FOCUS ON LIVING WELL WITH HIV/AIDS

HIV THERAPY ONLINE COURSE

2007-11-19T15:32:00.000-08:00

Here is a link to an online course about HIV (presented by GeneEd, a company which writes online training courses for life-science professionals). The course is very well presented and is actually quite easy to understand; I think that most people would actually enjoy it, especially if they are "visual learners". The slides are animated yet not cluttered or confusing, and the course is easy to follow.

Learning topics include:

What is HIV? (HIV viral structure, HIV viral life cycle)
How Does HIV Affect the Body? (HIV and the Immune system)

In order to understand what effects HIV has on the body, it is important to understand the virus itself- what makes HIV unique and what gives it the ability to integrate itself into the immune system. In order to understand how the antiretroviral medications used to treat HIV actually work, it is essential to first understand how the virus replicates and infects the CD4+ (T-cells) lymphocytes. This course provides an easy-to-understand base for that knowledge.

ACCESS THE COURSE HERE

HIV STIGMA - THE WORLD'S IGNORANCE

2007-11-16T06:40:00.000-08:00

As we approach World AIDS Day (12/1/08), I was disheartened to read an article that appeared in a several UK newspapers announcing that a top Catholic school in the UK, which taught former British Prime Minister Tony Blair's children, has cancelled its plans to raise money for a leading AIDS charity. The school's internationally famous choir (the London Oratory School Schola) is one of the country's leading choirs and is a highly sought-after commercial choir; they have performed on soundtracks for Harry Potter and The Lord of the Rings.

The concert was planned by the school to raise money for World AIDS Day. The nominated charity to receive the proceeds was the Terrence Higgins Trust, which is Britain's foremost charity for people living with HIV. This was changed abruptly by the headmaster of the school after a group of the students' parents protested strongly, saying that they "disagreed with the proceeds of the charity benefit going to an organization whose aims and practices conflicted with the teachings and viewpoint of the Catholic church". The headmaster of the school announced that it would be inappropriate for the school to financially support a charity with proceeds from the concert because he did "not feel that the Terrence Higgins Trust was an organization whose philosophy, aims, and practices support Christian values".

A spokesperson for the Terrence Higgins Trust said that they were surprised and disappointed by the decision... I feel that this abrupt decision was very unfair to the Terrence Higgins Trust. This event was being planned for several months, and volunteers at the Terrence Higgins Trust had already spent countless hours working on and promoting the event after it had been designated by the school as the recipient for the proceeds. Raising money for HIV/AIDS is extremely challenging, and cancelling the event less than 1 month before World AIDS day was very inappropriate.

As for the school's opinions that a benefit to support those who are infected with and affected by HIV and AIDS does not support Christian values and teachings- I feel that this is the most "Un-Christian" decision that could have been made. Christian values are supposed to be about love and tolerance, and this is anything but that. I am angered, outraged, and disheartened that Christianity can so selectively determine who deserves to be helped. this decision is certainly not Christian; it is pure evil and full of hatred.

As World AIDS Day approaches, the headmaster of the London Oratory School, the parents of the students who protested the concert, and the so-called Christian leaders who made the decision should take a close look at the HIV/AIDS epidemic. The worldwide statistics are alarming. In the UK alone there are an estimated 88,267 people living with HIV/AIDS. The annual number of newly diagnosed infections in the UK is approximately 8,000, and that number is increasing rapidly, especially among heterosexuals.

HIV affects all of humanity: male, female, single, married, all races and social classes, heterosexual, gay, lesbian, bisexual, transgendered, young, old, educated, professional, unemployed...

HIV and AIDS does not discriminate- so what right does the Catholic church have to discriminate? The leaders of the church should all be ashamed of themselves. This horrible disease can affect anyone. I wonder how the church officials or the parents of the school's children will feel when this disease enter their lives... and we can be sure that it will, eventually.

WHAT IS HIV?

2007-11-15T09:54:00.000-08:00

I frequently hear people using the acronyms "HIV" and "AIDS" interchangeably. I wanted to clarify this issue, as it is important to have an accurate understanding of the basics so that you can participate in the fight against this disease by educating others about it.

HIV is an acronym for human immunodeficiency virus, which is the virus that has been proven to cause HIV disease and AIDS. A person who is HIV positive has HIV disease, which means that they have been infected with HIV. They may or may not have any symptoms of the disease, and they may or may not have AIDS. HIV positive and HIV disease simply means that you have antibodies to the virus or that you have had detectable HIV replication in your blood.

AIDS is an acronym for acquired immunodeficiency syndrome, which is an advanced stage of HIV disease. If you have been diagnosed with AIDS, then you are definitely HIV positive. Certain laboratory markers and the presence of certain symptoms or opportunistic infections put an HIV positive person into the AIDS category (these will be discussed in a later post).

The classification of AIDS has a certain stigma attached to it (above and beyond that which is already associated with having HIV), especially among the HIV positive population itself.Progression of HIV disease to AIDS often makes a person feel as if their health status is rapidly deteriorating, and this can be very distressing for some patients. Everybody who has AIDS also has HIV disease, however not everybody who has HIV disease has AIDS.

As we approach World AIDS Day (December 1, 2007), let's remember to be sensitive to the emotional needs of those who are infected with and affected by HIV/AIDS.

HOW LONG DOES THC (MARIJUANA) STAY IN THE BODY?

2007-11-12T08:17:00.000-08:00

Marijuana is the most commonly used and tested for illicit drug in the United States. There is no simple and accurate answer to the question "how long does THC stay in the body?". THC can remain in the body and its metabolites can be detected by many drug tests from 3 to 90 days after it is ingested orally or smoked. Many factors go into determining how long drug toxins will remain in a person's body; these factors vary from person to person and include the analytical method used to detect the drug, your overall health, your body weight and body fat percentage, your metabolic rate, your fluid intake, the type of drug used, and the degree of exposure to the drug toxin.

THC (delta-9-tetrahydrocannabinol) is one of nearly 400 chemicals found in a cannabis (marijuana) plant; it is the particular chemical that accounts for most of marijuana's mind-altering (psychoactive) or so-called pleasurable effects. The strength of the drug (marijuana) and the degree of mind-altering effects obtained after smoking the drug is determined by the amount of THC it contains, and this varies from plant to plant.

In order to answer the question "how long does THC stay in the body?", you have to first understand how the drug is absorbed into the body and how it is metabolized by the body. The THC in marijuana enters the bloodstream within minutes of being smoked (within 30 minutes to 2 hours if ingested orally) and is then rapidly absorbed and stored in fatty body tissue, including the brain, liver, bladder, and kidneys. The fact that THC is fat soluble is the reason why THC is able to remain in the body and be detected for a relatively long period of time when compared to other controlled substances. Once it is stored in the fatty tissues of various organs, THC is slowly released and metabolized by the body. The metabolites (byproducts of the drug after it has run its course throughout the body) of THC are then excreted and cleared from the body; these metabolites of THC (specifically 9-carboxy-THC) are detectable for a much longer period of time than THC is, and this is the reason why most drug toxicology tests look for the metablolites of THC rather than the THC itself.

As pointed out earlier, marijuana's effects on the body and the speed at which it leaves the body (the detection time) is dependent on many variables, but especially on the strength or potency of the marijuana (the amount of THC contained in the plant). It has been estimated that marijuana can have a half-life (the amount of time that it takes for half of the total amount of drug taken to be eliminated from the body) ranging from 1-15 days; therefore it can be expected that the drug will remain detectable in the body for 2-30 days. Since marijuana is an illegal drug, not a pharmaceutical product regulated by the FDA, it is impossible to predict the potency of the drug or what the half life of a particular plant will be. The detection time is also influenced by the amount of exposure you have to the drug. If you inhale second-hand marijuana smoke, there may be detectable metabolites in your body for several days. If you smoke it occasionally, it will usually remain in your system for up to 10 days. If you smoke it on a regular basis it will stay in your system for up to 45 days. THC has a cumulative effect, so if you smoke marijuana heavily on a daily basis, it can stay in the body for up to 90 days. This is because THC is stored in the fat cells in the body's major organs, including the brain, the liver, the bladder, and the kidneys. Once the THC is stored, it is slowly broken down to it's active metabolites (the detectable traces of THC), which can be picked up on a drug test.

Drug tests can detect active drugs as well as their metabolites. Drug testing can be done by analyzing blood, urine, hair follicles, and even saliva. As can be seen from the preceding information, the answer to the original question of "How long does THC stay in the body?" is extremely complicated, as there is not a simple formula or calculation for a time limit between when the drug is ingested and when it will no longer be detectable. There is much human variation as well as variation between different types and species of cannabis plants. To complicate matters even more, there are tests that look for a much smaller cut-off amount of the drug; some tests detect up to 50ng/ml, whereas other tests are more sensitive and will detect a smaller, trace amount.

There are numerous websites that offer home cleansing remedies that claim to rid the metabolites of THC from your body, and others that offer home testing kits. None of these, however, have been proven to be effective; in fact the general opinion is that these sites are a huge scam. Increasing your metabolism through vigorous physical exercise may theoretically remove traces of drugs from your body. Others say that flushing your system with a lot of extra water will increase the elimination of THC. This all sounds ridiculous, if you consider that the THC is bound to the fat cells in the body. Water is not going to flush the THC out of the fat; it's only usefulness may be to help the kidneys to eliminate the metabolites of the THC through the urine.

The best way to be sure to pass a drug test is to not use drugs. The purpose of this article is not to discuss or debate the dangers of drug use, however I feel that I would be remiss if I did not mention that marijuana, although deemed to be harmless by many, is an illegal drug and its use has consequences in our society. Regardless of how much one may feel that it should be legalized, the fact of the matter is that it is not. I will even go so far as to support the argument that other things (such as cigarettes) are equally as harmful and should also be illegal, however that is not the way things are, and as members of a civilized society we need to live by the laws. We don't get to pick and choose which ones to obey because we agree with them. In addition to the legalities, consider once again that THC contains over 400 chemicals, many of which have proven to be carcinogenic. In most cases marijuana is smoked, which causes damage to the lungs such as chronic bronchitis, emphysema, and lung cancer. THC is stored in the fat in various organs; it has been shown to contribute to bladder cancer, just as cigarettes are. In an era where society's focus is on health and wellness, where we are concerned about e-coli poisoning in our food and about vaccinations for infectious diseases, it just makes no sense to inhale over 400 toxic chemicals directly into the lungs, does it?

DOES ONLINE HEALTH IMFORMATION HELP THE PROVIDER-PATIENT RELATIONSHIP?

2007-11-12T08:14:00.000-08:00

As a healthcare provider and a prescriber, I can say that overall I appreciate a well-informed patient who is actively involved in his or her health care. The fact that someone takes the time and makes the effort to try to learn about their health conditions or about preventive and wellness initiatives means that they have an interest in their health and that they will be willing to make an effort towards their own wellness. This can only make my job easier. I like to think of a patient-provider relationship as a partnership, not as a dictatorship. I can bark out all the orders I want and can write endless prescriptions, however a patient will not follow my directions unless they buy into and believe in what I am saying. I think that my job is to accurately and competently assess a patient, order the correct diagnostic tests and interventions, and then decide together with the patient about what the treatment plan will be. Of course I present the most current, up-to-date, evidence-based treatment options, but I will always discuss alternative treatments if a patient brings them up and will always take the time to listen to a patient if he or she has ideas gained from internet or other research. Afterall, the patient knows his or her body even better than I do.

As for direct to consumer pharmaceutical advertising: there have been many times when a patient has been unable to accurately describe symptoms to me or another provider, and then has gone home and heard a pharmaceutical advertisement describing a certain condition. As if a light bulb is turned on, the patient will say "that is exactly what I feel" or "that is what I have". When that information is again relayed to me, I find it to be very helpful. Oftentimes providers are not able to illicit the correct information from patients, either because we ask the wrong questions or we don't take the time to listen. The reverse side of this, of course, is that in some cases we have to be explaining to people why they don't have a certain condition or why they don't need a certain drug.

I don't feel that the abundance of information available on the Internet, on TV or in magazines gives patients too much control over their own treatments. As I've said, it can be a great help to have a patient walk in armed with some insight into their problems. It is then up to the provider to use good, sound professional judgment and to make all treatment decisions based on evidence obtained from current research studies and standards of practice, and to use that data to explain to the patient why a particular treatment may or may not be best for them. Patients want to get well or to stay well; they do not want to walk into the office and "get their own way". I feel that if a patient is insistent about a particular treatment which I don't agree with then I owe it to them to consider it and to present the facts and reasons why it is not the best course of action for them. I don't see that abundant health information is going to be harmful unless providers become so lazy and unethical that they stop communicating with their patients and just "give in" whenever a patient requests a certain drug. Although the provider-patient relationship should be a partnership, the provider is the one with the medical education and the professional licenses to treat and to prescribe, and the ethical duties involved in that must not be forgotten. Providers have a responsibility first to "do no harm" to their patients. This means taking the time to make the right decisions with the patient, not for him; it also means not becoming complacent and letting the patient call the shots and "get his way" because it is easier to do it that way. Practicing medicine is still going to be work; it's just that now we're dealing with a more informed patient population than before.

SEX, SEXUALITY, SEXUAL HEALTH, AND SEXUAL RIGHTS

2007-11-12T08:10:00.000-08:00

Most, if not all, adults desire a healthy, happy, and rewarding sex life. Sexual health is a state of well-being as we enjoy and experience our sexuality physically, emotionally, psychologically, spiritually, socially, and culturally.

SEX refers to the biological characteristics (reproductive organs and their functions) that differentiate human beings as being either male or female. In broader terms and in general use in many settings, SEX is often used to refer to "sexual activity".

SEXUALITY is a central part of being human. It involves your attitudes towards sex and intimacy, your sexual desires, and your ability to fulfill your desires. Sexuality encompasses the concepts of sex, gender identities and roles, sexual orientation and preference, intimacy, pleasure, eroticism, and reproduction. Sexual satisfaction is important and necessary for both men and women.
Our sexuality determines how we feel about the following things:
* Our body and how it works
* Our biological sex and gender (biological, social, and legal status as male or
female
* Our gender identity (feelings about our gender)
* Gender roles
* Our sexual orientation (straight, gay, or bisexual)
* Our values about life, love, and the people in our lives
* Eroticism, Intimacy, and Pleasure
* Reproduction

Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behavior, roles, and relationships. The experience and expression of sexuality is influenced by the interaction of physical, emotional, psychological, social, economic, political, cultural, ethical, moral, legal, religious, and spiritual factors.

SEXUAL HEALTH is not merely the absence of disease or dysfunction; it is a state of well-being related to our sexuality. It encompasses physical, emotional, psychological, spiritual, societal, and cultural aspects of sexuality. In order to make healthy and responsible choices about sex, you need to continuously seek out accurate and reliable information about sex and sexuality. Learning about issues related to the concepts of sexuality will make you more likely to feel good about yourself, allowing you to make the healthiest and the best possible choices for yourself, your sexual partner(s), and your future. Sexual health is best exemplified by voluntary and responsible sexual expressions and acts that enrich both you as an individual and your social life. You need to respect yourself and other people and take good care of your body in order to maintain good sexual health. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.

Sexual health is influenced by personal sexual attitudes, beliefs, and behaviors, as well as societal attitudes and beliefs (the "norm"), biological risk (diseases), and genetic predisposition to disease. Sexual health encompasses the problems of HIV and AIDS, Hepatitis, sexually transmitted diseases (STD), infertility and cancer resulting from STD, unplanned pregnancy, abortion, and sexual dysfunction. Sexual health is also influenced by mental health, acute and chronic illness and disease, disability, violence, and the abuse of drugs and alcohol.

Sexual health includes the ability to enjoy and control sexual and reproductive behavior in accordance with one's own personal beliefs as well as within social ethics. Sexual health means that a person is free of fear, shame, guilt, false beliefs, and other psychological and emotional factors that interfere with sexual response, sexual relations, sexual pleasure, and reproductive functions.

