A new challenge in life

[cupidsbwter]

So here is my story. Got diagnosed in April this year after years of safe fuck. Cant figure out how and who was it. But the question is how am i going to live my life. So many challenges both professionally and personally, but only support were my friends, and the doctor in BKK hospital. I have to travel to BKK for treatment from Singapore. My VL was 32100 and CD4 count was 642, started atripla after a month and within a month my VL went down to 150. It was really a good news. My next blood test is due in Nov next month. Fingers crossed and hopefully i have something to celebrate.
Apart from this after diagnosis i was suicidal, had sever depression lost lot of muscle mass. I'm still in and out of depression. Just cant find anything positive in life to look fwd to. I had so many questions about leaving my current job and living in a place were people are more open-minded but the progress on this has been much slow. I'm more scared to take any new step and don't want to loose my current job and end up with nothing.
I'm new new to this forum and have been reading a lot. Net i take up this as new challenge in my life and will overcome this. Not sure what is ahead in life perhaps new city, new job new friends but still the wound is fresh.
Sorry for the long msg but all i need is support and like to be a member of this forum and be a part of this this virtual brotherhood in difficult times.

[mecch]

I am sorry to hear what a rough ride you are having.
Well, at least your treatment results are great.
And, you've got some determination.
You know most of us don't know so much about what its like to live with HIV in countries that are not our own.  So besides the support you can get from the forum, you could also talk about your experiences specific to your location.

For example, I'm curious why you must go to another country for treatment. 
Also, is it absolutely necessary for you to get out of Singapore? Are you facing residency issues because of being HIV+?  And / or is the desired move because Singapore isn't hospitable to any and all HIV+ people and you would rather live and work in tolerant place.


About the depression, have you considered using a SSRI antidepressant, at least for a time?

[cupidsbwter]

Thanks Mr Mecch for your reply. I'm very glad for the offer of support from you.

Determination is what pushes me everyday when i get up. At the end of the day i'm glad the day passed without major issues and then it is time for next pill.

The main reason for opting another country is residency issue. Also in the long run being around people who are more "informed" about HIV+ individuals and being gay is not a criminal offense would help a lot. Said all this, I like this country and it has given me so much, but guess when things don't go that well in every front, the first option which comes to mind is leaving the country. For the same reason i cant go back to my country as well.

So being a non-resident i have to remain anonymous and seek treatment in BKK. Needless to say the hospital and my doctor are best i could find in S E Asia.

I was on sleeping tablets for almost two months but that had side-effects. So i stopped. Though i still have sleeping issues at times but i'm much better.

I did thought about anti-depressants and seeing a psychiatrist but didn't as that would mean being open about my reasons in this country and i don't want to complicate my situation any further.

[mecch]

Is gay sex a crime in Singapore?
Is it a crime in your country of citizenship?

Is the issue about living with HIV in your country of citizenship (NOT Singapore) that the treatment access or quality is not good? 

I don't know a country that denies its own citizens HIV treatment, but sure I know of countries where HIV treatment is not good.

I wonder if you have thought of asylum as a possible next step?

If gay sex is a crime in your home country, and furthermore if HIV treatment is bad or unavailable for some reason, you might be a candidate for asylum in countries that take such things into consideration.

[cupidsbwter]

It is according to law and my home country as well. In my home country the treatment is available but it isn't good and the social stigma of HIV+ and being gay will add more complexity to what i'm already going through.

I have looked at options in my home country it is not bad but still i would say BKK has the best treatment and facility in this region. I had a long chat about HIV/AIDS epidemic with my doctor in BKK and she was of the opinion that Thailand has faced the issue of HIV/AIDS much earlier then other countries and the local Govt. has taken lot of steps to control the situation. Guess there is lot to learn the way Thailand has approached this situation. The irony is i'm a AIDS awareness volunteer for quite some time, actually since my college days and now i'm experiencing it myself, life teaches us lessons in most unimaginable ways

Asylum has never crossed my mind, but i cant afford to loose even a months pay as i have financial commitments and i'm not sure how long will the asylum process will take and what all i need to go through.

The best option would be find a job in another country and then move but things are rather slow, and sometimes think i want to go easy. All my focus is right now to take care of my health to certain extent.

