Understanding HIV & AIDS
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Over one million Americans are infected with the sexually transmitted virus, HIV, which can eventually lead to the deadly disease known as AIDS.
Transcript: AIDS is a disease that represents the final stages of infection with an incurable virus known as the...
AIDS is a disease that represents the final stages of infection with an incurable virus known as the human immunodeficiency virus, or HIV. To understand how AIDS works, it helps to have a grasp of HIV. Simply put, HIV attacks and destroys cells in the immune system, much as an invading army might destroy a high wall that protects a city. With a weakened immune system, a person becomes less able to fight off infections, as an army would have trouble defending a city without a protective wall. Before HIV can attack, it has to get in. HIV lives in bodily fluids like semen, vaginal secretions, blood, and breast milk. A person who carries HIV can pass it to another through any of these, usually via sexual intercourse, breastfeeding, or the sharing of drug paraphernalia. Rarely, a person will contract HIV through blood transfusions. And while it is highly unlikely for people to acquire HIV through saliva, it is possible to pass it through oral sex. Once the virus is transferred, it attaches to its new host body's sex, or T-cells, which are integral parts of the immune system. Inside the T-cell, HIV literally changes to become part of the body's DNA, or genetic code. At this point, the body will be forced to produce the virus. Because HIV lives in the immune system, every time a foreign invader triggers this system to work, HIV is activated, too. This means that when "good" T-cells fight, for example, the flu virus, new HIV particles are formed. During the first days and weeks after a person is infected with HIV, he or she may experience flu-like symptoms, such as a fever, fatigue, and enlarged lymph nodes. These symptoms generally disappear without treatment. But, as the body is forced to create new HIV cells, the immune system gets weaker, a progression that can take from several months to more than ten years. Eventually, untreated HIV leads to acquired immune deficiency syndrome, or AIDS. The name is appropriate: Acquired means to obtain an infection. Immune deficiency refers to weakness in the immune system, and syndrome is a group of problems that comprise a disease. AIDS is generally diagnosed by a blood or saliva test that measures the T-cells in a person's body. If the count drops below 200/mm3, the immune system is seriously damaged and unable to fight infections properly. A diagnosis of AIDS also occurs if a person gets one of 26 opportunistic infections, which are conditions common in advanced HIV patients, but rarely found in people with intact immune systems. Most people who die of AIDS do so from one of these infections. But while there is no cure for the disease, the introduction of highly active antiretroviral therapy has caused the number of AIDS-related deaths to decrease significantly. Over one million Americans are infected with HIV. Because 300, 000 people are still unaware of their HIV infection, getting tested and making sure you know your partner's status is essential.More »
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HIV becomes AIDS when the patient has an extremely low T-cell count. Watch this video to get details on the moment HIV progresses to the final stage of infection.
Transcript: AIDS is an incurable disease that is the end result of infection by the human immunodeficiency virus,...
AIDS is an incurable disease that is the end result of infection by the human immunodeficiency virus, or HIV. An individual who contracts HIV may become sick quickly...or can live symptom-free for years. HIV and AIDS are not one-and-the same. Many people who become infected with HIV do not develop AIDs, or don't do so for decades...especially with modern treatments. AIDS, which is an acronym for "acquired immune deficiency syndrome," is the final stage of HIV infection. Because the virus attacks T-cells in the body's immune system, a person has AIDS when their T-cell levels fall below 200/mmc3, as opposed to the 500 to 1,500 found in a healthy person. An extremely low T-cell count means that a person's immune system is no longer healthy enough to effectively fight off intruding viruses and bacteria. Signs that HIV may be turning into AIDS include: extreme fatigue, rapid weight loss, persistent diarrhea, a high fever, and swollen glands in the neck, armpits, or groin. Even if a person doesn't have a low T-cell count, they are still classified as having AIDS if they contract any one of 26 opportunist conditions. These are a group of illnesses that don't generally occur in most people, but do show up in AIDS patients. Two of these are cancers. One, Kaposi's sarcoma, results from a tumor in the blood vessel walls. Kaposi's sarcoma usually appears as disfiguring pink or purple lesions on the skin and mouth. The other cancer, Non-Hodgkin's lymphoma, originates in the disease-fighting blood cells known as lymphocytes. This appears as swelling of the lymph nodes. Several