POZ Community Forums
Main Forums => Someone I Care About Has HIV => Topic started by: MedStudent86 on October 21, 2010, 08:23:02 pm
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First off, I am a medical student, but in no way, shape or form can give sound medical advice about HIV treatment. I come as simply a guy who is partnered with a man who is recently diagnosed with HIV. My partner and I have been together for over a year and a half and we just recently got engaged two months ago. A recent bout with kidney stones 3 weeks ago brought on his diagnosis when being admitted to the hospital. At this inner city hospital anyone who is admitted to the hospital is automatically OraQuicked. We have gone through the initial blood work and his CD4 is 200 and VL 35,000. Being both medically oriented (he's a nurse and I'm a soon to be doctor) we always think of everything. I have some basic questions regarding what is going on and would love help.
1) I was recently tested and I am negative. I was tested a week after we found out about him. What are the chances of testing negative about one month past last exposure (I bottom in the relationship) and then turning up positive on 3 month testing?
2) For serodiscordant couples do you engage in oral without condoms? I would rather give him oral sex and I am wondering what the practices are of couples that have been serodiscordant for years. Also did your sex drive essentially disappear right after you were diagnosed? How long did it take to come back?
3) If you are serodiscordant how often does your negative partner get tested? If you ever fear exposure for any reason do you take some of your partner's medicine as prophylaxis?
4) My partner just recently started Atripla. He swears it makes him really dizzy like he is "swimming in his head." I don't know if I believe it to be honest...does it really make people that dizzy? does it ever go away?
5) I understand you are supposed to take the medicine around the same time every night. We have gotten in the habit of taking it around 10 PM. What if we want to go out drinking one night, should he still take it at 10 or wait until we get home around 1 or 2? He says the medicine makes him very drowsy at first...
6) Have any HIV pos people had PCP (Pneumocystis)? What were your symptoms? I ask because he is a nurse and it is one of my biggest fears regarding his new status so I want to be aware of the symptoms to look for.
I know these are tons of questions and concerns. I'm really just overanalyzing everything and thinking of every possibility. I am very scared I am pos myself and then who even knows the restrictions I could face with my career :-/
I love this man with all of my heart and in no way will I leave him because of this. I'm in it for the long run and when he asked me to marry him I made that decision. Sorry for the incredibly long post.
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Welcome to the forums and kudos to you for sticking with your mate!
4) My partner just recently started Atripla. He swears it makes him really dizzy like he is "swimming in his head." I don't know if I believe it to be honest...does it really make people that dizzy? does it ever go away?
5) I understand you are supposed to take the medicine around the same time every night. We have gotten in the habit of taking it around 10 PM. What if we want to go out drinking one night, should he still take it at 10 or wait until we get home around 1 or 2? He says the medicine makes him very drowsy at first...
re: #4: The initial dizziness lasted about a week for me and then subsided.
re: #5: My docs and pharmacist advised the same time every night but admitted there is a 2-3 hour window. I was also advised to take it on an empty stomach, though, because having food in the belly apparently exacerbates some of the dizziness (there is something in the PDR about this, too). I went from very high VL to U/D on Atripla in just a few short weeks.
Best wishes to both of you
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Hey Med, sorry to hear about your b/f's diagnosis.
1) You should get tested at 3 months after your last test or your last unprotected sex (whichever occurred most recently). Also, now that you know he is positive, if you are negative and want to stay that way, than condoms are a must.
2) Even when I was negative, my ex and I had unprotected oral sex (of course, we also had unprotected anal sex - with me as bottom). He was on meds, long-term survivor, and was undetectable. I believe I contracted it either from the unprotected sex with him or from one of the outside of the relationship, unprotected sexual encounters I had. You will find a significant amount of differing opinions on the forums regarding the risk of infection from oral sex. I personally believe it is no risk. However, even if one believes it is a risk (a low one) - most would say that risk is on the person giving the oral sex. As I said though, there are differing opinions on this subject and it is a controversial one on here.
My sex drive went down after I was diagnosed - but went back up within a month or so after. I also think it went down because of other problems I was having in my relationship at that time.
3) When I was negative and with a positive partner, I got tested every 3 months. I never took his meds as a preventative measure - I would strongly advise against this - and I am sure that most doctors and others on here would as well. Best protection is condoms - every time. The meds can have side effects and you don't want to develop a resistance to them or side effects, etc.
4) I'm also on Atripla - most people have some dizziness or other effects the first few weeks - they subside. Taking on an empty stomach while getting used to it can help ease the effects. I take mine around 10 or 11 pm. If I'm going out drinking, I still take it with me and take it on time (or within an hour or two either way of when I am supposed to take it) - It really doesn't effect me at all any more - but everyone's experience is different.
5) See above.
6) Can't speak to the PCP - I was diagnosed when my cd4s were still pretty good and viral load was pretty low. I'm sure others will be able to respond to this.