I have been thinking a lot, even going for higher studies but i don't want to study any more after PhD

[wolfter]

Welcome to the forums.  Looking forward to hearing more from.

wolfie

[cupidsbwter]

Thanks wolfie.
Today depression is back. I just cant see positive things in my life. I do understand that this is mostly drug induced, but small incidents which makes me sad just gets blown up and i easliy slip into depression.
How are others coping on atripla and being poz?

[wolfter]

Here is an excellent thread that details many of our issues with the components of Atripla.  I'm sure you'll be receiving lots of suggestions but meanwhile, this might be of some use to see our experiences

http://forums.poz.com/index.php?topic=47901.100

I have that bookmarked as it's that important.

take care and stay on top of this issue
greg

[xinyuan]

Sorry about the diagnosis, but welcome.

Psychiatrists and psychologists should be bound by the same privacy standards as medical doctors.

So, what's the reason for not seeing one? If it's the mental health stigma, we all have got a far bigger stigma to handle. Getting depressed is a normal reaction, and we all go back into it every now and then.

But if you're getting suicidal, that's dangerous in multiple ways. I was passively suicidal myself after my diagnosis. Ended up seeing a psychologist for almost a year and doing considerably better. He was an immense help. I would personally recommend one early on.

Of course, do make sure your meds aren't contributing to the depression.

[zach]

only speaking of my own experience

atripla works amazingly well

it also can have some pretty serious CNS side effects... if you are having issues with depression and suicidal ideation... that may be the red flag warning

specifically, the sustiva (efavirenz) component of atripla is the bad actor

tell the doctor, there are other med options

btw, welcome, don't think i've seen you in here before

[mecch]

Get off the atripla (e.g. sustiva). If thats the option in BKK - its provisional solution. If they don't offer a good range of other combos, in the long run you should look for a better solution for living, working, staying well with HIV.
You have a doctorate?
Globally, that's got to be a ticket to a decent country where you will be OK with both HIV and your sexuality.  Which is why if I were you I would explore all options including asylum. If homosexuality is a criminal offense where you live and where you have a passport, don't settle for "make do" if you can do better for yourself and your future.

[simply1602]

Good to hear that your viral load reduced to low level in one month. By Nov, you will be undetectable.

I understand your feeling of being a foreigner in Singapore. Due to the regulations, the thoughts of future will overwhelming. I hope you are feeling better now. I was diagnose 3 months before your diagnosis and I have been through different stage of loss and griefs. Similarly to you, I don't know when I was infected and who past it to me. I have informed every contact that I had but the fact is still remain unknown. I am still clueless. We still got to move on in our life. It will take sometime for the recovery. Something useful that you may consider: find a support group to talk about it. I found it useful.

If you think the med is giving you depression, you should consult your doctor.

Live positive.

[cupidsbwter]

http://forums.poz.com/index.php?topic=47901.100

I have that bookmarked as it's that important.

take care and stay on top of this issue
greg

Greg: thanks for sharing guess it will take sometime to read all the posts but i did had a quick glance and looks like atripla is the culprit.

Sorry about the diagnosis, but welcome.

Psychiatrists and psychologists should be bound by the same privacy standards as medical doctors.

So, what's the reason for not seeing one? If it's the mental health stigma, we all have got a far bigger stigma to handle. Getting depressed is a normal reaction, and we all go back into it every now and then.

But if you're getting suicidal, that's dangerous in multiple ways. I was passively suicidal myself after my diagnosis. Ended up seeing a psychologist for almost a year and doing considerably better. He was an immense help. I would personally recommend one early on.

Of course, do make sure your meds aren't contributing to the depression.

Xinyuan: the system is bit complicated, i'm seeing someone who is by experience better than any psychiatrist. I was given an option to go see a psychiatrist but i think i would start pouring or even crying out and not sure that would be good idea now. I'm in a much better position in terms of my emotional health than few months ago.

only speaking of my own experience

atripla works amazingly well

it also can have some pretty serious CNS side effects... if you are having issues with depression and suicidal ideation... that may be the red flag warning

specifically, the sustiva (efavirenz) component of atripla is the bad actor

tell the doctor, there are other med options

btw, welcome, don't think i've seen you in here before

Zach: atripla works very well in terms of bringing the viral load for sure. THe real test will be next month when it will be six months on this med. When i look back i t was nightmare and i could not believe i did or thought about situations i would put myself. Not sure what lies ahead but certainly i went through shit. THe issue now is any small incidents of emotional disturbance especially if i get sad it gets amplified and then i'm in a whirlpool and all i can think of is hiv, suicide, pathetic life and so on... and more so when i'm alone. Not sure what this will teach me perhaps will make me a stronger person but i certainly think their are much better lessons in life to become a stronger person