opportunist conditions that confirm an AIDS diagnosis stem from invading bacteria, like tuberculosis and bacterial pneumonia. Bacterial pneumonia is a potentially deadly inflammation of the lungs that is one of the most common infections occurring in people with HIV worldwide. Tuberculosis is the leading opportunistic infection in developing nations where access to medications and health care is low. It occurs when bacteria infect the lungs and manifests as prolonged coughing fits. Sometimes, an opportunist infection can be fungal, like candidiasis. Candidiasis causes a white coating to form on the mouth, tongue, or vagina. Although HIV itself is a virus, another virus can enter the body and cause an opportunist infection. One example is cytomegalovirus, or CMV, a herpes virus that healthy adults fight easily. In people with HIV, however, the virus causes damages to the body, most notably the eyes. If untreated, CMV can lead to blindness. Other complications that lead to an AIDS diagnosis include wasting syndrome, whereby a person loses 10 percent or more of body weight, and AIDS dementia complex, where nerve cell damage causes diminished mental functioning. These conditions, and others, mean that HIV has progressed to AIDS. While this is disheartening, many modern medications can keep AIDS infections from progressing indefinitely. If you have HIV, talk to your doctor about diseases that can occur following infection and the best ways to treat them.More »
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The treatment of HIV has become advanced in recent years. Watch this video to learn how treating HIV can prevent AIDS.
Transcript: HIV is incurable and can lead to the potentially deadly disease AIDS. The GOOD news is that medications...
HIV is incurable and can lead to the potentially deadly disease AIDS. The GOOD news is that medications can slow the spread of HIV, and allow people who are infected to remain healthier for longer. To understand how medications work, it's helpful to understand the life cycle of HIV. This cyclical process begins when HIV enters the body and attaches to receptors on T-cells located in the immune system. One group of anti-HIV medications, entry inhibitors, stops this attaching process. An entry inhibitor binds either to the immune system's T-cells or to the invading HIV, thereby blocking the virus from bonding with healthy T-cells. Currently, the only FDA-approved entry inhibitor is marketed as Fuzeon, but others are being tested. Two other types of medication work to stop the second part of HIV's life cycle, reverse transcription. When HIV infects a cell, it copies its genetic code into that cell's DNA. As a result, the T-cell is "programmed" to create more copies of HIV. But because HIV is in the form of ribonucleic acid, or RNA, it must convert itself to the body's genetic make-up, which is deoxyribonucleic acid, or DNA, before it can infect the T-cells. This is what happens during reverse transcription. Nucleoside Reverse Transcriptase Inhibitors, or NRTIs, are one type of medication that stops this process, by interfering with the nucleotides, or building blocks, that convert RNA to DNA. In this manner, the new DNA cannot be built, and a cell cannot produce more HIV. The first HIV drug, "AZT," or Retrovir, is an NRTI medication. Other FDA-approved NRTIs include Emtriva, and Videx. Another type of medication which blocks RNA from converting to DNA is called Non-Nucleoside Reverse Transcriptase Inhibitors, or NNRTIs. While NNRTIs have the same mission as NRTIs, they accomplish it differently. HIV cannot transcribe its RNA to DNA without the aid of a transcriptase enzyme. NNRTI medications attach themselves to this enzyme and prevent the virus from converting. Four FDA-approved NNRTI medications can help stop this conversion process. A final anti-HIV treatment works to stop the last step of HIV infection, viral assembly. During viral assembly, a strand of DNA is cut up and put together to form new copies of HIV. This process requires the help of an enzyme called protease. A group of medications called protease inhibitors, or PIs, block the protease enzyme from cutting up the genetic material that will become HIV, thus stopping new cells of the virus from forming. There are ten PI medications on the market, including Aptivus, Kaletra, and Viracept. For antiretroviral treatment to be effective for a long time, multiple medications are usually taken. Most HIV patients are familiar with the term HAART, which stands for Highly Active Anti-Retroviral Therapy and it used to describe the combining of 3 or more HIV drugs. One drug, Atripla, which is known as the "triple cocktail" combines two NNRIs with one NNRTI. This medication is generally considered to be a once-a-day, all-inclusive HIV treatment. HIV treatment is an individualized process, so it's important to adhere to your doctor's instructions when taking medication to ensure that your body remains as healthy as it can for as long as possible!More »
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If you're living with HIV, you'll want to make smart changes to get the most out of your daily life. Find out how by watching this video.
