Diverse Video Testimonials Help Reach Out to Encourage HIV Testing

FOR IMMEDIATE RELEASE

CONTACT:  email, contact@ThePositiveProject.org; or call, Tony Miles or Dawn Shearer, 303-733-0545
Diverse Video Testimonials Help Reach Out to Encourage HIV Testing
The Positive Project Offers Video Segments to Help Outreach Efforts during the National AIDS Testing Day (June 27)
Denver, April, 2011- The Positive Project encourages AIDS Services Organizations to utilize their innovative video database in their campaigns geared to encourage Americans to get tested for HIV as part of the National HIV Testing Day on June 27. The National Association of People with AIDS (NAPWA) founded the day in 1995 and continues to lead its implementation each year. Non-profits and Public Health Entities around the United States that are seeking ways to attract more people to testing programs during that day may benefit from using videos in their campaigns to de-stigmatize getting tested for HIV.
In a statement made by president Obama during last year’s National Testing Day, he said: 
“One in five Americans who are currently living with HIV– more than 230,000 people — do not know their status.  The majority of HIV infections are spread by those who are unaware that they have the disease.  And research shows that people who know their status take better care of themselves and take steps to reduce the risk of transmitting HIV to others.  That is why it is so important that people get tested.”
“Established in 2000, The Positive Project is the largest searchable video archive in the world of people living with HIV. Our goal is to provide a mechanism by which people infected/affected by HIV/AIDS can share their experiences with those who can benefit from hearing them, to use their stories for the greater good. We know that people relate to people and stories are powerful tools. We aim to ensure that this disease does not lose its human face. Through The Positive Project, we are positioned to ask, listen, and utilize what we hear to raise awareness, reduce stigma, promote prevention, encourage testing, and enhance care and quality of life,” said Tony Miles, co-founder and Executive Director of the non-profit organization. “It is our wish that all organizations take advantage of our extensive archive of videos from people infected and affected with HIV in their educational, prevention and access to care activities,” added Miles.
The Centers for Disease Control and Prevention (CDC) recommends that all Americans between the ages of 13-64 get tested for HIV as part of their routine medical care.  Knowing their HIV status helps them take control of their health, protect their loved ones, and get connected to treatment, if needed. Close to 50,000 people get infected with HIV every year in the United States, and half of them are below 24 years of age.
After viewing clips from The Positive Project, Michelle (St Louis, Missouri), posted this comment, “Your clips are very encouraging. Up until now I have been very afraid to be tested, after having several partners in the past ten years. I believe I have now found the courage.”
“What’s unique about The Positive Project’s video database is not only its huge number of high quality videos but also its easy to use search engine that allows for finding videos tailored to specific populations,” said Nelson Vergel, a national health educator and activist. “One can search videos based on gender, ethnicity, age, keywords, sexual orientation, location, and language (English/Spanish). For non-profits looking for videos to help target specific populations, there is no better tool out there,” added Vergel.
For more information, visit, www.ThePositiveProject.org; email, contact@ThePositiveProject.org, or call, Tony Miles or Dawn Shearer, 303-733-0545
This is what professionals have to say about The Positive Project:       
 “The digital format maximizes the flexibility and utility of the interviews for prevention, care, education, and training purposes since it can be accessed and specifically tailored for targeted audiences. Building a workable digital database is the innovative essence of The Positive Project.”
John Anderson, Ph.D., Director, American Psychological Association, Office on AIDS
“This is an especially wonderful resource for people who live outside of major cities where there is no face to face information and support available.”
Craig Thompson, Executive Director-AIDS Project Los Angeles
 “Our medical and social work providers have been very impressed with the work of The Positive Project… Our clients often express a desire to learn about the experiences of others affected by HIV but frequently are not comfortable meeting other clients in person.”
Elizabeth McFarland, M.D., Director, The Children’s Hospital
 “The video segments compiled by The Positive Project clearly have the potential utility for use in health promotion interventions, including medication adherence interventions and safer-sex interventions for people living with the virus. Perhaps the greatest potential application of the video segments would be for newly-diagnosed persons who are isolated, frightened, and lack knowledge about HIV.”
Eric Benotsch, Ph.D. Associate Professor; Director, Health Psychology Program, Virginia Commonwealth University; Associate Editor, BMC Public Health

