Fwd: Hot Topics: Disclosing After Sex; Is My Decline Inevitable?; Is “Empty Stomach” a Must?; and More

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

June 17, 2014 Visit the Forums Read Past Email Newsletters Change/Update Subscription

Mixed-Status Couples  We Already Had Sex; How Do I Disclose?
I’ve been on a few dates with this amazing guy. I usually disclose before anything sexual happens, but in this case I was weak. I know I need to tell him about my status, but how do I bring it up?

David Wohl, M.D., responds in the “Safe Sex and HIV Prevention” forum

 HIV Disclosure: African Americans Tell How They Told
thumbnail image for blurbIt’s been said that the intense focus on privacy in many African-American communities creates a “veil of secrecy” around HIV, making it profoundly difficult for many individuals to be open about their HIV status. Here, 12 African Americans with HIV share their experiences.

Living With HIV  Is My Eventual Decline Inevitable?
As a newly seroconverted man in his late 20s, I’m terrified about the future. Is it likely that my health will deteriorate so much in the next few years that I’ll have to leave my job? Should I abandon my thoughts of having a family?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 Are Poppers Dangerous?
I sniff poppers about three times per week. I’m also taking Atripla. I don’t do any other party drugs and I’m extremely adherent to my HIV med doses, but am I hurting my immune system with the poppers?

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

 Should I Take Vitamin D Supplements?
What are the benefits of vitamin D3 for people with HIV? How much should I take daily?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 Can HIV-Positive People Have Babies? 7 Myths Dispelled
thumbnail image for blurbIf you think that HIV-positive people can’t have babies, then we have some news for you! Don’t let ancient medical reports and ignorance mislead you: Read about these seven major myths regarding HIV and having children.

how do you #LiveBold?
thumbnail image for blurbEach of us knows all too well how deeply stigma can affect the lives of people with HIV. We also know how much HIV-positive people do, day in and day out, to push back against that stigma.

TheBody.com‘s parent company, Remedy Health Media, is honoring that fight against stigma with a photo contest that gives you a chance to make a statement — and potentially win some cash in the process.

The Live Bold, Live Now Photo Contest invites people who are living with a significant health issue to share their story by July 11; public voting will determine the winners of a $500 first prize, $250 second prize and $100 third prize.

Visit the photo contest entry post on Remedy’s Facebook page to learn more and participate!

HIV/AIDS Treatment  How Strict Is the “Empty Stomach” Requirement for Atripla?
I’m currently on Sustiva, Epivir and Viread (a regimen very similar to Atripla). I’ve read that these should be taken on an empty stomach, but just how “empty” does my stomach need to be? What happens if I eat food when I take my meds?

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

 How Long Is the “Adjustment Period” When Starting Treatment?
Approximately how long does it take for the body to adjust to HIV meds? I just started taking Isentress and Truvada, and am wondering when I can stop worrying about certain side effects emerging.

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

 Is a Two-Drug, Single-Pill Regimen Possible?
I read a press release about a new one-pill regimen being developed that combines Edurant, an NNRTI, with Tivicay, an integrase inhibitor. The companies producing the drug are excited about it, obviously — but should I be?

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

 6 Reasons Why People Skip Their HIV Meds
thumbnail image for blurbWe all know it’s important to take HIV medications every day, but let’s face it: It’s not always the easiest thing to do. Here are six key obstacles that can block the way between you and your meds — and tips on how to get past them.

Insurance, Workplace & Legal Concerns  Will Medicare Give Me Decent HIV Care?
What can I expect from Medicare when I retire in two years? How good are they about paying for meds and labs?

Jacques Chambers, C.L.U., responds in the “Workplace and Insurance Issues” forum

 What Do I Need to Consider Before Switching Jobs?
I’m considering a new job with a new company, but I have questions about how my current medical coverage would translate into coverage under the new company’s insurance plan. How do I get answers without disclosing my status?

