Hot Topics at The Body's "Ask the Experts" Forums, August 22, 2005

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August 22, 2005

Mixed-Status Relationships

HIV Treatment Newcomers

HIV Treatment Veterans

• MIXED-STATUS RELATIONSHIPS

My Partner Will Sleep With Me, but Won't Kiss Me!
I was diagnosed with HIV eight years ago, and am in good health thanks to HIV meds. For more than a year I've been in a relationship with a wonderful HIV-negative man. We love each other truly and deeply, which is an incredible blessing -- except that I still experience real problems in sharing intimacy, because of my partner's excessive and unfounded fears about transmission risks. In the past year, we've never even truly kissed! Strange enough, he is not scared to be the insertive partner if he's using a good condom, but almost everything else is off-limits. How can I help him break down these barriers?

In Love With an HIVer, but Worried About the Long Term
I'm HIV negative, and I'm in love with a man who has AIDS. His CD4 count has been around 400 for the last three years. I want to spend my future with him, but I'm scared of the unknown and the possibility of him getting sick in the near future. I know you can't predict his life expectancy, but could you elaborate on the possible future for someone who has recovered from a very low CD4 count, is on treatment and is living a healthy life?

• HIV TREATMENT NEWCOMERS

How Does a Doctor Pick Someone's First HIV Treatment Regimen?
I'll be going to see a doctor soon to look into starting HIV treatment. I'm curious: How are HIV meds tailored to an individual? Apparently not everyone is the same and certain drugs work best with certain people. Will the doctor test some out on me? How long will this whole process take? I'm especially concerned because I have to travel to another country to see this doctor and get the meds; I live and work overseas, and don't want the country I am in to know my HIV status. How much time should I schedule for this trip?

CD4 Counts: What's Normal, and What Number Signifies It's Time for Treatment?
What's a normal CD4 count for a healthy, HIV-negative person? How low should a CD4 count be allowed to go before a person starts HIV treatment?

High Viral Load: Should I Start Treatment?
My CD4 count is around 480 -- it's been that way for more than a year -- but my viral load is generally well over 100,000. I'm feeling OK, but should I start HIV treatment?

My Doctor Feels It's Time for Treatment, but I'm Not as Sure
I tested positive in June 2005, with a CD4 count of 888 and a viral load of 100,000. By late July, my CD4 count had fallen to 798 and my viral load was up to 121,000. My doctor, citing the CD4 count drop and viral load rise, feels that I should start treatment now, but I'm concerned it's too soon. What do you think?

• HIV TREATMENT VETERANS

Is Treatment Failure Inevitable?
I've been on Combivir (AZT/3TC) + efavirenz (Sustiva, Stocrin) for almost seven years now. I've been undetectable for almost the whole time, with the rare "blip." I take my meds religiously and have no side effects to speak of. Is it inevitable that my regimen will eventually fail? How long can I continue my run of good luck?

Ending a Treatment Break: Can Viral Load Drop 479,000 in Two Months?
After a yearlong break from treatment, I restarted HIV meds in April with a viral load of 479,000. In just over two months since starting a regimen of atazanavir (Reyataz) + ritonavir (Norvir) + Truvada (FTC/tenofovir), my viral load had become undetectable! Is such a rapid drop really possible, or is this more likely a lab error?

• HEALTH COMPLICATIONS

Am I Truly Depressed -- And Could Efavirenz Be the Cause?
How can I differentiate between clinical depression and simply situational depression -- and how can I figure out if it's my efavirenz (Sustiva, Stocrin) that's causing it? I've been on treatment with efavirenz + Truvada (FTC/tenofovir) for 11 months; my viral load is undetectable, and I don't have any sleep problems. But at times I feel depressed and negative, and want to avoid friends and social commitments. Other times I feel like jumping out of my skin. What's behind all this -- and if it's the efavirenz, would a switch to nevirapine (Viramune) be a good idea?

Should HIVers Get Regular Rectal Exams?
Given that HIV-positive people are more at risk for anal/rectal cancers, should rectal exams be part of a routine checkup? Not that I really want a rectal exam, but I do have a history of prostate cancer in my family, so I'm a little concerned about that.

Darkening Skin on AZT?
I'm a black, African woman, and I've been on HIV treatment for years -- Combivir (AZT/3TC) + efavirenz (Sustiva, Stocrin) at first, but now Combivir + Kaletra (lopinavir/ritonavir). My skin color darkens every day, and is dry and itchy. No cream seems to help. I've lost my self-esteem; people who knew me before don't even recognize me anymore! Could the Combivir have something to do with this?

What's Mycobacterium Gordonia?
I'm a 38-year-old man who was recently diagnosed with AIDS. Recently, a mass was discovered on the outside of my left lung. After 23 days in a hospital, the doctors told me I had a very rare mycobacterium called Gordonia. I was put on several drugs to treat the infection, but nobody has told me how long I'll have to take these meds or what my prognosis for full recovery will be. Can you help?

• INSURANCE AND HIV

Life Insurance for HIVers
Are there any life insurance carriers in the United States that will provide a policy to somebody with HIV?

Privacy and Discrimination Concerns at a Self-Insured Company
I'm an HIV-positive person living in Texas, and I just started working for a self-insured company. My concern is that if I accept their insurance, my status will become known and I will face possible discrimination. I think HIV discrimination is against the law, but how much protection would that really provide me?

Switching Insurance Plans, HIV Testing and Pre-Existing Conditions
I had an HIV exposure a few months ago and started showing symptoms. My HIV test came out negative, but I'm about to start a new health insurance plan, and then plan to get retested. If the second test (under the new plan) comes out positive, could my insurance company say it's a pre-existing condition and refuse to cover me?

Missing Paperwork for a Health Coverage Switch
My COBRA health insurance coverage was terminated a couple of months ago. Now I'm applying for coverage from Blue Cross Blue Shield, but they're telling me I need some kind of letter from my last insurance company that I don't have. I've been paying for Blue Cross coverage for two months already, but still don't have a health plan! What do I do?

• HIV TRANSMISSION

After Hanging 10 With a Central American Surfer, a Traveler Is Worried
I was traveling in Central America about two months ago when I met an incredibly hot local Latin surfer dude. Being on vacation and having the voices of friends ringing in my head saying, "You need to live a little," caused a momentary lapse in judgement. I took him back to my hotel and performed oral sex on him (just so I get the lingo correct, I sucked on him); he also sucked on me. Then I found out he was HIV positive. Though healthcare is socialized in his country, I don't know what the treatment for HIV is or if he is even receiving treatment. My 28-day HIV test came out negative, but what do you think my risk is?

• STRANGE BUT TRUE

Touching Feces While Making Out
I was making out with a girl I'd met earlier that evening. She was still wearing clothes, and I put my hands down the back of her pants, inside her underwear. To my surprise, I felt something sticky and pulled my hands out. When I sniffed my fingers, it became obvious this girl hadn't wiped herself properly (or at all) since her last (heavy-duty) visit to the bathroom! That pretty much put a damper on things and we didn't go any further! I washed my hands with soap and water, for obvious reasons. But now I wonder: Is there any risk of catching HIV this way?

Meet the Winners of TheBody.com's 2005 HIV Leadership Awards!

Helen Rominger, winner of a TheBody.com 2005 HIV Leadership Award

It may have been chance that brought Cuban native Helen Rominger to Indianapolis as an HIV clinical research nurse, but to her colleagues and patients, it was fate handing them a wonderful gift. In nominating her for an HIV Leadership Award, the sister of one of her patients gushed, "To try to describe why Helen is so special would take up 100 of these entry forms. I keep telling my brother that God did not give him AIDS, but God has given us Helen."

We're honored to present Helen as one of 10 outstanding HIV nurse practitioners and physician assistants who have won a 2005 HIV Leadership Award from TheBody.com! To meet all 73 award winners in our nine award categories, click here.

Art From HIV-Positive Artists

"Greenport #1," 1996;
Nora Wallower

Visit the Visual AIDS Web Gallery to view hundreds of artworks created by HIV-positive artists!

Your Unused HIV Meds
Can Save Lives!

Got unused meds taking up space in your cabinet? The Starfish Project at NewYork-Presbyterian Hospital collects extra antiretrovirals and other HIV-related medications, which they ship to healthcare providers in Nigeria. All shipping costs will be reimbursed. Visit www.thestarfishproject.org or call (212) 746-7164 for more information.

To learn more about recycling your unused HIV meds, visit The Body's collection of articles.