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July 25, 2005
In This Hot Topics:
  • Living With HIV
  • HIV in the Workplace
  • Starting HIV Treatment
  • Switching/Stopping HIV Treatment
  • HIV/HAART-Related Health Issues
  • Strange but True
  •  LIVING WITH HIV

    Disclosing Your Status -- After Unprotected Sex
    I've had HIV for five years, and usually try to make sure I have safe sex. However, I met this guy after placing an ad, and after dinner and a few glasses of wine, I stayed over at his place and we had unprotected sex. He never told me his HIV status, and I never told him mine. Now he says he's feeling ill, and I'm a wreck; how do I tell him I have HIV?


    Does the U.S. Keep a Database of HIVers?
    I'm from the United Kingdom, but was diagnosed with HIV in the United States. I'd like to visit my aunt in Florida, but am worried that the U.S. government could link my passport with my health status and deny me entry to the country.


    Medical School Worries
    My adopted daughter, who was diagnosed with HIV when she was 14, is now 16 and thinking about going to medical school. Her viral load is undetectable and she's very compliant with her meds, but should we be worried about the effect the stress of medical school may have on her health? And what about disclosure -- can universities or medical schools refuse to accept HIV-positive students? Will she have a harder time getting a job as an HIV-positive doctor?


    Rubber Gloves at a Massage Clinic
    I recently went to a clinic at a massage school. After disclosing on their medical form that I had HIV, the staff began acting rather peculiar. Then, when my massage began, I noticed that the masseuse was wearing latex gloves. I was mortified! The way she massaged me seemed timid; I felt embarrassed and offended. Is this practice normal for massage therapists? If I hadn't disclosed my HIV status, would the masseuse still have used gloves?
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     HIV IN THE WORKPLACE

    Telling a Colleague He Has HIV
    I work at a small, close-knit HIV testing facility, and I have to tell a coworker that he is HIV positive. What is your advice on how to best give the results? Should it be inside or outside the office? Should one of our HIV case managers be present, just as though he were a regular client? If he discloses his status to our other coworkers, what sort of support or counseling might we all need?


    Changing Careers After an HIV Diagnosis
    I've been coping with my HIV infection for a year and a half, and I've come to the point where I'm sick of doing what everyone "expects" me to do -- namely, continue with what used to be a rewarding job that I loved. I've missed quite a bit of work since my diagnosis, and one of my immediate supervisors (who knows I have HIV) wants me out. My job is protected under the U.S. Family and Medical Leave Act, but my work environment has become hostile, which is beginning to affect my mental and physical health. I've always dreamt about changing careers, but with my health so up in the air I'm not sure it's worth the risk. At the same time, I'm tired of feeling trapped and treated like a second-class citizen. Should I go for it and try something new, or am I nuts to consider such a drastic career move at this point in my life?


    Eligibility for U.S. Social Security Disability Benefits
    What makes somebody in the United States a candidate to receive Social Security disability benefits? I was diagnosed with full-blown AIDS eight years ago, and was recently diagnosed with hepatitis B as well. I've worked full-time for 25 years, but now my liver is giving me problems and I may need to take time off. What should I do?


    "Pre-Existing Conditions" and HIV-Related Health Coverage
    I'm unclear about the "pre-existing condition" clause in U.S. health insurance policies. If you test HIV positive before the open enrollment period of a future employer, can you be denied any coverage at the time of open enrollment? Can your future insurance provider refuse to pay for any infections or medications that are HIV related?
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      STARTING HIV TREATMENT

    HAART Regimens Without Diet Restrictions or Body Changes?
    I want a HAART regimen that I don't have to take with food and that won't disfigure my body. What's the easiest regimen I could start treatment with?


    If My Viral Load Jumps, Is My New Treatment Still Working?
    I'm almost at the six-month mark of my efavirenz (Sustiva, Stocrin) + Truvada (tenofovir/FTC) regimen, and am worried about a jump in my viral load. After becoming undetectable 15 weeks after I started treatment, my viral load recently went up to 280, even though I've never missed a dose. Is my regimen still working?