SEXUAL RIGHTS include the right of all humans to pursue a safe, satisfying, and pleasurable sex life with the partner of their choice, free of coercion, discrimination, and violence. All humans should have these basic sexual rights; however, as evidenced by the continued oppression of women, arranged marriages, and the practice of genital mutilation of females in order to negate sexual pleasure which are still occurring in many areas of the world, these rights are being violated.

All humans should have the right to the highest possible standard of sexual health, which includes access to sexual and reproductive healthcare services. They should be able to seek, receive, and talk about information related to sexuality without punishment or discrimination. They should be able to decide whether they want to be sexually active or not and to choose their sexual partner(s). Sexual relations should be mutually consensual, and sexual as well as marriage partners should be an individual choice. Women should have the right to decide whether or not, and when, to have children. A human being should expect that sexual partners will respect their bodily integrity and refrain from mutilation and violence.

In order for sexual rights to be upheld, a legal regulatory system where the sexual rights of all humans are upheld is required. There also must be an integrated system of healthcare and community professionals who can address sexual health and rights at the individual, family, community, and health system levels and provide appropriate interventions and referrals. The responsible exercise of human rights requires that all persons respect the rights of others.

HOW TO KEEP HIV AT BAY

2007-11-12T07:44:00.000-08:00

Intensive prevention and education initiatives are the best way to keep HIV/AIDS "at bay". The problem with global efforts to prevent new HIV infections is that the education initiatives must be adaptable to the beliefs and customs of each individual culture and group of people; what works in one part of the world will be useless in another. A "canned approach" such as handing out free condoms to people will not work.

Condoms will only prevent disease if people use them. People will only use the condoms if they truly understand and believe that sexual contact without the protection of a condom will spread the HIV virus. In some parts of the world, people remain ignorant to the facts of science and refuse to believe that AIDS is caused by a virus. Many myths persist as to the cause of AIDS, and until these are dispelled we will continue to see an increase in the number of new infections worldwide. Education and prevention messages must be culturally based and individualized. In the under-developed parts of the world HIV/AIDS is growing at an alarming rate. Much needs to be done as far as prevention work goes, in addition to finding a way to fund the cost of treatment for those who do become infected.

Even in the developed world, where we have the benefits of advanced science, medical technology, and effective medical treatment, we still have a lot of work to do. People continue to engage in risky sexual behavior, and there are new infections diagnosed every day. There are many who have treatment available and who choose, for whatever reason, not to adhere to the treatment. There are know that they have the virus and yet they continue to engage in high-risk behavior.

Human behavior is a very complex phenomenon, and the study of human behavior and effecting changes in behavior is complicated by different cultures and belief systems. It is so easy for one to simply say that the best way to keep HIV/AIDS at bay is to use a condom. That is true; using a condom correctly with every single act of intimacy outside of a monogamous relationship with a known HIV negative partner is, in fact, the best way to prevent the transmission of HIV and other STD's. Anyone who understands HIV disease will adamantly support this fact. However, we need to take it a step further and begin to consider how we are going to get everyone worldwide to buy into this. Until we do, there will be no slowing of this horrible epidemic. You can lead a horse to water, but you cannot make him drink, just as you can hand out condoms but you cannot make people use them. We need to think outside of the box and start individualizing our prevention efforts worldwide.

HIV AND AIDS IN HIGH SCHOOL STUDENTS

2007-11-12T07:41:00.000-08:00

HIV and AIDS are very frightening to most people; public education is the key to ending most of the fear and stigma surrounding the disease. Once people understand how the disease is and is not spread, there will be less fear of those who are infected. HIV, the virus that causes AIDS, is transmitted from one person to another only through infected body fluids such as blood, semen, vaginal fluids, and breast milk. HIV is not spread through tears, by coughing, sharing straws, cups, or eating utensils, kissing, hugging, sitting next to someone who is infected or even through slow dancing with someone who is infected. Healthy children of all ages can attend the same schools as those who are HIV infected. No special precautions need to be taken other than that an HIV positive child should not play contact sports, such as football, hockey, or wrestling, where injury and bleeding are likely.

Whether we like it or not, we are ALL living with HIV, even if we are not actually infected with the virus. It is up to each and every one of us to adapt our lifestyle to prevent the spread of the infection and to teach our children and others important safety measures. All children should be taught not to touch blood without gloves under any circumstances, no matter who is bleeding. Safe sex education needs to start in elementary school and reinforced over and over and over again. Everyone should be taught about the importance of condom use with each and every intimate encounter, from start to finish. Children and teenagers need to realize that they cannot tell by looking at someone if they are HIV positive; someone may look healthy and be the most popular athlete at the school and turn out to have HIV.

We need to be more worried about the HIV status of those strangers whom teenagers are meeting and forming intimate relationships with rather than the people who are known to be HIV positive. Knowing someone's HIV status is actually better than not knowing and assuming that a potential sexual partner is HIV negative because they "don't look sick".

Sure, HIV and AIDS are frightening; so is cancer. The difference is that, for the most part, HIV and AIDS are preventable. Public education and sex education are the keys that will keep this epidemic from spreading further. Ignorance and ignoring the facts will spell disaster. A good place for people to begin learning about HIV and AIDS is http://www.thebody.com

DO NOT SHARE YOUR TOOTHBRUSH

2007-11-12T07:39:00.000-08:00

Not sharing toothbrushes, even with close family members, is an essential concept for health, wellness, and overall good hygiene, irregardless of whether someone has HIV/AIDS, Hepatitis B or Hepatitis C or some other blood-borne illness. Most people are turned off at the mention of someone using their toothbrush, even a spouse; the toothbrush is a very "personal" item, not meant to be shared.

Many bacteria and viruses are present in the mouth; these germs are transferred to the toothbrush and then have a nice moist place to multiply. For this reason it is recommended that the toothbrush be replaced after someone is treated for strep throat or some other serious throat infection. If a person has an outbreak of oral herpes, it would be prudent to change the toothbrush once the active lesions are healed, just as it is recommended by the CDC to change the toothbrush when it is visibly soiled with blood and at least once each month, no matter what.

It must be emphasized that transmission of HIV or Hepatitis from a toothbrush is a very improbable event; there needs to be visible blood on the brush in order to transmit the viruses (they are not transmitted in plain saliva or oral secretions). If there were visible blood on the brush, I would think that even one who had considered picking up another's toothbrush would be turned off...

WE ARE ALL AFFECTED BY HIV - WHAT YOU CAN DO TO FIGHT HIV & AIDS

2007-10-25T14:21:00.000-07:00

EVERYONE SHOULD GET TESTED AND KNOW THEIR HIV STATUS

Many people feel that if they are infected with HIV they would rather not know. Others will not take a test because they are afraid that they could not handle the results. No matter what the results of your HIV test are, remember that knowledge is power. Some very important facts about the fight against HIV & AIDS are:

If you test HIV negative, you will be educated about how the virus is transmitted and about the lifestyle changes that you can make immediately in order to protect yourself from becoming infected with HIV or another sexually transmitted disease.
It you test HIV positive, you can begin to receive specialized HIV treatment immediately; treatment of HIV early in the disease will help you to stay healthy longer and may delay the progression to AIDS and the onset of some of the more serious complications of HIV disease. It is very important that you receive regular care from a provider who specializes in the treatment of HIV & AIDS. To find a provider in your area, go to www.directory.poz.com
If you test positive, you will be given information about where to go for medical care, financial and case management services, and emotional support.
If you are HIV postive you can take extra precautions to prevent the spread of HIV to your loved ones and sexual partners.
If you are a woman and are pregnant or plan to become pregnant, you need to know your HIV status. If you are HIV positive, there are medications that are safe for you and your unborn baby that can help to prevent your baby from becoming infected.

Anyone who has unprotected oral, vaginal, or anal sex or who shares needles is at risk of becoming infected with HIV. You owe it to yourself and to others to take an HIV test and to learn what we can do to prevent the spread of the virus. To learn more about where to go for a test in your area, how the test is done, how and when you will receive results, and about confidentiality and anonymity, go to http://www.hivtest.org

If your healthcare provider does not suggest an HIV test, ask for one; ask your sexual partners to get tested, also.

Respect yourself by protecting yourself. Pledge to use a condom/ask your partner to use a condom with each and every intimate sexual act. We all have the power to fight HIV & AIDS. Let's use that power and stand up and fight this disease!

MYTHS ABOUT HIV TRANSMISSION

2007-10-21T08:30:00.000-07:00

I am amazed that so many people in the U.S. and other developed and scientifically advanced areas of the world are still clinging to false beliefs about HIV and AIDS. With that in mind, it is no wonder that AIDS is such a major problem in the under-developed nations, where the people do not have the benefit of the advanced healthcare systems, education, and scientific research that so many in the U.S. take for granted.

I read the following statement on a forum recently. It was written by a user identifying him/herself as being from the United States: "Straight people don't get AIDS".
The person went on to explain in a rather lengthy post that in the U.S. most of the people who are becoming infected are gays and drug addicts. Then, to make it even more disturbing, approximately 1/3 of the respondents to the post agreed with the original statement, although there was some argument from people who were trying to portray the facts and the truth. It kind of makes me think that we're beating our heads against the wall!

The fact is that the majority of HIV positive people worldwide are heterosexual, and even in the U.S. the rates of new HIV infections are increasing most rapidly among heterosexuals (women of color, specifically). Although the rates of transmission between homosexual men in the U.S, which had been down for years, is once again starting to climb (most likely due to complacency and the fact that more effective treatments are available which make HIV a less frightening disease), homosexuals are not the fastest growing group of new infections. Transmission through needle sharing among IV drug users is also way down, thanks to government sponsored needle exchange programs.

I hope that everyone reading this post faces the reality that the majority of people worldwide are heterosexual. HIV and AIDS knows no limits. It can, and does, affect and infect all types of people, irregardless of their sexual preferences. A straight man can infect a straight woman or another man, a straight woman can become infected by a bisexual man, a bisexual man can become infected from a straight woman or a gay man... HIV risk is about BEHAVIOR, not about the LABELS that society puts on groups of people.

Anyone who has unprotected sex or is intimate with another person is at risk. A straight man or woman who has unprotected sex just once puts themselves at a much greater risk for HIV than a gay man who has protected and safe sex with another gay man who is known to be HIV positive.

HIV prevention starts with educating yourself about the facts and then using that knowledge to educate others. Only then can we even hope to stop this epidemic. False beliefs based on discrimination and stigma towards certain groups of people will only hinder or efforts.

WEIGHING THE RISKS OF UNPROTECTED SEX

2007-10-21T04:37:00.000-07:00

When it comes down to making choices about using a condom or not, it is very simple:
unless a couple is in a serious, committed, monogamous relationship and the HIV and health status of each partner is known (through recent medical testing), condoms should be used for each and every intimate sexual encounter. Condoms need to be used correctly every time, from start to finish, with no exceptions if they are to effectively prevent infection with sexually transmitted diseases, HIV, or pregnancy.

There really is no "choice" here. Other than abstinence, condoms are the only effective way to prevent infection with diseases which range from annoying and embarrassing to life-altering and life-threatening. Trust in the person and the fact that a potential sexual partner looks healthy has nothing to do with it. Whether you trust a person or not does NOT tell you whether they are walking around with HIV replicating in their body, ready to pass it on to you. The person may look healthy, be active and athletic, and may be the most trustworthy and kind person that you have ever known and still have HIV. Unprotected sex without knowing the facts is always unsafe sex.

As for sex being more pleasurable without a condom, I disagree. An intimate sexual relationship between two people who care about each other is a complete connection, irregardless of a condom. Sensation and pleasure can even be enhanced if the right condom is chosen; the couple should experiment with different high-quality condoms to find one that is mutually pleasurable. There are thousands of couples in the U.S. alone where one partner is HIV positive and condoms must be used throughout their marriage. These people will attest that the condoms do NOT make their sex any less pleasurable.

Those who have the mindset that using a condom robs them of sexual pleasure are playing roulette with their lives. I don't think that AIDS is a very pleasurable thing, either. In this day and age, we don't have a choice in this. It is up to each and every one of us to make responsible decisions if we are to ever stall the HIV/AIDS epidemic. The choices that you make affect you as well as anyone else that you have "pleasurable unprotected sex" with. Do the right thing and use a condom.

WHAT IS THE "CAUSE" OF GENITAL HERPES?

2007-10-20T18:10:00.000-07:00

I read this question on a forum I was at tonight, and I was astounded at the answers. There is definitely a lack of understanding about genital herpes, as well as other sexually transmitted diseases (STD's) and HIV / AIDS. Bacteria and viruses "cause" these diseases; human carelessness or lack of knowledge and understanding is what gives the bacteria and viruses a way to infect people...

Infection with the Herpes Simplex II virus is the ONLY cause of genital herpes, however there are many ways to become infected with the virus. When most people think of genital herpes, they think of lesions on the vulva of a woman or the penis of a man. The name "genital" herpes is misleading, as this virus can cause outbreaks in the genital area, anal area, as well as in and around the mouth, depending on where the virus enters the body. I have even seen genital herpes lesions around the eye of a person who was giving oral sex to an infected partner and got seminal secretions around the eye. Oral lesions are quite common; they can be on the lips, inside the mouth on the cheeks, and even at the back of the throat spreading down the esophagus. Anal lesions can be on the outside as well as on the inside, and one can imagine how painful that would be. The hallmark of a new genital herpes outbreak is painful vesicular (small blister-like) lesions surrounded by redness. There may be just 1 or 2 lesions, however if it is an initial outbreak it is generally more severe and extensive, with clusters of multiple lesions. The infected person may feel fatigued for a day or so before the outbreak, and there may be some altered sensations at the site where the lesions will develop (such as numbness or tingling). Once the lesions appear, they are extremely painful. There is treatment for genital herpes outbreaks as well as antiviral medication that can be taken to suppress the virus and prevent or minimize the occurrence of future outbreaks, however the diagnosis and medical treatment of herpes is beyond the scope of this article.

The best way to prevent infection with genital herpes, as with any sexually transmitted disease including HIV (other than complete abstinence), is to have sex only in the context of a monogamous relationship where the status, history, and habits of your partner are known and trusted. Otherwise, avoiding multiple sexual partners and always using a condom, with every single intimate act, from start to finish, provides the best protection. This includes all acts of oral, vaginal, and anal sex, whether you are "giving" or "receiving". You should always avoid intimate contact with someone who appears ill or who has visible genital, anal, or oral lesions as well as someone with vaginal or urethral discharge. Keep in mind, however, that just as someone can appear to be completely healthy and actually be HIV positive, someone can have no visible genital lesions and can still be shedding the herpes virus. It is possible to become infected with genital herpes even when your partner has no visible lesions. It is also possible to have contact with an area that is shedding the virus and is not covered with the condom, such as the scrotum or area around the anus.

The only "good" thing about genital herpes is that it is now very treatable and much easier to control than it was several years ago. Remember, though, that it is still a chronic disease, and there is a stigma that comes along with it. I should also mention here that it is very common for all sexually transmitted diseases to occur along with other sexually transmitted diseases. If you don't practice safe sex, you could end up with genital herpes, HIV, and maybe gonorrhea or chlamydia along with it... The days of "free love" and "if it feels good, just do it" are long gone. We need to remember that every sexual encounter that we choose to become involved in could have life-altering and even life-threatening implications. That is the message that needs to reach everyone- teenagers, young adults, and even senior citizens.

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2007-10-14T17:15:00.000-07:00

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The site is changing constantly, with new products, articles, and information being added. The prices in the online store are extremely competitive, if not among the best, for adult sex toys.