Jacques Chambers, C.L.U., responds in the “Workplace and Insurance Issues” forum

Connect With Others One Year Later, Healthier and Happier
(A recent post from the “I Just Tested Positive” board)

“One year ago, I tested positive. … When the results came back, my counts were CD4 = 5 and viral load = 416,000. My life changed. I cleaned myself up. No more drugs. I was going to live.

“The reason I am posting here is so that others know that you can do it. Follow your doctor’s orders; be compliant no matter how bad you may feel. I am now undetectable and my CD4 is 233. I know [what it’s like to be] scared and angry. I am now happy and … I am here to give you hope and support.”

 — rsmithson

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 email address) — click here to get started!


Other Health Issues & HIV/AIDS  Seven Years of “AIDS” but Never Sick?
Seven years ago, I was diagnosed with “full-blown AIDS” — but I never felt sick. I’m 67 now, on treatment, and doing extremely well. I never even have a cold. How is all of this possible?

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

 Shingles Vaccine?
Should I take the shingles vaccine if I’m living with HIV? I’ve been positive since 1995, but my CD4 count is high and my viral load is undetectable.

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

 Can My Hep C Coinfection Go Away By Itself?
I’ve had confusing results from hepatitis C tests over the years. In the late ’90s, I seemed to test positive, but as recently as last month a test came out negative. Can someone be spontaneously cured of hep C? How does my HIV-positive and hepatitis B-positive status play into this?

Lynn Taylor, M.D., F.A.C.P., responds in the “Hepatitis and HIV Coinfection” forum

Understanding HIV/AIDS Labs  Is Today’s “Undetectable” The Same as Yesterday’s?
Why do my viral load test results say I have “<20 copies/mL” when most tests I read about measure “undetectable” at 50 copies/mL?

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

 Are CD4 Fluctuations Normal While Taking HIV Meds?
When I started treatment, my CD4 count was 225. Over the following six months, it has gone as high as 379 and as low as 304. Should I be concerned about these fluctuations?

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


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Activist Central
 Nelson Vergel Asks for Your Help to Save HIV+ Venezuelans’ Lives

 CDC Launches “Start Talking. Stop HIV.”: A New National HIV Prevention Campaign for Gay and Bisexual Men

 The HIV Economic Empowerment Campaign: A Time for Change, a Time for Action

 Tell the White House to Ensure HIV Coverage Under Obamacare

VIDEO: ALL YOU NEED TO KNOW ABOUT TESTOSTERONE

Nelson Vergel speaks about how to know if you need testosterone replacement, how to diagnose low testosterone, all testosterone treatment options, how to maximize benefits (increase muscle mass, mood, energy, sex drive and erectile quality) and minimize side effects (acne, increased red blood cells, etc).  For more information and to ask questions visit:

ExcelMale.com

In HIV News: Vitamin D Deficiency Impact; Hepatitis C Research Recap; Lower Prostate Cancer Risk; and More

 

If you have trouble reading this e-mail, you can read the online version at: www.thebodypro.com/newsletter.html
 
Welcome to TheBodyPRO.com Newsletter, a biweekly, professionally oriented review of the latest news, research and perspectives on HIV treatment, prevention and patient care.
Top Stories on TheBodyPRO.com: June 10, 2014

FEATURED STORIES

thumbnail for blurbVitamin D Deficiency When Starting Treatment Linked With Increased HIV Progression

Having low levels of vitamin D when starting treatment is associated with a more than doubled risk of HIV progression, virologic failure and death.

thumbnail for blurbRecapping 2014 Hepatitis C Treatment Research Thus Far

2014 has been a breakthrough year for hepatitis C treatment, with many new drugs to treat and cure the virus. Here’s an update on some of the major studies so far.

thumbnail for blurbTaking PrEP Does Not Increase Drug Resistance Risk

The risk of developing drug resistance does not appear to be greater for those on PrEP who may not be adhering properly, according to results from the iPrEx study.

thumbnail for blurbProstate Cancer Risk Lower for Men Living With HIV

A study finds the risk of prostate cancer to be 27% lower in HIV-positive men when compared to their negative counterparts.

