Monthly Archives - September 2011

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

From: “News at The Body” <update@news.thebody.com>
Date: 27 Sep 2011 18:08:41 -0400
To: <powertx@aol.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

September 27, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



LOSING DR. BOB: HIS FELLOW EXPERTS RESPOND
Dr. Bob FrascinoThe community on TheBody.com, and the HIV/AIDS community in general, have responded with inspiring outpourings of emotion at the passing of longtime HIV advocate and forum expert Bob Frascino, M.D., on Sept. 17. Since then, experts in our forums have answered some challenging questions raised by Dr. Bob’s death — and shared how they themselves grapple with grief. A sampling of those questions and responses appears below.

 Dear Nelson Vergel: What Is the Meaning of This?
Just learned of Dr. Bob’s passing and I am devastated. I read his answers and your answers daily for a source of strength of knowing that you were both still here. I do not know how to get that strength now. Dr. Bob wanted to “be here for the cure”; now that whole idea seems like a cosmic joke. How could he have been answering questions one day and then be dead the next? I feel like this life has no meaning.

Nelson Vergel responds in the “Nutrition and Exercise” forum

 How Do You Cope, As a Long-Term HIV Survivor?
I just read of Dr. Bob’s passing and I think I’m going to freak out. I’m back to feeling like there is no hope and this is a death sentence. When tragedies like this strike in our community, how do you get your mind around them?

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

 What’s Bacterial Sepsis?
I am devastated by the loss of Dr. Bob. Now I am full of fear all over again. Can you explain what bacterial sepsis is? Should HIV-positive people be especially worried about it?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum
BODY SHAPE CHANGES & HIV/AIDS
 What Are Some Alternatives to Megace for Weight Gain?
Is there a drug or supplement like Megace (megestrol) that I can take for weight gain that can be purchased over the counter? Why shouldn’t I take Megace in the first place?

Nelson Vergel responds in the “Nutrition and Exercise” forum
Visual AIDS: Art from HIV-Positive Artists
Image from the September 2011 Visual AIDS gallery Detail from:
“Two-Spirit Girl (Back),” 2001
Mooshka

Visit the September 2011 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month’s gallery, entitled "Making Do," is curated by David Getsy.

HIV/AIDS TREATMENT
 Atripla to Isentress and Truvada: What to Try Before Considering a Switch?
My partner has been on Atripla (efavirenz/tenofovir/FTC) awhile and has mostly tolerated it well. However, he wonders if he should switch to Isentress (raltegravir) and Truvada (tenofovir/FTC) due to some trouble falling asleep at night. Should he do something like change his dose times first, or just go ahead with the med switch?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum

 Can I Take My Old Regimen Until I Can Get a Refill of My New Meds?
I’m a 29-year-old man and I’ve been HIV positive for two years. My viral load is undetectable and my CD4 percentage is less than 18. I was on Atripla (efavirenz/tenofovir/FTC) when I first started HIV meds, but because of side effects I switched to a regimen that includes Epzicom (abacavir/3TC, Kivexa) and Reyataz (atazanavir). It has been fabulous for me — but today I ran out of meds. My doc is on vacation and I have no way of getting them. Should I take my old Atripla for two days until I can get my regular meds on Monday morning?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum

More Questions About HIV/AIDS Treatment:

OTHER HEALTH ISSUES & HIV/AIDS
 What Should Men Over 60 Be Aware of When Taking Testosterone?
I was on antidepressants and anxiety meds. My doctor checked my testosterone level and found that it was low, so I started testosterone replacement therapy. Now my depression is gone, I’ve gained muscle and lost fat, and at 68 years of age I’ve got woodies (erections) galore! I’m feeling much better and not having any negative effects. Is there anything I should keep in mind when taking testosterone, as a man over 60 and a type 2 diabetic?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 Should I Keep Taking Valium for Chronic Anxiety?
I was diagnosed with severe depression and general anxiety disorder three years ago. I just found out I’m HIV positive this past August 8 and know I was infected two years ago, though my virus has not progressed. My doctor told me I need to see a psychiatrist and get my depression and anxiety under control or it could have a negative effect on my HIV health. I’ve been taking Celexa (citalopram) for depression, as well as Valium (diazepam), for over a year and a half. While Valium is still helping my anxiety, Celexa no longer works for me. Would staying on Valium and switching antidepressants be safe for me?