BUY QUALITY CONDOMS AT DISCOUNT PRICES

2007-10-14T05:58:00.001-07:00

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HELP WANTED - HIV INFECTED OR AFFECTED PEOPLE TO VOICE YOUR OPINIONS AND MAKE SOME MONEY

2007-03-04T11:21:00.000-08:00

I posted on this once before but didn't get much of a response, so I thought that I would try again. I belong to a paid-per-post forum called myLot that allows you to post conversations on just about any topic that you can think of for discussion by the members. There are already almost 78,000 members of this International online community. I have actively posted there for about 3 months now, and have learned a lot about different cultures, traditions, religions, politics, and people. I have met some great online friends, and I find it a fun way to express my opinions and beliefs while making a few extra dollars.

MyLot pays you when you start a discussion, when you respond to a discussion, when you upload non-copyright protected images and pictures that pertain to a particular discussion, and when others respond to discussions which you started. You won't get rich posting at this site, but you will have fun and make some extra pocket money. The payout minimum is $10.00, which means if you meet the minimum you will be paid for what you earned by the 15th of the following month. There have been absolutely no problems with getting paid. The site has deposited my earnings into my PayPal account on time for the past 3 months. I have made a total of $135.00 at myLot, which is pretty good for something that you would be doing anyways.

My thought was that if you are reading this blog, you are likely to be infected with or affected by HIV. There is a great need for some open discussions on myLot about HIV/AIDS; people around the world are ignorant about the disease, living with HIV, prevention and safe sex, medications and side effects, stigma and discrimination, and gay rights. Anyone who could start discussions or contribute to existing ones about these topics would be an asset to the forum, and remember that you will earn a bit of money doing it. Click on any of the links in this post or on the logo at the top of the page to sign up and start contributing. This is a good way to help out in the worldwide HIV/AIDS prevention efforts. We all need to step up to the plate and take some responsibility for educating people around the world.

HIV STOPS WITH EACH ONE OF US!

UNDERSTANDING LAB TESTS - HIV VIRAL LOAD TESTS

2007-02-09T13:00:00.000-08:00

An important part of your HIV health care involves lab work at regular intervals to monitor the progression of your HIV disease and to provide information that will help your specialist make decisions regarding your treatment plan. Knowing and understanding the results of lab tests is an important way for you to understand and learn to live with HIV.

The HIV viral load test measures the amount of HIV in your blood and shows how actively the virus is reproducing in the body. The viral load is counted and reported in the form of copies per milliliter (ml) of blood. There are two different types of HIV viral load tests: polymerase chain reaction (PCR) test and the branched DNA (b-DNA) test. It is not necessary to understand how the tests differ, but you should know that the different test methods will give different results for the same sample and the tests are not interchangeable. Both tests measure the amount of HIV in the blood, but the results of the two tests do not correlate and it is like trying to compare apples to oranges. Because of this, you should have the same test done by the same lab each time; your provider will always order the same test.

When used in combination with the CD4 cell count (T cell) test, the HIV viral load test is used to monitor the status of HIV disease and to predict the future course of HIV. It is essential in determining when to start treatment for HIV with antiretroviral medications. It is also useful in monitoring the effectiveness of the medications. This test is done when you are first diagnosed with HIV as a baseline and then every 3 months, but it may be done more frequently if you are beginning medications, are changing medications, or have been missing doses of medications. To monitor stable long term therapy, the viral load and CD4 counts are done every 3-6 months, with most HIV treatment specialists preferring to do them at 3 month intervals.

A high viral load measurement (10,000 copies to over 1 million copies) indicates that the HIV is reproducing rapidly and that the disease will most likely progress faster than if the viral load measurement is lower. Current U.S. Government guidelines recommend that treatment with antiretroviral (ARV) medications be considered when the viral load is at or greater than 50,000 copies, although treatment can be considered with lower levels, especially if symptoms of HIV disease are present. Once starting on ARV medications to suppress the activity of the HIV, the viral load level will fall steadily to the goal of undetectable, which is less than 50 copies. Undetectable viral load means that the level of virus in your blood is below the lowest level that the test can detect, but it does not mean that you are cured. The viral load test determines the amount of virus that can be detected in the blood. It is important to note that only about 5% of the HIV in the body of an infected person is detectable in the blood. This test does not measure the amount of HIV that is present in other body tissues like the lymph nodes, spleen or brain. If the viral load level is low or is below the level of detection because you are taking medications to treat HIV, you can still infect others with the virus. HIV is still present in your body and in body fluids. Although the risk of passing the virus to another person is lower with a lower viral load, there is no safe level and infecting others is always possible.

If the viral load level does not fall to the level of undetectable or if it increases after a period of being undetectable, this may indicate that the medications you are taking are no longer effective (your virus has become resistant to them) or that you are not taking the medications exactly as prescribed. It is important to take the medications exactly as you are instructed to do, including paying attention to the timing and any food or meal restrictions or other drug interactions. An undetectable viral load reduces the risk of disease progression by preserving the integrity of the CD4 cells and the body's immune function, keeping you healthier for a longer period of time.

Research has recently noticed that there is a common phenomenon referred to as viral load "blips", in which there is a slight rise in the viral load from an undetectable level to a low level (less than 500 copies) and a spontaneous return to an undetectable level. This does not seem to indicate that the HIV is becoming resistant to the medication, as long as the level returns to undetectable and stays at that level. If you have recently received an immunization (like a flu or pneumonia shot) or if your body is fighting off an infection (like a cold), the viral load may blip and then return to undetectable. The important thing is the trend in the results. If the viral load goes up and stays up, something is wrong with your treatment.

As a final note, I will repeat that a viral load that is undetectable does not mean that the HIV is cured and it does not mean that you can not infect others. You must still practice safe sex and use condoms with all intimate sexual activity to avoid passing the infection to your partner.

UNDERSTANDING LAB TESTS - CD4 CELL COUNT TESTS

2007-01-30T09:04:00.000-08:00

A regular part of HIV health care involves having blood tests done every 3-6 months to monitor your overall health, the progression of HIV disease, your immune system's response to medications that you are taking, and any medication-related side effects or complications. Some of the most common laboratory tests done are the CD4 cell count, HIV viral load, blood chemistry (includes liver and kidney function tests), blood lipid panels (cholesterol, blood fats), blood sugar tests, and complete blood count, or CBC (checks for low white cell counts and anemia). It is important for a person who is being treated for any chronic disease to be educated about the disease and its treatment in order to be a true "partner" in their own health care. HIV is no exception. You should know what lab tests are being done, what they are measuring or monitoring, and the implications of the results. In this post I will discuss the CD4 cell count (T Cells).

In order to understand how HIV breaks down the immune system, it is important for you to have a basic understanding of how the immune system works when it is healthy and not compromised by HIV. The immune system is one of the most complex systems in the human body. HIV harms the body's immune system by targeting and infecting the CD4 cells, or T-cells, which are a type of white blood cell whose purpose in the body is to resist infection and protect the body from illness. The CD4 cells are a major part of the body's natural first-line defense against illness. Once inside the CD4 cells, HIV takes over the cells and turns them into "virus factories" within the body, making thousands of copies of itself in each cell. As the amount of virus grows, the original CD4 cell is damaged and eventually destroyed. HIV eventually kills so many of these cells that the immune system is weakened and the body is no longer able to defend itself against infections (bacteria, viruses, parasites, molds) and certain cancers. If left untreated, HIV can lead to the development of opportunistic infections, AIDS, and death.

So, why do you need to know all of this? Because you need to understand how HIV affects the immune system in order to understand and appreciate the role of antiretroviral medications (drugs used to treat HIV and AIDS) in your treatment plan. I have found from dealing with patients that those patients who had a good basic understanding of how the medications worked and why it was important to keep the CD4 cell count higher remained healthier and had much better medication adherence rates and fewer missed doses.

Your HIV specialist will monitor many laboratory tests besides the absolute CD4 cell count, which is the measurement of the total number of CD4 cells (T cells) in your body; this reflects the health of your immune system. They will also monitor the CD4 cell percentage and the ratio of CD4 to CD8 cells, but as a start you should focus on the absolute number of CD4 cells. A normal, healthy person who is not infected with HIV has a CD4 count of 500-16oo cells; this number varies from day to day, depending on the physical and emotional strssors on the body. In an HIV infected person, the CD4 count declines gradually as HIV kills more and more cells. The more CD4 cells a person has, the stronger the immune system is; a CD4 cell count above 500 indicates that the immune system is fairly intact, and the chances of becoming sick are minimal. As the CD4 count decreases, the chances of permanent immune system damage and of developing symptoms of HIV disease are increased. That is why most HIV specialists will begin to discuss starting antiretroviral medications (ARV) to treat the HIV when your CD4 count is between 350-500. United States Government guidelines currently recommend starting ARV medications when the CD4 cell count falls below 350, but this starting point is constantly being debated by the experts and thought-leaders in the field as the risks of opportunistic illness and the toxicities of the medications are considered and compared. If the CD4 count falls below 2oo, your disease has progressed from HIV to AIDS, and you are at a high risk for developing certain opportunistic illnesses; your provider will prescribe certain medications to try to prevent some of these illnesses, but it will be important for you to also take the ARV medications that are prescribed to treat the HIV/AIDS in order to hopefully bring your CD4 count up again. Studies have shown that waiting too long to start treatment with ARV medications and letting the CD4 cell count drop to low may compromise the ability of the immune system to respond to the ARV medications.

A common question is "how long from the time of infection with HIV will it take for the CD4 cells to fall to the level where ARV medications are needed?". This is very difficult to answer, because there are many different variables to consider. First of all, it depends on the CD4 count at baseline. When HIV infection occurs initially, there will be a very rapid rise in HIV viral load and a decrease in the CD4 cell count as the body responds to the acute infection. Over a period of 3-6 months, the CD4 count will stabilize at a somewhat consistent level, and it is predicted that on average about 45 CD4 cells will be lost every 6 months, with slightly higher numbers lost with very high counts. Obviously, it will take longer to progress to needing medications if one starts off with a CD4 count in the high 800's (which is not at all uncommon) than if the baseline CD4 count is 350. This decrease of 45 cells every 6 months is an average, and there are many other factors to consider. Lifestyle plays a very important role in the destruction of CD4 cells, with factors such as high stress, drug use, alcohol abuse, and smoking causing some dramatic drops in CD4 cells in many cases. That is why you will be educated thoroughly about lifestyle changes and the importance of good nutrition, exercise, and sleep habits from the beginning of your treatment. All of these things will affect your overall health and the progression of the disease.

Once you begin ARV medications, your CD4 count should begin to increase slowly. The CD4 count will fluctuate normally throughout treatment, so it is important not to be too overly concerned about or place to much emphasis on a single result. Most HIV specialists will track your results over time on a graph or flow-chart, and you can download a tracker and do this yourself also. Remember, those who actively participate in their care remain healthier and do better overall; you and your provider are equal partners in the fight against HIV/AIDS.

SELENIUM SUPPLEMENTS MAY CONTRIBUTE TO REDUCED HIV VIRAL LOAD

2007-01-27T11:15:00.000-08:00

Selenium is a trace mineral that is found in soil that can be absorbed by plants. Research has linked Selenium deficiencies to certain forms of heart disease, hypothyroidism, and immune dysfunction. This mineral has been of interest to researchers in the HIV field for years, and several previous studies have found that HIV positive persons have lower levels of Selenium in their blood than do their HIV negative counterparts, and that this mineral suppresses the replication of HIV in the laboratory. The exact mechanism of the effects of Selenium on HIV is not known, although it is postulated that Selenium has antioxidant properties which may repair damage done to the immune cells. However, much more research is needed to confirm this hypothesis.

A recent study conducted at the University of Miami in Florida has found that supplementation of the mineral Selenium may be helpful to HIV patients by reducing the HIV viral load. The results of this study was published in the January 22, 2007 issue of Archives of Internal Medicine, where the entire study and conclusions can be read online.

In the study, the researchers followed 262 HIV positive patients with normal selenium levels from 3 counties in Florida. The patients were randomly assigned to one of two groups: one group took a 200 mcg. capsule of Selenium daily, while the other group took a placebo. A total of 174 patients completed the study. About 2/3 of all of the participants were already taking antiretroviral medications to treat HIV; these medications were continued. The researchers found that the group taking Selenium experienced an average decrease in the blood HIV viral load levels (the number of copies of the HIV virus in the blood) of 12%; these patients also showed a mean increase of 30 CD4+ cells (a measure of the health of the immune system. The higher the CD4+ cell count, the healthier the immune system is), which appears to indicate that the Selenium makes the HIV less virulent and less capable of replicating, thus enhancing the immune function of the CD4+ cells. The placebo group had an increase in the HIV viral load of 10,000-20,000 viral particles per milliliter of blood and a decrease of about 30 CD4+ cells.

Put into perspective, this study shows that the mineral Selenium does appear to help immune function at a maximum dose of 200 mcg. per day, and it has no known serious side effects or drug-drug interactions. It is an inexpensive and safe adjunct ("booster") therapy to use along with conventional antiretroviral medications, and should also be considered for those HIV positive patients who are not yet taking medications for HIV, as it may help to delay the need to start treatment.

Plant foods are the major dietary sources of Selenium. It must be noted that Selenium deficiencies are rare in the U.S. in the normal population. There is a fine line between therapeutic levels and toxicity, which can have serious implications including loss of hair and nails, skin redness and blistering, vomiting, fatigue, neurological defects, and damage to the liver and spleen. Anyone considering taking a supplement should first consult with their healthcare provider and decide if this is a right for them to do. If taken as a supplement, Selenium can be purchased over the counter, and the maximum dosage should be 200 mcg. per day. Given the quality of the current research, it seems reasonable to take a daily supplement of Selenium along with any other prescribed treatment for HIV disease.

NEW YORK CITY'S OFFICIAL CITY CONDOM

2007-01-27T08:26:00.000-08:00

New York City is the "capital" of the HIV and AIDS epidemic in the United States, with more cases than any other area of the country. Currently, more than 100,000 people in New York City are known to have HIV or AIDS, and AIDS is the city's third-leading cause of death among all people under the age of 65. During 2005, NY City Mayor Michael Bloomberg and the NY City Department of Health and Mental Hygiene began a massive free condom distribution campaign in an effort to reduce the prevalence of sexually transmitted diseases, including HIV. The condoms are distributed locally and via the Internet at no cost to the community and to social service organizations.

It is estimated that as many as 20,000 people in NY City alone are HIV positive but are unaware of their status, which puts literally thousands of other people at risk for becoming infected with the virus. Aggressive HIV testing programs and free condom distribution are among the initiatives that have been implemented in NY to help prevent the spread of HIV and other sexually transmitted diseases. HIV testing is offered free and anonymously to anyone in an effort to identify infection earlier and possibly prevent the inadvertent spread of the disease. Consistent use of latex condoms has been proven to be an effective means of preventing HIV infection as well as most other sexually transmitted diseases. Condoms are manufactured according to strict standards, and the minuscule failure rate of condoms has been shown to be mostly due to human error, such as improper size, improper application, condoms not being used for the entire duration of intercourse, or condoms being used with spermicides or oils which cause them to rip and tear.

NY City hands out 18 million free condoms each year for distribution at health clinics, advocacy groups, bars and nightclubs, restaurants, beauty salons, and prisons. That is about 1.5 million condoms each month! It is estimated that the city spends approximately $750,000 per year to buy the condoms. NY City officials are predicting that people would be even more likely to use the condoms if they came in distinctive packages, as marketing experts will confirm that brands and effective packaging work and that people are more likely to use a branded item. They also feel that the use of a memorable package might help them to more accurately conduct health surveys and track the effectiveness of the campaign; if a respondent describes the wrapper, then it is more likely that they have used the condoms.

The NY Post recently reported that NY Mayor Bloomberg is about to unveil the city's own "NY City brand" of free condoms for distribution. The condoms will be packaged in noticeable and memorable foils featuring a variety of different colors representing the city's different subway lines. NY will be the first city in the nation to have its own signature condoms. The condoms will be made of standard, lubricated latex and will continue to be distributed free of charge in order to promote safe sex and prevent HIV/AIDS and other sexually transmitted diseases.

