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November 16, 2004
In This Hot Topics:
  • U.S. Health Insurance & the Workplace
  • Sex & Disclosure
  • Stopping HIV Treatment
  • HIV Treatment & Advocacy
  • Complications of HIV/HAART
  • Post-Exposure HIV Prevention
  • Hepatitis
  • Strange but True


    New Job, New Insurance ... New HIV Disclosure?
    I am starting a new job next month and am HIV positive. Do I need to tell my new employer or my new insurance company that I have HIV? What information will I need to provide?

    Can a Latin-American Worker Get U.S. Health Insurance?
    I work in Latin America for a subsidiary of a U.S. company. My local health insurance policy doesn't cover HIV-related issues, so I'm exploring ways to improve my coverage. Since my parent company is in the United States, is there any way I can get individual U.S. health insurance, even though I'm not a U.S. citizen or resident?


    Does Your Sex Partner Have to Know?
    If an HIV-positive person always makes sure to use a condom, should he have to tell his partner he has HIV?



    Stopping Treatment Without Consulting Your Doc
    After almost 10 years of strong drug compliance, eight months ago I decided on my own to stop HIV treatment altogether to see how things would go. My latest labs, however, were much worse than I expected. My viral load has increased from undetectable to 78,000, and my CD4 count is down from 240 to 117. I am going back on the original medication plan this week, but 'd like to hear what you think about my original decision to stop my medications, and how able you think I'll be to regain the ground I've lost.

    Am I a Good Candidate for HIV Treatment Interruption?
    I'm a recovering crystal meth user who was infected with HIV two years ago. I started treatment almost immediately (my CD4 count was 610, but my viral load was 750,000) and watched my CD4 count increase to 800 while my viral load dropped to undetectable. I also made many changes in my life -- I got sober, stopped taking meth, moved from New York City to Los Angeles and reconnected with family and old friends. Now my new doc in Los Angeles is suggesting I stop my meds, while my doc in New York says I shouldn't. I'm doing very well, but am concerned about developing resistance if I stop. What do you think?


    Using the New Fixed-Dose Combination Drugs
    I started HIV treatment last month with efavirenz (Sustiva, Stocrin) and the new once-daily combo pill Epzicom (abacavir/3TC). I developed a full-body rash starting on day 12 and replaced Epzicom with another new combo pill, Truvada (tenofovir/FTC), on day 15. The rash disappeared within two days. Aside from the slight "high" feeling I get from the efavirenz an hour after taking it, I have had no troublesome side effects and generally feel great. My two-week lab results showed my viral load has already dropped from 330,000 to 2,207 and my CD4 count has jumped from 230 to 437. Have you seen similar results in your patients with this regimen, or am I a fluke?

    Why Can't HIV Docs Campaign for HIV Treatment Research?
    Do you think it would be possible for HIV doctors to get involved in campaigning to change the way HIV treatment research is conducted? Big funding sources seem not to want to look at this disease in a rational manner and coherently fill in gaps in our knowledge. Don't you think a consortium of researchers -- AIDS Docs for a Cure, say --- would really get things going?


    Personal Experience With Poly-L-Lactic Acid (Sculptra, New-Fill)
    Dear Dr. Bob: Since you've received poly-L-lactic acid as a facial wasting treatment, what's your opinion on it? I've been on successful HIV treatment since 1989, but am experiencing moderate facial wasting. I receive Medicare, Medicaid and Supplemental Security Income, so cost is a concern.

    Expensive Vitamins for Treating Fatigue?
    I'm experiencing severe fatigue while on my HAART regimen. I read an article about these vitamins you can buy online that help against fatigue, but they're really expensive -- $129.50 a month. Do you think they're worth it?

    Other Causes & Treatments for Chronic Fatigue
    I had serious chronic fatigue problems before I was diagnosed with HIV a year ago, but since I started HAART, it's gotten nearly debilitating. Besides the meds, could you suggest any other possible causes I should have my doctor investigate? Also, I've started taking injectable steroids (though they're unprescribed) to improve my energy levels and offset my decreased physical activity. How much damage am I doing to myself by injecting? Do the steroids interfere with my meds? What other options do I have?


    Concerned About Post-Exposure Prophylaxis
    Dear Dr. Bob: I just started taking post-exposure HIV prophylaxis (PEP), and wonder whether it will work. I read that you took PEP after you were exposed to HIV through a needlestick injury, but yet you still became HIV positive. Why didn't PEP work for you?

    "Spontaneous" Elimination of Hepatitis B?
    Two years ago, I tested positive for hepatitis B, and my liver function tests were slightly elevated. My doc said there was no need for treatment. Now, two years later, I seem to no longer be hepatitis B positive, and my liver function tests are normal. Could the hepatitis B really be gone?

    HIV Medications and Hepatitis
    Can HIV medications cause hepatitis A, B or C?

    Scratched by a Stripper (and Married)
    I'm a married man who received two lap dances from a stripper while on a business trip. The stripper clawed at the top of my bald head with her long fingernails. I think she also touched herself during the dance. It doesn't look like her nails broke the skin on my head, but do you think she could have given me HIV? My wife desperately wants to have sex, but I don't want to infect her.


    The Body's HIV Leadership Awards

    Pregunte a Dr. Natterstad Acerca:

    Dr. Steven Natterstad

    Need to talk to a Spanish-speaking HIV doctor about HIV treatment? Post your question for Dr. Steven Natterstad, one of two talented physicians answering questions in our "Tratamientos del VIH/SIDA" Ask the Experts forum.

    Image from the November 2004 Visual AIDS Web Gallery
    Untitled (Self-Portrait), 1993-96;
    Nelson Edwin Rodriguez
    Visit the November 2004 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.