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

 Can I Start a Family With Hepatitis C?
I’m a 27-year-old male and I just found out I have hepatitis C. The only thing that has ever really mattered to me is the hope that one day I would have a daughter and son of my own. Is it possible for me to have my own children without infecting either the babies or their mother?

Barbara McGovern, M.D., responds in the “Hepatitis and HIV Coinfection” forum
Connect With Others Is HIV Multiplying in My Blood?
(A recent post from the "I Just Tested Positive" board)

I was diagnosed with HIV in November 2010. Right before testing positive, I was experiencing night sweats. Now I’m starting to have night sweats again. Does this mean the virus is multiplying in my blood? Has anyone else experienced this symptom? — Still_here76

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!

UNDERSTANDING HIV/AIDS LABS
 Where’s the Majority of My Virus?
I’m newly diagnosed HIV positive, seven weeks into treatment and with fingers crossed on the road to undetectable status. I understand that only 2 percent of the virus is in the blood. Where is the other 98 percent? Also, if the virus is undetectable in your blood, how is the assumption made that it’s not undetectable in these other places?

Mark Holodniy, M.D., F.A.C.P., C.I.C., responds in the “Understanding Your Labs” forum
STD TRANSMISSION
 Could I Have Gonorrhea of the Throat?
I’ve gotten two blowjobs recently. I know the chance of getting HIV from a blowjob is very small. Several weeks after the last blowjob I got tested for all sexually transmitted diseases (STDs) and HIV. All tests came back negative. But last Friday I got a call from the woman who blew me, saying she has gonorrhea in her throat. I know that she hooked up again with her ex-boyfriend. But what if she already had gonorrhea in her throat when she gave me those blowjobs? Could I have it too, even if I tested negative after my last contact?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum

Worried Your Spam Filter Might Trash Our Mailings? The Body’s e-mail updates are especially prone to being caught up in spam filters, since our newsletters tend to refer frequently to sex, drugs, the human anatomy and so forth.

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Activist Central
 Tell Your Representative to Join the Congressional AIDS Caucus

 Building a Bridge to 2014 for People Living With HIV: Update and Advocacy Strategy

 Action Alert: Tell Congress NO on Cuts to Medicaid!

 Community Input for 2012 International AIDS Conference

 You Are Invited! The Inaugural HIV Prevention Justice Leadership Assembly

 Call for Abstracts: 2012 National African-American MSM Leadership Conference on HIV/AIDS and Other Health Disparities in New Orleans

 AIDS Healthcare Foundation Announces March on Washington

 HIV+ Gay and Bi Men! Sign-On Letter Supporting an Informed Debate About PrEP Based on Facts, Not Misinformation