Fw: News and Views: Abuse, HIV and Silence; Barriers to Lipo Treatment; PrEP Research Shock; and More

From: “News at The Body” <update@news.thebody.com>
Date: 21 Apr 2011 14:09:14 -0400
To: <nelsonvergel@yahoo.com>
ReplyTo: “News at The Body” <update@news.thebody.com>
Subject: News and Views: Abuse, HIV and Silence; Barriers to Lipo Treatment; PrEP Research Shock; and More

If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/updates.html

April 21, 2011 Top Stories at TheBody.com News & Views Library Change/Update Subscription


ON THE PERSONAL SIDE Rae Lewis-Thornton Rae Lewis-Thornton: Never Suffer in Silence
“I lived in silence for years as an abused child, and that silence led to my silence around my HIV status as a secret for years,” writes Rae Lewis-Thornton. In this blog entry, Rae describes a typical struggle from her childhood and questions the code of silence in many communities when it comes to “family business” such as abuse.

Autumn Preusser My Name Is Autumn, and I’m Learning to Live With HIV
“I am a transgender woman living in rural Arkansas. I’m NOT, nor have I ever been, a sex worker, escort or anything of the sort. I don’t use IV drugs and I’m not promiscuous. Just the recipient of a shit storm of bad luck,” writes Autumn Preusser. She started keeping an online journal several days after her diagnosis; in it, she candidly shares her experiences as she adjusts to life with HIV.

Justin B. Terry-Smith Justin B: Terry-Smith: Rape, Violence and What I Can Now Say About “Don’t Ask, Don’t Tell”
“I felt alone; even though I had many friends I couldn’t tell them about this. I couldn’t even tell my superior about it. Why? Because of the ‘Don’t Ask, Don’t Tell’ policy.” In this heartbreaking video blog entry, Justin B. Terry-Smith reveals that he was raped, and later became part of an abusive relationship, during his time in the U.S. Air Force. Unfortunately, back then, asking for help would have led to his discharge.
'poetry month @ thebody.com: submit your work!
quillDon’t tell me I can’t
because I will.
Don’t tell me my limits
because I have none.

–From “Don’t,” by Chad

To mark National Poetry Month in the U.S., we’re posting our readers’ poetry submissions about living with, or being affected by, HIV/AIDS!

Anything you write is fair game. Pieces can be literal or abstract, serious or funny, short or long (but hopefully not too long) — whatever you want. Select poems will be featured on our site and in e-mail newsletters all this month. Click here for more detailed information on how you can submit your poem (anonymously, if you’d like).

HIV NEWS & VIEWS Maxine Waters Q&A With Rep. Maxine Waters, Legislator and AIDS Activist
The key to improving HIV/AIDS policies in the U.S. is to have politicians who passionately advocate for the cause. One such politician is Rep. Maxine Waters (D-Calif.). The Black AIDS Institute’s Nick Chiles sits down with Waters to discuss how the country’s ongoing health care reform might impact the HIV community — and how she’s trying to advocate for the community on Capitol Hill.

 White House Releases Further Plans for National HIV/AIDS Strategy; HIV/AIDS Activists “Cautiously Optimistic”
Amidst pressure to slash the federal budget, “President Obama’s proposed FY 2012 budget drew some praise from AIDS advocates for its modest funding increases to federal AIDS programs,” writes political columnist Rod McCullom. The budget includes detailed plans to implement the National HIV/AIDS Strategy.

 Upcoming Changes to U.S. Disability Benefits: How to Prepare for the Future
While many people living with HIV/AIDS in the U.S. rely on disability benefits, there is a growing trend of people who are not eligible for disability because of outdated standards. Thanks to health care reform, this all may change for the better in 2014. Project Inform’s Julie Cross talks about the three most important things that you should do before those changes go into full effect.

