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March 13, 2006
In This Hot Topics:
  • Mixed-Status Relationships
  • Complications of HIV & HIV Meds
  • Debate Over Side Effects & Honesty
  • Choosing Your Meds
  • Living With HIV
  • Health Insurance & HIV
  • Strange but True
  •  MIXED-STATUS RELATIONSHIPS

    How Often Should the Negative Partner In a "Magnetic" Couple Get Tested?
    My boyfriend was diagnosed with HIV in December; I'm still negative. We've only had protected sex since his diagnosis, so I'm curious: How often do you think I should get tested for HIV? Should it be every few months or so, or only if something specific happens that puts me at risk (like a broken condom)?
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     COMPLICATIONS OF HIV & HIV MEDS

    I Tried Liposuction, but the Fat Came Back
    I'm on triple-drug therapy, have an undetectable viral load and have a CD4 count around 1,150. Although I have always been thin, my abdomen has gotten huge over the last four years, I guess because of my HIV meds. I've had two stomach liposuctions within the last year, only to have a lot of the fat come back. Is this a losing battle? What else can I try?


    HIV and Obesity: "You'll Need the Weight When You Get Sick"?
    I'm a 38-year-old woman who's been living with HIV for 15 years. I'm 5'9" and weigh 210 pounds. I have talked to my doctor about losing weight, but she is no help: She tells me I'll need the weight when I get sick. Personally, I would rather be sick and look the way I want. What do you think, and what options do I have for reducing my weight?


    Constantly Tired, but With No Idea Why
    I was diagnosed in 1999, and ever since I've suffered from fatigue and sleepiness. My sleep patterns are also horrible. But I can't find a reason why: My viral load has been undetectable for years and my CD4 count is 550. I'm on treatment for an underactive thyroid, but all my other numbers, including testosterone levels, are normal. Neither my job nor my personal life are stressful to any great degree. I'm taking efavirenz (Sustiva, Stocrin) and Epzicom (abacavir/3TC, Kivexa). Could either of those be causing this, or is it something to do with HIV itself?
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      DEBATE OVER SIDE EFFECTS, HONESTY & QUALITY OF LIFE

    A reader recently asked the experts at The Body's "Choosing Your Meds" forum if they felt they were talking honestly about the side effects that HIV meds can cause. How do you feel about this issue? Read below to see the original post (with Dr. Ben Young's response) and another user's response, and then share your own thoughts!


    Original Post: Why Don't You Talk Honestly About HIV Med Side Effects?
    You doctors seem to loathe talking honestly about some of the dreadful side effects many HIV medications can cause. Why are you in denial about this? You talk of how these meds have extended people's lives, as I'm sure they have done. But, what kind of life is it you are talking about? What possible point is there to life if a person is reduced to being some genetic freak (lipodystrophy), or has chronic bowel problems, headaches, liver disease, etc.? You have a professional and ethical responsibility to inform patients honestly of treatments and let them make the decision of taking meds or not.


    An HIV-Positive Person's Response: There's No Side Effect Conspiracy!
    Frankly, I find the negativity as espoused in the previous respondent's message deeply disturbing and wholly irresponsible. Please, if you have recently been infected, be reassured by the fact that I have received nothing but outstanding medical care since my diagnosis. My doctors have been honest and transparent and, whilst I am entirely cognizant of the fact that I am lucky to have responded so well, I firmly believe that maintaining a positive outlook ensures the best likelihood of an optimal long-term prognosis. Please don't believe the conspiracy theorists. There is no pharmaceutical company driven agenda to mislead and obfuscate. All medications carry with them side effects, no one has denied this, but these can and, in most cases do, have limited or no impact on your daily routine.


    On a related note, another person recently posted this question to our "Mental Health & HIV" forum:

    Are All of These Meds Really Worth It?
    I'm 50 years old, and have been living with HIV for eight years. It's been an up-and-down ride, and other life issues have left me extremely depressed. I'm left wondering if it's really worth it for me to keep paying $1,500 a month on HIV meds just to make drug companies rich. I feel so much better when I'm off meds! I'd like to stop treatment and just let this disease take its course, but I feel pressured to hang on as long as possible. Where's the line between quantity of life and quality of life?

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     CHOOSING HIV MEDS

    Should Atazanavir Always Be Boosted With Ritonavir?
    My partner recently started his first treatment regimen: atazanavir (Reyataz) + Epzicom (abacavir/3TC, Kivexa). He seems to be doing well, but I'm concerned that he's been given a "second-rate" regimen -- that he would do much better if his regimen was boosted with ritonavir (Norvir). What do you think?