HIV Cure Research Update at Shanti- Orange County

http://www.shantioc.org/news/?p=206

BY  | SEPTEMBER 21, 2011
Shanti Orange County welcomes humanitarian, chemical engineer and author Nelson Vergel to speak at the October 18, 2011 Big 7: Latest Advances on HIV Cure Research seminar. Nelson has been HIV positive since 1983 and over the years he has become one of the leading treatment advocates on HIV disease in the U.S.
In 1994 Nelson created “Program for Wellness Restoration” (PoWeR), a national non-profit organization, which is a comprehensive survival program that distributes information on maximizing health and productivity for individuals living with HIV. He has lectured around the country and overseas providing more than 500 seminars on clinical and nutritional information. Nelson is also the founder of Body Positive Wellness Center in Houston, Texas, which has helped nearly 4,000 patients living with HIV live a healthier life and on September 13, 2001, Lee Brown, Mayor of the City of Houston, designated that day “Nelson Vergel Day.”
Although Nelson has graced many magazine covers and has had several articles written about him and his efforts, he is also an accomplished author. His most recent publication, Testosterone: A Man’s Guide – Practical Tips for Boosting Physical, Mental and Sexual Vitality (2010), focuses on men’s mental and physical health. He also co-authored Built to Survive (2001), which is a comprehensive guide to medical use of anabolic steroids, nutrition and exercise for men who are HIV positive.
Shanti is honored to have Nelson Vergel lead the Big 7 seminar and welcome him back to the Shanti Family; he’s been a Caring Heart friend for many years. For more information on Nelson Vergel please visit NelsonVergel.com and PowerUSA.org.

HIV and HPV – Short Lecture on What You Should Know to Prevent Anal Cancer

There are no guidelines currently set about anal cancer diagnosis. But many doctors are referring their patients to colon-rectal surgeons every two years or so to get high resolution anoscopies. Others just use anal pap smears as a first step to determine if an anoscopy is justified. These simple tests can detect precancerous tissue before they may become a problem. They are removed with infrared coagulation. Biopsies are usually taken prior to the removal of the suspect tissue to determine it is low grade or high grade dysplasia.
Wkipedia has a good explanation for dysplasia:
“Dysplasia is the earliest form of pre-cancerous lesion recognizable in a pap smear or in a biopsy by a pathologist. Dysplasia can be low grade or high grade (see “Carcinoma in situ,” below). The risk of low grade dysplasia transforming into high grade dysplasia, and eventually cancer, is low. Treatment is usually straightforward.
High grade dysplasia represents a more advanced progression towards malignant transformation.
Carcinoma in situ, meaning “cancer in place,” represents the transformation of a neoplastic lesion to one in which cells undergo essentially no maturation, and thus may be considered cancer-like. In this state, epithelial cells have lost their tissue identity and have reverted back to a primitive cell form that grows rapidly and without regulation. However, this form of cancer remains localized, and has not invaded past the basement membrane into tissues below the surface.
Invasive carcinoma is the final step in this sequence. It is a cancer which has invaded beyond the basement membrane and has potential to metastasize (spread to other parts of the body). Invasive carcinoma can usually be treated, but not always successfully. However, if it is left untreated, it is almost always fatal.”
The American Cancer Society says that a great deal of research is now under way to learn how HPV might cause anal cancer. There is good evidence that HPV causes many anal squamous cell carcinomas. But the role of this virus in causing anal adenocarcinomas is less certain. More than 100 subtypes of HPV have been found. The subtype known as HPV-16 is often found in squamous cell carcinoma and is also found in some anal warts. Another type, HPV-18, is found less often. Most anal warts are caused by HPV-6 and HPV-11. Warts containing HPV-6 or HPV-11 are much less likely to become cancerous than those containing HPV-16.
The HPV tests on the market are only used to help screen for cervical cancer. There is no general test for men or women to check one’s overall “HPV status,” nor is there an HPV test to find HPV on the genitals or in the mouth or throat. But HPV usually goes away on its own, without causing health problems. So an HPV infection that is found today will most likely not be there a year or two from now.
I tell HIV+ long term survivors not to neglect their anal area ( tops or bottoms, women or men). Although anal cancer is a disease that progresses slowly, it is better to be proactive about it than waiting until it needs chemotherapy.
I posted a list of doctors in a previous answer on this subject. I live in Houston and used to travel to New York once a year for an anoscopy, but gladly there is now a physician trained in my city. If you live in a place where there is no colon rectal doctors who perform this procedure, have your doctor contact local physicians to see if any of them is interested in being trained at the University of California- San Francisco. They provide a two day training session. Their web site is http://www.ucsfhealth.org/adult/special/d/12748.html
Doctors that are trained on this issue will be better equipped to help people as they age with HIV, so it is a good thing to do right now while we wait for more data that will support future guidelines on this important cancer that is showing up as one of the highest incidence in HIV.

