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
  Keeping 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
 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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