More News & Views Headlines:

Connect With Others Music That Helps Me Be a Fighter
(A recent post from the "I Just Tested Positive" board)

“When things start looking a bit bleak or I feel a bit down, I play “Heart of Steel” by Manowar at full blast and sing along as loud as I can. It helps a hell of a lot. If this can inspire just one person out there, I’d consider this post a success. Community support is invaluable, but at the end of the day, you need to believe in yourself and your own strength to get through this.”

 — Nocturnity

Click here to join this discussion, or to start your own!

To do this, you’ll need to register with TheBody.com’s bulletin boards if you’re a new user. Registration is quick and anonymous (all you need is an e-mail address) — click here to get started!

HIV TREATMENT & HEALTH ISSUES face with lipo Nelson Vergel: U.S. Must Remove Barriers to Lipoatrophy Treatment Access
The good news: Medicare now covers facial filler treatments for HIVers with lipoatrophy. The bad news: Because Medicare doesn’t reimburse doctors enough to provide the service, “access to these products has gotten worse, not better” since the Medicare approval, treatment advocate Nelson Vergel writes.

illustrated smile Paging the Tooth Fairy: Good Dental Care Is Critical
Everyone knows it’s important to brush their teeth, but for HIVers, dental health is even more critical. As this article from the Canadian AIDS Treatment Information Exchange explains, there are links between oral health and overall health, which include potential impact on cardiovascular disease and inflammation. Read up for some warning signs that you may need a dental checkup.

More Headlines on HIV Treatment and Health Issues:


HIV TRANSMISSION & EDUCATION  PrEP Ineffective for Women? Study on Truvada for HIV Prevention Is Unexpectedly Cut Short
A clinical trial investigating the use of pre-exposure prophylaxis (PrEP) to prevent HIV infection among women has been cancelled after early results suggested the approach would be ineffective — even though another major study last year found PrEP was effective among gay men. The findings are likely to make clinicians much more reluctant to prescribe Truvada (tenofovir/FTC) to HIV-negative women at potentially high risk for HIV.

More Transmission & Education Headlines:


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Activist Central
 May 1 Deadline: Call For Submissions: 2011 State of AIDS Report — 30 Under 30

 Facial Lipoatrophy Treatments for HIVers: Sign a Petition to Help Remove Barriers to Access!

 Sign a Birthday Card for Health Care Reform!

 Choice in HIV Prevention — Let FDA Look at the PrEP Data

 Sign on, Sign Up, Speak Out: Save Prevention Access

 House Votes to Defund Planned Parenthood: Sign a Letter to Congress to Save Critical Services!

How to Fight Insurance Companies that Refuse to Pay for Anal Cancer Procedures

Question:

I am looking for any peer-reviewed articles regarding anal cancer screening studies, even with preliminary results, which substantiate the effectiveness of preventive screenings as relates to anal cancer.

My insurance will pay for some “emerging or experimental” treatments in areas such as cancer, etc, which look promising but may not yet have produced concrete recommendations or generally-accepted treatment guidelines.  I’d like to find some peer-reviewed articles I can submit with my claim, to get them to call this “preventive”, and so fully paid-for.  Does anyone have any links to such articles published in any medical journals?  Thanks!

Answer from Nelson:

There is nothing better anywhere in the world than this info on anal cancer guidelines. NY State is the only place worldwide where they recommend high resolution anoscopies and infrared coagulation (IRC).  The info has all the references you need for a doctor to write a good letter to fight the insurance company.
There is a study that may or may not be approved to follow people for 7 years with and without IRC to prove to insurance companies that (and if) IRC works to prevent people from progressing into anal cancer. But many companies (and Medicare) are paying for this now.  The key is finding a doctor who is willing to write a good medical necessity letter if you get denied, like it sounds you did.