The Cure of HIV is Possible- But We Need Your Help

After attending a meeting sponsored by several organizations (TAG, AMFAR, Project Inform, the AIDS Policy Project) in Baltimore on April 20-21 this year, I came to the realization that we needed a video that would wake people up to the challenges ahead of us to get to a cure of HIV that is accessible and practical.  As most of you know, the case of Timothy Brown (aka The Berlin patient), a person who got cured of HIV and leukemia 5 years ago, has jolted a new energy and hope in the search for the cure.  But most people with HIV, policy makers and potential funding sources are not fully aware of this case and what the new movement for a search for a cure are all about.  So, I decided to travel around the country to interview key players in advancing this field to make a short video that could serve as a catalyst for awareness and change. This short video, done with a very low budget with the help of my activist friend Greg Fowler, is only part of a longer, more detailed documentary to be finished before World AIDS Day this year, the 30 year anniversary of the first AIDS cases. Please watch it and forward it to your friends.  Please follow the suggestions made in that video and become part of the cure! Everyone can do something now to raise awareness and funds not only for research but also for advocacy and education in this important new and expanding area.  I hope I can count on you.

Do You Need Testosterone?

Great article recently published in Charles Poliquin’s web site.  Charles is one of the leading experts on exercise and power lifting in the world.

http://www.charlespoliquin.com/ArticlesMultimedia/Articles/Article/694/Do_You_Need_Testosterone_Replacement_Therapy.aspx?lang=EN

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

From: “News at The Body” <update@news.thebody.com>
Date: 13 Sep 2011 17:54:00 -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

September 13, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



LIVING WITH HIV/AIDS
 How Can HIVers Take Better Care of Our Guts?
I’ve not had a normal gut since taking a combo of Crixivan (indinavir), Epivir (lamivudine, 3TC) and Zerit (stavudine, d4T) years ago. Even though I’m on much more tolerable HIV meds now, my gut has never been the same. If I don’t take Metamucil faithfully every night, I won’t have a bowel movement. Coffee helps, as do occasional probiotic supplements. Even my HIV doctor doesn’t seem to clue in on the relationship between gut effects and HIV meds, so I really appreciated your recent article on TheBodyPRO.com about new research on gut health and HIV. What do you recommend in terms of supplements and other actions to improve gut health?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 What’s the Latest on HIV-Positive Mothers Breastfeeding Their Babies?
What does the World Health Organization say about breastfeeding for HIV-positive moms? What steps would they have to take to keep the process safe for the baby?

Robert J. Frascino, M.D., responds in the “Fatigue and Anemia” forum

 Opinion: Compared to the Deaths I’ve Seen, HIV Meds Are a Piece of Cake
In 1982 I became an end-stage caregiver when HIV was still called the HTLV-3 virus. Since the beginning of the pandemic, I’ve held eight men at the moment of their death and helped many more before the end of life. Before the cocktails, the demise we had to look forward to was horrendous. Since the cocktails, death is now a long way after being diagnosed. I’ve been on the cocktail for well over 12 years and I just turned 76 years old. I’ll probably die of old age, and not from HIV. Compared to dying of AIDS complications, I would take the meds any day.

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum
MIXED-STATUS COUPLES
 What Do You Think About Open Relationships?
I am HIV positive and seeing someone HIV negative, and it’s going well. We have a great connection and I think we will be able to form a loving relationship. He keeps telling me he wants it to be open, that he needs to be non-exclusive. I understand his feelings. There were many times in monogamous partnerships when I resented feeling bound to one person. The problem I’m having is that the thought of him finding people to do things that he won’t do with me is sometimes painful. I can’t figure out if my anxiety is based in healthy reality or just plain jealousy. Do you have any thoughts or resources on open relationships?