    Should We Wait for Resistance Test Results?
    Although my boyfriend tested HIV negative four months ago, he was hospitalized just two months later with many symptoms of primary HIV infection. A new HIV test in mid-July came back positive -- and his CD4 count is already down to 140, with a viral load of 140,000! His doctor wants to hold off on treatment until he's performed a genotypic test to see if my boyfriend has HIV drug resistance. Do you think it's reasonable to wait for the resistance test results, or should he start treatment right away and then change meds later on if the test suggests he should?

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      SWITCHING/STOPPING HIV TREATMENT

    How Long Can My Treatment Interruption Last?
    After talking it over with my doctor, I took a break from my HAART regimen -- Combivir (AZT/3TC) + efavirenz (Sustiva, Stocrin) -- seven months ago. I had been taking the regimen for over three years and was in great health, but I suspected it was the reason for my severe depression. After seven months off meds, I've realized I was right! Even better, my CD4 count is still extremely high and my viral load is undetectable. How much longer can I expect these terrific numbers to continue?


    What Should I Switch to if I Have High Cholesterol?
    I'm considering a regimen switch because of my cholesterol levels. Two years ago I started taking my first regimen, Combivir (AZT/3TC) + Kaletra (lopinavir/ritonavir). It's worked fine, with nearly no side effects, an undetectable viral load and a CD4 count up from 150 to 430. Unfortunately, my cholesterol levels are relatively high, so I asked my doc if I should switch to a regimen of atazanavir (Reyataz) + Truvada (tenofovir/FTC), which I've heard causes fewer problems with lipid levels. My doctor countered with another suggestion that he said was even better: fosamprenavir (908, Lexiva, Telzir) + ritonavir (Norvir) + Truvada. Which regimen do you feel is best?

    Changing an Effective Regimen: What Are the Risks?
    I've been doing very well on a HAART regimen consisting of four different meds, but I recently changed jobs, and my new health insurance provider has refused coverage for two of the meds. What are the possible effects of changing an effective regimen? Will stopping those two meds put me at a greater risk for resistance problems in the future?

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      HIV/HAART-RELATED HEALTH ISSUES

    What Are the Odds of Developing Dementia?
    I've read that even when a person is on HAART and has an undetectable viral load, dementia will eventually occur anyway. Is this true? How often do you see dementia in your long-term HIV-positive patients?


    What's Causing My Arms to Shrink?
    About a year ago I went on a combination of Combivir (AZT/3TC) + fosamprenavir (908, Lexiva, Telzir) + ritonavir (Norvir) + tenofovir (Viread). I've recently noticed that my arms seem to be getting progressively skinnier, and the veins are popping out. Do you think one or more of the meds in my regimen are the culprit?


    Benefits of Failed Hepatitis C Treatment for People Coinfected With HIV
    You've said that even if a person's hepatitis C treatment is unsuccessful, it could still help slow the progression of hepatitis C disease. Is this true even for people with HIV?

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      STRANGE BUT TRUE

    More Sex in a Fitting Room
    As an employee at a retail-clothing store, I often need to check the fitting rooms. While doing so recently, I put my hand on a doorknob that was covered in semen -- though I didn't realize it was semen until after I wiped my eye with the same hand. Could I have been infected with HIV or hepatitis C?


    Sore Throat From Autofellatio?
    I recently discovered that I have the ability to give myself oral sex, and now I can't stop doing it! Recently, though, I've had a sore throat. I'm not otherwise sexually active, so could my autofellatio be the cause?
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    Meet the Winners of TheBody.com's 2005 HIV Leadership Awards!
    Dr. J. Kevin Carmichael, winner of a TheBody.com 2005 HIV Leadership Award
    Dr. J. Kevin Carmichael from Tucson, Ariz., is one of 10 outstanding HIV physicians who have won a 2005 HIV Leadership Award from TheBody.com. Dr. Carmichael oversees the care of 1,500 HIV-positive people in Tucson, Ariz., and regularly travels the state to provide patient care and clinical support to HIV physicians in far-flung rural areas.

    Want to meet all 73 winners of TheBody.com's 2005 HIV Leadership Awards? Click here!
    Art From HIV-Positive Artists
    Image from the July 2005 Visual AIDS Web Gallery
    "Boys Wonder," 1999;
    Raymond Bordeaux
    Visit the July 2005 Visual AIDS Web Gallery to view this month's 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? AID FOR AIDS will pay the price of postage if you're unable to afford the cost. Click here to learn more.