Facial Lipoatrophy Treatments: Help Us Remove Barriers to Access

 Back to Web version of article

April 15, 2011

Facial Lipoatrophy Treatments: Help Us Remove Barriers to Access

Sign a petition to improve access to facial lipoatrophy treatments through Medicare — and read on for more information.
The road to regaining a healthy look for people affected by HIV-associated facial lipoatrophy has been a long one. Improvements have come, but challenges are still here. Most people in the United States still do not have access, 7 years after the approval of the first product for this disfiguring problem.
Since the first reports of the drastic disappearance of fat under the skin in HIV-positive people taking D4T (Zerit) or AZT in 1998, the community started experimenting with poly-L-lactic acid (called New-Fill in those days) imported from France. An HIV-positive doctor there had used this nonpermanent substance to illicit collagen formation on his and his patients’ faces.
The French manufacturers sold the rights to a large company (Aventis) and this company gathered data for FDA approval of this product for facial lipoatrophy. Most of the data had been generated by three doctors who were using the imported product with the help of their activist patients.
FDA approval came on August of 2004 with a new name: Sculptra. The product was priced at $1,000 per session, plus $400-$600 for doctor’s injection fees. Depending on the severity of their facial wasting, patients would need 3 to 7 sessions, with yearly touch ups (this product helps faces gain collagen but it is not a permanent option).
Activists ensured that the expensive product would be provided for free for patients with yearly incomes of under 40K (higher for patients with dependants). Patients still have to pay $300-$600 dollars per session for doctor’s fees out of their own pockets. This made access still limited even for those who qualified for free product.
Radiesse, made by Merz Aesthetics, was the second product approved for HIV facial lipoatrophy. It is as expensive and non permanent as Sculptra, and with a more limited patient assistance program that provides discounts (not free product) for those who qualify due to income.
It took 6 years of activism to get Medicare to gather public comments for approval. Medicare approved payments for Sculptra and Radiesse (plus doctor’s fees) in January of 2010.
However, the cost of acquiring and administering the product is higher than the payment amount set by Medicare. As a result, physicians are not accepting Medicare payments for this service, and patient access to these effective therapies remains quite limited at the current reimbursement rates. In 2010 the Medicare allowance for an injection fee was set at 80% of $99-$115 (depending on which part of the country the service is administered). The procedure typically takes between 45 to 60 minutes of surgery by a trained physician required to administer Sculptra and/or Radiesse. This is making it unaffordable and impractical for HIV specialists, dermatologists, or plastic surgeons to administer this treatment.
To make matters worse, both Aventis and Merz have already started to limit their patient assistance programs since Medicare’s approval, which has left some patients in a bind since they cannot find doctors who would bill Medicare; and the companies tell them that they no longer can help them since Medicare pays for the products and procedure. So, access to these products has gotten worse, not better, after January of 2010.
Now we are asking for your help to sign this petition to be sent to Medicare to have them increase the rates for administering the products to patients.
Please forward it to your physician and friends. The deadline to sign is April 24, 2011.
I will write a blog entry with an update after I hear from Medicare.
Send Nelson an e-mail.

General practitioners are effective at increasing the level of physical activity among their inactive patients during the initial six-months of an intervention

Two-Year Longitudinal Analysis of a Cluster Randomized Trial of Physical Activity Promotion by General Practitioners

Gonzalo Grandes1*, Alvaro Sanchez1, Imanol Montoya1,Ricardo Ortega Sanchez-Pinilla2, Jesús Torcal3, for the PEPAF Group
1 Primary Care Research Unit of Bizkaia, Basque Healthcare Service (BHS), Bilbao, Spain, 2 Santa Barbara Primary Care Centre, Castilla-La Mancha Healthcare Service, Toledo, Spain, 3 Basauri-Ariz Primary Care Centre, Basque Healthcare Service, Basauri, Spain

Abstract Top

Background

We evaluate the effectiveness of a physical activity promotion programme carried out by general practitioners with inactive patients in routine care.