    Long-Term Survivor, but Running Out of Options
    I've had HIV for more than 12 years. My last CD4 count was 19, and my viral load was 230,000. I've never been good at adhering to my treatment regimens, and my doctor says that there are only a few HIV meds left that might work against my virus. I just completed rehab for Vicodin addiction, though, and I want to live. What options do I have left?
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     LIVING WITH HIV

    Pos-Pos Couples: HIV Meds, Wild-Type Virus and Unprotected Sex
    My partner and I have both been HIV-positive for years, and have been off meds for well over a year. Since neither of us has been on treatment for a while, does this mean that our virus has reverted to wild type (i.e., no drug resistance)? If this is true and we now have the same strain, is it OK to have unprotected sex?


    Is HIV All That Different From Diabetes?
    If HIV is a chronic, treatable disease much like diabetes, then why do people immediately start asking questions about life expectancy when they find out they are HIV positive? When people get diabetes, they seem more likely to just accept it and move on.
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     HEALTH INSURANCE & HIV

    If I'm Getting VA Benefits, Do I Need Medicare Part D?
    I'm an American on Social Security disability; I receive my health care and medication from the Veterans Administration (VA). I've looked over the book that Medicare sent on its new Part D prescription drug plan, and if I am interpreting it correctly, I don't need Part D because of the VA coverage. However, I've been told I'm eligible for Part D. Should I switch from my VA plan to Part D?


    Will My Employer Know I'm Taking HIV Meds?
    I was recently diagnosed with HIV, and am wondering if my employer will find out when the time comes for me to start taking meds under its prescription drug plan. As it is, I've already been paying out-of-pocket for all blood draws and doctor's visits, because I'm afraid my employer might discover my status.


    Leaving a Small Company: COBRA and HIPPA Concerns
    I'm HIV positive and have great health insurance, but am ready to leave my job and become self-employed. The problem is, I feel trapped: I feel my employers take advantage of me in the workplace, because they think I am uninsurable and therefore will not leave them to go out on my own. I've also heard that, because my company is very small, I can't qualify for COBRA. Is this true? If I leave my job and look for a new health insurance carrier, how can I use HIPPA to ensure I don't get overcharged?
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      STRANGE BUT TRUE

    Could Picking My Nose Give Me HIV?
    When I was on my way home after having protected sex with a sex worker, I picked my nose. Since I'd gotten some of the sex worker's fluids on my hand earlier, do you think my nose-picking put me at risk for HIV?


    Can I Get HIV From a Porn DVD?
    I recently rented some porn movies online, and I noticed there were smudges on the bottom of one of the DVDs. At one point, I touched a smudge. Although I washed my hands afterward, a few weeks later, I started to feel sick. Could it be HIV?
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    Visual AIDS
    Art From HIV-Positive Artists

    Image from the March 2006 Visual AIDS Web Gallery
    Untitled 3 (Physician Desk Reference), 1993; Gin Louie
    Visit the March 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The March 2006 Web Gallery is entitled "Anti-Bodies"; it's curated by Michael Sappol, a curator-historian at the U.S. National Library of Medicine.
    Join a Study!
    Featured Clinical Trial
    of the Month
    Partners AIDS Research Center

    What's Being Studied?
    How HIV-positive, long-term nonprogressors are able to control HIV without taking meds.

    Who's Eligible?
    HIVers living anywhere in the United States, and possibly outside it as well. Although the study is based in Boston, volunteers can ask their doctor to send a blood sample by mail at no cost; no traveling is required. Please note that this study requires the cooperation of your health care provider.

    Volunteers must also:

    -- have been HIV positive for at least seven years, but never had any symptoms

    -- be between 18 and 64 years of age

    -- have a viral load below 2,000

    -- have not taken HIV meds for at least the last seven years

    -- be willing to have their blood drawn (this will only be done once)

    Who's Sponsoring It?
    The laboratory of noted HIV researcher Dr. Bruce Walker, located in the Partners AIDS Research Center at Massachusetts General Hospital in Boston, Mass.

    How Can You Learn More?
    E-mail or call Dr. Florencia Pereya or Dr. Peggy Ueda at (617) 726-5536. If you live in the Boston area and would like to make an appointment to discuss the trial at Massachusetts General Hospital, e-mail or call Mary Johnston at (617) 724-0070.