Walk in my shoes...living with HIV

I have worked in HIV for many years. I have seen hundreds of people infected with HIV, many of them suffering from AIDS. My role in the HIV community is to provide medical care, to educate patients and families, and to offer support. But what I have found out quite unexpectedly, is that my patients have become my teachers in many ways. Their daily struggle goes unnoticed by most but deserves to be told. Walk in their shoes now if only for a moment.

Getting the news
The words echo in my head like a gunshot in the night. Panic begins to swell inside, my heart races and my chest pounds in fear. The sky, so blue and bright just a short time ago, now looks dull and gray. The people around me continue about their daily lives. Don't they what has happened? I have just been told I am HIV positive, and realize my life will never be the same.

It's been a week now, and I can't stop thinking about it. It's the first thing I think about each morning and the thing that keeps me up all night. What I dread the most, is the fact that this feeling of fear and isolation may never go away. I feel that I will never be able to escape the realization that I am sick and too frightened to tell anyone.

How do I tell? Who do I tell?
I have never felt so alone. I have to tell someone what has happened but who should I tell. Nobody will understand. I fear telling my family most of all. They will never forgive me. They won't understand. I'm afraid to tell anyone because of what they may think, what they may do. But I feel so alone. I'm not going to tell a soul. People seem to look at me differently now. Maybe they already know what has happened. I have to tell someone. My family will have to understand...or will they? What's worse, I may have infected the one I love most, but how do I break the news. Our relationship will never be the same...how could it. If I passed this on to someone else, I will never forgive myself. I have to tell...but if I do I may lose the one I love so much. I don't know what to do. I'm so tired.

I'm so tired
It's ten o'clock in the morning, I have to get out of this bed. Another work day missed. How do I explain my absence to the boss? I can't tell him the truth. I'm exhausted. Seems like I can never get enough sleep. The bed is soaked again. The night sweats make it so hard to rest. I have my first doctor's appointment in the morning. I am afraid of what I may hear. Am I going to die? Will I have to take a bunch of pills? How am I ever going to pay for all of this. I am so tired.

So much to learn
I am still so tired. My doctor seems very nice but I didn't understand most of what was said. There's just too much information to remember. CD4, T-cells, viral loads...what does it all mean? The nurse is going to come in and tell me about the medicines I am going to take. I've heard some real horror stories about HIV meds. Do I really need them so soon? Other than being tired, I really don't feel that bad. But, I agreed to give it a try. I hope I made the right decision. Take with food...take on an empty stomach...three pills twice a day...or is it two pills three times a day. How am I ever going to remember all this? And so many side effects to worry about. I wonder if I will have any problems? I hope I made the right decision.

I feel worse
There is no way I can take these meds with food. I feel like I am going to throw-up. I always feel like I'm going to throw-up. The pills are helping...my counts are better. So why do I feel so bad? I felt better when I wasn't taking anything. My pills cause diarrhea. So I will take these other pills to stop the diarrhea. That makes an even dozen now. Damn! I forgot another dose. Well that's OK. It's only one dose. What can it hurt? Plus I feel pretty good today. I don't want to throw-up again. I saw my doctor today. My counts are better. The drugs seem to be working. But my insurance doesn't want to cover the cost. How am I going to pay for them. I missed another day of work today. Just too tired to get out of bed.

A Course in the Biology of HIV

A Course in the Biology of HIV

Two decades ago, an AIDS diagnosis usually meant death would soon follow. But today, thanks to the development of HIV medications, people are no longer dying from AIDS they are living with HIV. To live a productive, healthy life with HIV, one must learn as much as possible about the disease; they must at least understand HIV basics or as some call it HIV 101. Knowledge is power, and never has that been more true than when dealing with HIV. Here are some common questions about the biology of HIV with easy to understand answers.

What is HIV?

In 1985, scientists discovered the HIV virus and concluded that it was the cause of AIDS. Human Immunodeficiency Virus (HIV) is a virus that is transmitted from person to person through the exchange of body fluids such as blood, semen, vaginal secretions or breast milk.

The most common way exposure to bodily fluids occur is through sexual contact but HIV can also be transmitted by exposure to infected blood through transfusions, sharing needles to inject drugs, or from mother to child during pregnancy, childbirth, or while breast feeding.

Is HIV and AIDS the same?

HIV and AIDS are not the same. HIV damages the the immune system making a person at risk for infections and illnesses considered AIDS defining. People who have HIV and contract one of the AIDS defining illnesses is said to have AIDS. A person can be infected for years without having AIDS. Having HIV infection does not mean you have AIDS.