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View week 96 data from a head-to-head study comparing two HIV-1 single-tablet regimens >

UNBP0518 04/14

 

thumbnail for blurbTobacco Smoking Impairs Immune System in People Living With HIV

A recent study suggests that smoking in HIV-positive individuals causes increased immune activation, microbial translocation and impairment of CD4-cell functions that could influence disease progression and management.

thumbnail for blurbHIV Criminalization: A Physician’s Perspective

Wendy Armstrong, M.D., gives a personal account on how she felt after being called to testify in a criminal court regarding a patient’s HIV status.

thumbnail for blurbMedicare Will Pay for Hepatitis C Screenings for Baby Boomers

More than two thirds of new hepatitis C cases are found in baby boomers, prompting a decision by the U.S. Centers for Medicare and Medicaid Services to pay for screenings.

thumbnail for blurbSouth Africa: Herpes Infections Higher in Women With HIV

A South African study finds a more-than-double herpes simplex virus rates in HIV-positive women compared to negative women.

DOWNLOAD THEBODYPRO.COM’S MOBILE APP

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This app will help health care professionals such as yourself keep up to date with the latest in HIV research, news, conference coverage, interviews and more by bringing the best of TheBodyPRO.com’s content directly to your phone.

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HIV MANAGEMENT IN DEPTH: EXCLUSIVE EXPERT INTERVIEWS
•  New HIV Heart Disease Findings Not as Dire as They May Seem, featuring David Alain Wohl, Ph.D.

•  How to Make HIV “Take Up Knitting,” featuring David Harrich, Ph.D.

•  Kaposi’s Sarcoma and HIV: Not Gone, Not Forgotten, featuring Jeffrey Martin, M.D., M.P.H.

•  Can Antiretrovirals Help Those Who Control HIV Naturally?, featuring Jonathan Li, M.D.

•  Why Nutrition Matters in HIV Care, featuring Jül Gerrior-Schofield, R.D.

•  Solving the HIV Treatment Adherence Enigma, featuring Benjamin Young, M.D., Ph.D.

•  HIV Care and the Affordable Care Act, featuring Michael Saag, M.D., and Michael Wong, M.D.

Hot Topics: Slowing CD4 Decline; Pill Care on Road Trips; Assessing Your Brain Health; and More

If you have trouble reading this email, you can see the online version at: www.thebody.com/topics.html
June 10, 2014 Visit the Forums Read Past Email Newsletters Change/Update Subscription

Living With HIV

 Can I Slow My CD4 Decline Without Taking Meds?
I’m a woman who’s been living with HIV for four years, but hasn’t started medications. I’m in good health, but my CD4 count is dropping very slowly. Is there anything I can do to delay starting HIV treatment as long as possible?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 How Does Substance Use Affect Our Lives With HIV?
How does the use of recreational drugs — crystal meth, for instance — affect our life expectancy as people with HIV? If I’m diagnosed late while doing drugs, how does drug addiction change my chances for long-term survival?

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

 Is Xanax a Good Way to Reduce Bedtime Anxiety?
I sometimes have panic attacks at bedtime, and they often result in my not sleeping for 24 hours or more. My doctor has prescribed Xanax to help, and it’s calmed me down a bit, but is this the right solution?

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

 What Are the Best Developing Countries to Live in With HIV?
As I reach retirement age, I’m considering moving outside the U.S. Where would be the best place to find information about retiring overseas (Mexico, Thailand, Costa Rica) for someone who has HIV?