Of course there has been opposition to the distribution of free condoms by some social conservatives and religious groups who claim that the government is encouraging and condoning sexual promiscuity, but the campaign has been largely well-received by the government and the public.

New York may be the first city to have its own signature condoms, but I can see that many other cities will soon be following in its footsteps. Here In Buffalo, NY I hope that our condoms are packaged in foils with hockey players and Chicken Wings!

NEW HIGH-TECH CONDOMS BEING DEVELOPED

2007-01-17T10:10:00.000-08:00

SPRAY-ON CONDOMS: "TAILOR-MADE" FOR ALL SIZES OF MEN, MAKING SAFE SEX EASIER?
Reuters Photo: December, 2006; Jan Vinzenz Krause of the Institute for Condom Consultancy in Berlin, Germany produces a prototype of a new spray-on condom that is currently being developed.

A Reuters News article recently described the efforts of a German research team to develop "the perfect condom" for men that would be suited to every size of penis, enabling people to enjoy more comfortable and safer sex lives. The researcher reported that his inspiration for this idea came from evaluating and considering the difficulties that many men report when using condoms.

The biggest prevention message since the beginning of the HIV/AIDS epidemic has been to practice safe sex using a latex condom with a water-based lubricant with every intimate encounter. Research studies have confirmed that some people really do experience practical difficulties with the use of condoms. Problems with the use of condoms can make them less effective or cause the couple to be less likely to use them.

Access to condoms is sometimes reported as a problem. Even though condoms are reasonably priced, the cost may be prohibitive for people who have difficulty making ends meet and live from paycheck to paycheck; condoms may fall to the bottom of the priority list. Couples are encouraged to check if their health insurance will cover all or part of the cost of condoms, or to go to the local Health Department, family planning center, STD clinic, or HIV testing center for access to free condoms.
Many men report difficulty putting condoms on. Men are encouraged to read the insert in the package and to follow the instructions for putting the condom on properly; they can also get information about condom use at most clinics offering STD testing and testing.
All men are not built alike, and penises come in a variety of shapes and sizes. One size of latex condom does not fit all men comfortably. Finding the right size and fit for a condom may take some experimenting. Men may prefer a slightly looser or snugger fit, or may want to try a flared condom which is a bit roomier at the head. The important thing is that the condom fits snugly enough so that it does not slip off during intercourse.
Both slippage and breakage of condoms can be prevented by choosing the right fit and type of condom. If a man's penis is thick but not exceptionally long, he may need to experiment with sizes to find a condom that is not likely to break. Ultra-strong or thicker latex condoms are recommended for heavy-duty, rough sex or for anal intercourse. Condoms must be used with plenty of water-based lubricant; the use of oils and oil-based lubricants, spermicidal creams, or antifungal vaginal creams will cause the condom to break down and rupture quickly. Condoms have expiration dates and specific storage recommendations that ensure the quality of the latex. If a condom has been stored in a wallet or the glove-box of a car for "emergency use", it will most likely be prone to breakage and should not be used. In order to prevent the condom from slipping off, the man should apply lubricant to the outside of the condom, never on the penis itself or on the inside of the condom. He should also hold the base of the penis and condom when pulling out after sex to prevent the condom from slipping.

These are the major difficulties reported by couples when using condoms. Now, with the introduction of this new spray-on condom, is it really possible that the days of fumbling with condom wrappers and condoms are going to be a thing of the past?

The research team plans to make the spray-on condom available in different strengths and colors, and hope that it will be on the market by 2008. The projected cost for the device is approximately $13 for 20 applications, which is relatively inexpensive for a condom product.

My opinion is that we will not see this product approved by the U.S. FDA and on the marketplace in the U.S. any time soon, if at all. First of all, in order for the FDA to grant approval, the company will have to conduct extensive tests in order to ensure that the latex is spread evenly over the penis when sprayed. They would also have to submit scientific proof of the quality of the condoms; in the U.S. there is an "acceptable failure rate" for products like latex condoms and latex surgical gloves, and the manufacturers of these products are held to high standards. Given that each spray-on condom is made individually, there does not seem to be any way of accurately determining the quality of the condoms and evaluating the failure rate of the product. In addition, the process of hardening and the degree of elasticity of the condoms, as well as the breakdown of the product for removal will need to be scientifically determined. Another problem would be the possibility of the spraying mechanism becoming clogged by the latex, which could interfere with the proper application of the product.

Lastly, let's consider one of the major problems with traditional condom use; many couples state that the lack of spontaneity is a major reason for not stopping to use condoms. I have to think that this spray-on protection would elicit the same response from couples. The bottom line is this: the spray-on condom is most likely a pipe-dream that we will not see in the U.S. It is an interesting concept, but it certainly nowhere near ready for "Prime Time". Continue to stock up on latex condoms for now!

TOP 10 MYTHS ABOUT HIV AND AIDS AND WHY THEY ARE NOT TRUE

2007-01-15T09:36:00.000-08:00

There has been a tremendous amount of progress in increasing worldwide awareness about HIV and AIDS, and massive education and prevention efforts are ongoing. However, many people remain ignorant to the facts about HIV and AIDS and to how they can prevent the spread of the disease. In this video, Dr. Becky Kuhn, an HIV treatment specialist, talks about the top 10 myths on HIV and AIDS and explains why they are not true.

Dr. Becky Kuhn is the co-founder of Global Lifeworks, which is a not-for-profit organization with the goal of "Bridging Diverse Communities in the HIV/AIDS Pandemic". The vision statement of this organization is: "to pioneer new and unique methods for HIV/AIDS awareness, education, and care for the purpose of improving the quality of life of those infected and affected by HIV/AIDS". The website is full of information; it contains articles, blogs, videos, and photo galleries. I recommend that anyone interested in the worldwide AIDS pandemic visit and explore this worthwhile site.

IDEAS ON ERADICATING HIV AND AIDS WORLDWIDE

2007-01-13T11:35:00.000-08:00

Education and Prevention Initiatives which are culturally specific and sensitive are the best chance of controlling the spread of HIV and ultimately eradicating HIV and AIDS.

Sexual transmission, whether it is heterosexual or homosexual, remains the #1 route of transmission worldwide. The blood supply is now extremely safe, due to careful screening of donors and donated blood. Hospital workers and other medical and rescue personnel who may have contact with blood or body fluids are very well trained on the proper precautions to take in order to prevent transmission of blood-borne infections. IV drug users have access to clean needles and works in many areas of the world, and there have been campaigns to educate them on the dangers of sharing needles and how to clean the needles after use.

HIV prevention efforts have failed miserably in the developed parts of the world such as the United States, as evidenced by continued new infections being diagnosed every day; even people who are well-educated on the risks of unprotected sex (including people working in the HIV field) and those who have unlimited access to free condoms are not using them consistently and are becoming infected with the virus. Given these facts, how can we expect to eradicate this disease in areas of the world where the people are poverty-stricken, uneducated, and do not have access to quality medical care or health education programs?

This makes me think that education regarding safer sexual strategies needs to be changed and improved. In most cases, it is not that people are not educated and do not understand the principles of safe sex; for some reason, people tend to make poor choices in the heat of the moment. Humans also tend to have the mindset of "it won't happen to me"... Maybe cognitive-behavioural specialists need to be involved in the education and prevention efforts; these specialists are able to understand and analyze the behaviour of human beings in a more abstract way.

The HIV transmission rates in the developing areas of the world are astounding. In addition to education and prevention efforts, these areas need access to condoms, medical care, HIV testing, and HIV treatment. Much is being done in all of these areas, and much remains to be done. This pandemic is here to stay for a while, and the responsibility lies with each one of us to educate ourselves and others as much as possible and to be compassionate to those who are affected.

WHERE DID HIV COME FROM?

2007-01-11T16:49:00.000-08:00

Scientists have developed many different theories about the origin of HIV, but none of them have been proven. HIV is a human virus that is closely related to simian immunodeficiency virus (SIV), a virus that infects chimpanzees and monkeys. SIV has been a known virus in monkeys for thousands of years and does not cause illness in these primates. Studies about the evolution of HIV have estimated that SIV passed from monkeys to humans approximately 80 years ago in the 1930's. It is speculated that human hunters first became infected with the virus after coming into contact with the blood of the monkeys that they had killed for food. In 1999, an international team of scientists confirmed that a chimpanzee native to west equatorial Africa carried a form of SIV which was nearly identical to an aggressive form of HIV. It appears that chimpanzees were the source of HIV, and that the virus somehow crossed species from the chimpanzees to humans. It is not clear when this happened, but there have been reports of HIV infection since the middle of the twentieth century. The earliest known case of HIV in a human was a man in Kinshasa, Democratic Republic of China. Analysis of his blood sample suggested that HIV may have developed from a single virus in the late 1940's or early 1950's.

HIV has existed in the United States since the mid-to late 1970's, when men who had sex with other men were being diagnosed with rare types of pneumonia, cancers, and other unusual illnesses which did not normally occur in people with healthy and intact immune systems in Los Angeles and New York City. In 1982, public health officials began to call this syndrome of opportunistic infections, Kaposi's sarcoma, and Pneumocystis carinii pneumonia in previously healthy men "acquired immunodeficiency syndrome", or AIDS. Formal surveillance of AIDS cases by the U.S. government began in 1982.

HIV, the virus that is known to cause AIDS, was isolated in humans by scientists in 1983; the virus was initially named LTLV-III/LAV. The name was later changed to human immunodeficiency virus (HIV).

HIV started to infect humans and quickly became an epidemic in the middle of the twentieth century. International travel is a key factor that facilitated the movement of HIV from epidemic to pandemic. Even today, the debate over the exact origin of HIV continues. Perhaps it would be more beneficial to the millions of people worldwide who are infected to put that energy and research into how we can better treat existing cases of HIV and AIDS and prevent new infections from occurring.

GREAT RESOURCES FOR COPING WITH NEUROPATHY

2007-01-11T15:16:00.000-08:00

John A. Senneff's books have been mentioned in many articles that I have been reading about peripheral neuropathy. His books offer useful insight into coping with the sometimes disabling symptoms of peripheral neuropathy; they are written from a patient's perspective in a down-to-earth and easy to understand way. He discusses traditional as well as complimentary, alternative and experimental therapies to treat neuropathy.

Check out the reviews at Amazon.com
New and used copies are available.

HIV PERIPHERAL NEUROPATHY

2007-01-10T17:55:00.000-08:00

Peripheral neuropathy is a painful condition that is caused by damage to the nerves in the peripheral nervous system, which includes the nerves that run from the brain and the spinal cord to the arms, hands, legs, and feet. The damaged nerves alter sensations and feelings such as pain, temperature, and touch. Peripheral neuropathy occurs frequently with HIV disease and can result in a great deal of pain. It greatly impacts the quality of life of an HIV positive person, often leading to isolation and depression. It is reported in approximately 1/3 of patients who are AIDS diagnosed, but it can occur at any stage of HIV disease including the acute seroconversion stage and the latent (asymptomatic) period.

Causes of peripheral neuropathy:
Peripheral neuropathy is often a side effect of the medications used to treat HIV, but can also be caused by HIV infection itself. Neuropathy can also be caused by vitamin deficiencies (vitamin B12, folate), diabetes, or thyroid abnormalities. Alcohol abuse, older age (greater than 50), and low CD4+cell counts are also assosiated with an increased incidence of peripheral neuropathy.

Drugs that cause peripheral neuropathy:

Videx (didanisone, ddi), antiretroviral medication used to treat HIV
Zerit (stavudine, d4t), antiretroviral medication used to treat HIV
Dapsone, used to treat or prevent PCP pneumonia
Metronidazole (flagyl), antibiotic
Isoniazid (INH), antibiotic used to treat tuberculosis
Pyridoxine (vitamin B6)
Ethambutol (used to treat MAC infection)
Vincristine (chemotherapy to treat Kaposi's sarcoma)
Hydroxyurea
ALCOHOL

Symptoms of peripheral neuropathy:
The earliest symptoms of peripheral neuropathy are pain, numbness, and tingling in the hands and feet in the classic "sock and glove" distribution. The pain is often described as burning, shooting, electric-shock like, throbbing, or aching. Some people describe an altered sensation when picking up objects, as if their fingers are "made of plastic", or feelings of their hands and feet falling asleep. The patient may complain of their feet throbbing or cramping at night or of stumbling when they try to walk. The symptoms are generally symmetric (occur on both sides of the body), although they may be more severe on one side. If the neuropathy is severe, touching the affected extremity can feel like an open wound is being touched. In the most severe cases, severe pain and dysfunction of the nerves can result in difficulty walking and disability.

Diagnosis of peripheral neuropathy:
The diagnosis of peripheral neuropathy can generally be made by a healthcare provider who is experienced in the treatment of HIV disease based on a history of the symptoms and a comprehensive physical examination which includes testing of the reflexes and evaluation of the sense of vibration,touch, pressure, and pain in the extremities. Bloodwork will be done to check CD4+ cell count, HIV viral load, blood glucose (sugar), thyroid function, Vitamin B1, B6, and B12 levels, folate levels, Vitamin E levels, and Magnesium levels. The HIV specialist may refer the patient to a neurologist for an evaluation and treatment recommendations, and nerve-conduction studies (electromyography, or EMG) may be scheduled.

Treatment of peripheral neuropathy:
Unfortunately, there iss no cure for peripheral neuropathy. They key to treatment is to remove the underlying cause and to control the pain.

If a vitamin deficiency is the cause of the neuropathy, restoring the nutritional balance with vitamin supplementation will often reverse the process.
In cases of medication-induced neuropathy, reducing the dosage of the offending drug or discontinuing it will oftentimes reverse the neuropathy, although this may take 2-4 months.
If heavy alcohol consumption has been determined to be a contributing factor, all use of alcohol must be stopped. Substance abuse counselling services may be needed.
Metabolic conditions such as diabetes and thyroid disorders need to be stabilized.
HIV needs to be well-controlled, with an undetectable HIV viral load.

Medications used to treat peripheral neuropathy:

Certain anticonvulsants (Tegretol, Lamictal, Neurontin, or Dilantin) have been used with some success in treating HIV related peripheral neuropathy. These medications can change the levels of HIV medications in your body, so be sure to tell your HIV specialist if another healthcare provider prescribes these for you.
Antidepressants (Elavil, Cymbalta) have shown to have some effect on decreasing the pain associated with neuropathy.
Topical anesthetics such as lidocaine cream patches or Capsaicin cream may provide some pain relief.
If Tylenol or Motrin do not provide pain relief, you may need narcotic (opiate-based) pain medications in addition to some of the other medications listed. Narcotics are started at a low dose and are increased gradually until the pain is controlled, as long as there are no side effects.

Other things to try:

Be sure to keep your healthcare provider informed about how your symptoms are, especially if they are worsening. Report any medication side effects.
Inspect your feet carefully every morning and every night, including between the toes and the bottoms of the feet. You may hurt your foot and have an infection, but may fail to feel pain due to the neuropathy. Always were socks and properly fitted shoes; do not go barefoot.
Massaging your hands and feet or soaking them in cold water may provide temporary pain relief.
Keep your hands and feet cool; many people report feeling more comfortable sleeping without sheets or blankets on their feet.
Click here for some refernces about experimental treatments that you may wish to consider.
Some people report good pain relief with accupuncture. Many AIDS Service Organizations offer accupuncture to patients free of charge.
Get up and walk around!

DISCLOSING YOUR HIV STATUS TO OTHERS

2007-01-08T07:31:00.000-08:00

If you recently found out that you are HIV positive, you will need to notify any sexual partners or people with whom you have shared needles of your status so that they can get tested. If you are unable to do this yourself, the local Health Department in your area will notify people that they might have been exposed to HIV without mentioning your name.

Whether you have just recently tested positive for HIV or have known your status for a while, it can be difficult to know who to tell about it, when to tell them, and how to go about telling them. Other than notifying sexual partners or people with whom you have shared needles that they may have been exposed, the decision to disclose your HIV status is entirely up to you. You don't have to tell anybody. Once you tell somebody that you are infected with HIV, they will never forget it, so it is important that you take your time to decide if you are ready to do this.