David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum
starting hiv meds: advice from people who've been there People Who've Been There

Starting HIV meds — or thinking about taking this step? We reached out to a group of those most in the know about the intricacies of starting treatment — HIV-positive people who’ve made the decision to start themselves — and asked:

If you could go back in time to the moment before you started HIV treatment, what advice would you give yourself?

BODY SHAPE CHANGES & HIV/AIDS
 Starting Meds: Should I Worry About Lipodystrophy?
I’m about to start HIV meds. I’m resistant to certain types, so I’ve been prescribed Epivir (lamivudine, 3TC), Norvir (ritonavir), Prezista (darunavir) and Viramune (nevirapine). My biggest fear is lipodystrophy; this fear has actually stopped me from starting meds until now. Should I expect to see this condition once I start taking this combination of meds?

Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum
HIV/AIDS TREATMENT
 Which HIV Meds Are Due to Be Available in Generic Formulations in the U.S.?
I recently read that several major drugs are potentially going to be available in more affordable, equally safe generic form in the U.S. in the next several years. Which HIV meds are among the ones whose patents will soon expire? How does this process work?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum

 Unexpected 4-Week Break From Regimen: Will This Lead to Resistance?
I started taking Atripla (efavirenz/tenofovir/FTC) about two years ago. After a year of never missing a dose, I went four weeks without meds because of insurance issues and a change in docs. I’ve since started taking my meds again. I haven’t had any new lab tests done yet, but I feel fine. I have not seen my new doctor yet. Do you think a four-week break could cause drug resistance or other damage?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum
Connect With Others How Do I Find Meaningful Activities to Do — Just for Myself?
(A recent post from the "Living With HIV" board)

I’m constantly doing things for everyone but myself, and I’m beginning to realize I need to find something for me to do. It used to be going out and hanging around at the bars with my friends, but that’s old hat. Pool and darts are an easy way to get caught up in the drinking scene again. A person can only go out to eat so many times. Reading is OK but not fulfilling to my mind. And I don’t know where to begin with starting a blog. … I do like coming to these bulletin boards and helping people out where I can, but even that sometimes isn’t enough.

I feel like I’m not going anywhere in my life, and I’m at a dead end. I know there’s more in the world for me, I just have to seek it out.

Is anybody out there engaged in some fulfilling activity? If so, what is it you do; and how did you find that activity? — alive2

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

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OTHER HEALTH ISSUES & HIV/AIDS
 How Can I Help Myself Get and Keep an Erection?
l’m a 60-year-old HIV-positive gay man with an undetectable viral load for a few years and a T-cell count over 600. l can’t seem to get an erection when l have sexual relations. Is there anything besides medication that l can do to resolve this situation?

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

 What’s the Proper Treatment Regimen for Syphilis?
I contracted syphilis last May, which I originally mistook for a regular throat infection. I have gotten a load of conflicting information about the course of treatment. Now, because of all the shuffling around and miscommunication between members of my health care team, I might be facing treatment failure and could well have put my new boyfriend at risk for syphilis. What do you know about the course of treatment for syphilis? Should I be worried for my boyfriend?

Robert J. Frascino, M.D., responds in the “Fatigue and Anemia” forum

More Questions About Other Health Issues & HIV/AIDS:

HIV TRANSMISSION & TESTING
 Could an HIV Nonprogressor Be Reinfected With a Virus That Progresses?
If a person who was part of the tiny percentage of HIV-positive people whose bodies control the virus in various ways without the aid of meds (called nonprogressors) was reinfected with a different strain of HIV years after their initial infection, could they still have genetic viability against the new infection? Would the protective effect depend on viral strain, mutation, etc.?

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

 Tested Positive During Pregnancy: How Can I Be Sure It’s a False Positive?
I am nearing the end of my pregnancy and have had two positive ELISA tests and two indeterminate Western blots. I was sent to an infectious disease specialist who told me he believed it was a false positive because there is no virus showing on the tests. Why does my obstetrical nurse still believe I should have a C-section? How can I prove once and for all, to myself and everyone else involved, that my tests were false positives?

