HIV Drugs - Start Early or Later......?

Do you remember the days when “hit hard hit early” were the norm. It wasn’t that long ago that HIV-positive individuals were told to start taking HIV medications right away. Due to side effects and resistance, we re-examined this and learned that you didn’t need to start drugs so quickly. Now the trend seems to be to start earlier again. There are a lot of new drugs coming down the pipe, however we still don’t know what the long term side effects will be from these drugs. There’s also a theory that expanding access to antiretrovirals may help curb the growth of the HIV epidemic (by getting everyone undetectable). A lot of research going on, but are we revisiting the past? Two steps forward, one step back? What do you think about all of this?

Marijuana in B.C.

Marijuana benefits HIV-positive individuals as it is used principally to suppress nausea and vomiting due to side effects of HIV medications. Did you know that HIV-positive individuals are being cut off their legal supply of medicinal marijuana because they cannot afford to pay? It is appalling that people in need of this medical necessity are referred to a collection agency. Recent court rulings have ordered the federal government to provide medical marijuana to chronically ill patients, however current policies have presented obstacles for HIV-positive individuals securing medicinal marijuana. BCPWA has written a letter about this to the Federal Justice Minister. Let us know your thoughts on this issue. Any bad experiences?

Gotta Go.....Doctor

TIP has heard reports of patients really not liking their doctors. For example, a doctor in Ottawa, told a member who once lived there (from way across his doctor’s office, and as he wrote in the chart) that the member had herpes. The doc barely looked up as he said this. While he’d taken a look at a possible herpes lesion, the physician never did any tests. It was only years later, when informing a BC nurse about this diagnosis, when this member even learned that only if a lesion is active can a culture from it make any definitive diagnosis. In another instance, this same doctor started telling the member what symptoms he was experiencing (when diagnosed with giardiasis), instead of listening to the member’s own experience. Perhaps it’s time for a new doctor? You need to work well with the doctor because if you don’t, the paths and directions that you choose to follow, or not – will affect your health outcomes. Horror stories seem to abound. What have been your experiences?

A Bureaucratic Response on Facial Lipoatrophy!

The BCPWA Society has been advocating to get coverage for injectable compounds used to treat HIV associated facial lipoatrophy through the Medical Services Plan (MSP) so that PWAs don’t have to pay out of their own pockets. Compounds such as Bio Alcamid and Sculptra are used to treat HIV associated facial lipoatrophy. Doctors treating people with HIV associated facial lipoatrophy state clearly that it is a treatment leading to longterm health improvement as opposed to a mere cosmetic procedure. Recently, the Ministry of Health Pharmaceutical Services responded and informed us that they were not familiar with the injectable compounds used as treatments for HIV associated facial lipoatrophy. They needed more information. We have been writing to the Ministry for well over a year on this issue, and now they need more information! It boggles the mind. Just more bureaucracy! What do you think? If interested in working with us on this important health issue, please contact zorans@bcpwa.org or make a comment on this blog.

Bone Health

There is growing evidence that HIV-positive individuals are more likely to have bone problems. It is not fully known whether this is the cause of HIV or HIV medications. Osteoporosis occurs when your bones lose mineral content and can become more brittle and fracture more easily. Osteopenia is the loss of bone minerals that is less severe than osteoporosis, however it is a warning sign. Lots of folks talk calcium supplements to improve their bone health in addition to weight bearing exercises. What do you do? What questions do you have about bone health and HIV? What are your thoughts on bones?

Syphilis and HIV

Syphilis is on the rise here in Vancouver. Early symptoms of syphilis are an open area called a chancre which can be firm, round, small and painless. There are some indications that it may progress more quickly and severly in people with HIV. If untreated, syphilis can progress to late stages of the infection leading to organ damage. The treatment for syphilis consists of a course of antibiotic injections. These injections may involve higher doses for a longer period of time in HIV-positive individuals. It is important to take the entire course of this treatment. What questions do you have about this or any other sexually transmitted infection, and its treatments?

Cardiovascular Health and HIV

As people with HIV get older, cardiovascular conditions become an increasing concern. Cholesterol and triglycerides are two major lipids (types of fat) that circulate in the blood and can contribute to cardiovascular disease when they become high. Many use lipid lowering drugs like statins (i.e. Lipitor, Lescol) to manage high lipid levels. Some lipid lowering drugs can interact with your HIV medications and may increase risks of side effects. There are other things people do to manage cardiovascular conditions such as healthy diet, weight management and physical activity. What are your experiences with statins? What else do you do to manage high lipid levels? What questions do you have?