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February 28, 2005
In This Hot Topics:
  • HIV Transmission: Multi-Drug Resistance
  • Mixed-Status Relationships
  • HIV Treatment
  • HIV/HAART-Related Health Problems
  • Mental Health & HIV
  • Hepatitis & HIV
  • Strange but True
  •   HIV TRANSMISSION: MULTI-DRUG RESISTANCE

    What's Your Take on the New York City HIV Strain?
    I heard about the news that doctors in New York City found a new strain of HIV that is resistant to three out of four types of HIV medications and progresses to AIDS very quickly. One doctor said that it's "much ado about nothing." To me it seems much more serious than that. What are your thoughts?


    The HIV Strain Announcement: Too Little, Too Quick?
    Regardless of the outcome of this scary potential development in the HIV crisis, I have real trouble with the dramatic presentation by these medical professionals. Did this single case of HIV warrant such an alarming announcement by the New York Health Department, before further scientific study was conducted or additional cases were reported?


    For much more on this quickly evolving story, be sure to visit The Body's collection of articles and viewpoints on the transmission of multi-drug resistant HIV -- which includes Dr. David Wohl's coverage of a hastily organized special session on this issue from arguably the most important AIDS research meeting of the year, the Conference on Retroviruses and Opportunistic Infections.

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      MIXED-STATUS RELATIONSHIPS

    Helping a Newly Pos Partner Cope With an HIV Diagnosis
    My partner of eight years tested positive a month ago. I am negative. What can I do to help him deal with the guilt and dread that he is experiencing?


    HIV-Negative and Uncomfortable With a Magnetic Relationship
    I have been dating an HIV-positive woman and have real issues with it. I've read many responses in this forum saying that being HIV positive is no reason not to pursue a relationship. How can you say this when there's never 100% chance of being safe?

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      HIV TREATMENT

    Should I Keep Taking a Regimen That Doesn't Work?
    I've gone through a few different HAART regimens, and my latest one doesn't seem to be working very well, even though I'm more compliant with it than I was with earlier regimens. My CD4 count is 800 and my viral load is 21,000. Should I keep taking this failing regimen?


    Doctors' Dubious Decisions Leave an HIVer's Partner Concerned
    I'm concerned about the care my boyfriend is getting from his HIV specialist. He was diagnosed with AIDS in 2001, and has been on Combivir (AZT/3TC) and nelfinavir (Viracept) for the last three years. His viral load hasn't been undetectable since the first month after he started, but his specialist has never ordered a resistance test. When my boyfriend's viral load hit 2,800 recently, they doubled his nelfinavir dosage and added ddI (didanosine, Videx). When that didn't work after a month, they dropped the ddI and added efavirenz (Sustiva, Stocrin). He's feeling a lot of side effects from his new regimen, and it seems like his doctors are just shooting in the dark. Why haven't they done a resistance test? What can I do to improve this situation?


    Factors Influencing When Treatment Needs to Start
    What determines the time it will take for someone's CD4 count to fall? Will exercise, healthy eating, etc., make a big difference? Or is the determining factor more likely to be the particular strain of someone's virus?


    Is Politics Why It Takes So Long to Approve New Drugs?
    Why does it seem to take ten years to get a new HIV drug approved? Many people are running out of options while the HIV drug pipeline slows down. If the approval process was based on science, not on politics, couldn't we get new drugs in two to three years with the same amount of safety and efficacy data we get now?

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     HIV/HAART-RELATED HEALTH PROBLEMS

    What Can I Do to Ease Body Shape Changes?
    I have been living with AIDS for over 12 years, and am a crystal meth addict in recovery for two and a half years. When I got clean I started my most recent HAART regimen: atazanavir (Reyataz), ritonavir (Norvir) and Truvada (tenofovir/FTC). As of a few months ago, my CD4 was 298 and my viral load was undetectable. I've been working out religiously and moderating my food intake, but my body fat percentage is increasing, my buffalo hump is huge and my midsection is protruding out of proportion. I also haven't seen any visible muscle gain. I'm already taking testosterone shots every other week, but is there anything else I can do to change my body shape problems?


    Testicle Shrinkage on Testosterone Supplements
    Do testosterone supplements like AndroGel cause testicle shrinkage? If so, is it safe for me stop or "cycle" (periodically stop and restart) the treatment, and would doing so reverse this side effect?


    Risks of Yellow Fever Vaccination for HIVers
    My question has to do with the vaccine for yellow fever. I'm planning to travel abroad this summer and some African countries require this vaccination. I'm stable on my HAART regimen -- efavirenz (Sustiva, Stocrin) + Epzicom (abacavir/3TC) -- but was wondering if some vaccines could compromise my immune system or interact with my medications. What are your thoughts?

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     MENTAL HEALTH & HIV

    Different Side Effects From Different Antidepressants?
    Ever since my doctor changed my antidepressant from paroxetine (Paxil) to escitalopram (Lexapro), I've stopped dreaming normally. I've always had vivid, almost cinematic dreams in color and extensive detail. Now, if I do have dreams, they are peculiar -- like black-and-white line drawings. I don't feel refreshed when I wake and I am unable to think or focus well. I know that Lexapro and Paxil work in similar ways; could they really cause such radically different reactions?


    Dealing With Neurological Problems and Depression
    My partner has had limb tremors for five years; he's been HIV positive for 20. One year ago, they detected lesions on his brain. He now loses balance, is horribly confused and anxious, and is extremely depressed despite taking sertraline (Zoloft). What do you suggest we do? MRIs, blood work, x-rays and spinal taps have come up with nothing.


    Interactions Between HIV Meds and Schizophrenia Meds
    I'm taking ziprasidone (Geodon) and Symbyax (olanzapine and fluoxetine HCl capsules) for schizophrenia and am about to start taking Combivir (AZT/3TC) and nevirapine (Viramune). Are there any interactions between all of these drugs I should know about?
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      HEPATITIS & HIV

    Hepatitis C: Undetectable = Cured?
    If I'm taking hepatitis C treatment and my hepatitis C viral load becomes undetectable, does that mean I'm completely cured? Would there be any way I can still transmit the virus?


    Am I Just Lucky?
    I was coinfected with HIV, hepatitis B and hepatitis C. I've never taken meds for any of them, yet my doctors have told me the hepatitis C seems to "have been cleared by your body," that "you have no hepatitis B activity that we can measure" and that "we can't believe that you are still undetectable ... for the last 18 years and that your CD4 count is still above 800." What's going on here? Is there anyone in the freaking world who is like me?

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      STRANGE BUT TRUE

    Live on Camera Phone: A Scary Handjob
    About 3 weeks ago I got a protected handjob from a prostitute, which I caught on my mobile phone's video camera. Now I know that sounds weird, but I was trying it out for the first time, and since she was OK with it, I decided to "capture the moment" for posterity. I caught it on camera all the way up until the point where I took off the condom in order to ejaculate. When I did this, she took my penis and rubbed the unprotected head against her breast for about 10 seconds. Prior to this she had been rubbing her vagina and then her breasts, so my worry is that some of her vaginal fluids could have been on her breast and would then have contacted my penis. What's my HIV risk?
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    Art From HIV-Positive Artists
    Image from the February 2005 Visual AIDS Web Gallery
    "X Drawing," 1997;
    Bruce Wesley Boyce
    Visit the February 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.