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January 17, 2005
In This Hot Topics:
  • HIV Treatment
  • Living With HIV
  • HIV-Related Health Problems
  • Health Insurance & HIV
  • HIV/Hepatitis Transmission
  • Strange but True
  •   HIV TREATMENT

    Efavirenz + Truvada as First-Line Treatment
    Since my diagnosis in late 1999, my CD4 count has steadily dropped -- from 618 to 218 -- while my viral load has stayed low, hovering between 2,000 and 10,000. My docs are waiting for my next CD4 count before we decide whether to start treatment, but they've recommended efavirenz (Sustiva, Stocrin) and Truvada (tenofovir/FTC) as a first regimen, if the need arises. What's your take on this regimen, and on my situation in general?


    Should I Restart an Old, Unusual Regimen?
    I spent 8 and a half years on a HAART regimen that worked well, even though researchers later found that it generally doesn't work in HIV-positive people. I had to stop taking the regimen recently, after I lost my job and health insurance, and was put on a waiting list for my state's AIDS Drug Assistance Program. When I stopped, my CD4 count was in the high 800s and my viral load was undetectable. Six months later, my CD4 count has slipped to between 675 and 750, and my viral load has climbed to 4,000. However, I found a new job and am once again covered by health insurance. Should I restart my old treatment?


    Which Is Better: A Massive HIV Clinic or a Small Private Practice?
    I was diagnosed last October and referred to a large HIV clinic at a reputable university for my care. I felt physically horrible -- anxiety/panic attacks, blurred vision, swollen glands -- but my doctor at the clinic didn't seem concerned. My symptoms got worse, and I had to harass the clinic to get more lab work done; the tests found that although my CD4 count was holding around 400, my viral load had jumped from 26,000 to 36,000 in a month. Still, the clinic doctor insisted my symptoms were related to depression and sent me on my way. In December, I went to a much smaller, private practice, where the doctor gave much more personal attention -- and where new labs showed my viral load had jumped to 130,000. I was immediately put on treatment. I'm glad I got that second opinion, but now I'm wondering: Should I stay at this small, private office? Or should I go back to the clinic, which is much more well-known and has a much more comprehensive approach to my overall health care?


    Effects of Crack on HIV and HAART
    Before I was diagnosed with HIV, I never took drugs. But when I was diagnosed last summer, I started smoking crack once a week -- I figured I might as well, since I've ruined my life anyway. But now, I'm about to start HIV meds, and I'm worried. Do you think the crack has made my HIV disease worse, or that smoking it will interfere with my treatment?

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     LIVING WITH HIV

    Prognosis for Someone Who's Refusing HIV Treatment
    My partner stopped taking his meds 14 months ago, and now he has a CD4 count of 50 and a viral load over 80,000. He's refusing any kind of HIV treatment or meds to reduce his risk of other infections. What's his prognosis? Is there anything I can do?

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     HIV-RELATED HEALTH PROBLEMS

    Are There Interactions Between Cholesterol Drugs and NNRTIs?
    Are there any interactions between statins -- cholesterol-lowering drugs like atorvastatin (Lipitor) -- and non-nucleoside reverse transcriptase inhibitors (NNRTIs)?


    Diagnosing and Treating Mild Anemia (and Finding a Good HIV Doctor)
    Should mild anemia be treated -- and if so, with what? I've read conflicting advice in literature, and my doctors have been no help at all. They didn't even tell me I had anemia, even though I've had two extended bouts of fatigue in the past two years. [Editor's Note: This is an exceedingly long, though interesting, forum post.]

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     HEALTH INSURANCE & HIV

    Can a Same-Sex Couple Married in Mass. Share Insurance Benefits Elsewhere?
    My partner and I were legally married in Massachusetts, but we live in Washington, D.C. I have health insurance, but he doesn't -- and he's the one who has HIV. He's on the Ticket to Work program (which helps train people on disability to re-enter the work force), which has income restrictions, so I'm basically supporting both of us, which is expensive. Given that we're married legally in Massachusetts, could I just put him on my insurance plan here in D.C.?


    My Disclosure Fears Are Founded; Should I Still Use My Company's Plan?
    I manage a small unit of a self-insured company. Our human resources director recently called me to inquire about an employee who I terminated for poor performance. He asked me if the former employee was "a drug addict," given that he'd approved large payments for medication for the employee under our health plan. I told the director that his question was inappropriate, and that it was illegal to share this kind of information about a fellow employee. Now the problem: I'm HIV positive and haven't used the company insurance plan for fear something like this would happen to me. I've been paying for my own insurance privately, which I no longer can afford. I want to use the company health plan, but how do I protect myself?


    Fear, HIV and Joining a Partner's Employee Health Plan
    My partner works for a large company that offers health insurance to domestic partners. I haven't joined his plan, since I'm worried that I'll have to fill out a form disclosing that I'm HIV positive, and that my partner's boss will find out. Do you think my fears are founded? If I join his plan, what would happen to my health coverage if he ever leaves his job?
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      HIV/HEPATITIS TRANSMISSION

    Hepatitis C Sexual Transmission Risks
    How common is sexual transmission of hepatitis C between men? Should an HIV-positive man who has unprotected anal sex with other HIV-positive men be worried about the risk of coinfection with hepatitis C?


    Anal Fisting and Hepatitis C
    If I'm the insertive partner in anal fisting with a hepatitis C-positive guy, and I don't wear gloves, what are the risks of me contracting hepatitis C as well?


    Canine HIV Transmission
    Let's say a dog scratches or bites an HIV-positive person and then scratches or bites you. Can the dog transmit HIV?

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      STRANGE BUT TRUE: MUCH ADO ABOUT SEX TOYS

    A Virgin, a Sex Doll and a Wet Finger
    I'm a virgin, and before I had sex with my girlfriend, I wanted to try it out first. So I bought a sex doll. But when I put my finger in its vagina, it came out wet; I'm sure that means somebody used it before, so I didn't have sex with it. But now I'm worried: If the person who used it before had hepatitis or something, could I have been infected with it?


    Nonoxynol-9 + Anal Sex Toy + Burger = HIV?
    I'm a 20-year-old woman who uses anal sex toys. I'm worried that, because I've used nonoxynol-9 on my toys until very recently, I may have put myself at risk for HIV. I once ate a cheeseburger that I think had blood on it, so I may have been exposed.
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    Art From HIV-Positive Artists
    Image from the January 2005 Visual AIDS Web Gallery
    "When I Was 29," 1997;
    Eric Rhein
    Visit the January 2005 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.

    Your Unused HIV Meds
    Can Save Lives!

    Aid for AIDS

    AID for AIDS is a New York-based nonprofit organization that collects unused, HIV-related medications and redistributes them to people living with AIDS in Africa, the Caribbean and Latin America.

    Have HIV-related medications (including antiretrovirals and meds used to prevent or treat opportunistic infections) you'd like to donate? Click here to find out how.