The Benefits of Telling Others:

You can choose to tell people who you trust and who you feel will be able to offer you love and support. The support and understanding of close family members and friends will help you to deal with the diagnosis of HIV and with the physical and mental health challenges that you will face living with this chronic disease. Having someone to talk with will help as you deal with the emotions that you undoubtedly are feeling; anxiety, fear, anger, disbelief, and depression are all very common.
You will not have to hide your HIV status; keeping a secret of this magnitude from those you are close to can be extremely stressful. By disclosing your status, it will be easier for you to go to appointments for health care and to take medications if needed. You will also have the option of having someone come with you to medical appointments in order to help you to understand and deal with your health issues. In addition, your family will benefit from knowing that you are receiving good health care.
You will reduce the chances of transmitting the virus to others. You will be able to educate yourself and others about how the virus is spread and dispel any myths about casual household contact resulting in infection. You will learn how to protect yourself and your sexual partners. It is important to note that in many states in the U.S. not telling a sexual partner that you are HIV positive before having intimate contact is considered to be a felony.Whether
Whether or not you disclose your HIV status to other health care providers is your decision, but they will be able to provide better and more appropriate care to you if they are aware of your stHealthcarelthcare providers are knowledgeable about how to protect themselves against HIV.

The Downside to Telling Others:

People may discriminate against you because you have HIV. This is largely due to fear of the disease and the lack of understanding in the general population about HIV and how the infection is spread. There are also issues of stigma relating to sexual preferences or even drug use that many people have to deal with. You may face uncomfortable questions from people about how you became infected.
Others may have a difficult time accepting your status; they may back away from you because they do not know what to say or do, or they may be overly-concerned and overprotective. Again, educating people oftentimes helps those close to you to accept and deal with an HIV diagnosis.
You may be rejected in dating situations and find it difficult to become indiagnosis.Youew relationship due to the fear of rejection once you disclose your status. Every situation is different, and you don't have to tell everyone that you date that you are HIV positive. However, if the relationship evolves to a point where you will be in an intimate situation where HIV could be transmitted, you will need to discuss your HIV status. The longer you wait, the more difficult it can be for both you and your potential sexual partner.
It is illegal for employers to inquire about your health or any disabilities partner.Itay have, however they may legally ask you if you have any conditions that would result in you being unable to perform essential functions of the job. All HIV positive Americans are protected from job discrimination under the Americans with Disabilities Act (ADA). As long as you are able to perform the essential duties of the job, your employer cannot discriminate against you because of your HIV status. If your illness or the side effects of medications interfere with your performance, or if you require time away from work frequently for medical appointments, you may want to consider discussing your HIV status with your employers and presenting them with a letter from your healthcare provider verifying your disability. Most employers will gladly make any accomodations necessary for an employee who wants to continue working. Be sure to inform them if you want to keep your HIV status confidential; they are prohibited by law from disclosing your status to anybody else.

When you are considering telling someone else that you are HIV positive, try to anticipate and prepare for their reaction. Be ready to answer questions about your health and about HIV disease itself. You may want to have some brochures or written information available to help the person to understand. Above all else, realize that you cannot control how other people will react to or feel about the news that you are infected with HIV. Have someone available who can support you and help you to accept the reaction that you get.

THE NEWBORN OF AN HIV POSITVE WOMAN

2007-01-03T04:39:00.000-08:00

Despite careful pre-pregnancy planning, close prenatal monitoring and excellent HIV specialist care, there is still that minute (less than 2%) chance that an HIV positive mother will deliver a baby who has been infected with the virus. It is natural to want to know immediately whether or not the baby is infected with HIV, but it takes at least 3 months and sometimes as long as 18 months to definitively determine the HIV status of the baby. During this time, the baby will receive a number of blood tests and will be given medication.

All babies born to HIV positive mothers will test positive for HIV antibodies at birth and for many months afterwards, because the baby is born with the mother's antibodies (this is true for HIV positive as well as HIV negative babies). Over a period of months, the baby will lose the mother's antibodies and develop his or her own. HIV antibody testing will be done on the baby at birth and then again at 1 month and at 3 months (also at 6 months if the 3 month result is positive or questionable). Once the HIV antibody test comes back negative, the baby is determined to be HIV negative, and no further testing is required. If the tests remain positive, further tests will be done to determine if the baby is infected with HIV.

After the baby is born, he or she will take an anti-HIV medication, usually AZT in liquid form, once daily for 4-6 weeks. Studies have shown that this may play a role in further decreasing the risk of HIV infection in the baby. Along with AZT, the baby will also take medication to prevent pneumonia. Both of these medications will be stopped after the baby is determined to be HIV negative.

Breastfeeding is a major mode of transmission of HIV; studies have shown an estimated 29% transmission rate from mothers who breastfeed their babies. Therefore, the newborn cannot be breastfed. The healthcare provider will prescribe the right formula for the baby and will monitor his or her tolerance to the food an growth.

After the baby is born, the mom must continue to closely follow all of the recommendations of her HIV treatment specialist and do everything that she can to keep herself healthy. By working closely with her healthcare providers, the HIV positive mom can look forward to raising children and seeing them grow and mature into adulthood. HIV no longer prevents women from fulfilling their dreams to have families, and that is a huge step forward in this epidemic.

PRENATAL CARE FOR THE HIV POSITIVE WOMAN

2007-01-02T14:41:00.000-08:00

HIV infection no longer prevents a couple from having children. With the proper planning and medical care and by taking good care of herself during the pregnancy, an HIV+ woman can look forward to a long and healthy life for herself and her child. If an HIV positive woman is pregnant, she has hopefully planned the pregnancy and discussed the appropriate HIV treatment and medical precautions that must be taken to minimize the risk of transmission of HIV to her baby with her HIV specialist and with her obstetrician. By instinct, most women will do whatever it takes to care for their unborn children. Good prenatal care and monitoring is essential for any woman, but especially for the HIV+ woman.

Pregnancy and HIV disease: Pregnancy does not affect the course of HIV disease in any way. It will not make the HIV better or worse. The CD4+ cell count will drop during pregnancy, which is normal for any woman, regardless of HIV status, but this will return to the pre-pregnancy levels after delivery. If the CD4+ cell count drops too low, the woman may need additional medications to prevent opportunistic infections.

Mother-to-Child Transmission of HIV: If a woman is HIV+, the virus can be transmitted to the baby while the baby is in the uterus, during labor and delivery, or through breastfeeding. The factors that can reduce the transmission for each of these situations will be discussed. Overall, with proper medical care, the rate of mother-to-child transmission in the U.S. is less than 2%.

HIV medications and Pregnancy: Certain HIV medications, as well as other medications, can result in birth defects; hopefully the woman has discussed her pregnancy plans with her HIV treatment specialist and is on an appropriate regimen of antiretroviral medications (ARV) before she conceives, if they are needed. If so, she may continue with these medications as long as she is able to be adherent to them consistently throughout the pregnancy, or she may discuss stopping the medications until after the first trimester, when organ development of the baby is complete. If a woman is not on HIV medications, she should be at some point during the pregnancy; an undetectable HIV viral load decreases the risk for transmission to the baby during the pregnancy and during delivery. Most often, the ARV medications will not be started until after the first trimester; morning sickness may make it difficult to adhere to medications initially, and the effects of ARV medications on the development of the baby are not fully known. Click here to view the current U.S. Department of Health and Human Services Guidelines for ARV therapy during pregnancy.

Delivery: Today, HIV+ women who are on effective ARV therapy and whose HIV viral load is undetectable, vaginal delivery is a viable option; under these circumstances, the risk of transmission is about the same as with a C-Section, and the C-Section carries with it the risk of any major surgery. If a woman is not on ARV therapy or if her viral load is >1,000 at the time of delivery, however, a C-Section becomes necessary to reduce the risks of transmission of HIV to the baby. The method of delivery will be decided upon after the woman and her treatment specialists discuss her particular situation and the risks and benefits of each method.

Through careful planning and by following the advice of an experienced HIV treatment specialist, HIV+ women can now fulfill their hopes and dreams of having happy, healthy children.

Future posts will discuss the care of the newborn, including HIV testing.

SOUND OFF AND MAKE A FEW $$$$

2006-12-29T13:33:00.000-08:00

I came across a site called "MyLot", which is basically a discussion forum which has recently exploded with members; currently there are over 50,ooo worldwide. MyLot earns money from third-party advertising that is displayed on the site, directed towards target audiences. The ads are displayed based on the particular discussion that is going on. For example, if you are initiating or responding to a discussion using the keywords "aids" or "HIV", the ads that are displayed are those that would likely be of interest to you, such as ads for HIV medications, medical information, websites centered around HIV disease, and health insurance. A very small portion of the revenue generated from these ads is payed to the members, based on the number of responses and the quality and depth of the discussion. Just about anything is discussed: health issues, religion, current events, sexuality, politics, foreign relations... it's pretty much endless. This is NOT a get-rich-quick scheme; in fact, the money that you make will be only "pocket change". I was thinking that it would be great to have more people there who would get involved with some discussions to educate people worldwide about HIV/AIDS, sexuality issues, discrimination associated with HIV, and perhaps most importantly about HIV prevention. There are a lot of users from developing nations who have only a very basic knowledge of HIV; it's pretty pathetic. If this is something that appeals to you, check it out through this link.

WEIGHT LOSS INFORMATION

2006-12-29T12:37:00.000-08:00

As everybody knows, more people with HIV and AIDS are living longer, and the days of everybody who is infected with HIV being "skinny" and "wasted" are behind us. Granted, I will not make light of lipodystrophy syndrome, nor will I minimize its devastating effects on those who suffer from it; but we are seeing a dramatic increase in the number of HIV+ people who are overweight and/or obese. This, combined with some of the metabolic and lipid problems associated with HIV disease (high blood sugar, high cholesterol and abnormal ratios of good vs. bad cholesterol) makes these people particularly vulnerable to the development of Diabetes and early, aggressive heart and blood vessel disease.

A healthy diet and exercise program are recommended for all HIV+ persons, just as it is for anyone else. For those who are looking for a little bit of "help" with their weight loss efforts and who are interested in an all-natural product to decrease their appetite, I am including links to my blog about the supplement Hoodia Gordonii, as well as to my Website. Both of these sites offer a wealth of easy-to-understand information about Hoodia.

As always, please discuss any weight loss, exercise, or natural products that you plan to take with your healthcare provider. I will note here that the supplement Hoodia has no known side effects, and there are no interactions with any medications.

ABOUT RYAN WHITE AND THE RYAN WHITE CARE ACT

2006-12-28T11:23:00.000-08:00

RYAN WHITE
Anyone who is involved with the HIV/AIDS epidemic in any way, either as a patient, a family member or a friend of a patient, or as an employee or volunteer in the healthcare field has undoubtedly heard about The Ryan White Care Act and about the federal funding for HIV/AIDS programs that is supplied as a result of the program. However, many people today do not know the background of the Ryan White Care Act, and I feel that it is essential for all of us involved in this epidemic to know the history behind this program and to know Ryan White.

Ryan White was born in Kokomo, Indiana (U.S.) in 1971. He was diagnosed with hemophilia (a disorder where the blood is unable to clot normally due to a deficiency of Factor VIII, one of the essential clotting factors) when he was only 3 days old. Ryan needed transfusions of Factor VIII ( a blood clotting factor) twice a week for his entire life to prevent him from bleeding to death.

In 1984, while he was hospitalized for the treatment of an aggressive pneumonia, Ryan was diagnosed with AIDS after he had surgery to remove a part of his lung to treat the pneumonia.

He had been infected with HIV through one of the multiple life-saving transfusions that he had received. Ryan was 13 years old, and was given 6 months to live. He went on to fight the disease and turn his illness into something that people would learn from and benefit from for years.

In the early 1980's, AIDS caused panic and fear among just about everyone due to the fact that not much was known about the disease at that time. Ryan was expelled from his school due to the supposed risk to the other students, but was determined to return to school and live his life normally. After legal battles, Ryan won the case and was readmitted to school with the provisions of a separate restroom and disposable utensils and plates in the cafeteria. Ryan and his family continued to face discrimination and threats of violence; his locker at school was vandalized and a bullet was even fired into the family's home. Ryan and his family eventually moved to Cicero, Indiana, a neighboring town, in order to escape the discrimination.

In Cicero, Ryan and his family were welcomed by the town, his new classmates, and the school faculty. The Whites lived in a house that was purchased for them by Michael Jackson, and Ryan became well-known and well-respected by his classmates. Ryan participated in benefits to raise awareness about AIDS and money for AIDS patients. He was actively involved in educating people about the nature of HIV and AIDS and how it could be transmitted; he was proof that it was not a "gay" disease. He was instrumental in educating the country that it was safe to be around someone with the disease and that the virus was not transmitted by casual contact. Ryan made a big difference in the early years of the AIDS epidemic. He even spoke before the President's Commission about AIDS; click here to read his testimony. Ryan appeared on national television news shows and talk shows many times, attended many benefits for HIV/AIDS and acted as the "poster-boy" of the disease, and even had a movie made about him, "The Ryan White Story", which aired on ABC.

Ryan died in 1990 of pneumonia caused by AIDS, at the age of 18. His funeral was a standing-room-only event attended by many celebrities including Elton John, Michael Jackson, Phil Donahue, and Judith Light.

Congress enacted the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act in 1990. Besides Medicare and Medicaid, this program is the largest federally funded program for the the medical and psychological care of those living with HIV and AIDS. The program has been continuously funded since it began.

POLITICS AND HIV/AIDS IN THE UNITED STATES

2006-12-23T08:53:00.000-08:00

Last weekend, Congress passed the Ryan White Care Act Re-authorization Bill, which provides funding for HIV/AIDS programs in the United States. The bill was passed by a voice vote as a Compromise Measure. The initial bill was passed by the House earlier this year, and vetoed by Congress due to disagreement regarding the allocation of funds; President Bush praised the members of Congress for their bipartisan compromise regarding the bill.

The original bill, which was vetoed by Congress early in 2006, called for a decrease in federal funding to urban areas for HIV/AIDS care and an increase in funding to rural areas which were experiencing an increase in the numbers of HIV/AIDS patients. The Compromise Measure will maintain 95% of the funding levels of 2006 for urban areas in the coming year (although the urban areas were requesting a great increase in funds), and increase the funding to some rural areas in need. The funds for prescription drugs used to treat HIV/AIDS will be unchanged. The legislation also calls for reconsideration of the bill and restructure the Ryan White Care Program with new laws after 3 years.

These changes will allow the Secretary of Health and Human Services more flexibility when deciding which areas of the country have the greatest need and then directing the federal funds to those areas. This will provide the patients who are in the high-need rural areas more access to life-saving services than they have had in the past, and will also maintain most of the funding to the urban areas so that they can continue to provide adequate services to those infected with or affected by HIV/AIDS.

Click here to read the full article from the NY Times.

LOOKING TO THE FUTURE- THE WORK WE HAVE AHEAD OF US IN THE FIGHT AGAINST HIV/AIDS

2006-12-23T04:30:00.000-08:00

There is no way to predict how the HIV/AIDS pandemic will turn out. Many feel that entire developing nations will literally "disappear" as more and more of their people become infected with HIV and do not have access to care. I think that this is an unrealistic and improbable prediction. The international community has recognized the seriousness of the problem and seen the impact of HIV/AIDS in some of the developing nations. Governments are becoming mobilized and involved in the fight against this devastating disease. HIV and AIDS is now being recognized internationally as a major health issue, a social issue, and a political issue. Most would agree that it is going to take international effort and the collaboration and cooperation of many different governments to contain the spread of HIV and to resolve the issues surrounding it, such as access to early testing and adequate care and medications.

