Depression and HIV

I recently have a talk to one pozzie who said that he has depression from taking Efavirenz. His doctor almost prescribed him with an anti-depressant however, he said that he doesn’t want to be dependent on it so he declined it.

I told him that the power of the mind is strong especially when we have HIV. We think about a lot of things. But we all have to fight this way of thinking. Instead we should do more productive things and boost up our egos. We should also learn how to relax our minds and think of positive things through meditation like yoga or tai-chi which are the two ways I used to calm my mind when I was first diagnosed.

Talking to others also helps, but the most important thing is really accepting the disease that we have and start to live our lives to the fullest once again.

Because of this I researched about depression accompanying HIV and or HIV medications. I found this in the internet again.

To you my friend, this is for you!

Source: aidsinfonet.org

WHAT IS DEPRESSION?

Depression is a mood disorder. It is more than sadness or grief. Depression is sadness or grief that is more intense and lasts longer than it should. It has various causes:

• events in your daily life
• chemical changes in the brain
• a side effect of medications
• several physical disorders

About 5% to 10% of the general population gets depressed. However, rates of depression in people with HIV are as high as 60%. Women with HIV are twice as likely as men to be depressed.

Being depressed is not a sign of weakness. It doesn’t mean you’re going crazy. You cannot “just get over it.” Don’t expect to be depressed because you are dealing with HIV. And don't think that you have to be depressed because you have HIV.

IS DEPRESSION IMPORTANT?

Depression can lead people to miss doses of their medication. It can increase high-risk behaviors that transmit HIV infection to others. Depression might cause some latent viral infections to become active. Overall, depression can make HIV disease progress faster. It also interferes with your ability to enjoy life.

Depression often gets overlooked. Also, many HIV specialists have not been trained to recognize depression. Depression can also be mistaken for signs of advancing HIV.

  

WHAT ARE THE SIGNS OF DEPRESSION?

Symptoms of depression vary from person to person. Most health care providers suspect depression if patients report feeling blue or having very little interest in daily activities. If these feelings go on for two weeks or longer, and the patient also has some of the following symptoms, they are probably depressed:

• Fatigue or feeling slow and sluggish
• Problems concentrating
• Low sex drive
• Problems sleeping; waking very early or excessive sleeping
• Feeling guilty, worthless, or hopeless
• Decreased appetite or weight loss
• Overeating

WHAT CAUSES DEPRESSION?

Some medications used to treat HIV can cause or worsen depression, especially efavirenz (Sustiva). Diseases such as anemia or diabetes can cause symptoms that look like depression. So can drug use, or low levels of testosterone, vitamin B6, or vitamin B12.

People who are infected with both HIV and hepatitis B or C (see fact sheet 506) are more likely to be depressed, especially if they are being treated with interferon.
Other risk factors include:

• Being female
• Having a personal or family history of mental illness, alcohol and substance abuse
• Not having enough social support
• Not telling others you are HIV-positive
• Treatment failure (HIV or other)

   

TREATMENT FOR DEPRESSION

Depression can be treated with lifestyle changes, alternative therapies, and/or with medications. Many medications and therapies for depression can interfere with your HIV treatment. Your health care provider can help you select the therapy or combination of therapies most appropriate for you. Do not try to self-medicate with alcohol or recreational drugs, as these can increase depression and create additional problems.

Lifestyle changes can improve depression for some people. These include:

• Regular exercise
• Increased exposure to sunlight
• Stress management
• Counseling
• Improved sleep habits

Alternative therapies

Some people get good results from massage, acupuncture, or exercise. St. John’s Wort is widely used to treat depression. However, it interferes with some HIV medications.

Valerian or Melatonin may help improve your sleep. Supplements of vitamins B6 or B12 can help if you have a shortage.

Antidepressants

Some people with depression respond best to medication. Antidepressants can interact with ARVs. They must be used under the supervision of a health care provider who is familiar with your HIV treatment. Protease inhibitors have many interactions with antidepressants.

The most common antidepressants used are Selective Serotonin Reuptake Inhibitors, called SSRIs. They can cause loss of sexual desire and function, lack of appetite, headache, insomnia, fatigue, upset stomach, diarrhea, and restlessness or anxiety.

The tricyclics have more side effects than the SSRIs. They can also cause sedation, constipation, and erratic heart beat.

Some health care providers also use psychostimulants, the drugs used to treat attention deficit disorder.

A recent study showed that treatment with dehydroepiandrosterone (DHEA) can reduce depression in some HIV patients.

THE BOTTOM LINE

Depression is a very common condition for people with HIV. Untreated depression can cause you to miss medication doses and lower your quality of life.

Depression is a “whole body” issue that can interfere with your physical health, thinking, feeling, and behavior.

Credits: 
http://www.aidsinfonet.org/fact_sheets/view/558                                                             

FOR TOPIC SUGGESTIONS, please email me at pozziepinoy@yahoo.com

DONATE to The Love Fund : The Love Fund

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May 2012: New HIV/AIDS Cases

The Philippine Department of Health - National Epidemiology Center has recently released its update on the number of new HIV and AIDS cases in the Philippines for May 2012.

In the report, it said that in May 2012, there were 273 HIV Ab sero-positive individuals confirmed by the STD/AIDS Cooperative Central Laboratory (SACCL). It also said that this figure was 48% higher compared to the same period of last year.

From the report, it said that most of the cases are still males which comprise 96% of the cases with median age of 27 years old.  The age range was from 9 to 52 years of age. The 20 to 29 years of age which comprise 63% has the most number of cases. It also said that 51% (138) of the reported cases came from the National Capital Region or NCR (Metro Manila area).