Methods and Findings

Pragmatic, cluster randomised clinical trial conducted in eleven public primary care centres in Spain. Fifty-six general practitioners (GPs) were randomly assigned to intervention (29) or standard care (27) groups. They assessed the physical activity level of a systematic sample of patients in routine practice and recruited 4317 individuals (2248 intervention and 2069 control) who did not meet minimum physical activity recommendations. Intervention GPs provided advice to all patients and a physical activity prescription to the subgroup attending an additional appointment (30%). A third of these prescriptions were opportunistically repeated. Control GPs provided standard care. Primary outcome measure was the change in self-reported physical activity from baseline to six, 12 and 24 months. Secondary outcomes included cardiorespiratory fitness and health-related quality of life.
A total of 3691 patients (85%) were included in the longitudinal analysis and overall trends over the whole 24 month follow-up were significantly better in the intervention group (p<0.01). The greatest differences with the control group were observed at six months (adjusted difference 1.7 MET*hr/wk [95% CI, 0.8 to 2.6], 25 min/wk [95% CI, 11.3 to 38.4], and a 5.3% higher percentage of patients meeting minimum recommendations [95% CI: 2.1% to 8.8%] NNT = 19). These differences were not statistically significant at 12 and 24 months. No differences were found in secondary outcomes. A significant difference was maintained until 24 months in the proportion of patients achieving minimum recommendation in the subgroup that received a repeat prescription (adjusted difference 10.2%, 95% CI 1.5% to 19.4%).

Conclusions

General practitioners are effective at increasing the level of physical activity among their inactive patients during the initial six-months of an intervention but this effect wears off at 12 and 24 months. Only in the subgroup of patients receiving repeat prescriptions of physical activity is the effect maintained in long-term.

Sign-On to Support an Increase in Medicare Reimbursement for Facial Fillers

April 8, 2011
Sign-On to Support an Increase in Medicare Reimbursement for Facial Fillers

A prominent AIDS activist is asking people with HIV and the organizations that serve them to sign on to a letter asking the agency that sets reimbursement rates for Medicare to boost the rate it offers doctors to administer the facial fillers Sculptra (poly-L-lactic acid) and Radiesse (calcium hydroxylapatite).

Activists thought they’d won a major battle when the Center for Medicare and Medicaid Services (CMS) announced in March 2010 that the government health insurance program would begin covering the costs of Sculptra and Radiesse for people who have psychological trauma due to loss of fat in their faces, a condition known as lipoatrophy or facial wasting.

Sculptra and Radiesse are both temporary facial fillers that require touch-ups at least once per year for most people. The retail cost of a vial of Sculptra or Radiesse usually tops $500. As most people need a minimum of four to six treatments, and as doctors charge about $500 to $900 to inject the filler, a full course of treatment can easily exceed $4,000.

It’s the latter point, reimbursement for the physician’s fee, that has Nelson Vergel, a longtime AIDS activist from Houston, and other activists up in arms. Though doctors typically got $500 or more per treatment from their cash-paying patients to inject the facial fillers, Medicare is typically reimbursing only about $80. Obviously, the math doesn’t add up.

“The cost of acquiring and administering the product is higher than the payment amount set by Medicare,” he explains in the letter he’s asking people to sign on to. “As a result, physicians are not accepting Medicare payments for this service, and patient access to these effective therapies remains quite limited at the current reimbursement rates.”

To sign on to a letter demanding that Medicare increase its reimbursement rate for Sculptra and Radiesse treatment, click herebefore April 18.

Fw: The Hard Facts on Sexual Dysfunction: Pills, Pumps and Prothetics

——Original Message——

From: Mark S. King

To: mark@marksking.com

ReplyTo: Mark S King

Subject: The Hard Facts on Sexual Dysfunction: Pills, Pumps and Prothetics

Sent: Apr 6, 2011 8:44 AM

In my newest blog video, HIV advocate and fitness author Nelson Vergel

("Testosterone: A Man's Guide") explains erectile dysfunction and its

treatments, including issues related to those with HIV.

PLUS: A certain blogger you know is now a New York Times bestselling author;

and I share one of my favorite internet links!

The Hard Facts on Erectile Dysfunction: Pills, Pumps and Prosthetics

http://marksking.com/my-fabulous-disease/the-hard-facts-on-erectile-dysfunction-pills-pumps-and-prosthetics/

You're on the "My Fabulous Disease" e-mail list. To opt out, simply visit the

site and unsubscribe.

Please be well,

Mark S. King

mark@marksking.com

www.MyFabulousDisease.com

p.s. Please join my mail list, become a "My Fabulous Disease" Facebook fan, or

follow me on Twitter @MyFabDisease!