Transcript: HIV is a life-changing illness. So, when you're diagnosed, you'll want to make SMART CHANGES in your...
HIV is a life-changing illness. So, when you're diagnosed, you'll want to make SMART CHANGES in your day-to-day routines. Create a daily schedule-even if you're already pretty well organized. Your medication regimen needs to be followed precisely, so set up systems and reminders to keep you on schedule. And pencil in periods of rest and relaxation--your body needs time to revive and recuperate from stress and physical activity. Also make time in your schedule for support group meetings. They make it easier to handle the all the many challenges of living with HIV. - Make your sex life a SAFE sex life. You MUST disclose your diagnosis to spouses and partners and ALWAYS practice safe sex, EVEN IF your partner is also HIV positive -- you can still catch and spread various strains of the virus, plus, you're at increased risk of catching other STDs. And women, discuss birth control methods with your doctor. - Upgrade your diet. To boost your strength and guard against medication-related digestive upset, you'll want to eat smaller, nutrient-rich, meals throughout the day. Steer clear of foods that can harbor bacteria, such as undercooked meat, raw fish or unpasteurized dairy. And speak to your doctor before taking any supplements. Exercise wisely. Moderate exercise can strengthen your immune system, but too much can weaken your immune system. It's important to know your limits. Become aware of transmission risks. Don't share razors and toothbrushes, for example, since the virus is easily spread through infected blood. If you have an open cut, you'll want to disclose your diagnosis to those helping you. And you can no longer donate blood or organs. But, it's just as important to recognize what does NOT change once you're diagnosed: Who you are as a person. While your diagnosis may initially strain some relationships, those who truly care about and love you, will be there to support you the best they can. For more information on living with HIV, check out other videos in this series.More »
Last Modified: 2013-02-08 | Tags »
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The FDA has approved a pre-exposure prophylaxis for those most at risk of catching HIV. Watch this to see how it works.
Transcript: If somebody is always at risk for HIV, because of just high risk behavior, whether that again is sharing...
If somebody is always at risk for HIV, because of just high risk behavior, whether that again is sharing needles or having occasional episodes of unprotected sex, the FDA in just the last year or so approved something called pre-exposure prophylaxis, or PrEP. You have to take a pill once a day, kind of like a multivitamin. By taking it once a day you create a chemical barrier that helps condoms and other barriers you may use. So, pre-exposure prophylaxis is really based on the patient's risk. If you are someone who is at risk for HIV, recurrently at risk, then you may be someone who should take pre-exposure prophylaxis. If you have something that's called zero discordant partners; one that's positive and one that's negative, the HIV negative partner takes pre-exposure prophylaxis and still practices condoms and all the other safe sex measures -- it really takes care of mistakes that can happen. The idea of chemoprophylaxis, which is what PEP and PrEP are, are a great addition to barrier protection like condoms. No matter what, no matter how scared you are, it's important to make sure that at least once a year, if you're at risk for HIV, that you get tested. Because there is nothing scarier than being sick, at all. Knowing that you have HIV prevents a lot of complications. So, my personal message of the day is just get tested.More »
Last Modified: 2013-02-21 | Tags »
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HIV makes your immune system more susceptible to infections. Learn more about avoiding infections with HIV by watching this video.
Transcript: HIV weakens your immune system, making you more susceptible to everything from the common cold to fungal...
