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April 24, 2006
In This Hot Topics:
  • HIV Treatment
  • Living With HIV
  • Complications of HIV & HIV Meds
  • Women & Pregnancy
  • Hepatitis
  • HIV Transmission & Prevention
  • Strange but True
  •  HIV TREATMENT

    Newly Diagnosed: Can Vitamins Keep Me Off HIV Meds Indefinitely?
    I was diagnosed with HIV just a few months ago, and have been taking a bunch of vitamins (including K-PAX multivitamins) every day to stay healthy. I've been told that if I take these vitamins religiously, eat healthy, exercise and avoid alcohol and cigarettes, that I won't need to start taking HIV meds. Part of me wants to believe this, but part of me thinks that the vitamin store is just promoting these products to increase their sales. What's your opinion?


    Are HIV Meds More Dangerous Than HIV Itself?
    I've noticed that HIV meds can have dangerous side effects, some of which seem worse than the opportunistic infections associated with AIDS. I've even heard that meds can cause cancer. Additionally, every pharmaceutical company that makes an HIV med claims not to know the long-term effects of their product. Is it more dangerous for me to start meds and take my chances with their side effects, or go without meds and risk getting opportunistic infections?


    Starting Early vs. Waiting: Which Is the Better Strategy?
    I'm so confused! I became HIV positive just a few months ago; my CD4 count is around 1,000 and my latest viral load was 37,000. Two of my three doctors are recommending I start treatment, saying it will save my immune system from further damage. But the third doctor recommends I wait. Who is right?


    After 10 Years on NRTIs, Concerns About Switching Meds
    For the past 10 years, I've only taken HIV medications from a single drug class: nucleoside/tide reverse transcriptase inhibitors (NRTIs). Although my numbers have been steady throughout this time (CD4 count between 220 and 320, viral load between 500 and 2,000), my doctor recently did a resistance test that found I had become resistant to all NRTIs. I know I should switch meds, but I'm frightened: I don't want to develop lipodystrophy, and I don't want to mess up my next regimen and eliminate my treatment options. Do you have any advice?
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     LIVING WITH HIV

    Is It Time to Put My Poz Partner in a Nursing Facility?
    I've been caring for my HIV-positive partner for 10 years. I've watched him lose physical strength and coordination, but now he's got dementia -- he can't even remember how to get to and from his doctor's office anymore. I love this man, but it's heartbreaking to watch him slip away like this. I'm struggling with whether or not to put him in a nursing facility. He's still physically functional, but he can't live by himself anymore with these cognitive problems. How do you know when it's the right time to place a loved one in a nursing facility? I am near the end of my rope and it tears me up to watch him fade away. I dread the long goodbye.


    Doctors Get HIV, Too
    Is there any statistic on how many physicians get HIV from occupational injuries? I know that they get HIV -- my husband is living proof. This disease affects everyone, including health care workers. I think it is very hard for doctors, because even though they work in the health industry, they must keep HIV as confidential as possible. No one deserves this type of discrimination.
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     COMPLICATIONS OF HIV & HIV MEDS

    Gaining Muscle When You Have Low Testosterone and Anemia
    I'm 6'2", but I weigh only 180 pounds. I'd like to bulk up a little bit, but going to the gym seems to have very little effect. I'm slightly anemic and have low testosterone levels. I don't want to look like a muscled Chelsea boy, but I don't want to look sick either. Do you have any advice?


    Help for Achy, Tingling Arms and Legs
    I was diagnosed with HIV early this year and started meds two weeks ago. I'm participating in a clinical trial in which I'm taking efavirenz (Sustiva, Stocrin) and either Epzicom (abacavir/3TC, Kivexa) or Truvada (tenofovir/FTC). During my third night on treatment, I noticed some burning on the tops of my feet and tingling in my hands and arms. This has somewhat subsided, but about six days into the meds my legs started to ache. The leg pain is often so bad it wakes me up at night and I can't get back to sleep. I also notice the aching during the day, particularly when I'm sitting. What causes this aching and what can I do about it?
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     WOMEN & PREGNANCY

    What's the Best Way to Deliver a Baby When You Have an Undetectable Viral Load?
    I'm an HIV-positive woman due to give birth in June. I'm in good health, with a CD4 count of 450 and a viral load that's been undetectable for the past three years. I'm having a very hard time deciding whether it's better to have my baby delivered vaginally or by cesarean section. Which would you recommend?