Fw: Hot Topics at The Body’s “Ask the Experts” Forums

From: “News at The Body” <update@news.thebody.com>
Date: 05 Apr 2011 16:02:30 -0400
To: <nelsonvergel@yahoo.com>
ReplyTo: “News at The Body” <update@news.thebody.com>
Subject: Hot Topics at The Body’s “Ask the Experts” Forums

If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html

April 5, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



LIVING WITH HIV/AIDS
 Should I Change My HIV Status on a Hook-Up Web Site Profile?
My profile on a hook-up Web site states that I’m HIV positive, and it rarely gets any “hits.” I met up with a nice guy last year but we’re not having sex. I’m thinking about creating a new profile stating that I’m HIV negative. I wouldn’t have unprotected sex; but I’ve been out of circulation for a while due to medical issues, and I need to get laid. What do you think?

David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum

 What Do You Think of Compounded Testosterone?
I just turned 57 and I’ve been using Androgel for almost two years. I don’t qualify for patient assistance and I’m finding it harder to pay for this medication, so I’ve been thinking about compounding pharmacies. I’ve also read that men who don’t respond to Androgel or Testim usually respond to compounded testosterone cream. Since I do respond to Androgel, will the cream be too much? What do I look for in a compounding pharmacy? Do you have any recommendations?

Nelson Vergel responds in the “Nutrition and Exercise” forum
MIXED-STATUS COUPLES
 How Safe Is Oral Sex With My HIV-Positive Partner?
I’ve been seeing this guy for a little while now. He’s great and I couldn’t be happier. He’s HIV positive and I’m HIV negative. I’ve been reading the archives about magnetic couples and it’s helped a lot, but one thing that I’m worried about is oral sex. We use condoms but not for oral. He never ejaculates in my mouth but sometimes there is precum. I also once brushed my teeth about 10 minutes before we did the deed and I was the receptive partner. How risky is this? Would HIV testing be warranted from this type of exposure?

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

 How Do I Stop Freaking Out Every Time My Boyfriend Gets an HIV Test?
I’m a 29-year-old HIV-positive woman in a two-year relationship with an HIV-negative guy. We were together for a few months before I discovered my HIV status; he was a great support for me after my diagnosis, and we’re very happy. He takes an HIV test every three months and has become quite chilled out about it; meanwhile, I freak out every time he goes to the clinic. I can’t deal with the fact that I might have infected him. Usually it leads to a massive crisis in our relationship. What should I do? Is the only solution to end the relationship in order to protect my partner?

David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum
'poetry month @ thebody.com: submit your work!
quillRemember last year’s Poetry Month at TheBody.com? Well, it’s that time again! From now through the end of April, we’ll be accepting and posting submissions of poetry about living with, or being affected by, HIV/AIDS. Anything you write is fair game. Pieces can be literal or abstract, serious or funny, short or long (but hopefully not too long), whatever you want. Select poems will be highlighted on our site throughout the month of April!

Please e-mail your poems to content@thebody.com with the subject line “Poetry: [Title of Your Piece].” Be sure to specify what name or alias you’d like to use, as well as any details about yourself that you feel comfortable letting readers know — your age, the city you live in, your gender, etc. Please note that if we post something you send us, it can be Googled, so be sure to think through what kind of information you want to provide.

If you’d rather send us a poem without having to use e-mail, use our feedback page. You can leave out any contact information, but please write “POETRY” at the top of the form so we can spot it easily.

BODY SHAPE CHANGES & HIV/AIDS
 Am I Doing the Right Things to Reduce My Belly?
I’m a weightlifter and I’ve been HIV positive for 23 years. I eat right and take vitamins and supplements. For years I’ve been trying hard to manage my “pot belly,” with no luck. I’ve gotten sick of people making comments like “When is the baby due?” (If they only knew how hurtful that is.) I’ve switched from Norvir (ritonavir) and Reyataz (atazanavir) to Intelence (etravirine) and Isentress (raltegravir) — my other meds are Epivir (lamivudine, 3TC) and Viread (tenofovir). Was this a good move from a visceral-fat standpoint? What else can I do to get rid of this belly?