Get off the atripla (e.g. sustiva). If thats the option in BKK - its provisional solution. If they don't offer a good range of other combos, in the long run you should look for a better solution for living, working, staying well with HIV.
You have a doctorate?
Globally, that's got to be a ticket to a decent country where you will be OK with both HIV and your sexuality.  Which is why if I were you I would explore all options including asylum. If homosexuality is a criminal offense where you live and where you have a passport, don't settle for "make do" if you can do better for yourself and your future.

Mecch: I have appointment with my doctor next month in BKK, will discuss all the options. Actually i'm much comfortable with once a day pill at night so i can be as discreet as possible from the outside world. I did thought about other pill and regime but i have to look at cost, availability in this part of world without insurance and so forth. But with the side effects i will definitely look for something better which is easily manageable.
Yes i've a doctorate. Everyone says it should get me a job outside. I'm looking and talking to friends in Germany, Switzerland and US.
Actually i dont know what is the process to seek asylum and what all it would take to apply for one and if that involves that i should be "out" in public as gay and poz then i have second thoughts. I'm trying to apply for online jobs and looks a bit tricky with my current passport. I'm actually going through phase of "i'm fine" one moment and "i'm in shit" the next moment. I'm much confused than ever before, but hope things will settle down for good and get out of this country for good.

Good to hear that your viral load reduced to low level in one month. By Nov, you will be undetectable.

I understand your feeling of being a foreigner in Singapore. Due to the regulations, the thoughts of future will overwhelming. I hope you are feeling better now. I was diagnose 3 months before your diagnosis and I have been through different stage of loss and griefs. Similarly to you, I don't know when I was infected and who past it to me. I have informed every contact that I had but the fact is still remain unknown. I am still clueless. We still got to move on in our life. It will take sometime for the recovery. Something useful that you may consider: find a support group to talk about it. I found it useful.

If you think the med is giving you depression, you should consult your doctor.

Live positive.

Simply1602: thanks and i hope i go undetectable in Nov, it is just few weeks away and i'm actually getting stressed, as if i have less stress :p
I feel sorry for your situation. Last week i think i found out the guy who likely passed me the "gift". I wasn't angry at all. I'm responsible for my own action, no one else to blame. THe only support group i can think is this virtual group and few other guys online who lives thousands of mile away.

Finally thanks all for your wonderful message and sorry for my long reply. It matters a lot to for me to see the support and care which you all have for others. Really appreciate it.

[zach]

Zach: atripla works very well in terms of bringing the viral load for sure. THe real test will be next month when it will be six months on this med. When i look back i t was nightmare and i could not believe i did or thought about situations i would put myself. Not sure what lies ahead but certainly i went through shit. THe issue now is any small incidents of emotional disturbance especially if i get sad it gets amplified and then i'm in a whirlpool and all i can think of is hiv, suicide, pathetic life and so on... and more so when i'm alone. Not sure what this will teach me perhaps will make me a stronger person but i certainly think their are much better lessons in life to become a stronger person

if you're already to that place with it, get off that shit, no waiting, go now

it doesn't teach you anything, it's rolling the dice

[mecch]

Actually i dont know what is the process to seek asylum and what all it would take to apply for one and if that involves that i should be "out" in public as gay and poz then i have second thoughts. I'm trying to apply for online jobs and looks a bit tricky with my current passport. I'm actually going through phase of "i'm fine" one moment and "i'm in shit" the next moment. I'm much confused than ever before, but hope things will settle down for good and get out of this country for good.

If you got asylum somewhere because your life is impossible due to sexuality and HIV in your country of citizenship, why would that require "outing" you "in public" in the new country???  The immigration officials would know and thats it.  2nd, i will tell you that in Swizterland your employer would never find out about your medical history unless you tell them, and why would you do that?  Here, when you get a contract, any red flag is sent to an independent cantonal doctor.  Neither HR nor the boss would know anything.  The doctor judges you fit to work or not, and thats it.