Nelson Vergel responds in the “Aging With HIV” forum

 Lynda Arnold: Living With Memory Loss
thumbnail image for blurb“I don’t remember how long I truly have been battling this,” TheBody.com blogger Lynda Arnold writes, “but I do know that in the past two years it has risen to a crisis in my mind.”



hiv is not a crime

thumbnail image for blurbMore than 30 years into the HIV epidemic, the general public remains remarkably uninformed about the nature of HIV. This misinformation, combined with rampant HIV stigma, has created a landscape in the U.S. and in many other countries where laws regarding HIV transmission are based on HIV myths and stigma rather than cogent scientific fact.

TheBody.com’s HIV Criminalization Spotlight Series aims to show the faces of those affected by criminalization, report on the progress of anti-criminalization activists nationwide and abroad and dispel the stigma around HIV. Come read our latest additions!


HIV/AIDS Treatment

 Will My HIV Meds Survive a Road Trip?
I’m a 60-year-old man doing well on Complera. I’ve been planning a two-week motorcycle trip through an area where temperatures can often be over 100 degrees Fahrenheit. Will my Complera be OK?

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

 Pluses and Minuses of Stribild
I had settled on starting Stribild, but I heard other poz folks say they would go with Tivicay plus Truvada over Stribild. Can you help me decide?

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

 Is Atripla OK for Pregnant Women?
My wife and I are planning to have a baby. She is currently on Atripla, has an undetectable viral load and a CD4 count of 520. Should she switch off of the Atripla, or will it be safe for her during pregnancy?

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

 You and Your Meds: The Dance of a Lifetime
thumbnail image for blurbAs the saying goes: It takes two to tango. With good preparation and coordination, you and your meds will dance together beautifully — a partnership that will likely keep you healthy for the rest of your (long) life.

Other Health Issues & HIV/AIDS

 Neurocognitive Problems: How Can I Know for Sure?
Is it possible that, despite maintaining viral control in the blood, my HIV meds are not adequately penetrating into my brain? How can I tell if the neurological symptoms I’ve been experiencing lately are a prelude to HIV-associated neurocognitive disorder (HAND)?

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

 How Do I Get My Butt Back?
I’m having an issue with wasting of buttock area and was wondering what are my options are to treat it. I don’t want implants because I have heard they can be dangerous due to infection and the recovery is long.

Nelson Vergel responds in the “Nutrition and Exercise” forum

 Is My Hair Loss Caused By Stress or Meds?
I was diagnosed in January 2014. I am now on week 10 of treatment. I noticed about five to six weeks ago that hair has been brittle and falling out, noticeably when I run my hands through my hair. How can I figure out what’s causing this and how to fix it?

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


other sides of hiv

thumbnail image for blurbMany types of medications can save or improve lives, but they can also have unintended consequences. Side effects of meds (whether for HIV or some other condition) can be mild or life altering, horrible or even pleasurable; some people living with HIV never experience any at all. Whether you’ve worried about side effects or dealt with them firsthand, it seems like everyone’s got a story about them. We want to know about yours.

To share your “side effects” story, write it out in 1,000 words or fewer, or film a YouTube video, and email it to mrodriguez@thebody.com. Many readers’ stories will be posted on TheBody.com!



HIV Transmission

 Can PEP and Pregnancy Mix?
I’m on day 10 of my HIV post-exposure prophylaxis (PEP). My wife has mentioned wanting to try to have a baby in the near future. Can we do this while I’m on PEP — and if she gets pregnant, are there risks of side effects to the baby from me taking this medication?

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

 How Can I Get Over My Fear of HIV Testing?
I am scared to get the HIV test. I need to talk to a friendly doctor who won’t scare me and can reassure me that the symptoms I’m feeling can be fixed. Do you know of any gay-friendly doctors I can turn to?

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

 Long-Term HIV Risk Estimate for Mixed-Status Couples Is Not Zero
thumbnail image for blurbThe risk of transmitting HIV within mixed-status couples may be higher than the “zero” number widely reported in a recent major study, even when the positive partner is on treatment and condoms are being used consistently.