All governments in the world must be actively involved in the fight against HIV and AIDS.
Education and prevention efforts must be culturally specific.
All age groups need to be educated regarding condom use and the prevention of HIV.
Common myths and misconceptions about sexuality and HIV need to be challenged; for example, some cultures believe that AIDS is a curse of the Devil, and that praying to God will prevent or cure it.
Education and legislation is needed to reduce the discrimination and prejudice that exists towards those who are infected with HIV.
Access to free condoms needs to be increased.
Free HIV testing needs to be available worldwide.
Adequate treatment and medications must be made available to all who are HIV+ so that they can live longer, healthier lives and also avoid transmitting the virus to others.
The pharmaceutical companies who manufacture and market antiretroviral drugs for the treatment of HIV must continue to provide medications at an affordable price or at cost to the developing world.
The children worldwide who are orphaned as a result of AIDS must be cared for in stable environments and educated about prevention of HIV infection.

Unlike any other time in history, this is the time for the entire world to unite and work together.

WORLDWIDE HIV & AIDS STATISTICS

2006-12-22T20:23:00.000-08:00

WORLDWIDE:
As of late in 2006, the world population (the total number of human beings alive on the planet Earth) was 6.5 billion people.

In 2006, there were approximately 42 million people in the world living with HIV and AIDS, and 74 % of these people live in sub-Saharan Africa.

Over 19 million women worldwide are currently living with HIV/AIDS.
There are 2.3 million children worldwide living with HIV/AIDS.
Over 22 million people worldwide have died from AIDS since 1981.
There were 2.9 million deaths worldwide from AIDS in 2006.
The United Nations estimates that there are currently 14 million AIDS orphans worldwide, and they have predicted that number to increase to 25 million children by the year 2010.
Ethiopia, Nigeria, China, India, and Russia account for 40% of the world's population, and it is estimated that there will be 50-75 million people infected with HIV living in these areas by the year 2010.
Every day, 14,ooo new HIV infections are diagnosed worldwide; 95% of these people live in developing nations.
There are approximately 5 million new infections worldwide each year, with half of them occurring in people ages 15-24 years.

UNITED STATES STATISTICS:

It is estimated that 1 million people in the United States are currently living with HIV and AIDS.
There were approximately 14.000 deaths due to AIDS in the U.S. in 2006.
Approximately 40,ooo new infections are diagnosed each year.
Half of all new infections in the U.S. occur in people less than 25 years of age.
70% of new infections in the U.S. occur in men, and 30% occur in women.
75% of the new infections occurring in women in the U.S. are transmitted heterosexually.
54% of the new infections in the U.S. occur in African Americans; 64% of all new infections among women in the U.S. occur in African American women.
HIV/AIDS has been reported in all 50 states, the District of Columbia, and all U.S. territories.
It is estimated that there are up to 1/4 million people in the U.S. who are HIV positive and are unaware of their status.

These are very alarming statistics; it is possible that these numbers are actually low, especially for the worldwide cases, as many developing nations lack the sophistication to track and report cases accurately. People are living longer with HIV/AIDS due to advances in the development of new antiretroviral medications and better laboratory monitoring. In addition, the availability of rapid HIV testing procedures has helped to diagnose more people at an earlier stage of HIV disease, getting them into treatment before the disease progresses to AIDS.

It is clear that action needs to be taken by all of the nations in the world to launch widespread campaigns to educate people about HIV/AIDS and about the use of condoms and other means to prevent infection. This has become much more than a health issue; it is now one of the most important social and political issues in the world today.

WE HAVE A LOT OF WORK TO DO WHEN IT COMES TO HIV AND AIDS EDUCATION

2006-12-21T05:52:00.000-08:00

The following quote was posted on a message board and discussion forum that I visit frequently. The writer listed his location as Nigeria and his age as 29 years; no information regarding education was given:

"Can you contact AIDS after having sex. I don`t think so.AIDS has its spiritual origin from the marine kingdom.It is the Devil that afflict people with it.We normally cast it out through prayer and the afflicted receive their healing.I have seen people that contacted it without even being unfaithful to their partner.If you see yourself eating in the dream when sleeping,there`s the possibility that you can contact it.You need to be totally delivered from every manipulation of the Devil".

The first response of any person in the Western World who is educated about HIV and AIDS, regardless of their ethnic or religious background, would be a reactionary one; we would respond in an emotional fit of anger, most likely referring to the person as ignorant, stupid, or a lunatic. After I re-read this post and gave it some serious thought, I realized more than ever how much work we have ahead of us in the development and initiation of HIV and AIDS prevention and education initiatives in the developing world. If this is truly the belief of the people in some of these areas, such as Africa and India, where the epidemic is growing at alarming rates, then approaching these societies with our beliefs is not going to have an impact. The education and teaching has got to be culturally sensitive and specific, and it must be approached within the context of the belief systems of the people involved.

Every human being has a right to their own religious belief system, and we need to be tolerant of their beliefs and values. The leaders in global education and prevention need to come up with a way to help these people understand what HIV is, how HIV is transmitted, how to prevent infection, and how HIV and AIDS is treated. The teaching is going to have to incorporate the people's religious belief systems into this education in order to get them to buy into it. If people believe that HIV and AIDS is the curse of the Devil and that it can be cured by prayer, it is going to take a lot more creativity than sending a few celebrities across the world to hand out free condoms and offer HIV testing to these people to contain the epidemic.

I have included some links to organizations that address the World AIDS Prevention efforts:

http://www.unaids.org/en/

http://www.cdc.gov/nchstp/od/gap/

http://www.alertnet.org/thenews/fromthefield/219487/116654337195.htm

http://www.globalstrategies.org/

BRISTOL-MYERS SQUIBB "LIGHT TO UNITE PRGRAM"

2006-12-15T08:24:00.000-08:00

Bristol-Myers Squibb(BMS) and the National AIDS Fund launched the 3rd annual "Light to Unite Campaign" on 11/27/06 to support World AIDS Day. I just found out about this campaign today, and will pass along the information, since the campaign is active until 12/31/06.

Bristol-Myers Squibb is a major pharmaceutical company whose mission statement includes: "At Bristol-Myers Squibb, our mission is to extend and enhance human life by providing the highest quality pharmaceuticals and health care products". Bristol-Myers Squibb developed, manufactures, and sells several life-saving antiretroviral medications to treat HIV and AIDS: Sustiva (efavirenz), Reyataz (atazanavir), Zerit (stavudine), Videx EC (didanosine), and it shares the co-marketing of Atripla (Truvada plus Sustiva in a combination pill) with another major pharmaceutical company.

The National AIDS Fund was founded in 1988 to reduce the incidence and impact of HIV/AIDS by promoting leadership and generating resources for effective community responses to the epidemic; the organization connects national and local funders, scientists, and community based organizations in the fight against the worldwide pandemic of HIV and AIDS.

People across the United States are encouraged to visit the "Light to Unite" website to educate themselves about HIV and AIDS and the issues surrounding the disease, as well as to show their support for those who are infected with or affected by the virus. On the website, visitors can light a "virtual candle" to show support for those living with HIV and AIDS. For each candle that is lit, BMS will donate $1, up to a maximum of $100,ooo, to benefit AIDS Service Organizations in under-served areas of the United States. This campaign is active until 12/31/06, however at this time the maximum of $100,000 has already been reached. Please continue to visit the site, share your experiences and knowledge, and educate yourself about the disease. BMS has a strong commitment to the support of HIV and AIDS education and treatment, and it would not surprise me if they responded to an overwhelming response to the campaign with additional contributions.

BMS also sponsors a program called "Secure the Future", which is dedicated to providing care and support to women and children in Africa with HIV and AIDS. Click here to learn more.

DECIDING TO HAVE A BABY WHEN YOU ARE HIV+

2006-12-13T05:43:00.000-08:00

Not too many years ago, the idea of an HIV infected woman choosing to have a baby brought about strong opposition from just about everyone, including medical professionals who were involved in the treatment of HIV disease. In the past, people with HIV were not expected to live long, and the chances of their children being born HIV+ was greater than 25%. Today, with the advances in the care and treatment of HIV, people are living longer, healthier lives. Many HIV+ women are now making the decision to become pregnant and start a family, with the support of their HIV treatment specialists.

Although there are still many people, including medical professionals, who would discourage an HIV+ woman from having a baby because of the risk of mother-to-child transmission of the virus, most HIV treatment specialists now have an acceptance that starting a family is in fact an option for an HIV+ woman. With the advances in treatment, the risk of transmitting the virus is less than 2% overall, and studies have proven that pregnancy and childbirth does not affect the progression of HIV in the mother in any way.

Women who take HIV medications and have an undetectable HIV viral load have the lowest risk for transmission of the virus to their babies; however, certain medications can cause serious birth defects and must not be taken if a woman is pregnant or trying to become pregnant. It is vital that the decision to become pregnant be discussed with the healthcare provider in advance so that the woman is on an appropriate regimen of medications.

Most couples cannot afford procedures such as sperm-washing, so they will make the decision to have unprotected sex in order to get pregnant; unprotected sex itself has risks (other than pregnancy) which the couple needs to consider. This is a personal and individual decision which both partners must make after they have been informed of the potential risks and the ways to minimize those risks as much as possible. If the man is HIV negative, he should know that unprotected sex with an HIV+ woman could put him at risk for becoming HIV+, although the transmission rate from females to males through unprotected vaginal sex is lower than it is from males to females; the risk is decreased even further if the woman is taking antiretroviral medications to treat the HIV and her viral load is undetectable. If both partners are HIV+, unprotected sex can cause one partner to become reinfected with a different HIV virus, potentially leading to treatment complications in the future. Either way, there is risk involved. If a woman is trying to become pregnant by having unprotected sex, she should be taking HIV medications consistently and have an undetectable HIV viral load (as should her partner, if he is also HIV+). The couple should receive preconception counselling from an obstetrician to determine the time of the month when the woman is most fertile, and engage in unprotected sex only at that time; condoms should be used for the remainder of the month.

As with any woman, an HIV+ woman who is trying to become pregnant should give up smoking and avoid all alcohol and drug use. She should have a gynecological examination and PAP smear and be screened for other sexually transmitted diseases, and she should start taking prescription prenatal vitamins containing folic acid and calcium before she becomes pregnant to help ensure the health of her baby.

A couple will most likely encounter some critical, negative, and unsupportive attitudes from certain family members or friends regarding their decision to have a baby, and they should be prepared to deal with this. Many people are unaware of the advances in HIV treatment, and simply educating them will help them to become more understanding and supportive. The couple should encourage people who are critical of their decision to ask questions, and assist them in getting the knowledge that they need to understand their decision. To reduce stress, the couple may find it helpful to seek supportive counselling from a mental health professional so that they can discuss their feelings openly.

Future posts will discuss other aspects of pregnancy and HIV disease, including childbirth and the care of the newborn.

AT THE TOP OF THIS POST IS A PICTURE OF MY GOD-DAUGHTER, ZARIA, WHEN SHE WAS 3 MONTHS OLD. BOTH OF HER PARENTS ARE HIV+ ( IN FACT, HER DAD IS AIDS-DEFINED, BUT IS DOING VERY WELL ON MEDICATIONS). ZARIA IS NOW 1 YEAR OLD, AND IS HIV NEGATIVE. SHE IS A VERY HAPPY, HEALTHY BABY WHO HAS BROUGHT LOVE AND JOY TO A LOT OF PEOPLE, BUT ESPECIALLY TO HER PARENTS, WHO WANTED TO HAVE A BABY TOGETHER AND PLANNED HER BIRTH.

THE POSSIBILITY OF A CURE FOR AIDS

2006-12-06T11:37:00.000-08:00

Although great advances have been made in the treatment and monitoring of HIV and AIDS since the 1990's, the possibility for a cure remains elusive.

The possibility of scientists finding a cure for AIDS (acquired immune deficiency syndrome) or a vaccine to prevent the transmission of HIV (human immunodeficiency virus, which causes AIDS) in the foreseeable future is very improbable, if not impossible. This is definitely not due to a lack of effort on the part of science. The fact is, HIV is a very clever and resilient virus; it is capable of mutating very rapidly in order to ensure its survival in the body. As the virus mutates and is transmitted to another human being through blood and body fluid contact, such as unprotected sexual activity, it will continue to mutate and change in the new host.

Scientists are zealously studying and trying to understand this virus, and will continue to do so, in hopes of discovering a breakthrough "cure". In the meantime, billions of dollars are spent by the pharmaceutical companies each year on research and development of new and less toxic treatments for HIV and AIDS. To say that nothing is being done is very much a wrong impression. The work is being done, it just doesn't seem to be giving us the instant results that we want.

We may not be happy about the fact that this disease is here, and seems to be here to stay. We may be appalled at the rates of infection in areas of the world without sophisticated medical care, such as South Africa, parts of Asia, and the Caribbean. But we have to admit that the effort is being made, and will continue to be made, to control and contain this virus- if not eradicate it.

HIV and AIDS knows no boundaries. It is no longer about politics, sexual orientation, lifestyle, or drug use. It is about being human. It is not up to us to judge how someone might have become infected; that really doesn't matter. We are all susceptible; the next diagnosed case of HIV could be any one of us. We have a responsibility to be compassionate to any human being who is infected with or affected by HIV.

THE GLOBAL IMPACT OF HIV AND AIDS

2006-11-30T04:51:00.000-08:00

Tomorrow (Friday, December 1, 2006) is designated as the 18th annual World AIDS Day. The goals of this international effort are to increase awareness about HIV and AIDS, encourage support and understanding for people living with HIV and AIDS, and reinforce the need for continued education about the disease and the development of new and more effective prevention initiatives that can be used in the developed as well as the developing areas of the world.

My postings on this blog have centered mostly around the issues and treatment of HIV infected persons living in the United States, or other medically advanced societies. This is not to ignore the worldwide pandemic. I am very much aware of the devastation that this disease is causing worldwide, and of the seemingly insurmountable obstacles to education, prevention, diagnosis, and adequate treatment that exist in other parts of the world. I want to share some facts about the global impact of HIV and AIDS.

HIV and AIDS has been reported in all regions of the world, but most of the people infected with the virus are living in lower income (developing) countries. The pandemic is growing at alarming rates; It is estimated that AIDS has already claimed over 25 million lives, and that close to 40 million people worldwide are currently living with HIV and AIDS, although these numbers are not precise because many areas of the world lack the sophistication to develop accurate surveillance and reporting systems.

In the United States, HIV and AIDS prevalence continues to be high among certain sub-populations, such as African American and Hispanic women. However, certain regions of the world have been particularly hard hit by the pandemic; the most affected regions of the world are: Sub-Saharan Africa, Latin America and the Caribbean, Eastern Europe, and Asia. Heterosexual transmission is the most common method if infection in these areas.

The United Nations and many international donors, as well as the governments of affected nations have made great efforts at fund raising to develop prevention and treatment initiatives that will be effective in these hard hit areas, but much work remains to be done. I also want to mention that, as a consultant and advisor for several major pharmaceutical companies who do research, development, and marketing of drugs used to treat HIV and AIDS, I know that the pharmaceutical companies themselves have become very much involved in manufacturing their drugs and distributing them at cost (with no profit to the company) in many of these regions.

HIV and AIDS is clearly not going away anytime soon. In a sense, we are all living with HIV. We need to promote education and understanding in our communities that these issues affect everyone. World AIDS Day is a start; don't forget to wear a red ribbon to show your support.

DO SMOKERS HAVE THE RIGHT TO SMOKE?

2006-11-29T07:12:00.000-08:00

Some businesses provide an area where their employees can smoke. This businessman got very creative when painting the ceiling in his company's smoking room. How could anyone "enjoy" a smoke while looking up at a simulation of their own funeral? What better incentive could there be to quit!

Read my previous post on "Smoking and HIV". It contains some very compelling reasons why you should continue to make serious attempts to quit until you are successful, as well as some great links to help you out.

