Questions and Answers Related to HIV/AIDS

Got questions about living with HIV/AIDS? Check out the listing below for some of the most useful reader questions and expert answers from TheBody.com's "Ask the Experts" forums on topics of concern to gay men. And if you don't see your questions below -- or on one of our other frequently asked questions pages -- you can e-mail your questions to TheBody.com's team of HIV/AIDS experts!

Taking HIV Meds and Other Health Issues | Sexual Risk and HIV Transmission | Insurance and Legal Issues | Anal Cancers, HPV and HIV | Mixed-Status Couples | Serosorting | Nutrition and Fitness | Other Complications of HIV

Taking HIV Meds and Other Health Issues

• If someone controls their virus without medication for five years, does that mean they will have a normal life span once they start their meds?
• I keep reading that the new drugs have few side effects. If I am going to be on treatment for many years anyway, why should I wait to start instead of treating immediately?
• Could starting HIV treatment shortly after being infected protect my immune system from long-term damage?
• What are the pros and cons of taking Kaletra (lopinavir/ritonavir) and Truvada (tenofovir/FTC)? This is my third year on meds, but I'm not sure if I should switch to something else. My CD4 count is in the 700s and my viral load is undetectable.
• I have been taking testosterone replacement treatments (most recently Androgel) for many years to treat the negative effects of HIV and HIV meds. However, my new doctor says testosterone replacement is bad for HIV-positive people because the risks are too great and there are no benefits. This is completely opposite my prior doctors' advice for the past 10-plus years. Who's right?
• I know there's no way to tell what my CD4 count was before I had HIV, but can HIV meds raise someone's CD4 count above pre-infection levels? Is there such a thing as a "maximum" CD4 count, or can it just keep climbing?
• I've been on Norvir (ritonavir), Reyataz (atazanavir) and Truvada (tenofovir/FTC) since June 2009. I started with a CD4 count of 450 and a viral load of 37,000 copies. My CD4 count as of today is 798 and my viral load is at 114 copies. I seem to be stable at these numbers. Why isn't my virus undetectable yet?
• How can I tell if Atripla (efavirenz/tenofovir/FTC) is right for me?
• Which erection enhancers can I take with my HIV meds?
• What steps can HIVers safely take to relieve seasonal allergy symptoms? Are there any allergy medications that interact with HIV meds?
• Dear Nelson Vergel: I just started taking Testopel (testosterone pellets). As a long-term HIV survivor yourself, can you elaborate on your own experience taking it? How frequently do you suggest having testosterone levels tested? When should I have more pellets inserted?
• My partner and I are both HIV positive. I had what was probably a severe allergic reaction to abacavir sulfate (Ziagen) and was advised never to take Ziagen again. Now my partner's taking it, and we've read that small amounts of Ziagen are present in semen. If I give him unprotected oral sex and I ingest semen, could I potentially develop an allergic reaction?
• Due to fatigue, I would like to take a drug holiday. How long is safe? What are the risks?

Read frequently asked questions on starting treatment, life expectancy, CD4 counts and viral load testing.

Sexual Risk and HIV Transmission

• About a year ago, I had unprotected receptive anal sex with a man I now discover to be HIV positive. Needless to say I'm regretful, scared and intend to get tested soon. But in the meantime, what are my chances of being infected?
• I was lying in bed with my ex-boyfriend. We were both naked and I started rubbing my unprotected erect penis against his anus. I did apply some pressure and minimal penetration could have occurred. What are my chances of being infected with HIV? Does the fact he is on HAART affect the risk?
• I met a complete stranger in a bathroom and we performed mutual masturbation. I did not get his semen on my hand and did not see any obvious open sores on him or any blood anywhere. Could I have gotten HIV from this experience?
• Is anal sex supposed to hurt? My partner did not use a condom but he said he pulled out before he came. Should I get tested for HIV?
• Several friends and I are all HIV positive and have all been in magnetic partnerships -- all of us have had unprotected sex at some point, all of us were medicated and none of us has infected an HIV-negative partner. Yet, my doctor tells me it's still possible to infect someone while I'm on HIV meds. How possible is it if someone's viral load is undetectable?

Read more frequently asked questions on HIV risks.

Insurance and Legal Issues

• My new boss recently told me that my HIV status was disclosed to her when she first became my manager. Is it legal for anyone at work to disclose my status without first asking me?
• Will my company insurance carrier report my HIV status to my employer once they start to see HIV meds and treatment claims by my doctor?
• I have been recently hired by a company and after 90 days I will be eligible for group health insurance. I have great concerns about disclosing my HIV status when I fill out the application. How does this work, and what should I do?
• Does HIPAA (Health Insurance Portability and Accountability Act) apply to someone who is HIV positive and under his parents' insurance?
• I'm trying to get a letter from my physician assistant (PA) at Veterans Affairs stating that I am a disabled person based on my HIV/AIDS diagnosis. When the PA told me that I was not a disabled person, I pointed out that people with HIV are protected by the Americans With Disabilities Act. It seems, however, that I'm "not disabled enough." What are some different disability designations in the U.S., and how do they apply to HIVers?
• 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?
• I am going through acute HIV infection right now and over the past couple of weeks I've had to take a few days off from work. I had the sick time to cover those days, but I am now out of sick time. Would it be wise for me to file an intermittent Family and Medical Leave Act (FMLA) claim through the U.S. Department of Labor?