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About This Email
This email update has been sent to nelsonvergel@yahoo.com.

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Many of our emails have been getting caught in Gmail spam. If you have noticed this, please help us by marking our newsletters as “Not Spam.” We hate that our subscribers are missing the latest updates because of this. Thank you for helping!

— Warren Tong, Research Editor

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Activist Central
 Nelson Vergel Asks for Your Help to Save HIV+ Venezuelans’ Lives

 CDC Launches “Start Talking. Stop HIV.”: A New National HIV Prevention Campaign for Gay and Bisexual Men

 The HIV Economic Empowerment Campaign: A Time for Change, a Time for Action

 Tell the White House to Ensure HIV Coverage Under Obamacare

Injection Every 3 Months to Prevent HIV- Study in San Francisco Enrolling Now

There’s a new clinical trial about to get started in SF looking for 25 men or transwomen who are at relatively low risk for HIV to test the safety, tolerability and acceptability of a very long acting (injected once every three months) for Pre-exposure prophylaxis (PrEP). If that sounds like you or someone you know, you can get more info by calling 415-881-7190

HIV-Positive Venezuelans Are Desperately Seeking HIV Medications- Please Help

Even though Venezuela is the third largest oil exporter to the United States and has the largest oil reserves in the world, you would not know that if you visited the country now.

The country’s infrastructure is in ruins. State officials have been able to pocket much of the oil revenues and imposed illogical dollar exchange restrictions that are suffocating the economy and its people. The inflation rate is 57% and the crime rate is among one of the worst in the world. Since February 12, students and the general population have been out in the streets protesting the scarcity of goods and high crime rate.
At least 41 people have been killed since February 12 and hundreds have been jailed for protesting against the regime. The Venezuelan Supreme Court, which consists mostly of regimen backers (Chavistas), has recently made it illegal to protest to scare the population. Leopoldo Lopez, the opposition leader educated in Harvard, is in prison due to the regime’s claims that he incited protests. All TV and radio stations that criticized the regimen have been shut down. Opposition newspapers have been denied currency to import paper, so they are also unable to provide news. Twitter is the only media venue left for Venezuelans to get news not distorted by the regimen. Most Latin American countries and the United States have turned a deaf ear to the situation. Some speculate that Venezuela’s oil is keeping leaders around the world quiet.
The government controls access to foreign currency but hasn’t made enough dollars available to cover imports of medicines. Venezuela imports about 90% of its pharmaceutical drugs.
Venezuela imports 29 HIV antiretrovirals and produces none. It also imports most of its food. Due to currency exchange restrictions, red tape and price controls, medication and food imports have halted in the past quarter. Many importers have run up big debts with providers abroad due to red tape and delays acquiring dollars through the highly corrupted state currency agency.
The shortage of medicines is part of broader economic turmoil that forces Venezuelans to routinely form hours-long lines outside shops to buy staples such as toilet paper, cooking oil, flour and milk.
“Companies that import and make medicines and medical items say they now owe their suppliers some $1.2 billion,” said Freddy Ceballos, president of Pharmaceutical Federation of Venezuela in an interview for USA Today.
The wretched condition of Venezuela under its socialist leadership is now worsening the ability of hospitals to treat people, especially patients with HIV.
The latest shortage in antiretrovirals exposed the debilitation of the country’s socialized medical system, which is touted as free and comprehensive by the government but often is neither. Former president Hugo Chavez often cited the country’s health system as one of his revolution’s greatest accomplishments. But it has been a total failure.
“I go to the state hospital once or twice a week to see if my pills have arrived,” says schoolteacher Jose Ramos, 38, who stays alive with antiretroviral medicines that have always been free here under a government program. “They always tell me to come back later.”
Ramos isn’t alone. Nearly 50,000 Venezuelans are taking antiretrovirals to keep HIV from turning into full-blown AIDS. “Thousands of HIV patients are now without their medicines,” said Feliciano Reyna, a leading HIV activist in Venezuela and founder of Acción Solidaria, a non-profit organization in Caracas.
With HIV/AIDS, the shortages have been made up in antiretroviral donations from outside the country.
“It’s not easy to find donations abroad now,” says Feliciano Reyna. Reyna returned last year after a trip abroad with 120 bottles of antiretrovirals. A similar trip this month netted nothing. “Our situation is really critical.”
The government repeatedly denies any problems and blames the opposition and the “Empire” (the United States).
The danger of this medication shortage for HIV positive people is that any interruption in their drug regimen not only can allow the virus to acquire resistance to the medications but would also mean death to thousands if the problem is not resolved. No one knows if in fact it will be eventually be resolved by the regimen.
Please help by donating your unused medications to: http://aidforaids.org/recycling-drive/.
Aid for Aids is a cost effective organization with a reach far greater than its size, with a massive impact that today reaches people in over 40 developing countries. AFA was founded in 1996 by a simple, yet powerful idea: a lot of very expensive HIV medication is thrown away; why not collect it and get it to people who need it but can’t get it? Since their founding in 1996, they have redistributed over $110 million of life-saving medication to more than 18,000 people worldwide.

