April 27, 2010
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HIV/AIDS & BODY SHAPE CHANGES


 What Can Be Done About a "Mixed Pattern" of Lipodystrophy?
I've been taking Epivir (3TC, lamivudine), Sustiva (efavirenz, Stocrin) and Zerit (d4T, stavudine) since 2006. I have a big belly and a buffalo hump on my neck, and the rest of my upper body is also big; but my hips are completely gone and my legs are thinning. I look shapeless. What can I do?


 What Do You Think About Artefill for Lipoatrophy?
What are some of the benefits and drawbacks to Artefill (polymethyl-methacrylate, also known as PMMA, Articol or Metacrill) for treating lipoatrophy?


 Is It Possible to Remove Bio-Alcamid From My Wife's Lips?
My wife had Bio-Alcamid (polyalkylimide) injections done in her lips in her native country, Turkey. She now wants the Bio-Alcamid removed. Is it safe to have it removed? If so, how would it be done?


LIVING WITH HIV/AIDS


 What's Age Got to Do With HIV Disease Progression?
Does older age at the time someone becomes HIV positive mean faster progression of the disease -- especially without treatment?


 Dear Dr. Bob: Is It "Cool" to Be HIV Positive Nowadays?
Do you think that the "fear HIV" method of prevention is still working after decades of this epidemic? Don't you think it's the same as putting warning messages on cigarette packages, which never proves effective in lowering the actual number of smokers? I regularly meet people who are not concerned about HIV, and others already infected who claim to feel great. Don't you think that some prevention messages serve to keep the stigma around HIV?


Also Worth Noting: Visual AIDS

Image from the April 2010 Visual AIDS Web Gallery
"Good Humor" 2001; Michael Golden

Visit the April 2010 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery, entitled "Help! Hold Me!," is curated by Emily Nepon.
EXERCISE & NUTRITION


 Too Weak to Exercise: How Can I Strengthen the Muscles in My Legs?
I received an AIDS diagnosis in 2005. I had a CD4 count of 7 and my viral load was over 600,000. During that time I couldn't get out of bed due to depression, and my legs became so weak I lost the ability to walk. Now, five years later, I still can't walk and have gained over 100 pounds. Can you recommend any exercises or supplements to build strength in my legs so I can exercise like I used to and lose some weight?


 What's Wrong With Low-Calorie Diets?
I'm HIV positive with a CD4 count in the mid-300s and a nearly undetectable viral load (189 when last I checked). This is an improvement in just the past year from a CD4 count of 124, a viral load over 1 million and severe fatigue and pain. I now take Atripla (efavirenz/tenofovir/FTC), but I've put on a lot of weight since getting better. What do you think of the "HCG diet" (a very low-calorie diet combined with hormone treatments) and other calorie-cutting diets?


MIXED-STATUS COUPLES


 Could Non-HIV Blood Work Detect That My Partner Is HIV Positive?
After I was diagnosed with HIV about 14 months ago, my partner got tested twice and was HIV negative, thankfully. He insists on performing unprotected oral sex on me as he believes the risk of his becoming infected is very low. I know that, too, but I still worry. Anyway, he had a physical for his job and many of his blood-level tests came back low. Could these blood test results indicate HIV infection?


HIV/AIDS TREATMENT


 We Want to Get Pregnant: How's Our Regimen?
My wife and I are both HIV positive with undetectable viral loads and CD4 counts in the 300 range, and we're both taking Sustiva (efavirenz, Stocrin) and Truvada (tenofovir/FTC). Would it be possible for us to have an HIV-negative baby? Is our HIV med regimen good for a pregnant woman?


 Is There Another Triglyceride-Friendly Med Besides Expensive Isentress?
I am currently on a regimen of Combivir (AZT/3TC) and Sustiva (efavirenz, Stocrin). My viral load is undetectable and my CD4 count is around 600, but my triglyceride level has gone through the roof! My doctor has suggested that I switch from Sustiva to Isentress (raltegravir) to help lower my triglyceride level. However, my insurance co-pay for Isentress is about 10 times that of Sustiva. Are there any alternatives to Isentress for lowering my triglycerides?


More Questions About HIV/AIDS Treatment:


OTHER HEALTH ISSUES


 How Can I Tell if My Rash Is Due to Atripla?
I've been taking Atripla (efavirenz/tenofovir/FTC) since I was diagnosed with HIV. I came down with shingles and my doctor gave me Valtrex (valacyclovir) for it, which seems to be working. However, I've noticed small bumps on my body that don't look like shingles. How can I tell if it's Atripla, shingles or something else causing this rash?


 If I Start HIV Meds, Will My Neutrophil Count Improve?
I recently received my latest lab results. My viral load is 70,000, my CD4 count is 926 and my doctor also informed me that my neutrophil (a type of white blood cell) levels have dipped lower than he would like to see them. He wants me to start HIV meds as a result. I'm not sure I want to start meds yet, but I will if it means better overall neutrophil levels. What do you think?


More Questions About Other Health Issues:


Also Worth Noting: Connect With Others
Do I Need to Detox Before I Start HIV Meds Again?
(A recent post from the "Living With HIV" board)

I got infected in 1996 and was confirmed HIV positive in 1997 and was at the same time labeled with AIDS. I have been off and on treatments over the years. I have had four children and was on treatments throughout my pregnancies. My last baby is two now and I have not been on treatment for two years. I have tried a few combos but I was not able to tolerate the side effects. I am wondering if it would help for me to try to detoxify my body before trying to start meds again. I drink a lot of sodas and sweets and don't get enough exercise. If I cut out the sodas and sweets as much as possible and start walking daily, would that help with the side effects? I was also wondering about alternative and complementary treatments I could do along with the meds. I am really worried because my last T cells were 124. I would really like to get that number up as much as possible. Does anyone have any advice? -- cdhaileyp7
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UNDERSTANDING HIV/AIDS LABS


 What Are Some Ways to Raise My CD4 Count?
I am a 50-year-old man and I was diagnosed with HIV in June 2008. At that time my CD4 count was around 36 and my viral load was well over 350,000. I finally got to see an HIV specialist here in Mississippi and was started on Atripla (efavirenz/tenofovir/FTC) and Bactrim (co-trimoxazole). I have never missed a single dose, and my viral load dropped to undetectable after about nine months. However, my CD4 count seems to have peaked at around 260 and at my last doctor visit it was back down to 175. Is there anything else I can do to raise my CD4 count?


 How Do I Find Out Which Lab Tests My Insurance Covers?
I have health insurance through my employer and I see the doctor four times a year. I thought my insurance covered my lab tests, but a few months ago I got four large bills in the mail for lab work dating back to January 2009. Shouldn't I have been informed if my insurance doesn't cover lab work? How could I have avoided this situation?


HIV TRANSMISSION, TESTING & DISCLOSURE


 How Do I Tell My Ex She Might Have HIV?
I recently tested HIV positive. I think I may have become infected while I was married. How do I tell my ex-wife that she might be HIV positive as well?


 Possible Exposure to Rare Types of HIV: Are the Usual Tests Reliable?
I have had unprotected sex with people from all over the world. I've tested HIV negative twice for HIV-1 and HIV-2, but I'm extremely concerned about rare strains of HIV from other parts of the world. How are cases of HIV types N and O detected if there aren't tests for those strains in the first place?


 Stepdaughter and Her Boyfriend Recently Diagnosed: Who Was Infected First?
My stepdaughter and her boyfriend both recently tested HIV positive. His CD4 count was 540 and his viral load was 6,000. Her CD4 count was 280 and her viral load was 30,000. He also had some flu-like symptoms, and she had them about a month later. Are there any reliable clues here to determine which of the two of them was infected first?


STRANGE BUT TRUE


 Family Picnic -- on the HIV-Sprinkled Grass?
My family recently went on a picnic. When we were done I was walking back to the car, dragging the cooler behind me on wheels. The cooler tipped over; some potato salad fell to the ground and the lid came off on the grass near where some men were playing soccer. I turned it back over and was going to deal with it when I got home. Before I was able to do so, I caught my daughter eating out of the potato salad bowl. If one of the soccer players was HIV positive and bled on the grass where the salad fell, and my child then ate that salad, what are the chances my child could have HIV?






Activist Central

 China: Release Activist on Medical Parole


 Women Living With HIV: Take a Survey on Sexual and Reproductive Health Services


 Tell HHS That Black Women Openly Living With HIV/AIDS Should Be Represented on PACHA


 Action Alert: Tell Congress You Support a Permanent Fix to Ryan White Housing Policy!


 Volunteer Doctors and Nurses Needed in Haiti Thru April 30, 2010