Still the biggest percentage of the mode of transmission among the reported cases were sexual contact (268), needle sharing among drug users (4) and mother to child transmission (1). Like in previous months, males having sex with other males (MSM), were the predominant type of sexual transmission which comprise 87% of the total cases. Most of the cases, 96% of the total cases, were still asymptomatic at the time of reporting.

From the said report, of the 273 cases, twelve (12) were reported as AIDS cases, nine (9) were males and three (3) females. The median age is 41 years with age range of 9 to 52 years of age. Eleven (11) acquired infection through sexual contact (8 homosexuals, 2 heterosexuals and 1 bisexual). one acquired through mother-to-child transmission.

The report said that of the AIDS cases, there were two (2) reported deaths, both were males aged 27 and 42 years old.

Twenty five (25) of the 273 cases (9%) were overseas Filipino workers (OFW).

Credits:
Philippine HIV/AIDS Registry NEC-DOH

FOR TOPIC SUGGESTIONS, please email me at pozziepinoy@yahoo.com

DONATE to The Love Fund : The Love Fund

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Love Fund: June Report

The Love Fund has been helping HIV patients. Ms. Maram Bartolome of RITM-ARG just sent me the list of patients and how they have been helped by the fund.

1. HIV with Pulmonary TB: PTB medicines 

2. HIV with Breast Cancer: medicine (cream ointment) for her wound 

3. HIV: no fare to go home 

4. HIV with Oral Candidiasis: medicine (fluconazole) for 7 days

5. New HIV patient: registration fee (orange card)

6. HIV patient with hypersensitivity reaction with nevirapine: prophylaxic antibiotic

7. HIV with Herpes Zoster: medicine 

8. HIV with CMV: antibiotics 

9. 2 Yr old HIV patient: diaper, milk and other baby supplies

10. HIV patient with adverse reaction to nevirapine: medicine

Aside from the Love Fund we were able to help HIV patients thru PCSO with the help of our contact. Dr. Ditangco and I have frequent communications when it comes to helping out patients who are in need of huge amounts of money for treatment of OI’s or for lab exams.

The following patients were given assistance this month.

1. HIV with CMV Retinitis- he was given financial support for his P4,000 a day treatment good for 3 months.
2. HIV with breast cancer - for her 3 chemotherapy sessions amounting to P50,000 per session.

To all those who have helped out, THANK YOU so much. There are more patients who are needing assistance if you can donate, please do so. Any amount will do.

Once again, THANK YOU so much!

 FOR TOPIC SUGGESTIONS, please email me at pozziepinoy@yahoo.com
DONATE to The Love Fund : The Love Fund                                                                    

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HIV Travel Restrictions

A lot of my new acquaintances seemed depressed after finding out that they are positive with HIV. The reason is that their dream of working abroad has been shattered. 

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Sex Re-Education

Let’s talk about sex here. I need to open this up because most blogs don’t discuss it. 

It is my fault why I got this dreaded disease. I was promiscuous. I had multiple sex with unknown partners. I had both protected and unprotected sex. Tag and I had an open relationship (sounds familiar to couples?) before. I hooked up with people from the internet. It was all fun and I wasn’t careful.

Even though I knew about STD’s and HIV, it came to a point that I didn’t care. What I knew before was it was really fun to have sex. Now, look what I got my partner and my family into.

Well, everything now is history. Now I am focused to what is the reality, that is, HIV is real and everybody can get it. 

Let’s all go back then to HIV 101 and relearn everything from scratch once more. 

I got this from the CDC website:

Can I have HIV from Anal Sex?

Yes. In fact, unprotected (without a condom) anal sex (intercourse) is considered to be very risky behavior. It is possible for either sex partner to become infected with HIV during anal sex. HIV can be found in the blood, semen, pre-seminal fluid, or vaginal fluid of a person infected with the virus. In general, the person receiving the semen is at greater risk of getting HIV because the lining of the rectum is thin and may allow the virus to enter the body during anal sex. However, a person who inserts his penis into an infected partner also is at risk because HIV can enter through the urethra (the opening at the tip of the penis) or through small cuts, abrasions, or open sores on the penis.

Not having (abstaining from) sex is the most effective way to avoid HIV. If people choose to have anal sex, they should use a latex condom. Most of the time, condoms work well. However, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky. A person should use generous amounts of water-based lubricant in addition to the condom to reduce the chances of the condom breaking.

Can I have HIV from Vaginal Sex?

Yes, it is possible for either partner to become infected with HIV through vaginal sex* (intercourse). In fact, it is the most common way the virus is transmitted in much of the world. HIV can be found in the blood, semen (cum), pre-seminal fluid (pre-cum) or vaginal fluid of a person infected with the virus.

In women, the lining of the vagina can sometimes tear and possibly allow HIV to enter the body. HIV can also be directly absorbed through the mucous membranes that line the vagina and cervix.

In men, HIV can enter the body through the urethra (the opening at the tip of the penis) or through small cuts or open sores on the penis.

Risk for HIV infection increases if you or a partner has a sexually transmitted disease (STD).

Not having (abstaining from) sex is the most effective way to avoid HIV. If you choose to have vaginal sex, use a latex condom to help protect both you and your partner from HIV and other STDs. Studies have shown that latex condoms are very effective, though not perfect, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used.

Can I have HIV from Oral Sex?