HIV weakens your immune system, making you more susceptible to everything from the common cold to fungal infections. But there are several ways you can reduce your infection risk, starting with your antiretroviral medication regimen, if you're on one. Highly Active Antiretroviral Therapy (HAART) not only reduces the amount of HIV in your body, it also strengthens your immune system. Other ways to bolster your immune system include:Eating a balanced diet. Make vegetables, fruit, whole grains and lean proteins such as fish and skinless poultry your dietary staples. Just be sure to avoid undercooked meats, raw fish and unpasteurized dairy. Exercising regularly-without overdoing it. Know your limits and avoid exhaustion. Making sure you don't smoke or drink heavily. Staying up to date on vaccines your doctor recommends. Practicing good hygiene. That includes trimming your nails regularly, washing your hands after using the bathroom and before eating or preparing food, and avoiding pet excrement-let someone else change the kitty litter or walk the dog. And of course, sticking to your antiretroviral medication regimen. Poor adherence can lead to drug resistance, which leaves your immune system vulnerable to the ravages of HIV and additional infections.For tips on how to stick with your medication routine, check out other videos in this series.More »
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Paying for HIV treatment can be costly. Learn about organizations and programs that can help you pay for it by watching this video.
Transcript: While the results of HIV treatment might seem PRICELESS, in reality it can be VERY EXPENSIVE. Fortunately,...
While the results of HIV treatment might seem PRICELESS, in reality it can be VERY EXPENSIVE. Fortunately, there are many programs to help you pay for your antiviral medications. You should take advantage of them-getting on and STAYING ON the medicines can give you a long and relatively healthy life. If you need financial help, first get in touch with your local AIDS service organization. It will have case managers and benefit counselors that can explain the ins-and-outs of each program, while breaking down financial jargon and helping with paperwork. Even if you have personal health insurance, between doctor's visits, lab tests, therapy sessions and expensive antiretroviral prescriptions, most plans barely cover the basic costs. A federally-funded, state-run AIDS drug assistance program, known as ADAP, can help you with prescription costs. Close to one-third of all HIV patients get their medications through such programs. The prescriptions ADAP covers vary from state to state, as do income qualifications, so look into what's available where you live. Federal programs such as social security and Medicaid are available for HIV patients who are unable to work and, as a result, can't afford treatment. Symptoms such as chronic fatigue, depression and chronic diarrhea usually qualify a person for disability coverage. You'll be able to collect supplemental security income (SSI) from social security and you'll likely be eligible for Medicaid, a federally- funded health insurance program. Approximately 50 percent of people living with HIV have enrolled in it. If you receive social security disability benefits for more than two years, or if you're older than 65, Medicare, another federally-funded program, becomes an option. Veterans can receive assistance through Veterans Affairs. And then there's the pharmaceutical companies themselves. Most offer a patient assistance program, or PAP, for people without insurance and who don't qualify for Medicare, Medicaid, or ADAP. These programs offer either free or low-cost prescriptions. They also may have co-pay assistance programs for low-income patients who do have drug coverage through private health insurance. Criteria vary among companies, so look into the programs offered by each of the companies that make your medications. Having trouble paying for your HIV treatments should NOT keep you from getting the attention you need. You have options. Taking advantage of them could be a lifesaver.More »
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HIV drugs can have tons of side effects. Find out the most common side effects of HIV treatment by tuning into this video.
Transcript: HIV medications are usually taken as a multi-drug cocktail called highly active antiretroviral therapy,...
HIV medications are usually taken as a multi-drug cocktail called highly active antiretroviral therapy, or HAART. This powerful treatment can reduce your viral load-even making the HIV undetectable. But all this power comes with the risk of side effects-and they need to be managed so you can get all the benefits that treatment can offer. The most common side effects, such as headaches, diarrhea, nausea, vomiting and skin rashes are typically more noticeable during the first 4 to 6 weeks of treatment. Once your body gets used to taking the medications, the side effects may improve or go away altogether. Other side effects, however, such as peripheral neuropathy and fat redistribution can become more severe over time. But HIV medications affect everyone differently: They cause some people few or no problems, others find them extremely challenging to deal with. That's because the risk for side effects increases if you have pre-existing conditions like hepatitis or high blood pressure. People with smaller body frames may also experience more side effects. In addition, certain side effects are associated with particular medications. Protease inhibitors can elevate blood sugar and cholesterol levels. Nucleoside reverse transcriptase inhibitors-or NRTIs-can elevate blood lactate levels and cause liver enlargement. The NON-nucleoside reverse transcriptase inhibitor efavirenz is associated with emotional side effects. If you're experiencing severe side effects, talk with your doctor about how to control them or if you should change your medication. Remember, HIV itself can trigger many of the same symptoms as the medications. So can opportunistic infections, stress, dietary issues, and non-HIV drugs. Keeping a daily diary of how you're feeling-and sharing it with your doctor--can help pinpoint what's going on and let you find a way to manage or eliminate your most troubling side effects.More »
Last Modified: 2014-01-20 | Tags »
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If you're being treated for HIV, you may be at risk for insulin resistance AND diabetes. Watch this video to learn more about HIV treatment and diabetes.
Transcript: If you're on anti-HIV medication, you know antivirals can come with side effects. But you might not...
If you're on anti-HIV medication, you know antivirals can come with side effects. But you might not know that diabetes is one of the possible complications. The multidrug cocktail known as HAART or highly active antiretroviral therapy, which is so effective in controlling HIV, often increases insulin RESISTANCE. Insulin is a hormone that helps move glucose from the bloodstream into your cells for energy. If the insulin can't do its job, your blood sugar levels rise-and that MAY trigger type 2 diabetes. If you develop chronic high glucose levels, you may have to modify your medication regimen. Since switching treatment is a complex process, work with your doctor to find the best way to control both your HIV and your glucose levels. Other possible diabetes triggers that many HIV positive people have include hepatitis C and high blood pressure. Pregnant women on antiviral therapy need to make sure they eat a healthy diet and monitor their blood sugar levels, as they have an increased risk of developing GESTATIONAL diabetes. If you do develop type 2 diabetes, it is essential that you try to reduce the risk of diabetes-related complications, like heart disease and nerve damage. Additionally, having regular check-ups, getting consistent exercise, eating a well-balanced diet, and quitting smoking can help you lower your blood sugar levels and hopefully avoid these additional health issues altogether .More »
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With HIV, you'll be havings tons of tests done so it's important to know what they all mean. Get tips for understanding your lab results by watching this video.
Transcript: Regular blood tests will help you know what HIV is doing in your body, and how well your medication...
Regular blood tests will help you know what HIV is doing in your body, and how well your medication is working. Here's a quick look at what the test results will indicate. A viral load test will measure the amount of HIV virus in your blood. A viral load test, if given right after you were infected by HIV, often registers MILLIONS of copies of the virus per cubic millimeter of blood. Once you start treatment-or if you change medications--you will have a viral load test every 2 to 8 weeks. If your load is going DOWN, that means the medications are doing their job. You blood test may come back as an "undetectable viral load." This can happen within 6 months of starting treatment IF you stick to your medication regimen exactly. An undetectable viral load means that the blood levels are too small to detect. It does NOT mean you are virus-free. You should get viral load tests every 3 to 6 months; and you'll be looking for TRENDS in your load, not any one reading. A blood test will also track your CD-4 count. CD-4s are infection-fighting T cells in your immune system. A healthy CD-4 count in someone without HIV is between 500 - 1500 cells per cubic mm of blood. Most doctors now feel you should start Antiviral treatment as soon as you're diagnosed, regardless of your CD-4 count. After starting treatment, regular tests every 3 to 6 months should confirm that your CD-4 count is going UP, and that your treatment is effective. It's normal for slight fluctuations to happen in a CD-4 count -- depending on when you have the test, your stress levels, if you're a smoker or whether or not you're fighting off other illnesses. So if your CD-4 count DECREASES, opt for re-testing before drawing any conclusions. CONSISTENTLY falling counts may indicate that you have become resistant to your medication and need to switch to a new treatment regimen. A count lower than 200, indicates a diagnosis of AIDS.More »
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For people who have been exposed to HIV, there’s something called post-exposure prophylaxis, or PEP. See how the emergency medication works.
Transcript: For people who have been exposed to HIV; so they've had a condom break, they shared a needle or they...
For people who have been exposed to HIV; so they've had a condom break, they shared a needle or they found out one of their partners is HIV positive, there's something called post-exposure prophylaxis, or PEP. What that is is a 28 day regimen of HIV medicines, and if you start it within 72 hours of the exposure people prevent getting HIV. So it actually stops the virus from taking ground in their immune system. We know from healthcare workers, and also from mothers who deliver babies, that it's probably between 70 and 90 percent advantageous in preventing HIV. You have to do it within 72 hours of the exposure, the sooner the better. So if you can do it within 2 hours, great. If you get pasted 72, there's really not much point in doing it. So generally for post-exposure prophylaxis, the guidelines say you have to take it for 28 days after the exposure. So you're going to want to get tested a few weeks after post-exposure prophylaxis ends and 3 and 6 months after that. It's absolutely worth it if there's a risk. Generally if you're insured you're able to access the meds, sometimes there is a copay . There are a lot of programs in a lot of cities that allow you to access it for either free or affordable. Often public hospitals will have programs, sometimes AIDS service organizations will have programs, gay/ lesbian / bisexual/transgender clinics often have programs. You should really look online to see best options, but if you think you've been exposed or potentially exposed, definitely worth your time to go to an emergency room or walk in or call your doctor.More »
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As more generic HIV medications roll out, watch this to see if they're just as effective on the treatment, and cost, front.
Transcript: Anything that pushes HIV therapy into a cheaper bracket is great. So the fact that some meds will go...
Anything that pushes HIV therapy into a cheaper bracket is great. So the fact that some meds will go into generics is actually great news. It makes it more accessible, payers are more willing to pay it and people who don't have insurance may be able to support such a cost rather than the $15,000 to $18,000 or $2,000 a month that HIV medicines cost, depending on what you're on. The fear we all have is that insurance companies will say, 'well, you have to be on the generic.' And sometimes you have to individualize HIV medications to both the patient's virus and to the patient's life. So that flexibility is critical. You would lose some bang for your buck from HIV medicines if you're forced to use only one or two regimens, it may not work. Your first line regimen for a generic will probably be a ok, but if doctors, and other healthcare providers, have a lot of hurdles to jump in order to get other medicines just to create a viable HIV regimen, it's going to be a significant impact on the HIV positive population. If you have a person on medicines and they don't match their life, they don't take them as often and they get resistance they can go on and have a complication like an infection or another opportunistic condition. Or get resistance and require a change in regimen to very expensive meds. There have been studies where they've looked at cost effectiveness of generics for HIV and it actually ends up being less cost effective because of resistance and intolerance. So you have to put everything into the equation and not just how much the drugs cost. All of the parts of the formula that have to go in to figure out if it's cost effective, it's not just ' the drug costs 30 bucks,' it's it costs 30 bucks and it works and it matches people's lives. It's a great step, it needs to be rolled out in a smart way.More »
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If you’ve tested HIV positive, you’ll want to learn about the virus and how to best manage it. Start by asking your doctor these questions.
Transcript: If you've recently tested positive for HIV, you'll want to learn about the disease and how to best manage...
If you've recently tested positive for HIV, you'll want to learn about the disease and how to best manage it. So start by asking your doctor these questions. How much experience do you have with HIV positive patients? If your doctor doesn't have much experience, ask him or her for a referral to a physician who does. Once you have an HIV specialist, ask: What are my treatment options? And when should I start? Depending on the stage at which you're diagnosed and any pre-existing conditions you may have, the start time and medication regimen may vary. So make sure to tell your doctor your complete medical history. What are the side effects from the medications? Side effects from HIV treatment are common, but they're different for everyone, and usually ease over time. Keep your doctor posted about what you're experiencing. What kind of regular tests do I need to get? You'll get regular blood tests to measure your immune strength -or CD4 count--and the strength of the HIV virus -or viral load-- especially when starting treatment. These tests let you know if treatment is working. How do I keep from spreading the virus? You can't spread HIV through casual contact, but you shouldn't share toothbrushes, razors or anything else that may contain bodily fluids or blood. Your doctor can explain the risks associated with oral, anal and vaginal intercourse, suggest effective methods of protection, and fill you in on the effect of anti-HIV drugs on hormonal birth control. In addition, you may want to ask about getting financial aid to pay for your medications and information on support groups. For more detailed answers to these and other questions, check out the videos in this series.More »
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