Truvada (tenofovir/FTC) is not yet available here, so my doc is considering starting me on 3TC, abacavir (Ziagen) and Kaletra (lopinavir/ritonavir). Is this a good combination? Is it well tolerated? Should I be concerned about lipodystrophy? Is any further screening required before starting?


COINFECTIONS/COMPLICATIONS OF HIV/HIV MEDICATIONS


 What Options Are Available for Someone With a Huge, Deforming Buffalo Hump?
I am finding that my buffalo hump has grown so big that even being taken off one protease inhibitor and remaining only on Kaletra (lopinavir/ritonavir) is not helping at all. It is making it difficult to sleep. As for clothing, there is nothing that hides it. Even strangers come up to me to ask what is wrong with me. I am so depressed over this despite feeling so blessed because I am alive and raising my three beautiful children. I am on Medicaid and now reside in Texas. Could you please educate us on the latest data regarding this horrible side effect and what has been found to be promising regarding hopefully removing it permanently?


 How Long Will I Live With Hepatitis B?
I was recently diagnosed with hepatitis B. My level is only at 1,000 so I was told it was a mild case. My question is: How long is my life expectancy? Will I die early? I am only 31 with two kids.


 Liver Transplants for HIV-Positive People?
Can someone who has HIV and cirrhosis qualify for a liver transplant?


 Once Diagnosed With AIDS, Will I Have AIDS Forever?
I have been living with HIV since a series of transfusions in 1983. Fortunately I have been a slow progressor. Recently I was diagnosed with stage II primary non-Hodgkin's lymphoma of the central nervous system (CNS). I went through CHOP-Rituxan chemotherapy and am now in remission. One week later my doctor told me I had AIDS. I had a CD4 count of 250 at the time of diagnosis; now it's 400. I have been on Atripla (efavirenz/tenofovir/FTC) for two and a half years. My HIV specialist says I'm still an AIDS patient and always will be, even if my CD4 count reaches 1,500. Huh? Why does the medical establishment label AIDS patients for life? I'm over the stigma of AIDS (which I think affects non-gay patients worse, because we're not acculturated to it), but frustrated with having this AIDS diagnosis for life.


 Extremely Low CD4 Count: What Can Be Done?
My wife's CD4 count is 19 and her viral load is 13,632. She frequently suffers from fever, has pains in her mouth and is on complete bed rest. What kind of treatment is required? In how many months can she get healthy?


Also Worth Noting: Connect With Others
I Might Do Something Stupid
(A recent post from the "I Just Tested Positive" board)

I was diagnosed a few weeks back. I was so innocent and truthful, but I feel like God hates me now and itís not worth living. I am afraid I might do something stupid. I really need someone to talk to.

-- giveup

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Recycle Meds

Due to increased demand for certain medications, Aid for AIDS International is in great need of the following medications: Aptivus, Atripla, Emtriva, Epivir, Isentress, Norvir, Prezista, Retrovir, Truvada, Videx, Viread, Zerit, Emend and Metotrexate. If you or someone you know has an excess of these or any other antiretroviral, please e-mail Liliana Velasquez at Aid for AIDS. If you want to know where you can drop the medicine off, click here.
HIV TRANSMISSION


 Is It Possible to Get HIV by Sharing Cocaine Through a Rolled-Up Dollar Bill or Straw?
I did a really stupid thing. I shared a straw to snort drugs and my nose bled. I then used the straw again. I have no idea if there was blood on the straw from anyone else. I am terrified that I got HIV since I had a fever, a sore throat and pains in my hands and feet a few weeks later.


STRANGE BUT TRUE


 I Feel Like I'm Always Contracting HIV!
I am 23, I've never engaged in any sexual act and I've never done any drugs or shared any needles. However, since I was 14 years old I've felt as though I've been contracting HIV every day or so from bizarre conditions. Just to name a few: haircuts, waitresses with cuts on fingers, gingivitis, people pricking me with needles, blood coming in contact with cuts on my body (I have a mean cat), or fluids getting into my eyes or nose. In a few situations I have had every single acute HIV symptom exactly two to three weeks after the event. I am extremely afraid to get tested and don't know how I would handle a positive result. I just wanted to write to you to vent since no one else would listen to me.






Activist Central

 Action Alert: Easy Steps to Impact U.S. HIV/AIDS Policy!


 Call Assembly Speaker Silver: Stop The HASA Rent Crisis -- New Yorkers With HIV/AIDS Need Affordable Housing!


 Tell Senators Health Care Reform Must Include Medicaid Parity for U.S. Territories!


 Petition for a Robust National Public Health Care Option and Expansion and Enhancement of Medicaid Coverage


 Take a Survey Addressing the Vocational Needs of HIV-Positive People -- Deadline Extended!


 Ensure Congress Has a National AIDS Strategy


 Urge Your Senators to Co-Sponsor the Early Treatment for HIV Act