Finally, if you were in a more progressive country, there would be no special discrimination in your social circle for being HIV+ and for being LGBTQ.  People don't care.  If you were here, or in the Netherlands, or many countries, and you cared about friends or family knowing, thats your own affair, not because of some cultural bias.

 

[cupidsbwter]

if you're already to that place with it, get off that shit, no waiting, go now

Zach: i didnt really understood what you are referring to?
Yes, after talking to my doc and convincing her i will get out of atripla, all depends on my lab results.

If you got asylum somewhere because your life is impossible due to sexuality and HIV in your country of citizenship, why would that require "outing" you "in public" in the new country???  The immigration officials would know and thats it.  2nd, i will tell you that in Swizterland your employer would never find out about your medical history unless you tell them, and why would you do that?  Here, when you get a contract, any red flag is sent to an independent cantonal doctor.  Neither HR nor the boss would know anything.  The doctor judges you fit to work or not, and thats it.

Finally, if you were in a more progressive country, there would be no special discrimination in your social circle for being HIV+ and for being LGBTQ.  People don't care.  If you were here, or in the Netherlands, or many countries, and you cared about friends or family knowing, thats your own affair, not because of some cultural bias.

 

Mechh: i need to figure out how to seek asylum and what paper work etc i need to arrange before i can go ahead. My major concern is will i get medicine immediately after seeking asylum? And i need to get a job too, dont like to sit idle after studying for so long But thanks for suggesting and giving the perspective on some countries in Europe, i'm looking at this option now. Hopefully something will come out. But the question is to claim medical insurance woudn't my employer want to know the reasons?

[mecch]

I don't know any European country where medical insurance is related to the job.
The information I gave you about switzerland is that here when you get  job you can get a list of "conditions" and you don't have to say what one specifically, you say "yes" and then the cantonal doctor decides if your "condition" (and there are many many besides HIV) is a handicap for the job, and must be given special protection, or more rarely I suppose, if it means you can't do a job.
Medical insurance has nothing to do with the employer.

[mecch]

I don't know the answer to your question about how fast medical coverage kicks in. However, if we are talking about countries with national health services then I will bet that in most of those, coverage is instantaneous if the asylum is granted. because the point of the asylum is to integrate the person and help him/her become a citizen. asylum is permanent.

[mecch]

But don't rule out the USA, either!
http://online.wsj.com/articles/why-sexual-minorities-have-an-inside-track-to-a-u-s-green-card-1402676258

[simply1602]

Hi. Hope your emotion is recovering. Anticipation for lab result is always overwhelming, I experienced the same too. Just stick to your work routine and the anxiety will be subsided.

Good that you can find the support you need from here and your friends. Things will get better for you. I believe that your VL will be undetectable during your next visit.

Other than abiding to the meds regimen, try to eat healthy food. I believe you are doing so. Since you are taking Atripla, I am not sure if you have follow Atripla's recommendation that not to take any fatty food 2 hours before meds. It will help to reduce the side effects from the medication.

Aside from the above, you mentioned about finding out your point of infection. I will suggest you to do your personal contact tracing and ask them to get tested.  It will be good to find out earlier than later as treatment will be easier in the early stage. On the other hand, it will prevent the transmission snowballing. You may find out that things may not turn up as you expect, at least you have done your part.

Lastly, take one step at a time. You will feel easier.

[cupidsbwter]

I don't know any European country where medical insurance is related to the job.
The information I gave you about switzerland is that here when you get  job you can get a list of "conditions" and you don't have to say what one specifically, you say "yes" and then the cantonal doctor decides if your "condition" (and there are many many besides HIV) is a handicap for the job, and must be given special protection, or more rarely I suppose, if it means you can't do a job.
Medical insurance has nothing to do with the employer.

Mr Mecch: So to seek an asylum do i have to travel to the country of my interest or i can claim it through the embassy of my native country. I have no idea how the procedure works and i wan to make sure i'm completely aware of the situation and what will be the legal consequences. Until i'm granted the citizenship what ill be be status int he country after i seek asylum? and if the asylum is rejected then i'm in much more difficult situation than before. Do you have any insight into this?
I have US in mind and have been looking into east or west coast for possible jobs as well. Thanks for highlighting the article. I don't have access to WSJ but got the idea from the the title of the article.