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

Worried Your Spam Filter Might Trash Our Mailings? The Body’s e-mail updates are especially prone to being caught up in spam filters, since our newsletters tend to refer frequently to sex, drugs, the human anatomy and so forth.

To make sure you never miss one of our mailings because anti-spam software labeled it as junk mail, add update@news.thebody.com to your address book, talk to the person who manages your e-mail security or check your anti-spam program’s instructions for more information. About This E-mail This e-mail update has been sent to nelsonvergel@yahoo.com.

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Activist Central
 Sept. 15: “Obama-ADAP Twitter Day” to Raise Awareness About ADAP Crisis; Trend #ObamaADAP on Twitter

 U.S. Community Members: Register Your National HIV/AIDS and Aging Awareness Day Events!

 You Are Invited! The Inaugural HIV Prevention Justice Leadership Assembly

 Call for Abstracts: 2012 National African-American MSM Leadership Conference on HIV/AIDS and Other Health Disparities in New Orleans

 Scholarships for Activists: What Would You Do for the Cure? An AIDS Community Challenge

 AIDS Healthcare Foundation Announces March on Washington

 HIV+ Gay and Bi Men! Sign-On Letter Supporting an Informed Debate About PrEP Based on Facts, Not Misinformation

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

From: “News at The Body” <update@news.thebody.com>
Date: 07 Sep 2011 18:03:34 -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

September 7, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



LIVING WITH HIV/AIDS
 A “Normal Life” on HIV Treatment: Just a Fairy Tale?
It seems from my last lab test results that I’ll have to start HIV treatment soon. I’ve done my research and frankly, I have to wonder whether it’s worth it. Of course, without meds I may be more likely to become very ill and even die. But I found no pill that didn’t have some potential life-threatening side effects; and the ones that aren’t life threatening still seem to spell a life of misery: vomiting, diarrhea, psychiatric symptoms … I don’t think I’m the kind of tough guy who could endure all that. Do the stories of people living “normal” lives on HIV meds have any truth to them at all?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum
MIXED-STATUS COUPLES
 Can I Safely Breastfeed and Continue to Have Sex With My Poz Husband?
My husband of nearly two years is HIV positive with an undetectable viral load on Atripla (efavirenz/tenofovir/FTC). Last year we conceived a child and I’ve remained HIV negative thus far. Our son is 10 weeks old and I’m breastfeeding. We’ve recently resumed our sex life and use harm reduction strategies to prevent my becoming HIV positive, though we don’t use condoms. What’s your opinion of my continuing to breastfeed for up to a year when I’m still having unprotected sex with my husband?

Robert J. Frascino, M.D., responds in the “Fatigue and Anemia” forum
BODY SHAPE CHANGES & HIV/AIDS
 How to Lose Fat in All the Right Places?
I’m HIV positive and on treatment. I’ve been going to the gym to gain muscle mass and tone, and to remove localized fat. Which supplement would you recommend? What else do you suggest?

Nelson Vergel responds in the “Nutrition and Exercise” forum
video series: 'a day in the life' on hiv meds Damaries Cruz and Tree AlexanderKeeping up with HIV meds often means having to weave daily doses into a busy life. How do other HIVers do it? In each episode of this video series, we’ll take a peek into the day-to-day routine of a person who’s living with HIV, taking HIV meds, and dealing with situations that get in the way of adherence.

In the first two videos in the series — part of TheBody.com’s new Resource Center on Keeping Up With Your HIV Meds — longtime survivor Damaries Cruz discusses her fears about starting meds after 20 years, while 25-year-old Tree Alexander shares how temporary homelessness made adherence an extra-challenging chore.

Episode 1: Damaries Cruz

Episode 2: Tree Alexander

HIV/AIDS TREATMENT
 What Can I Do About Atripla-Induced Insomnia?
I’m HIV positive and have been taking Atripla (efavirenz/tenofovir/FTC) for a year with no issues. Lately, out of the blue, I’m having trouble falling asleep and staying asleep. I don’t want to take prescription sleep meds if I can help it. What else can I do?