Yes, it is possible for either partner to become infected with HIV through performing or receiving oral sex, though it is a less common mode of transmission than other sexual behaviors (anal and vaginal sex). There have been a few cases of HIV transmission from performing oral sex on a person infected with HIV. While no one knows exactly what the degree of risk is, evidence suggests that the risk is less than that of unprotected anal or vaginal sex.

If the person performing oral sex has HIV, blood from their mouth may enter the body of the person receiving oral sex through

• the lining of the urethra (the opening at the tip of the penis);
• the lining of the vagina or cervix;
• the lining of the anus; or
• directly into the body through small cuts or open sores.

If the person receiving oral sex has HIV, their blood, semen (cum), pre-seminal fluid (pre-cum), or vaginal fluid may contain the virus. Cells lining the mouth of the person performing oral sex may allow HIV to enter their body.

The risk of HIV transmission increases

• if the person performing oral sex has cuts or sores around or in their mouth or throat;
• if the person receiving oral sex ejaculates in the mouth of the person performing oral sex; or
• if the person receiving oral sex has another sexually transmitted disease (STD).

Not having (abstaining from) sex is the most effective way to avoid HIV.

If you choose to perform oral sex, and your partner is male,

• use a latex condom on the penis; or
• if you or your partner is allergic to latex, plastic (polyurethane) condoms can be used.

Studies have shown that latex condoms are very effective, though not perfect, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used. 

If you choose to have oral sex, and your partner is female,

• use a latex barrier (such as a natural rubber latex sheet, a dental dam, or a cut-open condom that makes a square) between your mouth and the vagina. A latex barrier such as a dental dam reduces the risk of blood or vaginal fluids entering your mouth. Plastic food wrap also can be used as a barrier.

If you choose to perform oral sex with either a male or female partner and this sex includes oral contact with your partners anus (analingus or rimming),

• use a latex barrier (such as a natural rubber latex sheet, a dental dam, or a cut-open condom that makes a square) between your mouth and the anus. Plastic food wrap also can be used as a barrier.

                                               

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Numbers!

"You look fine, you don't look sick at all", said Dr. Saniel as she motherly patted my thigh when she first saw me in TMC last October when my SGPT (ALT) shot up to 328. I was asked by Dr. B to see her because of my SGPT concerns and at that time Dr. T was in a US conference. Dr. Mediadora C. Saniel is a renowned infectious disease doctor who is a member of The Medical City's Board of Directors. She is also the Director of Proser Health Services, Inc, President of the University of the Philippines Medical Foundation, Inc., and the Director of the Philippine General Hospital Medical Foundation, Inc.

"The numbers are high but there are no signs of yellowing", she added.

That was what my GI doctor, Dr. N said too. He even palpated my liver and it was normal. My CT Scan of my liver showed normal. Dr. B then referred me to my current ID doctor, Dr. Ditangco, the Head of RITM-ARG and she said that ALT will go up because of my HIV but lamivudine, one of my meds, will take care of it so there is nothing to worry about.

Then, I told myself to relax and not think about numbers anymore. What is important for me is that I do feel well and great!

My CD4 result just came out and it increased by 696%. I was happy of course, but those are just numbers. To me, what is important is for the past 8 months, I never got sick with any major illnesses. I had bouts of colds that lasted for less than 3 days which is normal for any individual. I had sore eyes that lasted for a day. I had bloated stomach from over eating. Well, that's about it. Other than that, I am in perfect shape.

Just don't get sick! That is my command to myself. CD4 goes down whenever we have illnesses. If we feel something, consult with our doctors fast. The faster we cure our illnesses the better for our immune system to bounce back again.

Numbers are numbers. I prefer that I feel great and well!

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Email 18

I received this email and I thought that this would enlighten everybody about the topic that I wrote in my blog: Be Accountable! I deleted some pertinent information to conceal his identity and the people he was talking about.. The reason for posting his letter is for people to know that there are courageous people who know how to be "accountable" for their past actions and that there is still a way for all of us to help those who we had sexual contact with before, by telling them to get themselves tested before it is too late.

I hope everyone can learn something from this courageous writer and his email!

Hi Pozziepinoy.

This is a confession, a very long one. Please bear with me :)

I guess in our quest to make sense of what had just fucking happened to us, a sort-of reprieve to our "souls" or whatever lies beneath our HIV-infected bodies, we ask two things:

1. Who infected us?

2. Who are the people we have infected?

The first one is tricky. A person can have HIV and still be asymptomatic. For my case, I had just one major sickness XXX that only lasted for two weeks.The family doctor diagnosed it, prescribed meds and that was it. I got myself tested this year.... Because I don't usually get body malaise. I'm not feeling feverish but my lymph nodes are swollen. I know my body well and this is something new to me.

And the rest of my "thinking" of being pre-HIV is, as they say, history.

So, I can't tell who I got it from. I'm pure top. Have not sucked anybody. Have not bottomed. But yeah, I have fucked bareback a couple of many times. It was too late to figure out that top or bottom, it doesn't really matter to our new best friend, HIV.

Might as well tell people to get tested. I have run names through my mind. Set up a new account. Emailed them.

XXX is the first one to reply...... He said, yes, he had been tested. He's clean. I believed him on the 

spot ...........

"Stay clean." That was the bitter-side of me.

I was still clean mid-XXXX. And my major sickness that year (flu for 3 days, LBM for 2 days, then pain in urinating, which our doctor said is just UTI) happened middle part of 3rd quarter of XXXX. I think that was my initial stage of HIV infection. I have fucked 3 guys by then. All with bareback sessions.

The irony: all 3 guys...... Nobody from these people has replied to my messages.

Maybe it doesn't matter now. I was able to know when and perhaps know which one gave me the lifetime achievement award.

Going back to my second question, I have fucked at least 15 people from mid-XXXX up to XXXX.......

This worries me and related to your post I should "be accountable" for. I've heard that tops who are not aware of their HIV status are the major spreaders of the disease. I know I am guilty of this.

Out of 15, I have fucked three guys bareback and came inside them. One works in XXXX, a XXXX and then a XXXX ..... I have informed the 2 of them except for the XXXX. I can only reach him through BBM. Recently, I've been noticing a lot of strange status messages on BBM. He may have known his status now. What I'm sure of is that I'm not his only partner he's sleeping with. I am just speculating, that's the only thing I could do now. And yes, that has not given me peace of mind.

I have not heard from the other two.

The rest are all safe protected sex. The XXXX replied to my email. He just said, "Yeah sure." I gave him a list of centers he can get the test for free. I am just XX years old. I can still get the young ones. (That's just the conceited part of me).

Now things get complicated. This XXXX.....  is looking for partner while I was looking for a hookup. Our first date ended up in an overnight stay in a XXXX. Again, it was safe protected sex..... 

I have not asked him to get tested since I know I'm the last one who fucked him. I know I have used a condom but me being positive already made him a high risk for infection. He needs to be sure about his status.

The other one is the XXXX. We have a one-sided monogamous fuck-buddy relationship which started XXXX. I am the only one that fucks him. Our last was this XXX. I always use condom on him.

Recently,..... he informed me that he was sick. I was asking him for details, he brushed it off and said it was nothing and he's already okay. I wanted to press him for more info without appearing too suspicious but he will not say anything more.

I maybe using condom on him, but he has this habit of sucking me off and letting me cum on his mouth. He'll spit it though. He's a good guy. Again, he just wanted company. He's just wrong in choosing me as his company.

I cried after. Yes, I will admit that. Throughout my life I have believed on this: "Bakit ka maduduwag kung alam mo namang tama?"

I felt like a coward. I need to tell him to get tested so that he can be sure of his status. And I can't advise him that without disclosing my status. Of course, I wanted him to be negative. But I don't know what I will feel if I have known that he's positive because of me.

He wanted us to meet for the last time. Some people told me, as a rule of thumb, not to disclose my status if I am not comfortable with it. But now, is it being comfortable about it? Or is it, more importantly, to be accountable?

XXXXX

I feel sad writing this really :(

The last thing I want to do in life is to hurt people.

POZZIEPINOY"s REPLY

Hi XXXX,

Thank you for your letter. I see a lot of you in me. I even cried after reading your email.

You have so much courage brother which I initially didn't have. I am so proud of you for standing up for what you think is right. 

Like you, it was hard for me to tell my past sexmates to get themselves tested. But after my talk with Tag and after writing my entry in my blog I decided to text each one of them. Four replied and asked where to get the test and I replied back immediately. The rest, no response. I just hope and pray that all of them are still in good health.

Like you, I feel sad. If only I knew my status before. If only we all could have been careful. I don't know how many people got infected from the strain of virus that came from me and that really bothers me up to now.

Though sad, we just have to keep on doing our part. Let us all be accountable for our past actions. Let us all join hands and start telling our previous sexmates to get tested. This is for their safety and for the safety of others. This is also for our own peace of mind.

You be safe bro. What you are doing is right!

Pozziepinoy

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Prophylaxis with Low CD4

Today, Dr. Ditangco discontinued both my prophylaxis because my CD4 is now 487. I’ve been taking cotrimoxazole (bactrim) 800 mg, daily and azithromycin (zithromax), 1250 mg once a week for 8 months now. From what I researched before, if one has low CD4 like below 200 (or 250), the HIV specialist would recommend prophylaxis treatment as prevention of the major opportunistic infections.

I am so happy that at last I can stop taking them. They cost me P3,000 a month.

For the benefit of my readers, I researched on the different conditions and the specific prophylaxis prescribed.

Conditions

PCP

Bactrim (TMP-SMZ)

Dapsone; Dapsone + Daraprim (pyrimethamine) + Leucovorin; NebuPent (aerosolized pentamidine); Mepron (atovaquone)

Use if CD4 count is <200 or CD4% is <14% or if patient has a history of oral thrush.

Discontinue when CD4 count is >200 for 3-6 months.

Risk of recurrence is low if CD4 count increases to above 200 (or CD4% increases to above 14%), but there is currently no recommendation to discontinue secondary prophylaxis.

MAC Infection

Biaxin (clarithromycin); Zithromax (azithromycin)

Mycobutin (rifabutin)

Use if CD4 count is <50.

Discontinue when CD4 count is >100 for 3-6 months with sustained HIV suppression.

Risk of recurrence is low if CD4 count increases to above 100, but there is currently no recommendation to discontinue secondary prophylaxis.

CMV Infection

Cytovene (oral ganciclovir)

Not applicable

May be used if CD4 count is <50.

Discontinue when CD4 count is >150 for 3-6 months with sustained HIV suppression, only if non-sight- threatening lesions are present and the patient can undergo regular ophthalmic exams.

Toxoplasmic Encephilitis

Bactrim

Dapsone + Daraprim; Mepron +/- Daraprim

Start prophylaxis when CD4 count is <100.

Discontinue when CD4 count is >100 for 3-6 months.

After an incidence of toxoplasmic encephalitis, lifelong secondary prophylaxis with Bactrim should be administered.

There is no data to support discontinuing secondary prophylaxis.

Cryptococcosis

Diflucan (fluconazole); Sporanox (itraconazole)

Not applicable

May be used if CD4 count is <50.

After an incidence of cryptococcosis, lifelong secondary prophylaxis with Diflucan should be administered.

Risk of recurrence is low if CD4 count increases to above 100, but there is currently no recommendation to discontinue secondary prophylaxis.

Histoplasmosis

Sporanox

Not applicable

Use if CD4 cell count is <100 and patient lives in area with hyperendemic rate of histoplasmosis.

After an incidence of histoplasmosis, lifelong secondary prophylaxis with Sporanox should be administered.

Risk of recurrence may be low if CD4 count increases to above 100, but there is inadequate data to support discontinuing secondary prophylaxis.

Tuberculosis

Nydrazid (isoniazid); Rifadin (rifampin) or Mycobutin + Pyrazinamide

Not applicable

An individual who has a positive TB skin test but no evidence of active TB should initiate prophylaxis lasting 9 months (Nydrazid) or 2 months (Rifadin/ Pyrazinamide).

Lifelong secondary prophylaxis is not necessary once an individual completes treatment for active TB.

Bacterial Respiratory Infections

Bactrim

Biaxin, Zithromax

Do not use solely to prevent respiratory infections as resistant organisms may develop.

Bactrim may be prescribed for individuals with frequent respiratory infections.



Credits: 
http://www.thebody.com/content/art14578.html

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P.E.P.

Somebody emailed me about this and I asked Dr. Ditangco about this weeks ago. So what really is PEP? I researched about it and I found this from the WHO website.

What it is

Post-exposure prophylaxis (PEP) is short-term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure, either occupationally or through sexual intercourse. Within the health sector, PEP should be provided as part of a comprehensive universal precautions package that reduces staff exposure to infectious hazards at work.

Why it is important

The risk of transmission of HIV from an infected patient through a needlestick where the skin is punctured by a sharp is less than 1%. The risk for transmission from exposure to infected fluids or tissues is believed to be lower than for exposure to infected blood.

The risk of exposure from needlesticks and other means exists in many settings where protective supplies are limited and the rates of HIV infection in the patient population are high. The availability of PEP may reduce the occurrence of occupationally acquired HIV infection in health care workers. It is believed that the availability of PEP for health workers will serve to increase staff motivation to work with people infected with HIV, and may help to retain staff concerned about the risk of exposure to HIV in the workplace.

There is significant debate on the need to use PEP after sexual exposure. The UN offers PEP to its staff in cases of rape when the likelihood of HIV exposure is considered high.

How it is done

The proper use of supplies, staff education and supervision needs should be outlined clearly in institutional policies and guidelines.

Regular supervision in health care settings can help to deter or reduce risk of occupational hazards in the workplace. If injury or contamination result in exposure to HIV infected material, post exposure counselling, treatment, follow-up and care should be provided. Post-exposure prophylaxis (PEP) with antiretroviral treatment may reduce the risk of becoming infected.

Prevention of exposure

Prevention of exposure remains the most effective measure to reduce the risk of HIV transmission to health workers. The priority must be to train health workers in prevention methods (universal precautions) and to provide them with the necessary materials and protective equipment. Staff should as well be knowledgeable about risks of acquiring HIV sexually, and be easily able to access condoms and confidential STI treatment services.

Managing occupational exposure to HIV

1. First AID should be given immediately after the injury: wounds and skin sites exposed to blood or body fluids should be washed with soap and water, and mucous membranes flushed with water.
2. The exposure should be evaluated for potential to transmit HIV infection (based on body substance and severity of exposure).
3. The exposure source should be evaluated for HIV infection. Testing of source persons should only occur after obtaining informed consent, and should include appropriate counselling and care referral. Confidentiality must be maintained.
4. Clinical evaluation and baseline testing of the exposed health care worker should proceed only after informed consent.
5. Exposure risk reduction education should occur with counsellors reviewing the sequence of events that preceded the exposure in a sensitive and non-judgmental way.

              

                                            
Credits:http://www.who.int/hiv/topics/prophylaxis/en/ 
http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/
http://aids.about.com/od/hivprevention/a/pep.htm
                                                      

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Increasing Patients in Hubs

Wow! Yesterday a pozzie that I was assisting, stayed and waited for his lab results in RITM-ARG. He texted me that there were more than 45 patients waiting for their consultations and ARV refill there. On another hub, I read a tweet that yesterday in San Lazaro Hospital, there were more than 80 patients waiting for consultation, CD4 test and ARV refill. Unfortunately, I don't have figures from UP-PGH SAGIP, but I bet that their patient number also increased by a lot.

Now that the patient number is increasing, I do hope that our government will listen to the statistics. We need more help when it comes to assistance for HIV/AIDS patients. Eventually, space will be limited because these 3 major hubs can't accomodate everyone if the number doubles months from now. I hope that when the Global Fund ends in supporting our free ARV's program, PhilHealth will be able to finance all the ARV's for everybody.

There are more to be done. More preventive measures or else everybody will suffer. More information drives should be campaigned for so people will stop getting infected and spreading the virus.

We must do our part. The time is NOW! Educate people. Tell all your previous sexual partners that they need to be tested. Give them all details on where to get a free HIV test.

The increasing number of patients in the main hubs is a reality. We all should do our part now in stopping the spread of HIV in our country!

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Please Help!

An HIV patient who has gone blind because of CMV is needing financial support. His medicines cost P4,000 per day so I am asking everyone who is reading my blog to support the The Love Fund. Any amount will do.

Please help out. If you are going to RITM-ARG, please look for Ms. Maram Bartolome or Ellen Domingo and you can directly donate any amount for The Love Fund.

Thank you so much!

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Boost Your Own Immune System!

People have been asking me what I’ve been doing to help boost my immune system. Yesterday my CD4 count shot up to 487 from 70 in 8 months. Even my 4 other doctors were shocked when they heard about it. They said that when the CD4 is so low, the CD4 can’t get up that fast like mine. I’ve read that too before but being an optimistic person, I really don’t care about counts because what is important for me is that I don’t ever get sick at all!

So looking back, and to answer questions of my fellow pozzies, I want to give a recap of what I have been doing.

1. Strong Faith.

a. Believe in your doctors. Report everything to them, even minor symptoms. We can’t be “quack doctors” like before. Ask them about supplements you heard or read before taking them.

b. Believe in your medicines. Treat them with respect.

c. Believe in yourself. You alone can strengthen your immune system. Believe that you can get better soon. Be patient. You will get better but it will take time. Be optimistic. Your CD4 will increase too. Be positive and have a good disposition in life. Love others.

2. ARV Adherence. 

a. This is the most important.

b. Be strict with time. Take your ARV’s at the same time everyday or every night.

c. Don’t be late in taking your ARV’s. Have the habit of taking it at the exact time. I take all my ARV’s at exactly 10pm. I set my phone alarm to 9:58pm to give me time to run to my pill box. I always wait for the exact time. I don’t take them in advance at all.

d. Don’t miss any of your intakes. This is important.

e. Set all alarms at home to the time you need to take your meds. Get a pillbox. There are daily, weekly and monthly pillboxes. Choose one that suits you. This would help you prepare in advance your ARV’s once your alarm is on.

f. Bring all ARV’s when travelling. I always bring 3 sets in all my luggages when I am travelling. In case I lose one luggage, I still have two pillboxes.

g. When going out make sure you have one daily pillbox ready in your pocket. Make sure to buy a bottled water and make sure that it is ready when your time of intake is near.

3. Don’t Get sick!

a. Always remember that HIV replicates faster when we get sick!

b. Be vigilant. Stay away from people who are sick especially when your CD4 is still low.

c. Disinfect everything.

d. Use hand sanitizers or wash your hands frequently with soap.

e. Don’t eat uncooked food. Avoid eating in “turo-turo” for the meantime.

f. Wear masks when going to hospitals especially when your CD4 is low.

g. Avoid crowded places. If you're taking public transportation, avoid rush hours when it gets too crowded.

h. Wear shoes or flip flops every time. Don’t go barefooted on dirty floors or dirt or soil.

i. If possible, avoid having cats as pets. Keep your dogs well trimmed and clean areas where they poop. Use gloves whenever handling feces and urine of pets.

j. Wear a condom when you have sexual intercourse. We can have a superinfection which is another strain of HIV aside from the one you have that is resistant to our ARV’s. Know the person you are going to have sex first. Try to be monogamous or only if possible, abstain from sex

k. Have good oral hygiene. Brush regularly. Gargle with listerine or any mouthwash.

l. Shower when you come home from outside or from work.

4. Eat healthy foods.

a. Have a balanced diet.

b. Keep a regular supply of natural probiotics in your diet but ask your doctor first. I am still on yogurt and Yakult everyday.

c. Drink at least 8 glasses of water everyday

d. You can try supplements like multivitamins, vitamin C, grape seed, vitamin E, selenium and other antioxidants. Make sure to ask your doctor first before taking anything! Always remember your body is already bombarded with lots of medicines so be careful in taking anything. Believe in your doctors not in what other pozzies will tell you to take. You don’t want to complicate your condition. Remember too that what works with one person might not work for you so just ask your doctor first!

5. Exercise.

a. Try to add cardio workouts like walking, running, biking or swimming on a weekly basis. I do 2-3x a week aerobic exercises every week.

b. Do resistance training or functional training at least 3x a week. I do 5x a week of strength training up to now.

c. Be active. Do something everyday to increase your metabolism.

d. If you have pre-existing conditions with HIV, ask your doctor first for clearance for any exercise!

6. Remove all vices.

a. Avoid cigarette smoking

b. Avoid drinking alcoholic beverages

c. Don’t do drugs

d. Don't use recreational substances during sex, like poppers or ecstasy, etc.

7. Sleep.

a. Sleep or rest for a good 8 hours every night.

b. Take naps whenever necessary.

8. Vaccinations

a. Get the once a year flu shot: ask your doctor first!

b. Finish your Hepa B immunizations. Ask your doctor first. Better to have your hepa B vaccinations in the hubs because they do double dose injections all the time for HIV patients.

c. Meningococcemia vaccination. Ask your doctor first!

d. HPV vaccination. Ask your doctor first!

9. Avoid Stress

a. Avoid any kind of stress. Stress from work, stress from relationships, emotional stress, etc.

b. Learn how to relax. Do mind-body exercises like yoga, tai-chi, etc. During my 1st month of taking ARV's, I practiced relaxation through tai-chi. 

c. Get a relaxing massage.

c. Relax by having leisure and recreational times, like watching a movie, going on trips, etc.

d. Learn how to meditate for total relaxation. My brother from the US taught me some meditation techniques used by monks.

e. Get a hobby. Photography, reading books, etc.

f. Get into sports. Play basketball, swimming, tennis, golf, etc.

g. Don't procrastinate. 

h. Take a day at a time.

10. Stay Happy

a. Don't be serious all the time. Have fun time with friends.

b. Enjoy life. Enjoy families and loved ones

c. Enjoy the beauty of nature

d. Love each day.

e. Stop being critical of others. Be a friendly. Be loving.

f. Be positive in your outlook. Look at the bright side of things.

g. Have peace of mind. Do things the right way so you'll have peace of mind.

h. Live your life like it's your last day!

10. Help Others!

a. It comes back to you 10 fold.

b. If you want to help others, let me know. Donate to our Love Fund. Volunteer in hubs. Be a certified counselor. Teach and educate others.

c. Trust me this works!

© Copyright. All Rights Reserved by Pozziepinoy 2012

Credits:

Image by FreeDigitalPhotos.net

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Up By 696%

Yesterday, I went to RITM-ARG for my 2nd CD4 count test. I missed it two months ago because of procrastination but then last Saturday, I decided to go there. It has been 8 months since I got my initial CD4 count of 70. I told myself that no matter what the result is, I will still stay strong. There is an avid follower of my blog who I have been texting for quite sometime who will be going there too, so I told him to meet me there. I texted Ranz that in case I will be late, to please assist him. I told the new poz that everything is free (lab tests and CD4 test) since he is a first timer.

Tag drove me to Alabang and I came to RITM-ARG at around 8:45am. Good thing there were just a few patients there. Ranz saw me fast and led me to Ate Ellen. Wow. She wasn't busy at all. She told me that I am so muscular now. Well, thanks to my workouts in the gym, I said. Ate Ellen then just asked for my age and my ARV's and stamped "OHAT Package" on 3 pink slips. She told me to go to the Clinical Laboratory to get my blood drawn. Maram said hi to me but it seems like she was busy with work in the computer.Then I saw the new poz. He just got two vials of the Hepa B vaccine from the pharmacy which is free in RITM too. Wow that was fast. They got blood drawn from him already! He seemed happy to see me. I told him that all the staff there are friendly. Then left him to get my blood test done.

In the Laboratory, I waited for a minute because there was a patient inside. Then it was my turn. While sitting on the chair, I saw 3 other pozzies waiting outside.The nurse wasn't that great as I really felt the needle going in and he kept on moving it, maybe serving for my vessel. I got worried that I might get a bruise but oh well, it was free there. Then after 5 minutes, it was over. I went back to ARG. Letlet talked to me and we talked about another patient who is already blind from CMV and is needing financial support. She said that the patient can't afford the P4,000 a day of treatment. They are preparing all the required documents so we can assist them through PCSO. She told me that she will call me as soon as everything is ok. I then talked to the new poz who decided to stay til afternoon for all his lab tests. He seemed happy that everybody was friendly there. I told him to make sure to give his PhilHealth papers to Ranz. I then said goodbye to him and went inside to say goodbye to Ate Ellen and Ranz hugged me and thanked me for helping patients in RITM.

I left the clinic with a smile and headed to the lobby of the hospital and waited for Tag.

I went back to work and forgot about everything. I received a text from the new poz who was waiting in RITM and he said that there are already like 45 new patients there. Whoa! That many now!!!

Around 3:30 in the afternoon I received a text from one of the staff (well, actually it is not allowed for them to tell anybody the result of a CD4 test over text, but I somehow forced the person) in ARG and asked for my code. Then came the shock of all time. The staff texted back that its 487!!!! I was stunned. I asked him again to confirm if that is the result for my code and the staff said YES! I almost screamed at work, almost jumped for joy! I told the staff that my previous was just 70 and now it is 487!!! I was so happy that I told my coworker fast my result and she was happy too. Then, when I came home, I told Tag about it and we celebrated it with a good dinner in a restaurant.

487! I tweeted it fast. I texted all my other 4 doctors who belong to my team aside from Dr. Ditangco and everybody said it was such a great news. My twitter friends all said that it was a 696% increase from my previous count and almost all asked for tips on how I did it. I was so happy. I have angels all around me!

Life has been good to me. HIV is a challenge but for me the greatest challenge is proving to yourself that you can beat all the challenges that HIV has brought to you. It is a matter of choice, to fight back by restoring back your health and your life or give up. It really is all up to you!


                                                                   

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How to go to RITM-ARG?

I've been receiving a lot of emails on how to go to RITM-ARG. Most of them are first timers and some just want to switch hubs.

So I am making one entry just for this. I hope this could be of help to all who are interested.

Here are the maps of RITM-ARG

Private car: 

When coming from QC, Manila, Makati, Mandaluyong and Pasay take the South Expressway-Skyway and exit Alabang, then turn left on Filinvest Avenue. If coming from Cavite or Paranaque, take the Zapote Road, then turn right on Filinvest Ave, before Alabang. If coming from the south, Bicol, Quezon, Batangas, Laguna, take the SLEX or the National Road and once in Alabang, exit at Filinvest. Follow the map and you will see RITM on top of a hill. It is a white building on the right side.

Public Transportation:

Get a bus going to Alabang if you're coming from Q.C., Manila, Makati, Mandaluyong, and Pasay (via EDSA-South Expressway). Take either the bus or jeepney if you're coming from Cavite, Sucat, Paranaque (via Alabang Zapote Road). Take the bus if coming from Bicol, Quezon and Batangas. Take either a bus or jeepney if coming from Muntinlupa or Laguna. Get off at Alabang. Ask how to get to a jeepney or FX and ask the driver to drop you off at RITM.

Once you are in RITM, just ask the guard where ARG is. Once you are there, look for Maram Bartolome, Ellen Domingo or Let for assistance. Tell them I referred you there.

                                                                        

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This is for YOU!

It is your first time to take your ARV's. Your journey will just commence. Your life will change for the better.

Scared? Don't be! Always remember that your ARV's are the way for your immune system to rebound back to almost normal levels. Be glad then!

Here are some tips that might be useful for you:

1. Believe in the ARV's. Believe in your heart that your immune system will be stronger when you take them.

2. Proper scheduling is important. Try not to miss or skip an intake whether you are at home or somewhere else.

3. Have an alarm system to remind you of your scheduled intake. Use your phone alarm, your night stand alarm, and your watch alarm so you will always be reminded of the time.

4. Prepare your cocktail of ARV's in a pillbox for the entire week or for a month so you are not rushed in getting them from their separate bottles. Have a small pill container whenever you are going to be out for a movie, party, a trip, etc.

5. Think of your meds as vitamins so you won't be scared.

6. Always be watchful for side effects. The initial one month is crucial.

7. Have a logbook or a small notebook so you can write on it about what you are feeling or what you are noticing during the day. This is so important so it is easy to report all the signs and symptoms and the dates they occur during your consultation with your doctor.

8. Follow what your doctor tells you. Before changing schedules, ask your doctor's permission first.

9. Take them with a glass full of water.

10. Clarify to your doctor when to actually take them: should they be taken with or without food, etc.

11. When travelling make sure to put your ARV's in separate luggages in case you lose one luggage. Bring one batch on your carry on luggage.

Good luck. I know you can do it! Your new life is about to start!




Credits:

www.freedigitalphotos.net
                                                             

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Free for First Timers!

I recently assisted a new poz, "Believer" to get all his lab tests and CD4 done in RITM-ARG. At first, I thought that he had to pay for everything. I asked Ms. Maram how much money he should bring for all the tests and she said around P8,000 is enough for all the tests, except for the viral load. Well, I told Believer to bring P10,000 just in case.

We were communicating that day he went there. I made him look for Ms. Maram or Ate Ellen or Ranz. Maram was out so Ranz assisted him. Believer said that Ranz even looked for him. Around lunch time, he was done and he went back to Quezon City for a meeting. Believer said that he didn't pay anything because he was first time patient in the hub. Wow! He also said that he would get his CD4 result at 2pm that day. Another wow!

This is what I like about RITM-ARG. They know that the CD4 count is important that they have to rush it. Imagine, you can get the result on the same day! Other hubs don't do that. Instead, you have to wait for weeks! They also know that the initial lab tests are necessary so everything is done fast and for free for the first timers in the hub. This is so good especially for all the new pozzies who have just been shocked about their status and who are financially incapable to pay for all the lab tests.

Kudos to Dra.Ditangco and her staff. Dealing wit HIV/AIDS gets better and easier when people with gold hearts surround you!

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Seborrheic Dermatitis

Well, I thought it was dandruff even though I frequently take a shower. But this has been happening to my scalp since last year. I really thought it was dandruff and I enjoy removing the scales with my fingers. Then this year I had small patches of dried skin beside my nostrils and sometime on the bridge of my nose in between my eyebrows. Good thing I have several tinactin and trosyd at home so I just liberally apply them when they appear. They subside but if I stop using them, the scaling recurs. Frequent washing of the face also helps to remove the sweat from my face.

I read about it and found out that it is HIV related. Well, good thing I have this ointments because in some persons living with HIV, the skin disease becomes extreme.

I found this from the web:

One of the most common skin diseases experienced by HIV-infected individuals is seborrheic dermatitis.

Causes

Seborrheic dermatitis is a common disease that affects 2%-4% of the general population. However, up to 85% of HIV-infected people experience seborrheic dermatitis at some time after they acquire the infection. The cause of seborrheic dermatitis is unknown, but many investigators believe the yeast, Pityrosporum ovale, plays a role in the disease. It is further postulated that the alteration of the immune system in HIV-AIDS changes the way the skin responds to this yeast leading to the higher rate of infection.

Appearance

Seborrheic dermatitis causes redness of the skin, which produces a yellow, waxy scale or flake. In people without HIV-AIDS, the rash of seborrheic dermatitis occurs mainly on the scalp, and around the eyebrows, ears, and mustache. In HIV-infected individuals, the rash also appears on the chest, back, armpits, and groin.

Treatment

Seborrheic dermatitis is treated with antifungal shampoos and topical corticosteroids. These treatments are also used for HIV-infected individuals who need to use them frequently. People with HIV-AIDS who are being treated with antiviral therapy have fewer outbreaks of seborrheic dermatitis. In many cases, the severity of the rash corresponds with the degree of clinical deterioration.

Seeing a Doctor

A health care provider should evaluate cases of seborrheic dermatitis that do not respond to typical over-the-counter treatments. However, this does not necessarily imply that a person is HIV-positive. Someone with HIV-AIDS should notify their physician if they have a red, flaking rash that is getting worse so they can get appropriate treatment.

In my case, I reported it to my doctor and she said to continue what procedures I am doing. So now, I wash my hair as frequent as possible to remove the sweat. I wash my face too whenever it is sweaty. At night, I apply my tinactin ointment over the affected ares on my face. