February 9, 2011
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LIVING WITH HIV/AIDS


 How Long Are HIVers Expected to Live Nowadays?
I've been HIV positive for 25 years. My CD4 count is around 500 and my viral load is undetectable. What's my life expectancy? What would it be if I were a 20-year-old just starting HIV treatment today?

Nelson Vergel responds in the "Nutrition and Exercise" forum


 How Can I Get More Energy?
I try to work out but I have no energy. Before I was diagnosed with HIV, I was exercising four days a week. I'm now down to three days a month. I'm on testosterone replacement therapy but it doesn't help. How can I build up my energy -- or find out why I have none so I can do something about it?

Nelson Vergel responds in the "Nutrition and Exercise" forum


More Questions About Living With HIV/AIDS:


MIXED-STATUS COUPLES


 Is Starting HIV Meds a Good Way to Keep My Partner HIV Negative?
I'm HIV positive and I've never taken HIV meds before. My CD4 count is 526 and my viral load is 317. My partner is HIV negative and we'd like to keep it that way, so we practice safer sex every time. We recently had a condom break and my partner took post-exposure prophylaxis (PEP). In case this happens again, I'm contemplating starting treatment to reduce my partner's chances of becoming HIV positive. Do you think this is a good idea?

Robert J. Frascino, M.D., responds in the "Safe Sex and HIV Prevention" forum


 If I Receive a Live Vaccination, Am I Putting My HIV-Positive Partner at Risk?
I'm the HIV-negative partner in a mixed-status relationship. There's plenty of information on which vaccinations are recommended for people living with HIV, but can a negative partner's immunizations put the positive partner at any risk? Should negative partners also avoid receiving "live virus" vaccinations?

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


welcome to our new "workplace and insurance issues" expert

Michael J. Van EssenThere's another new expert on the block! Michael J. Van Essen has worked in benefits advocacy and outreach at several HIV/AIDS service organizations, and is equipped to answer questions on topics like health insurance, disability benefits, returning to work and much more. Mr. Van Essen joins longtime expert Lynn Franzoi in the "Workplace and Insurance Issues" forum. Learn more about Mr. Van Essen, and ask him a question in the forum!



BODY SHAPE CHANGES & HIV/AIDS


 Are Any of My Meds Contributing to My Lipoatrophy?
I've been HIV positive for 24 years and on many different meds. My CD4 count is over 900 and my viral load is undetectable. I currently take Epzicom (abacavir/3TC, Kivexa), Lexiva (fosamprenavir, Telzir), Norvir (ritonavir) and Viread (tenofovir). I don't want to be on any meds that could cause further facial wasting. Are any of these meds known to contribute to lipoatrophy? Which types of meds should be avoided, if possible?

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


 What's Going On With the Newly Approved Belly Fat Drug Egrifta?
I get my HIV meds through ADAP (AIDS Drug Assistance Program). My lipodystrophy belly is pretty big and I need to do something about it. What options are currently available to pay for Egrifta (tesamorelin)?

Nelson Vergel responds in the "Nutrition and Exercise" forum


HIV/AIDS TREATMENT & SIDE EFFECTS


 If You Were Diagnosed Today, Would You Start Treatment Right Away?
I became HIV positive last January and was very sick for a month. My CD4 count is now 590 and starting treatment no longer seems urgent, but I want to make sure the virus stays in check. Is there a downside to starting treatment now? What are the recommended regimens to start with, and what can I expect from each? With all the knowledge you have now, if you were diagnosed today, would you wait to start treatment?

Nelson Vergel responds in the "Nutrition and Exercise" forum


 What Can Be Done About Bone Problems?
My husband is 35 years old and was diagnosed HIV positive in 2006. He's been taking Viraday (efavirenz/tenofovir/FTC, the generic form of Atripla available in some countries outside the U.S.) regularly for three years. His numbers are good and he maintains an active, healthy lifestyle. However, he has regular bone-related problems in his wrists, elbows and ankles. Is this a side effect of Viraday? What can he do to reduce pain and build bone density?

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


 Do the Enzymes HIV Meds "Inhibit" Ever Do Anything Good?
I take a nucleoside reverse transcriptase inhibitor and an integrase inhibitor. Do these two enzymes have any positive effects for the body? Does inhibiting them cause any problems that we know of?

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


More Questions About HIV/AIDS Treatment & Side Effects:


OTHER HEALTH ISSUES & HIV/AIDS


 Which Form of Niacin Works Best at Increasing Good Cholesterol?
I know that niacin supplements are known to increase levels of HDL (high-density lipoprotein, or "good cholesterol"). Since over-the-counter niacin can cause a "flushing" sensation on a person's skin, which I can't stand, I've been taking "no-flush" niacin (inositol hexanicotinate) for many years. It's worked well generally, except when a brief switch to Lexiva (fosamprenavir, Telzir) caused my triglyceride levels to skyrocket. What do you know about the different kinds of niacin? Does the no-flush niacin work as well as regular "live" niacin at raising levels of HDL?

Nelson Vergel responds in the "Nutrition and Exercise" forum


 Why Do I Smell Something Foul All the Time?
For some reason, I smell a foul smell on me most of the time. I take my HIV meds and my doctor says I'm doing fine, but I feel like my body is rotting away. I was diagnosed with cryptococcal meningitis in 2005 -- could that have something to do with this unusual condition?

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




More Questions About HIV/AIDS Treatment & Side Effects:


Connect With Others

I Haven't Dated Anyone in Years: How Can I Learn to Trust Again?
(A recent post from the "Gay Men" board)

I'm 38 and I was diagnosed almost seven years ago. ... Dating has been very hard for me. I live in a rural part of the U.S. Shortly after I found out I was positive, I had two very horrible experiences of people telling a lot of people about my status, people who had no business knowing. It freaked me out enough that my answer was to just stop dating. It's been six years and I'm not willing to just not date for the rest of my life. ... I'm slowly putting myself back out there but I never know when the right time to reveal my status is and then I have flashbacks to the horrible incidents I had, get scared and shut down.

Has anyone else ever gone through this? Thanks in advance for any thoughts, ideas, etc. -- alittlelost

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UNDERSTANDING HIV/AIDS LABS


 My CD4 Count Is Slow to Increase: Does This Mean My Meds Don't Work?
I started taking Atripla (efavirenz/tenofovir/FTC) three years ago. Although my viral load is now undetectable, my CD4 count is only 400 and it's only ever gone as high as 500. Are my HIV meds not working? Should I start thinking about changing meds?

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


HIV TRANSMISSION


 Seconds of Unprotected Sex With a Positive Partner: Should I Take PEP?
I had insertive anal sex with a person who later informed me he was HIV positive with an undetectable viral load. Before I penetrated him, I introduced my penis head to his anus for about 10 seconds at most. Right after, I put on a condom and started penetration. I noticed he started to bleed and I stopped. The condom was intact and I didn't have any blood on my penis. It hasn't been 72 hours yet; should I start PEP (post-exposure prophylaxis)?

Robert J. Frascino, M.D., responds in the "Safe Sex and HIV Prevention" forum


STRANGE BUT TRUE


 There's No Sex in the Champagne Room ... But Is There HIV Risk?
Recently I met a girl in the Champagne Room at a strip club. I fondled her boobs and eventually inserted my penis between them. There was no visible blood, cuts or breast milk on or between her boobs, but I did notice small red pimples. Can you assess the risk of HIV transmission in this case? I'm very worried!

Robert J. Frascino, M.D., responds in the "Safe Sex and HIV Prevention" forum



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