Read more frequently asked questions on insurance.

Anal Cancers, HPV and HIV

• What can I do to prevent myself from getting anal cancer?
• I have been living with HIV for over 20 years now and have been on meds for the last ten years. Recently I was diagnosed again with squamous cell carcinoma. What can I do to prevent it from happening again?
• A doctor said that people with HIV and HPV (human papillomavirus) are at higher risk for anal cancer. Should I be asking for anal cancer and colon cancer tests because of my increased risk factor?
• I was diagnosed with HIV 19 years ago and have never had a low CD4 count or a detectable viral load. I have human papillomavirus (HPV), though, and I've had lesions removed from my anus twice in the past 15 years. What kind of follow-up should I do for my HPV to make sure it doesn't turn into anal cancer?
• I'm starting treatment for anal cancer. Both my HIV and cancer doctors tell me that my immune system will take a hit. My HIV doc says there's a good chance I'll return to a clinical AIDS diagnosis, and my virus may become resistant to my current meds. However, neither clinic is willing to do CD4 count and viral load tests beyond my regular quarterly blood work. Would it not be prudent to test my CD4 count and viral load along the way?

Read more about anal cancer and HIV/AIDS.

Mixed-Status Couples

• What are the risks of having unprotected anal sex between an HIV-negative top and an HIV-positive bottom?
• Is it OK to have unprotected sex if I'm on meds and my viral load is undetectable?
• I've known and dated my partner for about six years, but he recently tested positive. I want this relationship to work, regardless of his status. What do I need to know?
• A good friend and I have always been attracted to each other, and we finally made out. Yesterday he told me he's HIV positive. He says he's not sure he can do a relationship with me. I know that I want a partnership with him, but I'm scared he won't agree because I'm HIV negative. How can I show him that a relationship can work between a positive and a negative partner?
• What happens in the butt versus the mouth that makes it possible for an HIV-negative insertive partner to be infected with HIV by an HIV-positive partner?

Read more frequently asked questions on mixed-status relationships.

Serosorting

• Since telling others I'm HIV positive, I've been invited to parties with other positive guys. Is having unprotected sex with them safe?
• I've been asked by another positive guy to have bareback sex. Since we're both positive, I'm not sure if there are any risks. Does it make a difference who's the top and who's the bottom?
• What is serosorting and is it a good idea?

Ask TheBody.com's safer sex expert, Robert Frascino, M.D., questions about serosorting.

Read more frequently asked questions on HIV superinfection.

Nutrition and Fitness

• I was diagnosed two years ago. I am a vegan and work out five days a week, which includes cardio and weight training, I usually eat five to six small meals daily, including a great breakfast. I am currently on Atripla (efavirenz/tenofovir/FTC). I look and feel absolutely incredible. Will I be able to sustain this regimen for the next 10 years?
• Are supplements, such as creatine and whey protein, advisable for HIVers who lift weights on a regular basis? I have read conflicting information, so I'd like to clear up what is available for building and maintaining muscle.
• We are trying to develop a diet for an HIV-positive person. What sort of foods are great for HIV and why? Also, we would like to avoid supplements as much as possible. Is this a good idea?
• Is biking a good way to fight muscle mass loss in the limbs?
• I'm 28 years old with a CD4 count around 350. I've been going to the gym for a couple of years, but now I want more muscles and less fat. How often and hard should I train?
• I want to lose abdominal fat. Would you recommend using abdominal equipment?
• I'm HIV positive with a CD4 count in the mid-300s and a nearly undetectable viral load (189 when last I checked). 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?

Ask TheBody.com's nutrition and exercise expert, Nelson Vergel, questions about fitness.

Other Complications of HIV

• Am I losing my memory because of HIV? I am 47 years old and have been positive for 17 years, but I'm starting to forget a lot of things now. What can I do about it?
• I started meds 18 months ago. My viral load is undetectable and CD4 count is above 900. I was doing fine, but recently I've started feeling more fatigued during the day and need to sleep more than usual. Will the fatigue ever go away? What can I do?
• I have been positive for six years, my partner for about three. When we first met we had a great sex life. Now it is virtually nonexistent. He either does not have the energy or the interest. I have given up trying because I got tired of getting shot down. We are both in our mid-30s. How do I remain supportive without being bitter?

Ask Keith Henry, M.D., TheBody.com's expert on managing side effects, about complications of HIV and HIV meds.

Read frequently asked questions on other HIV/AIDS topics.

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