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March 28, 2006
In This Hot Topics:
  • Living With HIV
  • Complications of HIV & HIV Meds
  • HIV Treatment
  • HIV Basics & Understanding Your Labs
  • Health Insurance & HIV
  • HIV/STD Transmission
  • Strange but True

    Newly Diagnosed: How Do I Stay Healthy When My CD4 Count Is Low?
    I was recently diagnosed with HIV. Because of my low CD4 count (270), my doctor started me on meds, but I'm wondering if I have any other options. What else can I do to get my CD4 count up and stay healthy?

    Can an Antidepressant Help Wash Away My Shame?
    I'm a healthy, 41-year-old guy who's been doing well on HIV treatment for the past two years. I have a great support network and a therapist I can talk to whenever I need, but I'm finding that this is not enough. Talking can't alleviate the anger and shame I feel for the situation I've put myself in, the rather limited options for a long-term partner and the ever-present anxiety that my meds will eventually fail. Could antidepressants help me?

    When a Mixed-Status Relationship Goes South
    I'm a 52-year-old gay man who's been living with HIV for more than 15 years, the last 10 of which have been spent with my HIV-negative partner. Things were going well until my partner's 17-year-old son came to live with us a couple of years ago. Since then, our lives have fallen apart. His son has severe behavioral problems: He is physically and verbally abusive to me, he and his friends damage our property, we've become isolated from our friends, and our landlord is threatening to kick us out. My partner is extremely passive; he doesn't set any rules or force his son to answer for his actions. When I tried to explain to my partner how bad things have gotten, he told me that he read an article that says emotions can be heightened by AIDS and that I'm overreacting. I have had a therapist for many years to help me with depression and panic attacks; could my partner be right? Is there anything I can do to make this situation better, or am I insane to try to fight for a relationship with a person that I love with all my heart?

    Testosterone Supplements and HIV: Weighing the Pluses (Weight Gain, Mood Improvement) and Minuses (Fat Loss)
    Is it a good idea for me to take testosterone? I'm a severely underweight, HIV-positive man with a high CD4 count. If testosterone supplements can help me gain some desperately needed weight/muscle and improve my sex drive and self-esteem, is that worth any potential fat loss they may cause in my arms and legs?

    In this subsequent post, Dr. Wohl responds to AIDS treatment advocate Michael Mooney, who asks: What studies support the existence of a link between testosterone and lipoatrophy?

    Is It OK to Drink Wine When You're Taking HIV Meds?
    I tested positive eight months ago and immediately started treatment. Since then I haven't had alcohol, but I'm wondering now if it would be OK to have a glass of wine with dinner a few times a month? How will an occasional glass of wine affect my HIV meds?

    HIV Meds and Street Drugs: What Are the Interaction Risks?
    I'm going to an annual music festival, where every recreational drug in the world is going to be available. As I do every year, I plan to stop taking my HIV meds two days before the festival, party till it's over, and then restart meds the day after. Even though I'll be off meds, is there any risk that one of these street drugs -- crystal meth, heroin, Ecstasy, opium, LSD, cocaine, heroin, etc. -- can interact with the HIV meds that might still be going through my system?

    For info on potential interactions between HIV meds and recreational drugs, be sure to visit The Body's collection of articles.

    How Safe Are Treatment Interruptions for Someone With a Low CD4 Count?
    In spite of the positive impact HIV meds have had on my health, I'm exhausted with trying to keep up with my huge pill regimen. I've stuck pretty well to my medication schedule, even though I have HIV-related dementia, but I know I've been missing a few pills here and there. My last CD4 count was 205 (up from a low of 31) and my last viral load was 5,600 (down from a high of 550,000). Is it safe to take a break from my meds for maybe three to six months, or would this do more harm than good?

    Could a Four-Day Treatment Break Have Caused Resistance?
    I had gone two years on my HIV treatment regimen without having a detectable viral load. Six months ago, however, I had to stop taking meds for four days. Now my latest blood tests show that I've gone from undetectable to 780, and that my CD4 count has dropped from more than 550 to 421. Does this mean I've already developed resistance to my meds? Is it time to change regimens?