Nelson Vergel responds in the “Nutrition and Exercise” forum
HIV/AIDS TREATMENT
 Are HIV Meds Really More Toxic Than Other Kinds of Meds?
There’s so much talk about how toxic HIV meds may be. Are they any more toxic than other kinds of drugs, such as Lipitor (atorvastatin), antidepressants and other drugs that must be taken regularly? How likely is a person on HIV meds to experience higher-than-normal toxicity?

Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum

 Is Atripla a Good Choice if I’m Coinfected With HIV and Hepatitis B?
I’m living with chronic hepatitis B, and last February I was diagnosed HIV positive. My CD4 count is 761 and my viral load is 25,250. I feel fine but my doctor recommends that I start taking HIV meds soon to keep my immune system in good condition. He suggested Atripla (efavirenz/tenofovir/FTC) but I’m worried about how this pill will affect my liver. My doctor says that Atripla will actually help with my hepatitis B. What do you think?

Mark Holodniy, M.D., F.A.C.P., C.I.C., responds in the “Understanding Your Labs” forum

 Will I Become Resistant If I Miss 3 Days of Doses?
My CD4 count is 384 and my viral load is undetectable. I’ve been taking Atripla (efavirenz/tenofovir/FTC) religiously for the past six months, but my next batch of prescription meds won’t arrive for another three days. I’m terrified that I may become resistant to the meds. How likely is that to happen?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum
OTHER HEALTH ISSUES & HIV/AIDS
 What Can I Do About Erectile Dysfunction?
I’m a 39-year-old bisexual man. I’ve been HIV positive for 10 years and I take Atripla (efavirenz/tenofovir/FTC) as well as meds for high blood pressure, shingles, bipolar disorder and pain. I’ve also been an intravenous meth user for 15 years and have had little success in stopping. On top of all this, I’ve been experiencing erectile dysfunction, but my health insurance won’t cover Viagra (sildenafil) and I can’t afford it. I’m feeling desperate. What can I do?

Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum

 Toxoplasma Infection of the Brain: Is It Possible to Recover?
My brother is HIV positive and has a CD4 count of 50, and he’s just been diagnosed with toxoplasmosis. He has several infections on his brain; one is pressing on his left frontal lobe. Is there any chance he will get better?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum
Connect With Others Not Surprised to Test Positive: Now How Will I Live With HIV?
(A recent post from the "I Just Tested Positive" board)

I’m 34 years old — tested positive 3/8/11. Something in me always told me I would become HIV positive at some point. I’m of a generation of gay men whose earliest images and memories of gay life are of men in hospital beds covered in purple lesions. I literally remember being 6 years old or so and seeing this on the television, and somehow knowing that I was connected in some way to those men. … I think that I started to have unprotected sex (as stupid as it may sound) because I wanted to feel something intense, even if it only lasted as long as a fuck.

Though I am staying positive, productive, and integrated in my circles of friends — I feel more and more withdrawn … I need to find a support group. I need to share this pain and regret with other people who will understand. I feel myself changing. I don’t want to become cold and distant and bitter. I want to continue to love life as I did before I seroconverted. I want to learn the healthy way to live now. … I am hungry for dialogue with others who are going through this. Can anyone relate? — Genet

Click here to join this discussion, or to start your own!

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HIV TRANSMISSION
 Why Wouldn’t the ER Give Me PEP?
I live in Los Angeles and went to one local emergency room this morning seeking HIV post-exposure prophylaxis (PEP), but the nurse there said that the ER wasn’t equipped to give PEP except in life-threatening emergencies. I went to another ER that did give me PEP. Thank goodness I got the treatment before the 72-hour mark! Why do you think the other ER didn’t want to give me this treatment? Should I sue that hospital for refusing to treat me?

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

 Can an HIV-Positive Baby Pass HIV to Its Mother Through Breastfeeding?
I’m currently breastfeeding my 10-month-old; the baby’s dad is HIV positive and I’m negative. We found out he was positive when I was six weeks pregnant, and each test since my last potential exposure has been negative. I remember reading about the case of an HIV-positive baby in Africa infecting its mom. Is this common?

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

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