    Pregnancy for a Long-Term Survivor: A Wise Decision?
    I'm a 37-year-old woman who has been living with HIV since 1990. I was on HIV meds from 1997 until 2003, when I stopped because my CD4 count had hit 1,200 and my viral load was undetectable. I'm still doing well; although I have chronic fatigue, my CD4 count is now at 650 and my viral load is 12,000. My partner and I are considering having a baby. Do you think this is wise for somebody with my long history of HIV? Can I give birth to a healthy baby -- and can I live long enough to see it grow up?
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     HEPATITIS

    Can I Be Completely Cured of Hepatitis B Infection?
    I was shocked when my doctor told me that, after being HIV and hepatitis B positive for 13 years, I no longer had any hepatitis B virus in my body! I thought I was going to be a chronic hep B carrier for the rest of my life, but my doctor said that the Truvada (tenofovir/FTC) I was taking worked so well that it cleared the virus from my system. Am I truly free of hep B, or can the virus still come back?


    Hepatitis B Vaccination and Unprotected Sex
    I'm a hepatitis B carrier, and am concerned about infecting my boyfriend. So far, his hepatitis B tests have come back negative, but the doctor recommended that my boyfriend get vaccinated for hepatitis B. Will the vaccination guarantee he won't be infected, even though I may have already exposed him to the virus?
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     HIV TRANSMISSION & PREVENTION

    My HIV+ Boyfriend Says He Can't Infect Me With HIV. Is He Right?
    I recently hit it off with this guy; we've kissed and cuddled, but haven't had sex yet. He just told me that he's been HIV positive for 15 years, but that, in his words, "there's no risk" if we have sex, due to "the miracles that modern treatment can do." I think we're falling in love with each other; can there truly be no HIV risk if we have sex?


    My 18-Year-Old Just Told Me He's Gay; Should I Tell Him to Get Circumcised?
    I chose not to have my son circumcised when he was born 18 years ago. Now I'm second-guessing that decision, especially since he recently told me that he was gay. I've read that circumcision can dramatically reduce the risks of HIV transmission in men, and I'd like to convince my son to have the procedure done. What do you think?


    How Do We Know How Many People "Don't Know" They Have HIV?
    I've read that 25 percent of HIV-positive people don't know they have the virus, and I wonder: How do we know that? I mean, if people don't know they're infected, how can anybody else? I'm not doubting the statistic, I'm just curious about how these sorts of estimates are made.


    Can a Person Get PEP More Than Once?
    I'm HIV positive, but my partner is not. After an exposure in 2005, he went to a clinic and was given a six-month course of post-exposure prophylaxis (PEP) treatment. Ten hours ago, while we were having anal sex (I was the top), my condom broke. I think he should get PEP again, but the clinic says you can only get it once. Can you clear up the confusion?
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      STRANGE BUT TRUE

    My Mother, a Public Restroom, Unwashed Hands and a Sandwich
    I went to lunch with my mother the other day, and she touched my sandwich after using a public restroom. She often doesn't wash her hands after going to the restroom, so I'm worried that she may have accidentally touched someone else's HIV-infected menstrual blood while she was in there, and then infected me with HIV by touching my sandwich. How high is my risk?


    Can I Get HIV by Having Anal Sex With an HIV-Negative Guy?
    I've been told that a girl can get HIV while having anal sex, even if her partner is HIV negative. Is this true?
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    Connect With Others
    Live Chat on Lipoatrophy
    This Wednesday!

    When: Weds., April 26, 6 p.m. Eastern Daylight Time (3 p.m. Pacific)

    What: Lipoatrophy -- the loss of fat in certain parts of the body -- is a potentially disfiguring health problem that impacts many people with HIV. A knowledgeable HIV physician will answer your questions, provide possible strategies for preventing or dealing with lipoatrophy, and discuss the latest research.

    Who: Dr. Cal Cohen, research director of the Community Research Initiative of New England. Dr. Cohen is a noted HIV researcher and experienced HIV specialist who frequently gives talks about HIV-related issues.

    Where: Click here or visit www.thebody.com/chat/ a few minutes before the chat is scheduled to begin. You can also presubmit a question you'd like Dr. Cohen to answer by clicking here; a selection of presubmitted questions will be answered during the chat.

    Sponsorship: This chat is sponsored by Gilead Sciences, Inc.

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the April 2006 Visual AIDS Web Gallery
    "Eyeliner 1," 2001; Clifford Smith
    Visit the April 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The April 2006 Web Gallery is entitled "Diving Into the Archive"; it's curated by painter David Spiher, a gallery reviewer for Gay City News.