ROUTINE HIV SCREENING RECOMMENDATIONS

2006-11-28T13:36:00.000-08:00

Based on the lack of progress in preventing the transmission of HIV infection and the fact that early recognition and treatment of HIV disease keeps people healthy longer, slows the progression to AIDS, and may prevent the unknown transmission of the virus to others, the Centers for Disease Control (CDC) issued revised guidelines for routine screening for HIV infection in September, 2006. The new guidelines state that all patients ages 13-64 who present in any health care setting should have a baseline HIV test done as a part of normal preventive medical care. Testing should be voluntary; patients should be informed about HIV testing and given the choice to opt-out of it.

Repeat screening for persons determined not to be at high risk should be done based on clinical judgment, making it essential that healthcare providers incorporate a thorough assessment of lifestyle and sexual practices into annual healthcare for all patients in order to identify risk factors. Healthcare providers should encourage patients and any new prospective sexual partners to have HIV testing done prior to initiating a sexual relationship.

Persons considered to be at high risk should be screened at least annually; these people include injection drug users and their sexual partners, sexual partners of someone who is known to be HIV positive, persons who exchange sex for drugs or money, any male who has had sex with another male, anyone treated for a sexually transmitted disease, and anyone who has had unprotected sex or sex with more than one person since their last test.

Pregnant women should be tested during their first prenatal visit and then re-tested during the third trimester of pregnancy. This testing is voluntary, but if the woman refuses testing and her HIV status is unknown at the time of labor, the newborn should be screened immediately after birth; in the United States, screening of the newborn can be done without parental consent.

It goes without saying, of course, that prevention counselling and discussion of safe sexual practices should also be a part of the routine care of all patients, regardless of whether or not they admit to being sexually active. The hope is that this more aggressive approach to prevention of new HIV infections and early diagnosis will positively impact the transmission of HIV, thus decreasing the number of new infections.

REMEMBERING TO TAKE HIV MEDICATIONS

2006-11-27T05:57:00.000-08:00

It is well known and understood by everyone who treats HIV and by those who are taking medications for HIV that excellent adherence to the medication regimen is required in order for the medications to work and to prevent the virus from becoming resistant to the medications that are prescribed, as well as to other medications that may be needed in the future. The development of drug resistance is a very complicated issue. The bottom line is that many well-executed clinical trials have proven that these medications must be taken exactly as prescribed, following instructions for taking them with or without food, at the proper times and intervals. Adherence to these medications needs to be at least 95%, which doesn't leave much room for error, complacency, or "forgetting".

HIV treaters and the adherence counselors and nurses working with them spend many hours educating patients and assessing their adherence to medications. This issue is addressed intensively when a patient starts medications, and on all followup office visits. Most AIDS Service Organizations and HIV providers have a formal Adherence Program, which evaluates a patient's knowledge of HIV and his or her readiness to start medications and helps to identify any potential barriers to their success in being able to take the medications consistently. Drug and alcohol abuse and mental illness issues need to be addressed at this point, although in many cases patients with these issues are able to take the medications as prescribed. Close one-on-one counseling and support is provided, and the patient is empowered to incorporate the medication regimen into his or her daily life by examining daily routines and ways to be reminded to take the medication as well as how to prepare for unforeseen circumstances (such as working an extra shift at work). Education itself is the best tool for adherence; if patients know why medications are prescribed, believes that they will benefit from them and be healthier, and understands the implications of not taking them consistently, they will be more likely to be adherent. In addition to education, other tools to assist with adherence are the involvement of family or friends to provide reminders, charts with medication times to post in conspicuous areas of the home, organization of pills into weekly pillboxes, keeping an extra dose of medications at work, in the car, or in a purse, and electronic medication reminders.

So, what do we do when all of this fails, and a patient keeps "forgetting" to take their medications? It's back to square-one. The first thing is to re-assess the person's understanding of the importance of taking the medications as prescribed and the implications of missing doses. Next, reassess what is going on in his or her life; unusual or new stress, the breakup of a relationship, recent relapse or increase in drug or alcohol use, and transportation problems to get to the pharmacy are just a few of the many things that could result in someone becoming careless with their regimen. It might be that the patient needs to be referred for substance abuse or short-term mental health counseling.

If the patient convinces us that he or she is committed to taking the medications, but just keeps "forgetting" them, it may be helpful to get the patient to identify a reliable friend or family member who will be willing to commit to making a reminder phone call for each dose. The problem with this is that people get busy in their own lives and may forget to make the phone calls. Still, the idea of phone calls is a great one; most of us won't go anywhere without a cell phone anymore, so it makes sense that phone reminders would work. I did an Internet search for "telephone reminder calls" and "telephone wake-up calls" on Google, and came up with many services that could be utilized for this purpose. There are many different options and rates; the best I found was a place called "MyCalls". Pricing is by the minute or by the month (both are very reasonable), depending on the plan selected. The patient can choose the exact time of the calls, and can change these times online or over the phone if needed. The patient can set the ring-tone on his or her phone specifically for these calls, so that they are not ignored.

I realize that most people don't want another bill to pay each month, especially if they are not working. But the price paid for non-adherence to these medications is much higher than what one of these plans would be. Realistically, if someone can afford a cell phone, there is most likely a way to fit a reminder call service into their budget. A referral for Case Management services or Financial Planning may be beneficial.

WORLD AIDS DAY - DECEMBER 1, 2006

2006-11-27T04:40:00.000-08:00

Approximately 40 million people throughout the world are living with HIV and AIDS, and that number is increasing daily.
December 1 is recognized internationally as World AIDS Day. The aim of the campaign is to encourage people worldwide to unite in the fight against HIV and AIDS to stop the spread of this preventable disease and to end the ignorance and prejudice against those who are infected or affected.

There are campaigns worldwide to raise community awareness of the impact of HIV and AIDS on the population, the issues faced by those who are HIV positive, including their need for support and understanding, and the need for the development of more comprehensive worldwide prevention and education initiatives.

You can support World AIDS Day in many ways:
The Red Ribbon is an international symbol of AIDS awareness. Wear one on December 1 to show your support and to remind others of the need for their support and commitment. Get involved with local community events at AIDS treatment centers in your area. Help to educate people about HIV and AIDS and to raise awareness - get people talking and thinking! Promote education and understanding instead of stigma and discrimination. Encourage safe sex and HIV testing... Use your imagination!

AIDS is not over- in fact, the epidemic is going strong. It is up to all of us to make a difference and to work together towards an AIDS-free world.

FACTS ABOUT INFLUENZA (FLU) AND INFLUENZA VACCINE - Special Considerations for the HIV Positive Person

2006-11-15T19:46:00.000-08:00

When encouraging patients to receive the flu vaccine every fall, I always find it amazing that so many people have misconceptions about the flu and the flu shot. If I were to ask a group of patients what the flu is, I would get many different answers, including descriptions of symptoms of a viral gastrointestinal syndrome (nausea, vomiting, diarrhea), a sinus infection, the common cold, or of true influenza (flu) infection.

Influenza (referred to as flu in this article) is a serious and extremely contagious viral respiratory illness. Complications of the flu can lead to hospitalization and death. According to the Centers for Disease Control (CDC): Every year in the United States, 5% - 20% of the population gets the flu, approximately 200,000 people are hospitalized from flu complications, and approximately 36,000 people die from the flu.

The symptoms of the flu include fever (usually >102F), headache, extreme fatigue, sore throat, dry cough, runny or stuffy nose, and muscle aches. Nausea, vomiting, and diarrhea are uncommon with the flu. Although some flu symptoms resemble those of the common cold, flu symptoms have a much more abrupt onset and are more severe than those of a cold. Possible complications of the flu include bacterial or viral pneumonia, sinus infections, ear infections, dehydration, and worsening of other medical conditions such as diabetes, asthma, or chronic lung disease. These complications can prolong the illness and may lead to hospitalization.

The flu virus spreads from person to person through coughing or sneezing. You may get infected by touching something (such as a doorknob or telephone) that has flu virus on it and then touching your mouth or nose. The best way to prevent the flu is to get a flu vaccination each year between October and December. The flu shot can be offered to all healthy people who want to decrease their risk of getting the flu. Certain people are at high risk for flu complications and should be strongly encouraged to receive the vaccine. These groups are: children (6 months-5 years old), pregnant women, people over age 50, people with chronic medical conditions such as diabetes, asthma, emphysema, HIV infection, AIDS, heart disease), and people living in long term care facilities such as nursing homes and prisons. In addition, all healthcare workers and household contacts of people in the high risk groups, as well as household contacts of infants less than 6 months of age, should be vaccinated to prevent the spread of the virus to those people.

Let's clear up another very common misconception: The flu shot does not give you the flu, and does not make you sick! I can't even count the number of times that patients have told me that they received the shot and got the flu. The vaccine consists of killed influenza virus (killed virus is not capable of causing illness), which causes the body to respond by developing antibodies to protect against the flu. It is this response that causes common side effects of the vaccine, such as a slight fever, chills, headache, and fatigue, for the first 24 hours after the vaccine is given. Remember, this is not the flu.

Some people should not be vaccinated; they include: people with a severe allergy to eggs, people who have had a severe reaction to the flu shot in the past, children less than 6 months of age, and people with a history of Guillain-Barre syndrome (a paralyzing neuromuscular disorder). If you have a moderate or severe illness with a fever, you should wait until those symptoms resolve before getting vaccinated.

If you are HIV positive, most healthcare providers will recommend that you receive the flu vaccine each year. Although there has been some debate and controversy over this issue, it is generally thought that vaccination offers significant benefits to the HIV positive person, including the prevention of serious complications of the flu such as bacterial pneumonia and activation of HIV replication (leading to an increase in HIV viral load and a decrease in the CD4 cell count). In addition, the flu may resemble symptoms of an HIV or AIDS related opportunistic infection; thus, avoiding the flu will avoid an unnecessary workup. The vaccine itself is well tolerated by most people, including those who are HIV infected. There may be a very slight and temporary rise in the HIV viral load, but this will quickly resolve after vaccination. Studies have shown that the body's ability to respond to any vaccine and to build up protective antibodies may be decreased when the CD4 cell count is below 2oo, but it is still recommended to vaccinate these people, as there may still be some protective benefit.

You may hear about the Nasal-Spray Flu Vaccine, and think that this would be a great alternative to getting another injection. Sorry, but if you are HIV positive you cannot receive this vaccine. The nasal spray vaccine is a live vaccine, which contains weakened live virus (instead of killed virus in the injection), and is capable of producing severe illness in anyone with a weakened immune system. If you are HIV positive, you should never receive any live vaccines for this reason.

In conclusion, the flu vaccine is the best protection against getting the flu. However, you may still get other viral respiratory illnesses or even a strain of the flu that was not included in the flu shot. Besides vaccination, the next best defense against viral illness is frequent and thorough hand-washing and the use of antibacterial hand gels which can easily be carried in your pocket, purse, or car. This will help to prevent you from transferring virus you come into contact with to your mouth and nose.

HOME FOR THE HOLIDAYS - Traveling With Your HIV Medications

2006-11-13T15:23:00.000-08:00

Believe it or not, it's that time of year already! As you are busy preparing for the holiday season and making plans to visit with family and friends, you will need to add one more thing to your already long list of things to do. Anyone with a chronic disease has to consider their health when traveling, and HIV is no exception. You must give some thought to your HIV treatment and the medications that you are taking before you pack up and leave.

This article will focus mainly on travel within the United States, although I will briefly touch on a few special considerations regarding international travel. If you will be traveling internationally, you should find out in advance if the country you are planning to travel to has any restrictions on entry for people who are HIV positive; many countries, including the United States, ban people with HIV from entering. Discuss your travel plans with your doctor to determine if any special precautions or vaccinations will be necessary. You should be up to date with your influenza, pneumonia, tetanus, diphtheria, and hepatitis A and B vaccines. If you are traveling across international time zones, you may want to ask your healthcare provider, adherence counselor, or pharmacist to help you work out a plan for adjusting the times of your dosages to avoid long intervals between doses. Find out in advance where you would go if you were to require medical care, and check into getting travel insurance that does not exclude emergency treatment for HIV related illnesses. If you are fortunate enough to be going to a warm and sunny place, check with your pharmacist if any of your medications cause an increased sensitivity to the sun, and bring lots of sunscreen with you.

Discuss your plans to travel with your healthcare provider, and ask for a brief medical letter to carry with you. At the very least, you should have a copy of your latest blood work results, including your CD4 cell count and HIV viral load. Do not start any new medications within 4 weeks prior to traveling in case you should have an allergic reaction.

It is important to remember that taking a vacation does not mean that you take a "vacation" from your medications. As you have undoubtedly heard many times from your healthcare provider, anything less than 95% - 100% adherence to your medications may result in your HIV becoming resistant to your medications, which will cause them to stop working. Whenever your usual schedule and routine is changed, it will take a little bit of extra thought and planning to ensure that you are able to stay on track with your medications.

Whenever you travel, be sure to bring enough of all of your medications with you, as it may be impossible to get these medications when you are away from home. Count out your doses, and take several days worth of extra medications with you in case you get delayed or decide to lengthen your trip. Pack your medications in your carry-on luggage to avoid losing it. You should also carry a letter from your doctor listing your medications and stating that they are being taken for a chronic medical condition.

You may want to invest in some pillboxes to help you to stay on track. Consider prefilling a 7-day pillbox for each week that you will be away, and take along a few tiny single dose pillboxes that you can discreetly carry in your pocket or purse; this will be especially helpful if you will be spending time with people who are unaware of your HIV status.

Do a little bit of planning in advance, and then enjoy your vacation.

Here are a few options for pillboxes that you might want to check out. Once getting to Amazon.com, you can search the site for "pillbox" to view the complete selection and find the items which will meet your needs.

THE GREAT AMERICAN SMOKEOUT

2006-11-12T13:37:00.000-08:00

Meet Joe Chemo, a camel who wishes he'd never smoked cigarettes. Joe Chemo was developed as an anti smoking character by Scott Plous, a psychology professor at Wesleyan University, after his father nearly died from smoking. The idea was to present a more honest image of smoking than the Joe Camel character used by R. J. Reynolds.

Now, for the purpose of this post... The 30th annual Great American Smokeout!! The Smokeout takes place every year on the 3rd Thursday in November (1 week before Thanksgiving). This year's event is on Thursday, November 16, 2006. The Great American Smokeout, sponsored by the American Cancer Society, encourages all Americans to quit smoking for 24 hours- and hopefully longer (forever!!).

Click here for a list of resources and local events for each state. If you commit to quitting for 24 hours, you will not be alone!! This could be the first day of the rest of your (smoke-free) life!!
The best way to quit is one day at a time. Once you make it through the first 24 hours, the hope is that you go to bed at night and say to yourself "Well, I made it today. There's no reason that I can't make it for another 24 hours".

There are so many resources and tools to help you quit smoking - Try a Google Search for "smoking cessation", and see what you get.

A few really good resources are:
http://www.cancer.org/docroot/SPC/SPC_0.1.asp

www.quitsmokingonline.com

http://whyquit.com/

http://whyquit.com/whyquit/A_Symptoms.html

http://quitsmoking.about.com/od/forumgems/

You will also benefit from Allen Carr's book "The Easy Way to Quit Smoking"- I wrote about this book in an earlier post, so you might want to check it out. This book is fantastic; I highly recommend it. "Out of the Ashes", by Peter & Peggy Holmes, is an inspirational handbook designed to help ex-smokers on an ongoing basis.

You can also download an excellent free e-book about the cognitive-behavioural aspects of smoking cessation by clicking here.

Check out the following books at Amazon and Barnes & Noble:

The Easy Way to Stop Smoking

0925190578:Product Link on Barnes & Noble.com.