    High Liver Enzymes in a Newly Diagnosed HIVer
    My liver enzyme numbers are high, but I have no idea why. I was very recently infected with HIV, but I've never tested positive for hepatitis or syphilis, don't drink or do drugs, exercise often and eat properly. What could be causing my high liver enzymes, and what should I do about them?

    Why Do HIV Meds Lower Viral Load, and Why Does HIV Cause Illness?
    HIV meds don't actually kill HIV, they just stop it from replicating. And I've heard that HIV doesn't die on its own. So if this is true, how does a person's viral load drop when they're taking HIV meds? And how does HIV itself cause people to get sick?

    Does an Independent Medical Exam Mean They Might Cancel My Long-Term Disability?
    I'm a 50-year-old HIVer with a CD4 count of 70 and an undetectable viral load. I've been on long-term disability for eight years. Recently, my long-term disability carrier said it was reviewing my disability claim, and asked me to provide something called an IME (Independent Medical Examination). I loved my job and I miss it, but I'm just not healthy enough to return to work. What if this IME is just the first step toward cancelling my disability claim?

    My Company Can Find Out About Every Med I Take; What Do I Do?
    I work for a self-insured company that provides group medical coverage. A third-party company handles our claims, but our company human resources director can log on to that company's Web site and see a list of every single doctor visit I make and every prescription I fill. Is this legal? I'm worried that my company might find out about my HIV status and tell others, or use the info to fire me.

    "I'm an Evil, Rich, Hedonistic Gay Man"
    I'm a handsome, fit, successful, gay, 30-year-old entrepreneur living in London. As you might imagine, I pretty much have my pick of the litter when it comes to young gay men -- it's so easy to pick them up that I can't help myself. But with all the sex I'm having, I'm afraid I might have gotten HIV, and that I might have passed it on to some of these naive young guys that keep running after me. I'm always the top, and I usually use a condom, but not always. What do you think -- have I put myself at risk? Should I get tested even though I'm afraid to do so? Am I as evil as I think I might be?

    Hepatitis C Transmission Between Lesbians?
    I'm a lesbian with hepatitis C. Is it safe to have sex with my partner?

    A Menu Item You Usually Won't See at the Movies: HIV-Infected Popcorn
    Over the weekend, I took my 8-year-old son to the movies. I noticed that the food server at the concession stand had some type of wound on the arm -- I'm assuming from the popcorn machine. Was I wise to allow my son to consume the food and drink we bought from this concession stand? I saw no blood on our popcorn, the popcorn bag or his drink, but could my son have been exposed to HIV?

    Movers and Shakers
    African-American Leaders
    Speak Out About HIV

    Ron Oden

    Last year, Ron Oden was elected mayor of Palm Springs, Calif., which has one of the highest HIV rates in the United States. A long-time city council member, the openly gay Oden has consistently fought for increased funding for the Palm Springs' Desert AIDS Project, widely viewed as a model HIV service organization, as well as the rights of people with HIV.

    In this exclusive interview with The Body, Oden laments the many misperceptions that American society still holds about HIV, sexuality and African Americans. "I don't think the down low is a black thing -- it's a male thing," he says. "It happens with men of every ethnicity and race. ... [And] another part of the reality that we don't talk about ... is the number of men that we have incarcerated. When these men are in jail, you can bet they're having sex, and the women don't question that on their return. Because that's the man they love and he's straight. And he is -- but while he was away, he wasn't."

    Mayor Oden's interview is one of many we've conducted with some of the most prominent African-American movers and shakers in politics, AIDS activism and entertainment. This "Movers and Shakers" feature is just one small part of The Body's new African-American HIV/AIDS Resource Center!

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the March 2006 Visual AIDS Web Gallery
    "Butakalas," 1999;
    Rebecca Guberman
    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.