[cupidsbwter]

Hi. Hope your emotion is recovering. Anticipation for lab result is always overwhelming, I experienced the same too. Just stick to your work routine and the anxiety will be subsided.

Good that you can find the support you need from here and your friends. Things will get better for you. I believe that your VL will be undetectable during your next visit.

Other than abiding to the meds regimen, try to eat healthy food. I believe you are doing so. Since you are taking Atripla, I am not sure if you have follow Atripla's recommendation that not to take any fatty food 2 hours before meds. It will help to reduce the side effects from the medication.

Aside from the above, you mentioned about finding out your point of infection. I will suggest you to do your personal contact tracing and ask them to get tested.  It will be good to find out earlier than later as treatment will be easier in the early stage. On the other hand, it will prevent the transmission snowballing. You may find out that things may not turn up as you expect, at least you have done your part.

Lastly, take one step at a time. You will feel easier.

The emotion part is never in control but much better compared to when i was diagnosed.

I've been reading a lot about atripla and now i tend to understand the side effects.. But the vivid dreams are still real problem. So much so that i dont want to go to sleep, but i cant.

[mecch]

Mr Mecch: So to seek an asylum do i have to travel to the country of my interest or i can claim it through the embassy of my native country. I have no idea how the procedure works and i wan to make sure i'm completely aware of the situation and what will be the legal consequences. Until i'm granted the citizenship what ill be be status int he country after i seek asylum? and if the asylum is rejected then i'm in much more difficult situation than before. Do you have any insight into this?
I have US in mind and have been looking into east or west coast for possible jobs as well. Thanks for highlighting the article. I don't have access to WSJ but got the idea from the the title of the article.

I will get you a copy of that article. PM to me your email.

Listen I don't work in immigration.  I can help you do the research but you should be able to do a lot of this yourself, right?  You have a Phd and your communication skills are as good as anyones.

I volunteer to figure out what happens in Switzerland, however, and get back to you on that.  Give me a few days. 

[cupidsbwter]

I will get you a copy of that article. PM to me your email.
 

MR Mecch i PM you my email id few days ago. thanks for offering to help me.

[cupidsbwter]

okay time for good news

Got my blood test done after 6 months on atripla. VL - less than 20 copies. CD4 at 614. Doc was happy too. Now i need to check my blood work after 6 months. Only caution from doctor was not to get Hep C as it will be expensive to treat. Any thought on what i the current medication for Hep C costs?

And i will continue on Atripla for the time being as other one pill regime are not available in  S E Asia.

[Almost2late]

Congratulations!!! That was quick... Your docs right, keep your guard up with hep c.

[absopozilutely]

I believe the current cost in the US is over $100,000.00 but I could be incorrect.

[cupidsbwter]

Congratulations!!! That was quick... Your docs right, keep your guard up with hep c.

Thanks

I believe the current cost in the US is over $100,000.00 but I could be incorrect.

Thats insane, without insurance there is no way anyone will be able to afford this!

[simply1602]

Great news on your result!!! Congratulations.

[absopozilutely]

Thanks

Thats insane, without insurance there is no way anyone will be able to afford this!

Even with insurance I've read insurance companies are saying no. They'd rather keep you on treatment then pay for those meds. I'll have to google it later so I give you facts but yes it's very expensive

[mecch]

Even with insurance I've read insurance companies are saying no. They'd rather keep you on treatment then pay for those meds. I'll have to google it later so I give you facts but yes it's very expensive

"Keep someone on treatment" for HEP C?  What treatment would that be? 
Do you mean prefer the cheaper 1 year treatment?  How much cheaper is it, really?
I doubt many rich countries are going to be able to say no to the Hep C cure.  The argument is too strong that it needs to on the required treatment list and once the gov agency says that then game over and billions of profit to the company. I don't know how it will work in the USA but there is no credible argument contra the medical necessity. The only justification for refusal would be cost and there are other treatments such as for cancer that are equally expensive.

[cupidsbwter]

So are their various treatment options available for Hep C. I thought there was only one and living in this part of world it is almost non affordable. Whatever it is, come what may i have to face it. This year has been a roller coaster. Got diagnosed poz and now almost on the verge of losing job. A friend asked me yesterday how would i rate this year. I said the worst in my life. And he said "worst is over then ...." hoping for the best for me and everyone out there.