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

 Switching Regimens: What Changes Should I Expect?
I’m 47 years old. I was diagnosed with HIV six years ago and placed on a combo of Kaletra (lopinavir/ritonavir) and Truvada (tenofovir/FTC) within the first year. My doctor is now switching me from Kaletra and Truvada to Atripla (efavirenz/tenofovir/FTC). I’ve had some wasting in the face and legs on the first regimen. Can I expect the same from Atripla, or might I see some improvement in my wasting? Why else might my doctor have recommended this switch?

Gerald Pierone, M.D., responds in the “Facial Wasting” forum

 Cocaine, Methadone and HIV Meds: What Are the Risks?
I’ve been taking HIV meds since 2002 without any major problems so far. I’m coinfected with hepatitis C as well. I’m also a recovering drug user on methadone for the past 15 years. Methadone has enabled me to work and lead a normal life, though to be honest, sometimes I take some cocaine (about twice a month). What influence could methadone and occasional cocaine use have on my health?

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

More Questions About HIV/AIDS Treatment:

OTHER HEALTH ISSUES & HIV/AIDS
 Recently Diagnosed With Herpes: What Do I Need to Know?
I’m 37 years old. I’ve been HIV positive for the past five years. My CD4 count as of July was 830 and my viral load is 570. Two weeks ago I was diagnosed with genital herpes. I’m on Valtrex (valacyclovir) at the moment and my doctor thinks I may have to get on permanent suppressive therapy for herpes. I’ve been reading horror stories about HIV acceleration due to herpes. Will my numbers start crashing faster than usual now? What do you think of all this?

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

 What Can Milk Thistle Do for My Liver?
I’ve found conflicting information about the herbal supplement milk thistle (Silybum marianum). Some reports claim that it can help the liver, may lower cholesterol, and may reduce insulin resistance. On the other hand, I’ve also read that it may significantly slow down liver enzyme activity, thereby shifting concentrations of HIV meds processed by the liver. What’s your knowledge of this supplement?

Nelson Vergel responds in the “Nutrition and Exercise” forum
Connect With Others No More Flesh-to-Flesh: How Will I Deal With Having Protected Sex Forever?
(A recent post from the "I Just Tested Positive" board)

I was diagnosed on August 3, just over four weeks ago … and I’ve been keeping it a secret. … I don’t have close friends or a boyfriend. … I can’t tell my family as I hear comments they make about HIV-positive people.

When I find a partner I think that will be the first person I tell, because I wouldn’t want to infect someone knowingly. The thought of knowing I will never have sex flesh-to-flesh for the rest of my life kills me. I guess with time I’ll accept. Can someone share how they’ve coped with that? — shalomt

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UNDERSTANDING HIV/AIDS LABS
 Viral Load’s Gone Down, but CD4 Count Is Lagging: What’s Going On?
I was diagnosed with HIV two months ago with a viral load of 21,000 and a CD4 count of 140. I was put on Sustiva (efavirenz, Stocrin) and Truvada (tenofovir/FTC) and after four weeks my CD4 count went up to 190 and my viral load dropped to 97. I had a second blood test after nine weeks on meds and my viral load is undetectable, but my CD4 count dropped to 180 and my CD4 percentage went from 13 from 18. Can you help me understand this?

Robert J. Frascino, M.D., responds in the “Fatigue and Anemia” forum
HIV TRANSMISSION & PREVENTION
 Do I Really Need Both Truvada and Sustiva as PEP?
A few days ago I had receptive anal intercourse and the condom broke. I went to the ER and the attending physician put me on a PEP (post-exposure prophylaxis) regimen consisting of Sustiva (efavirenz, Stocrin) and Truvada (tenofovir/FTC). I’ve experienced side effects such as insomnia, bad dreams and nausea. Is it really necessary for me to take both of these medicines?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum

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