THE EASY WAY TO STOP SMOKING

2006-11-03T14:35:00.000-08:00

Quitting smoking may perhaps be the most difficult fight of your life. I have had many drug and alcohol addicted patients who are living successfully in recovery from their addictions tell me that quitting smoking will be much harder than abstaining from drug or alcohol use. Who knew, when they started smoking as teenagers, that the cigarette that made them look so "cool" was actually more addicting than heroin... Don't be discouraged. Just as you "learned to smoke", you can "learn to live again without smoking". Read on to discover one of the many tools that you can use as a weapon in your fight to become a non-smoker.

Allen Carr's book "The Easy Way to Stop Smoking" is a must read for anyone who is considering quitting smoking. In this international bestseller (over 6 million copies sold worldwide), Allen Carr teaches the method that he developed in 1983 to help himself quit a 3 pack per day cigarette habit. Since then, he has helped millions of people around the world to finally be free of smoking for good.

When following Allen Carr's method, you will continue to smoke while you study the book and focus on removing your psychological need to smoke. By the time you finish the book, you will have developed the skills to enjoy your life as a non-smoker, and can set a quit date with the confidence that you are prepared to handle any physical withdrawal pangs and tempting situations that occur.

People who have quit with the help of this book attest that they did not suffer from anxiety, depression, serious withdrawal pangs, weight gain, or feelings of deprivation. After hearing about this book, I picked up a copy and read through it myself. I was quite impressed with it; it really made sense.

Quitting smoking is sometimes the hardest thing that someone has to do. Why not pick up a copy. You can continue to smoke while you're reading the book and developing the skills needed to become a successful quitter. You have nothing to lose, except for the unhealthy, costly habit of cigarette smoking. Link to Amazon.com or Barnes & Noble through this site to view the book and purchase online (new and used copies are available).

The Easy Way to Stop Smoking

SMOKING AND HIV

2006-11-03T03:38:00.000-08:00

We all know that smoking is an unhealthy habit for anyone. Tobacco is an addictive and lethal drug, and there is no doubt that it causes many serious health conditions and even early death. Despite all that we know about the dangers of smoking and all of the warnings that are constantly in the media, tobacco is still a widely used drug. As HIV infected individuals are now living longer, we need to take a serious look at the long term health implications of smoking in this patient population.

I won't try to go into all of the health problems caused by smoking or discuss smoking cessation methods in detail here, but I'll provide some great links at the end of this article to get you all thinking about quitting. My objective today is to get HIV positive people thinking about the increased dangers of health problems associated with the combination of smoking and chronic HIV infection. You can get information regarding medical terms and opportunistic infections at TheBody.com.

The only "good" news is that most studies have shown that smoking, in itself, has not been shown to affect HIV infection itself. Smoking does not affect the rate at which the CD4 cell counts drop or how rapidly HIV progresses to AIDS. Antiretroviral medications used to treat HIV are just as effective in smokers as they are in nonsmokers. If you can even consider this to be "good" news, read on to learn about the specific risks associated with HIV and smoking.

Opportunistic Infections and AIDS-defining Illness: Smoking weakens the immune system and interferes with lung functioning. This leads to a decreased ability to fight off infections, making HIV positive smokers more likely to develop certain infections and AIDS-defining illnesses, particularly those related to the lungs (such as PCP pneumonia and MAC). Oral thrush, oral hairy leukoplakia, and bacterial pneumonia also occur much more frequently in HIV positive smokers. In women, smoking can increase the severity of human papilloma virus (HPV), leading to the increased risk of aggressive cervical cancers.
Chronic Lung Disease and Emphysema: Smoking causes a constant inflammatory state in all smokers, and this effect is greatly increased in HIV positive smokers. The lung destruction and emphysema that occurs as a result of this chronic inflammation is greatly accelerated in HIV positive smokers; emphysema will develop more frequently, at an earlier age and tends to be more aggressive and disabling.
Cancer: Smoking has been strongly linked to many types of cancer, including lung, throat and mouth, bladder, and pancreas. Cancers in general seem to occur more frequently in HIV positive people. Similar to chronic lung disease, these cancers tend to occur at an earlier age and be more aggressive in HIV infected people. This is true even in those who are taking HIV medications and have a well-controlled viral load.
Heart Disease: It has been well-established that cigarette smoking is the #1 modifiable risk factor for heart disease. Smoking also increases the risk for high blood pressure and stroke. It is likely that HIV infection itself can increase the risk of heart disease. It is known that certain HIV medications can raise the levels of cholesterol and other fats in your blood, and lower the "good cholesterol", (HDL) and cause certain metabolic changes such as diabetes and high blood sugar, which further increases the risk of heart disease.
Liver Disease: Nicotine is a drug, and it needs to be processed by the liver. When combined with the side effects of toxic HIV medications, liver problems may occur, and any pre-existing chronic hepatitis infections may worsen as a result of the stress on the liver. Smoking has also been shown to interfere with the liver's ability to process certain medications properly.
Osteoporosis (weak, brittle bones): This can be a result of chronic HIV infection itself or the long-term side effects of HIV medications. Smoking has been shown to increase the risk of osteoporosis in all people. As people are living longer with HIV, the risk of disabling bone fractures impacts on quality of life.

The bottom line is that stopping smoking (or not starting if you are a non-smoker) will greatly improve your health and decrease your risks for many serious health problems. Check some of the links below for information on smoking cessation.

http://www.thebody.com/index.html

http://www.quitnet.com/

http://www.quitsmokingonline.com/

http://www.joechemo.org/index.html

http://unr.edu/homepage/shubinsk/smoke.html

http://whyquit.com/

http://www.americanheart.org/presenter.jhtml?identifier=3038016

http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=22937

MORE ON CHOOSING AND TALKING WITH YOUR HIV PROVIDER

2006-11-01T18:50:00.000-08:00

There is much more to your relationship with your HIV specialist than medical appointments, discussing lab results, and medication prescriptions. Your partnership with your provider is your #1 "weapon" in your fight with HIV. In order to remain healthy, you will need to have trust and confidence in your provider. The decisions that you make about your care are very important ones.

Approach your initial meeting with the provider as if you are "interviewing" him or her for the position. Ask questions about his or her background, experience, and approach to treatment (conservative, "canned" approach vs. willingness to make a "custom" treatment plan with you). You should feel that the provider is non-judgemental and willing to listen to and discuss your treatment ideas and goals with you. The provider's role is to educate you so that together you can make informed and knowledgeable decisions, and he or she should be flexible enough to listen to and adjust to your needs. If your questions are met with resistance or hostility, this is a sign that you need to be wary and seriously consider if you will be able to establish a trusting, therapeutic relationship with this person.

Be honest with the provider. In HIV care, the provider needs to really know you as a person. All aspects of your lifestyle are important to your care. Be honest about sexual practices, the use of alcohol and recreational drugs, daily habits, your support system (family, friends, domestic partners), how you feel about having HIV and taking medications, and about any other treatments that you are using or are considering (such as vitamins, herbs, supplements, acupuncture, massage, etc.). If you feel that the provider is judgemental and that you have to hold back certain information or "tell them what they want to hear", then you need to continue searching for the right provider. You need to be totally honest with your provider and be comfortable asking him or her questions, even if they are personal and embarrassing to you.

Consider a situation where you might be having trouble taking your HIV medications (maybe you are having side effects, have a new work schedule, or are dealing with stressful events in your life). You need to be able to openly and honestly discuss these issues with your provider, instead of saying what you think they want to hear. In reality, a good HIV specialist wants to hear what is really going on with you so that they can help you to stick to your treatment plan or develop a new plan, remain health, and prevent complications.

Do not be afraid to ask questions and take notes. Before your appointments, write down your questions and concerns, and take notes so that you can remember what you are told. It is OK to ask for clarification of unclear or confusing explanations or medical terms - Keep asking until you understand. The same thing goes for a provider who speaks with an accent; ask for clarification until you understand what is being said. The provider should be willing and able to explain things so that you can understand them. If you have questions about something that you have heard from a friend, read, seen on the Internet or TV, ask your provider about them. It may also help you to bring a friend, family member, or partner with you to your appointments to help you remember what was discussed.

In my own practice with HIV positive patients, I have had many, many patients approach the first several visits as a "trial". I do not consider this to be threatening or insulting in any way. In fact, it is to be commended, because it shows that the patient is very willing to be an active part of his healthcare. I feel that my willingness to spend extra time with patients and really get to know them as people, and get to know what is going on in their lives, has helped me to provide better care to them. I remember one young man who was moving to my city from the west coast. He came in with his mother and sister for a "tour" of the office. It was clear from the beginning that he was considering 3 different sites for his HIV care, and that he was "interviewing" me. The meeting lasted for over an hour, and he asked most of the questions that I have brought up in this post. My willingness to listen to him and to discuss what was important to him is what won him over, and he initiated and continued his care with me. It turns out that he had a bad experience with a provider in the past regarding starting HIV medications. His CD4 cell count (T-Cells) had been in the 190-250 range for several years, and his provider was insisting that he must start medications. The patient tried to express his concerns, and was pretty much told what he "had to to". The provider did not listen to the patient... My approach was different. I discussed the progression of HIV disease with him, the current Department of Health and Human Services, and gave him the information that he needed to make an informed decision. He discussed his feelings and opinions with me. He felt well, led an active life (work, volunteer activities, social life), was in a monogamous, stable relationship with his domestic partner, ate right, exercised regularly, got plenty of sleep, and did not smoke, drink alcohol, or use recreational drugs. He was very knowledgeable about the side effects and long-term toxicities of the medications, and did not want to take them. We agreed that he was making a reasonable, informed choice, and that we would briefly discuss the issue on every visit, and that he would consider taking medications only if he became symptomatic of HIV disease (began not to feel well). This approach encouraged total honesty from the patient, and it helped me to provide the best care for him. The bottom line is that you and your HIV provider must work together as a team to fight your HIV. You need to be comfortable with each other and with each other's approach
to dealing with your treatment. This is a decision that you are making for life - so make it a good one!

CHOOSING A HEALTHCARE PROVIDER FOR YOUR HIV TREATMENT

2006-11-01T18:46:00.000-08:00

There are a number of things that you must consider when searching for the right healthcare provider for your HIV treatment. "Healthcare Provider" can mean a physician, a Nurse Practitioner, or a Physician's Assistant (Nurse Practitioners and Physician's Assistants are not doctors, but they have received extensive education and training and in most states they are allowed to treat patients with only a minimum amount of physician supervision). You and your provider must work together as a team- and remember, you are the most important member of that team. Take an active role in planning your healthcare, read and learn all that you can about the disease - The Body is a great informational website to explore. Work in partnership with your provider to make decisions about you health care. This will make it much easier for you to stick to your treatment plan and to remain healthy.

If you are newly diagnosed with HIV, you are most likely feeling overwhelmed, and may tend to avoid and procrastinate when it comes to seeking treatment. These behaviours are understandable, but may also be detrimental to your health. Early treatment will help you to understand what is going on in your body, and will also allow your provider to assess whether or not you need life-saving medications immediately. It can prevent or delay the progression of your disease to AIDS and prevent you from getting sick. You will also need a place to turn for emotional support, information, and education. Early in treatment, you will receive information regarding preventing the spread of HIV infection, safer sexual practices, and needle exchange programs if you are an intravenous drug user. You will also be directed to a counsellor or your local Health Department to discuss notification of any sexual or needle-sharing partners of their possible exposure to HIV.

If you are relocating to a new city, you will want to research the available healthcare options in your new location, and make the best decision for continuing your care in a timely manner.

You may also want to change providers as time goes on. You always have the right to stop seeing a provider and change to another at any time, for any reason. If you don't like your provider or you feel uncomfortable with him or her, or if you feel that your health care needs are not being addressed or your ideas about your treatment are now different from your provider's, then it is time to search for another provider.

Following are some important things to consider when choosing a provider:

Training and Experience: HIV treatment is very complicated and changes quickly, and there are many things to consider at all stages of the disease. It is essential that you see an HIV specialist (someone who treats a significant number of HIV infected patients and who is certified as a specialist by the American Academy of HIV Medicine. Your provider must be committed to staying current and up-to-date with the field. Ask how many HIV patients the provider has treated, and how many they currently see. Ask if he or she has experience treating patients at all stages of the disease.
Availability: Ask the office staff how long it usually takes to get an appointment, or to reschedule an appointment if you have to cancel. Also inquire about being able to get an appointment quickly if you are sick or are having a problem. You can see a general internist for other primary care needs, but I would recommend that you search for an HIV specialist who is also willing to provide primary care services. Every time another provider treats you, there is the potential for a possible HIV-related problem to be overlooked, or for a medication to be prescribed that has interactions with your HIV medications. You also need to find out how easy it is to have your provider return phone calls to you when you have questions that cannot be answered by the nursing staff.
Office Staff and Environment: You will most likely have complex problems and issues that will require expert assistance from support staff such as nurses, insurance and billing specialists, mental health and substance abuse counsellors, social workers, and case managers. The support staff is there to assist you in obtaining the benefits and help that you need. Although your initial visit to the office will be frightening and intimidating, you should be able to come out of the visit with a feel for whether or not the office and the provider will be a good fit for you and will provide you with the services that you need .
The Patient-Provider Relationship: Your relationship with your provider is perhaps the most important aspect of your care. During the initial visit with the provider, you will be able to assess if you will be able to develop trust and confidence in the provider. Most people do not want a "canned" approach to their healthcare, where every patient must do the same thing. Remember, this is a partnership, not a dictatorship. Discuss your goals and ideas about treatment to make sure that the provider is willing to be somewhat flexible and adjust to your needs, while still providing you with high-quality care. You will get a feel for the provider's overall outlook and approach during this initial visit - is it optimistic and hopeful? In order for you to get the best care, you must be comfortable discussing anything with your provider. He/she must be comfortable and non-judgemental about sensitive lifestyle issues such as sexual practices and drug use, to name just a few.

These are just a few things to consider when making this all-important decision. Take your time, and do your research. Choose a provider who is well-qualified, but who will also respect and listen to you. Remember, this is all about YOU!!!!!

INTRODUCTION TO FOCUS ON LIVING WELL WITH HIV/AIDS

2006-11-01T09:18:00.000-08:00

I am a Nurse Practitioner with many years of experience caring for and about patients. I have spent the past 6 years treating patients infected with the HIV virus. Due to funding cuts at the Not-for-Profit agency where I was working, I was recently laid-off. While I am looking for work in the HIV field, I have been busy keeping up with the developments in the field of HIV treatment by reading, attending conferences and continuing education programs, and networking with other providers in the field. I am now in the process of developing an informational website for HIV infected individuals and anyone else who wants to learn about all aspects of this chronic disease.

Over the years, I have attended many continuing education conferences, read extensively about HIV disease, and have become certified as an HIV Specialist by the American Academy of HIV Medicine. Although this knowledge is what makes me competent to care for patients, the fact that I truly care about each and every one of my patients and have been able to gain their trust and confidence by getting to know them as people is what makes me good at what I do. I love this specialty, and feel that I have truly found my "niche" in the treatment of HIV.

This blog will emphasize living with HIV, and living well. This is a chronic disease which can be treated, managed, and controlled. It is not a death sentence. In fact, it can be compared to living with any serious chronic medical condition, such as Diabetes. If an HIV positive person is diligent about staying in medical care, follows the directions of his/her health-care provider, and lives an overall healthy lifestyle, then he/she can expect to live a normal life, with the goal of a normal life expectancy. My goal is to help people to do that, through education and information about HIV disease and treatment, as well as maintaining good overall health.

I will post on many topics, including: HIV testing, prevention of HIV infection, STD's (sexually transmitted diseases), dealing with the social stigma of being HIV positive, sexual diversity, disclosing HIV status to friends, family, and new sexual partners, HIV treatment, medications, side effects, and complications, family planning (including decisions to have children), social support, mental health, drug and alcohol abuse, healthy diet, exercise, vitamin and herbal supplements, the global HIV and AIDS pandemic ... the list goes on & on. I will provide links to excellent web resources, as well as include experiences that I have encountered with patients over the years.

I am new to this, and this is my first attempt at blogging and developing a website, so it will surely be a "work in progress".