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September 6, 2005
In This Hot Topics:
  • Why Do People Still Get HIV?
  • Understanding CD4 Count & Viral Load
  • Cures, Prognoses & Living With HIV
  • HIV Disclosure
  • HIV Treatment Decisions
  • HIV Transmission
  • Strange but True

    The HIV pandemic is more than two decades old, and yet an estimated 40,000 people in the United States still test positive every year. At The Body's "Choosing Your Meds" forum, one of our experts and some readers have been involved in a heated conversation about why so many people continue to be infected with HIV. We highlight some of the posts below.

    The Original Post
    Dr. David Wohl, an expert in our "Choosing Your Meds" forum who often raises provocative issues in his responses, starts the discussion with this comment to a person who was recently diagnosed with HIV.

    Response #1: Disappointment
    In reply to Dr. Wohl's comment, another person writes: "I was a bit disappointed by your response. ... Even if his infection was the outcome of a particularly bad decision, your response seemed to be somewhat blind to the unfortunate intricacies of human nature that perhaps none of us understand."

    Response #2: Blame
    "I know it is not your fault I gave myself HIV," writes a forum visitor named Larry, "but I lay some blame on the drug companies for pushing the message with young, hot, healthy-looking guys subliminally saying that HIV is just a manageable condition. And some blame on the medical community for not telling the big drug companies to cut out this crap!"

    Response #3: Anti-Blame
    "It's all too easy to cast blame, and I strongly believe that the pharmaceutical industry is unfairly impugned by medical and media commentators alike," another reader replies. "Our culture is obsessed with casting blame -- this is unhealthy and entirely counter-productive. Yes, the pharma industry has issues, and yes, it would be nice if these companies operated in an entirely altruistic fashion, but that is not the nature of the capitalist world in which we live."

    Response #4: Personal Perspective
    And finally, in this emotional post, Larry talks further about why he got HIV, how he's coped with his diagnosis, and what he thinks could have been done to help him avoid infection in the first place. "I became addicted to the danger, the allure of doing something I shouldn't be doing," he writes. "The adrenaline rush was intense and helpful in making me forget the pain and reality of getting older. It also was a drug used to dull the pain of abuse as a child."


    CD4 Count and Viral Load Changes Soon After HIV Infection
    I was recently diagnosed with HIV. Two weeks ago, I had a viral load of 200,000 and a CD4 count of 420 (16%). Today, my viral load is the same, but my CD4 count is down to 320. What's going on? Is it likely that my viral load will remain at this level, or will it go down without my having to start meds? Are viral loads generally higher right after a person is infected?

    The Meaning of "Undetectable"
    Can you explain exactly what it means to be "undetectable"?

    Why Am I No Longer Undetectable?
    For the past three years I've always taken my meds on time, but according to my latest viral load test, I'm no longer undetectable. Does this mean I've developed HIV drug resistance? Do I need to change meds?


    Why Should a Drug Company Want to Cure HIV?
    What incentive is there for a pharmaceutical company to discover a cure for HIV? Won't they make more money if they just keep selling the meds they currently sell?

    Questions From an Anti-Treatment HIVer
    For the 13 years since my diagnosis, I've avoided HIV meds -- in fact, I've never had a CD4 count or viral load test taken. What can I expect to happen during the next few years? What should I do to prepare for the end?

    How Far Have We Come Since Philadelphia?
    I watched the 1993 movie Philadelphia with Tom Hanks, and being recently diagnosed with HIV myself, I'm worried about my future. My CD4 count is 750 and my viral load is 1,000, but my doctor -- a general practitioner -- says I'll probably live for only another 12 years at most. Is this true? How far have we come since Philadelphia came out in theaters?



    Hiding Status While on Treatment
    Nobody knows I have HIV. Because of my high viral load, my doc wants me to start taking meds. If I do, how difficult will it be to continue hiding my diagnosis?

    A Difficult Disclosure: Telling Your Wife
    How do I tell my wife that I've just been diagnosed with HIV? I'm not even sure how I got it.


    Considering a Treatment Break
    Can I take a break from my meds? I'm on efavirenz (Sustiva, Stocrin) and Combivir (AZT/3TC), have a viral load below 75 and a CD4 count of 646.

    Lipodystrophy's Coming; Should I Switch or Stop Treatment?
    I feel like I'm racing against the clock, as the first signs of lipodystrophy are changing my arms, legs and face. I've been positive for 20 years, and on meds for the last four. My latest treatment regimen was working well -- until the lipodystrophy started. My doctor has recommended a new regimen, but he's also encouraging a drug holiday, since my viral load is undetectable and my CD4 count is stable at more than 550. However, I had non-Hodgkin's lymphoma two years ago, which makes another doctor of mine reluctant to let me take a treatment break, even though I've completely recovered from the lymphoma. What's your take?


    Dr. Lorraine Day: Crazy or Correct?
    Dr. Lorraine Day, who was once a surgeon at San Francisco General Hospital, says you can potentially get HIV from just about anything. She says the U.S. Centers for Disease Control and Prevention lies about HIV risks. Do you think she has a point?


    Can I Get HIV From an HIVer's Car?
    I just bought a car from an HIV-positive man. Should I clean it with disinfectant just to be safe?

    The Bald Masturbator
    Does masturbation lead to baldness?

    The Faces of HIV Care
    Meet the Winners of's 2005 HIV Leadership Awards!

    Philomena McGee, winner of a 2005 HIV Leadership Award
    Philomena McGee spent part of her childhood in an orphanage in Ireland. Now she helps HIV-positive people in Hartford, Conn., who are struggling to overcome the burdens of substance abuse and incarceration. An HIV case manager since 1990, some of Philomena's most troubled clients have been women. "[American] society is not kind to women living with the virus," she says. "A lot of the women I see are wounded souls who experienced mental, emotional, physical or sexual abuse when they were children."

    We're honored to present Philomena as one of 10 outstanding HIV case managers and social workers who have won a 2005 HIV Leadership Award from! To meet all 73 award winners in our nine award categories, click here.

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the September 2005 Visual AIDS Web Gallery
    "Silence = Death," 1989;
    Keith Haring
    Visit the September 2005 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The September 2005 gallery is entitled "Crossing the Line."