How does HIV multiply?

Once inside the body the virus attacks specialized cells of the immune system called T-cells. The virus attaches to these T-cells and begins infecting them by injecting HIV proteins (DNA and RNA) in order to reproduce. New HIV virus then infects other T-cells as the cycle repeats itself.

How does HIV harm the body?

As HIV reproduces, the T-cells are damaged and become unable to perform their role as protectors as part of the immune system. As this process continues, the body's immune system weakens and the HIV infected person becomes ever more susceptible to a score of different infections, all capable of making the person sick and in extreme cases can lead to death. These opportunistic infections take advantage of a weakened immune system, thus the name opportunistic.

Can the Virus Be Stopped?

While there is no cure for HIV, medications are available that interferes with virus replication, which in turn helps preserve the health and function of the immune system. A healthy immune system is able to fight off those opportunistic infections and AIDS defining illnesses.

Important Warning!
HIV medications can't rid the body entirely of HIV. People can still infect others even when they are taking HIV medications so safer sex precautions in the form of condoms are a must with each anal, vaginal, or oral sexual contact.

Fact or Fiction...The HIV Urban Myth

Most of us have probably read the e-mail warnings of HIV infected needles found in movie theater seats and phone booth coin returns. The warnings tell of a girl who becomes HIV infected from a needle sticking out of a theater seat. Fact or fiction? Here is the real story.

Unfortunately, discarded needles and syringes are sometimes found outside the health care setting. Officials believe that most of these come from injection drug users while a very small portion are improperly discarded insulin syringes. For the most part, these syringes pose little if any danger to the general public. However, certain groups of workers are at higher risk of injury, most notably sanitation workers, housekeepers, policemen and paramedics.

It is true, improperly discarded syringes can transmit blood borne diseases such as hepatitis B, hepatitis C, and HIV.

However, transmission by discarded needles carries a very low risk. There are no reported cases of HIV infection from a needle stick outside of the health care setting. In fact, the Health ministry does not recommend testing discarded needles at all. Instead, they suggest each needle stick be handled on a case by case basis, taking into account the risk of infection by the source and the type of injury sustained. Any exposure should be reported to the local police and an evaluation from a physician or emergency room be done. The local health department should also be made aware of any incidence involving improperly discarded needles.

So the phone booth and movie seat stories seem to be fiction. If you see a discarded syringe or needle outside of a heath care setting, don't pick it up. Contact your local health department for guidance on disposal and who to contact.

HIV and the Older Adult - A Growing Population

HIV and the Older Adult - A Growing Population

When we think of HIV we have certain populations in mind. We hear about its ravages on young men and women; on the gay and lesbian populations; on the homeless and the intravenous drug user. We seldom think about hiv and senior citizens. What no one talks about is HIV and the older adult. It's no wonder that when you talk to our senior citizens, they feel HIV is not a risk to them. Is HIV a risk to older adults. Is HIV over 50 a problem?

The truth of the matter is that HIV surveillance shows that 11 percent of all new AIDS cases are in people over the age of 50. Statistics also show that new AIDS cases rose faster in the over 50 population than in people under 40. The following information sheds light on HIV and the older adult population and what can be done to raise awareness, slow the infection rate, and sustain a high quality of life for our seniors.

What is the HIV Over 50 Myth?

There is a myth that contributes to the growing rate of HIV among the over 50 population.

"Seniors don't have sex and therefore aren't at risk for HIV."

Nothing could be further from the truth.

In fact studies from the early 1990s provided data that proved sexual desire does not wane after the age of 50. Experts report that more than half of persons over 50 are having sex a couple times each month. Unfortunately, knowledge of safer sex practices among seniors is much less than that of persons in their late teens and early twenties. This combination of facts explains in part why the HIV population among seniors continues to grow.

HIV Over 50 is Not New - But the Mode of Transmission Is

HIV among adults over 50 is not a new phenomena. Since the early 80's, HIV in persons older than 50 have accounted for about 10 percent of all cases. What has changed is the mode of transmission. In the early years of the HIV epidemic, blood transfusion was the major transmission mode among the senior population. Today, heterosexual contact and needle sharing among IV drug users older than 50 are the main causes of HIV infection in our seniors. The figures are staggering. Heterosexual transmission in men over 50 is up 94 percent and the rate has doubled in women since 1991. And while prevention and education dollars are concentrated toward young adult populations, seniors are not getting safer sex education and continue to get HIV infected.

