The Season

At a time in the year when people's thoughts turn to holidays of one kind or another, whether travelling or hosting, whether near or far; regardless of religion or not, and with the emphasis on getting it all done, no matter what that may be (even just stocking up on supplies when things are closed down for so long): How do people cope? How does anyone cope with the rush, the demands, and the resulting stress that is seasonally ours - subscriber or not?

For some, it may be just turning to those they regularly seek out and are with; others may find comfort in finding long-ago (even recent) folks who've moved, been less involved or are otherwise distant. Reducing stress is shown to be of benefit in healthcare settings of all kinds, whether just helping to reduce blood pressure or helping with behaviour changes that reduce risk and include harm reduction measures. Friends, family and even strangers may have it in them to help, but we have to let them or seek it, or at least actively engage. Whatever way one does it, make sure that this holiday season, there is something in your stockings (whether hung or worn) that really helps take stress levels down as much as one can. You'll feel and be better for it!

So, what reduces your stress?

Most important considerations in choosing a regimen?

Anti-retroviral medications have improved, over time, with fewer (and sometimes better-managed) side effects, reduced numbers of required pills and less-frequent dosing.

Choosing the right medication combination is a very personal thing, and even each HIV specialist differs in their approaches: Some will choose a regimen that is very defensible while others prefer different choices. The choice often rests on the individual patient's priorities: Does the number of pills really seem important? For some, even many, it will. Is there any difficulty with varying day-to-day schedules (work, sleep, travel, etc...) making dosing schedules an important consideration. Are there certain other medications already (or likely to be) used to control such things as diabetes, high blood pressure, cholesterol issues (particularly triglycerides)? Interactions with certain medications is an issue. Is there a co-infection with hepatitis B or hepatitis C? This can influence the choice of medication and even the decision to start treatment or not. Is it likely that food will always be available at the specific time when one needs it for the medication (if the medication requires food)? For those who travel and who don't generally eat breakfast, this may influence once-a-day dosing scheduling as well as help decide whether or not once- or twice-a-day is best. And that can also lead to influencing decisions regarding which medication to choose as, for example, efavirenz (Sustiva) is often taken at nighttime in order to help manage certain possible side effects; however, there may be reasons to avoid that medication, so a different one may be needed.

For those folks being recommended to start treatment, these are among the questions that need to be thought out. If they are considered ahead of your appointment with the HIV specialist, a fuller discussion can be had and the result will be a better-tailored medication regimen that will work and that you can adhere to, which is the greatest single factor within our control that can prevent resistance developing by the virus to the medications... and obviously, that will lead to better health outcomes.

Starting Treatment & Patient-centred care

The question about when to start treatment has been a hotly-debated one, and over time, the target has been moving back-and-forth between lower and higher numbers of CD4s as a base for recommending the beginning of antiretroviral use. However, the decision remains a personal one that each individual must make in connection, and after discussion, with his or her healthcare provider. Gone are the days where one simply presents to a doctor with an illness and whatever is handed for treatment is taken without question. Patient-centred care is not only a valid buzzword but also a most necessary part of decision-making: When medications no longer have side effects, when food no longer needs to be taken, when housing and other necessities of life are fully assured, then there might be every reason to follow the doctor's advice without question, but still: You have a choice. Things must be carefully weighed and balanced, both medical considerations as well as personal ones, and the decision remains an individual one. If you need help making such a lifelong committment to treatment, you're not alone; there is support, and there are professonals to speak with who may be able to help with the reasoning process, and other important actions, as well. The take-home message is that one doesn't simply take a strong medical recommendation and follow it blindly without thinking about what it means. It has to be a balanced and thoughtful approach toward treatment. What do folks think about this?

World AIDS Day

Today is World AIDS Day. You may be hearing about funding cuts to HIV community based organizations in the Vancouver area today. How does this affect your health? Programs and services are needed for HIV-positive individuals as each year sees approximately 200-300 new HIV-positive results. What do you think of this? Share your thoughts on this.

HIV and Belly Fat

Belly fat is an issue for HIV-positive individuals (also known as lipodystrophy) and is a side effect of some HIV medications. As individuals age, they may also develop body fat especially with poor diet. Diet and exercise are increasingly important to reduce body fat. Some individuals have used alternative treatments to reduce fat levels. Tesamorelin is a new drug used for belly fat that has shown promising results so far. What have you been doing? Are you concerned about belly fat and what do you wish to know?

Naturopathy and HIV

BCPWA Treatment Information Program has started up an HIV Complementary Care Clinic which runs every Wednesday evening. This is a partnership with the Boucher Institute of Naturopathic Medicine in which naturopath students provide treatments under the supervision of a naturopath. Some of the naturopathic treatments available include: acupuncture, vitamin & mineral supplementation, nutritional counseling, homeopathy and botanical medicine. Have you used such treatments and what has been your experience? Share with us.

Cancer and HIV - News

There was a recent journal article from Lancet reporting that both non AIDS related and AIDS related cancer can occur earlier for HIV-positive individuals with low CD4 counts - by as much as 20 years earlier! This is another argument for starting treatment earlier to get your CD4 counts high and viral load to undetectable. What do you think of this?