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August 9, 2004
In This Hot Topics:
  • Living With HIV
  • Workplace & Insurance Issues
  • Questions About HIV Treatment
  • Mixed-Status Relationships
  • HIV/HAART-Related Health Problems
  • HIV Prevention & Transmission
  • Strange but True
  •  LIVING WITH HIV

    Does Undetectable Mean Negative?
    Since my HIV diagnosis in December, my viral load has dropped to undetectable, and my CD4 count has risen to 1,000. Do you think this might mean I don't have HIV anymore?


    Is a Job at an HIV Medical Facility Too Risky?
    I'm considering becoming an HIV case worker for a large HIV medical facility. I've had HIV myself for more than 17 years and am healthy (my viral load is undetectable and my CD4 count is around 300), but if I take this job, should I be concerned about catching opportunistic infections from my clients? I really want the job and think I would be great at it, but I would not want to endanger my own health.
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      WORKPLACE & INSURANCE ISSUES

    Selling Life Insurance
    I was recently diagnosed and have a few life insurance policies. Do you think I can sell them?


    Can Employers Waive the Waiting Period for Disability Benefits?
    I've been offered a new job that I want to accept, but health insurance is an issue. At my current job, I have insurance coverage for pre-existing conditions and long-term disability. However, the new job's long-term disability policy has a 12-month waiting period for pre-existing conditions. If, God forbid, something happens to me during those 12 months, I am ineligible to receive help, which is a risk I can't take. Can the company waive the waiting period if they want me badly enough?


    How to Fight an HIV-Related Firing
    My company, which knows about my HIV status, fired me. I filed suit in federal court, but the company says the suit is illegal because I didn't follow "internal dispute resolution policy." I don't have the money to pay for arbitration. Is there a way around this?


    AIDS Paranoia in a Small Town
    My husband and I own a restaurant and one of our cooks is a former prostitute. Can we legally require her to divulge her HIV status? This is a small town and the rumors that she is infected are hurting our business.


    When You're Hospitalized, How Much Does an Employer Need to Know?
    My brother is hospitalized with pneumonia. He's been on medical leave for the past 3 weeks from his job at a large corporation, which also provides his health insurance. The company knows about his pneumonia, but it doesn't know he has AIDS. We don't know how much longer he'll be hospitalized or when he will be able to return to work. What do we tell his company?


    Follow-Up: HIV Discrimination and HIPAA
    I have a follow-up comment to a post that was highlighted in the last Hot Topics mailing ("Disclosure at Public HIV Testing Sites," 7/27). My understanding of HIPAA is that each institution is required to have some internal framework to ensure compliance and review complaints. Concerns for privacy and disclosure issues are handled by the designated "HIPAA Privacy Officer," and shouldn't immediately be referred to the Equal Employment Opportunity Commission office.

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      QUESTIONS ABOUT HIV TREATMENT

    A Treatment Catch-22: Save My Liver, or Fight My HIV?
    I'm a 21-year-old man who was diagnosed with HIV 4 years ago. I've been on many different meds, but have been off treatment for about 4 months due to worsening liver problems. But now that I'm off the meds, my overall health is declining: My CD4 count is 150 and my viral load is 110,000, and 2 weeks ago I developed Pneumocystis carinii pnuemonia. I'm in a catch-22: stay off the meds and get sick or go back on them and damage my liver. I start college again in a couple of weeks, so I don't have time to waste on a body war. Is there another option I'm not seeing that could possibly keep me alive through graduation?


    Tenofovir: Take With a Meal or Not?
    My doctor just recommended I take efavirenz (Sustiva, Stocrin), FTC (emtricitabine, Emtriva) and tenofovir (Viread) once a day before bedtime. My treatment advocate says, though, that the recommended time to take tenofovir is with a meal. Who is right?


    Sudden Viral Load Jump After Infection
    When I was diagnosed in February, my viral load was 31,000. Two months later, my viral load was at 29,000. But I just got back my results for July, and suddenly my viral load is up to 117,000. Is it normal to have such a rapid increase months after my diagnosis? Does it mean I should begin treatment?


    Can Nevirapine Be Used Again After a Rash?
    A friend of mine had to stop taking nevirapine (Viramune) due to rash, but he doesn't think he did the usual two-week "ramp-up" period people normally do to acclimate to it. Taking efavirenz (Sustiva, Stocrin) instead isn't an option; he already switched off of it because of the side effects. Should he try taking nevirapine again, or is it too risky?

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     MIXED-STATUS RELATIONSHIPS

    Withdrawal vs. Condom Use
    My husband, who is HIV positive, won't wear a condom during sex. Instead, he withdraws prior to ejaculation and claims this is sufficient. What are the possibilities that I'll become infected? We've been together 5 years and he has been infected for at least 12; his viral load is 2,200 and his CD4 count is 550.
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     HIV/HAART-RELATED HEALTH PROBLEMS

    Therapeutic Benefits of Acetyl-L-Carnitine
    A recent study I read about acetyl-L-carnitine said that it stimulated nerve regeneration in HIV-positive people with peripheral neuropathy, and that it relieved neuropathic pain in most study participants. This sounds too good to be true! What do you think?

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     HIV PREVENTION & TRANSMISSION

    Condom Tips for the Nervous Lover
    I had so much trouble putting on a condom the last time I tried to have sex that I got nervous and lost my erection; it was frustrating for both of us. I want to be safe, but how can I maintain my erection when trying to put the thing on?


    Urine and HIV Risk
    Do watersports (sex that involves urine) carry any risk of HIV transmission?
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      STRANGE BUT TRUE

    HIV and Ear Wax
    This is a silly question, but I'd really appreciate if you can answer it: Can HIV be transmitted through ear wax?


    The Risks of a Sex Worker's Mouthwash Cup
    I recently went to a brothel. Before we got down to business, I used a Listerine cap full of mouthwash that the prostitute handed me. At the time, I had a cut in my inner cheek. Now I'm worried that I might have been infected with HIV -- I'm sure that bottle cap was used previously by other men.
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    Ask Dr. Pierone About:
    STARTING HIV TREATMENT

    Gerald Pierone Jr., M.D.

    Dr. Gerald Pierone Jr. is one of three highly skilled, personable HIV specialists staffing our "Ask the Experts" forum on starting HIV treatment. From choosing the right time to choosing your first regimen, Dr. Pierone, who founded and directs a 600-patient HIV clinic in Fort Pierce, Fla., can fill you in on what you need to know.

    ART FROM HIV-POSITIVE ARTISTS
    Image from the August 2004 Visual AIDS Web Gallery
    "San Francisco, CA," 1979;
    Tseng Kwong Chi
    Visit the August 2004 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.