AIDS SURVIVORS SUMMIT SAN FRANCISCO CONVENED ON JUNE 5, 2014 NATIONAL HIV/AIDS LONG-TERM SURVIVORS AWARENESS DAY

San Francisco, CA — June 5, 2014 is the first-ever National HIV/AIDS Long-Term Survivors Awareness Day (NHALTSAD). On that day, Let’s Kick ASS—AIDS Survivor Syndrome convenes the AIDS Survivors Summit/San Francisco 2014at theSan Francisco LGBT Center on June 5, 2014 from 1:00-9:00 PM. Let’s Kick ASS is bringing together survivors, both HIV-positive and negative, with key Bay Area AIDS organizations in an effort to begin addressing the unique challenges facing those longest affected by the HIV epidemic.
With over half the People Living With HIV already over age 50 in the Bay Area we realize that providers are attempting to figure out how to best serve this cohort. There is growing evidence of an AIDS survivor syndrome (ASS). It manifests in depression, anxiety, anger, isolation, posttraumatic stress, and lack of future orientation during this second wave of the epidemic. Some give up hope and end their lives rather than life with the losses and survivor guilt. Other related concerns are Aging with HIV, and retirement after disability among others.
The daylong gathering is designed to empower participants through talk show-style discussions and presentations with an emphasis on optimizing survivors’ lives and envisioning the future they never imagined. We want to help survivors live the best lives they can now while we begin making plans for the next. We want the recall the resilience, strength and bravery the community exhibited.
Visit: LetsKickASS.org. Twitter: @AIDSsurvivors

Bill sponsored by HIV-Positive Legislator Advances Tuesday to Help People with HIV-related Lipodystrophy

The bill was sponsored by Carl Sciortino, one of the nation’s few openly gay and openly HIV-positive legislators. The 35-year-old has since stepped down from the legislature to serve as executive director of the well-respected AIDS Action Committee.
The story of the young, handsome Sciortino is remarkable in and of itself. The child of a self-proclaimed Tea Party conservative, he told his dad in an endearing campaign ad in a bid for Congress that he is a “Massachusetts liberal.”
While most insurance companies pay for procedures to reconstruct a breast when a woman loses one to cancer, or at least a prosthesis, people with lipodystrophy and lipoatrophy must wear their deformity like a badge unless they have the resources to correct the problem. It’s a throwback to the days when people with HIV were thin and gaunt, essentially with bodies that screamed out “I have AIDS.”
Source: http://www.imstilljosh.com/breaking-news-hiv-positive-legislator-advances-bill-disfigured/
For more information about treatments for lipoatrophy and visceral fat accumulation in HIV, visit: