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September 20, 2005
In This Hot Topics:
  • HIV Medications
  • Complications of HIV & HIV Treatment
  • Living With HIV
  • Health Insurance
  • HIV Transmission
  • Strange but True

    Does Viral Breakthrough Mean I'm Resistant to My Entire Regimen?
    For the past two years, I've had an undetectable viral load while taking nevirapine (Viramune) + Truvada (tenofovir/FTC). My lab blood work shows that my health is better now than it was before I started meds, and I feel great. However, I'm concerned about what it might mean if my viral load becomes detectable again. When this happens, does it mean someone has resistance to just one of the drugs in his or her regimen, or is the entire regimen compromised?

    Options for Treatment Veterans
    I've been living with HIV for 23 years and taking HIV meds since 1995. I've been on many different treatment regimens, but my CD4 count has never gone above 160. What options do you think I still have?


    Will Efavirenz Make It Hard for Me to Focus on My Job?
    My doctor has prescribed efavirenz (Sustiva, Stocrin) as part of my first-line treatment regimen. I've heard about the drug's side effects, though, and I'm worried: My job requires me to stay sharp and alert throughout the day; will efavirenz's side effects dull my mental reflexes?

    What's Keeping Me Awake All Night?
    I take my HIV meds -- atazanavir (Reyataz) + ritonavir (Norvir) + Truvada (tenofovir/FTC) -- just before I go to bed. Even though I also take 50 mg of St. John's wort (sometimes sold under the name Seritol) to help me sleep, I'm up and down all night long, and in the morning I'm exhausted. I've tried everything to improve my sleep pattern, but nothing helps. What's going on?

    Making Testosterone More "Available"
    My libido has recently gone from hot to lukewarm. My testosterone levels are pretty much normal, but the amount of testosterone that's actually used by my body (the "bioavailability") is on the low side. My doctor has prescribed testosterone replacement gel. Are there any natural ways I can improve the bioavailability of the testosterone that's already in my body?

    Anemia and Exhaustion: Time to Talk to My HIV Doc?
    For the past three months, I have been exhausted: Even after 10 hours of sleep, I don't have the energy to wash dishes. I'm 46, have a viral load of 2,000 and a CD4 count of 215. I also just found out that I'm anemic -- my hemoglobin count is 12.6. Is this something I should talk to my HIV specialist about?



    Will Heroin Make My HIV Disease Worse?
    I've been addicted to heroin for three years. Yesterday, I found out that I have HIV. Will taking heroin affect my ability to fight off this virus?

    Viral Load and HIV Progression
    If I have a high viral load, can I still be a "long-term nonprogressor"? (A long-term nonprogressor is somebody who has had HIV for a very long time -- usually eight years or more -- but whose immune system remains perfectly healthy, even though they've never taken HIV meds.)


    From Medi-Cal to Medicare: Choosing an HMO
    I'm currently on California's Medi-Cal program, but just received notice that my HIV meds are going to be covered by Medicare and that I'm going to have to select an HMO. I don't want to change doctors; how do I figure out which HMO to choose?

    Confused About Seeking New, Individual Health Coverage
    I currently live in Ohio and have an individual insurance plan that offers me great, affordable health and prescription drug coverage. However, I might move to a state where my provider doesn't offer any coverage. Would I be foolish to move? How easy would it be to find an individual health plan that's as good as my current one?


    Final Thoughts on "Why Do People Still Get HIV?"
    In our last "Hot Topics" newsletter, we highlighted a series of posts from our "Choosing Your Meds" forum in which our readers and one of our experts debated why so many people in the United States are still becoming infected with HIV. In this post, the reader whose question inadvertently started this whole conversation writes one last time to explain his thoughts -- and our expert, Dr. David Wohl, sums up his feelings as well: "I am a doctor who sees a lot of people with HIV and hope one day to try to have to find another line of work because of a lack of business. After answering your original question and those posted by others who reported being recently infected, I felt it was time to put out to the universe a question: What is going on?"

    Want to get up to speed on this discussion? Click here to review highlighted posts from our last newsletter.

    When Do Symptoms of Acute HIV Infection Appear?
    If I became infected with HIV, how long would it take for symptoms of acute retroviral syndrome (ARS) to show up?


    What If a Hotel Worker Used My Butt Plug?
    I recently went abroad for a few days and took my anal sex toy with me. Even though I stored it in a bag that I kept in a drawer, I'm worried that one of the hotel's cleaning people came in and used it while I was out of the room. If he did, could that put me at risk for HIV?

    A Freaked-Out School Secretary
    A woman recently came in to register her child at the elementary school where I work as a secretary. Ours is a small community, so I know she has HIV and hepatitis C -- but I didn't recognize her until after I'd touched her paperwork and shook her hand! I'm scared that I may now have both diseases, and that I might spread it to the entire school! Are my fears warranted?
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    Visual AIDS
    Art From HIV-Positive Artists

    Image from the September 2005 Visual AIDS Web Gallery
    Untitled (Double Portrait), 1991;
    Felix Gonzalez-Torres
    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."

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

    Dr. Hunter A. Hammill, winner of a 2005 HIV Leadership Award
    "HIV is a chronic disease and not a death sentence," says Dr. Hunter A. Hammill. "Life goes on ... An eclipse does not destroy the sun." In his private practice and at two outreach centers he founded for uninsured people in Houston, Texas, Dr. Hammill's typical caseload includes 300 HIV-positive people. He also treats about 100 pregnant women with HIV each year; less than 1% of his pregnant patients pass HIV along to their babies.

    We're honored to present Dr. Hammill as one of 10 outstanding HIV physicians who have won a 2005 HIV Leadership Award from! To meet all 73 award winners in our nine award categories, click here.