What Can Be Done?

What the HIV medical community do to reverse this trend of a growing over 50 population that is infected with HIV. Interventions that will help include:

• Assess For Sexual Risk Factors
  Change the traditional mode of thinking. Studies have shown physicians do not routinely assess for HIV risk factors in persons over 50. The incorrect belief that people over 50 do not have sexual risk factors for HIV is contributing to the incidence of unprotected sex among seniors and the lack of safer sex education directed at people over 50. For example The Senior HIV Prevention Project in Nairobi reports that many seniors still believe that HIV is transmitted only by blood transfusion and casual contact. This lack of HIV knowledge combined with the belief that safer sex is only for young women wanting to prevent pregnancy leads to at risk behavior among our elders. Without intensive education, post menopausal adults are less likely to discuss condom use, now that the risk of pregnancy is removed.

• Breakdown Stereotypes
  Secondly, stereotypes must be broken down. Society stereotypes a homosexual man in his twenties or thirties. Because gay men are an at risk population, Prevention and education money is therefore directed to that groups. When in fact, gay men over the age of 50 is a growing population. People today are living longer, healthier lives, meaning the over 50 population is on the rise; including the number of gay men over 50. While young gay men have always been a target of prevention education, the prevention messages need to be adjusted to include the over 50 gay population. Proper and targeted prevention messages have been shown to have a bigger impact on behavior than does porly targeted education.
• IV Drug Users Are Getting Older
  The belief that IV drug users are younger adults couldn't be farther from the truth. The consensus used to be that IV drug users out grew their addiction, either by getting treatment or dying. The typical story goes something like this.

An older man develops a relationship with a younger, drug addicted woman. One thing leads to another and the seductive link between sex and drug use results in men over 50 trying drugs for the first time. Once addicted, the same rules hold true as they drug with young drug addicted persons. Sharing needles and "works" results in an increased risk of HIV transmission via needle sharing in the over 50 population.

Substance abuse treatment programs must consider this when developing substace abuse programs. Substance abuse rehab programs must include messages targeted to people over 50.

Today we are faced with new challenges in HIV treatment and prevention. We must take great effort in providing adults over 50 with the HIV prevention education they need to stay healthy. We must erase the myths and realize HIV can strike anyone. So many times our elderly are left to fend for themselves. We forget the contributions they have made and the respect they deserve. Society and the medical community must not forget our seniors. That much they deserve.

Top 10 Ways To Make Love Without Sex

Safer Sex Options for Teens

Teens feel the urges of sexual maturity everyday. Some feel sex is the only way to feel close with the ones they love. However, having sex is not without risks. There is safer sex for teens. HIV and teens is a growing problem but there are things that can be done. Here are 10 ways to make love and show your affection without having sex.

1. Give a hug...get a hug

So much can be said wth a hug. It provides closeness and intimacy. Sharing a hug can be one of the most loving things two people can do.

2. Share your feelings...tell each other how much you care.

Being honest with your feelings can be a very loving gesture. Let the one you love know just how much you care.

3. Hold Hands

Like a hug, holding hands is an intimate gesture that shows one another that you care. The touch of a hand can say so much.

4. Give one another a special gift.

Gift giving is not reserved for birthdays and holidays. Giving a gift "just because" can say so much about how you feel. And remember, price is not what's important. It's the giving that makes the gift a special expression of your feelings.

5. Get a special CD of love songs.

The language of love...said so well in a song. Find love songs that are special to the both you and your relationship. Put them on a CD and listen to them together. Nothings says love like music.

6. Take a walk together.

Take a walk...hold hands and enjoy the beauty of nature. Walks are quiet, peaceful and they provide the privacy you need to get to know one another better.

7. Choose "your song".

Every relationship needs a special song that is just for the two of you. Find that special song, share it, dance to it, claim it as your own.

8. Write each other a love letter.

If you're like me, it's easier to express your feelings with the written word than the spoken word. Write that special someone a love letter. Be creative and don't hold back. Show your love with your words...he or she will cherish it for ever.

9. Leave a little note where the other will find it.

What a surprise when you open up your favorite book and find a hand written not that says "I love you". Three little words scribbled on a piece of paper...what a simple way to make his or her day.

10. Flirt with each other.

A smile...a wink...or just a little whisper. Flirting is a harmless, fun way to tell someone you care or you're interested. Flirting is an art form...so go ahead and master your craft.