Once again, welcome - and make sure you also take care of yourself as well as being there for your partner. And to stay negative (hoping that you still are) - use condoms every time.
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Hello MedStudent86!
I was admitted into the hospital in March of this year and at that time diagnosed with PCP, Thrush, and will never forget the look on that doctors face when he told me I had full blown AIDS. OK, what I remember about symptoms would be this:
a) Nightsweats that progressively got worse over time - I look back and do recall that these started several years ago but were not an every night occurrence. My health took a 'nosedive' around December of 09. I was sleeping maybe 10 hours at night and also took an afternoon nap when I could get one (I was out of work therefore I was at home and found myself taking them almost every day).
b) Fatigue - I was ready to crash early and did so usually by 9:00 PM each night. I got to a point where I did not have energy to do my daily housework such as cleaning, or projects around the house. It was a huge effort to just run out to do errands during the day.
c) Rash - January of this year I developed a rash on my legs/arms/chest and went to a clinic so that it could be addressed. The doctor put me on steroid treatment for about a week. It went away but of course returned.
d) Foul taste/smell - Nothing that I would have usually enjoyed seemed to taste or smell good any longer (I think this may have been from having Thrush). I remember one week when everything in the house seemed to smell like rotten tennis shoes.
e) Fever - I had fever on a daily basis starting in January. I could not stay warm and had chills daily.
e) No appetite
f) Persistant cough
I was a sick man indeed. I was told that I had contracted the virus between 5 and 10 years ago so I guess that is why it got so bad in my case. I hope this helps and also hope that he is not experiencing all of these symptoms at this early stage. I would guess that he is not. On a brighter note, I feel great these days after being on Atripla since March and as of my last labs am now undetectable. Best to you both and it so so good to hear that you are 'in it for the long run'. He is a lucky man to have you as a partner.
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So PCP while not good is definitely not always fatal. Trust me, if he had PCP he would know it right quick. Also once he was diagnosed in the hospital they should have checked him for it seeing as 200 CD4 is the last step before an AIDS diagnosis. People with much lower CD4 counts don't necessarily get any of the major OIs associated with AIDS, it really is a game of Russian Roulette. My CD4 counts are much lower than your boyfriends (as are a couple of other people's here) and I'm doing fine. So try not to worry too much about what may come and deal with this one day at a time. You'll find that Atripla is one hell of an effective drug. 3 weeks from diagnosed to medicated is a very short time. Did they do a genotype to determine a resistance profile before beginning him on treatment?
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Thanks all for your advice so far! In response to a question: yes they did a resistance profile and I guess he is very lucky but it was sensitive to all of the major treatments. A very very good friend of mine and mentor who is also a gay doctor automatically took up his care after a phone call and got the ball rolling as quick as possible. Looking forward to hearing more advice :-)
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Welcome to the forums.
Have you found the lessons? http://www.aidsmeds.com/articles/Introduction_4702.shtml
There's a lot of useful info laid out there in a way that is less anecdotal than you will get here. The lesson on tips for taking sustiva (a component of atripla) may be particularly helpful to you. http://www.aidsmeds.com/articles/SustivaTips_7550.shtml
As far as PCP goes, it is a pneumonia, so you get tired easily because you don't breathe as well when your lungs are filling up with fluid. If he seems really tired, or has other unusual problems -- get him to a doctor -- they usually want to take extra good care of people at times when people start meds or change them.
Good luck to both of you.
A
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I posted on here to get multiple opinions especially from serodiscorsant couples and I haven't gotten that many responses :-( still looking for more advice
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My last partner was HIV neg and I am HIV pos. I am undectable and have been on Atriplia for 7 months now.
When it comes to oral sex, the pathway for HIV to transmit through the mouth is very unlikely. There can be a risk, but it is very rare. my partner performed oral sex on me numerous times and there was never any transmissions. Big thing to reduce that risk should be, don't do it right after brushing teeth, eating and so on (things that would break skin in the mouth). I know that there are some believe it is very possible, my opinion is that it is not a large concern. It also comes with when your partner reaches undectable, on whether you want to get into the swiss study, which personally I think makes sense to a point.
However, when it comes to anal sex, condoms, condoms, condoms. Skin breaks easier and so on, but since you are a soon to be doctor I won't preach that.
When it comes to the atripla, dizziness def occurs a lot, however, in my opinion I am happy I can take Atripla because the side effects generally wear off. I have no problem with any side effects now at all, except the pill still knocks me out for the most part. Good sleep, no nightmares. As for the timing of taking it, my doctor said that keeping it within a 4 hour window from the normal time you take it will not cause a problem. However, go later than that, which I forgot one night to take it, knocked me on my ass.
Also when I was HIV neg and dated a positive partner, I never contracted the virus from him from oral or what not and we were together for 2 years.
If you have any questions about anythign else regarding a neg and pos partner, feel free to contact me.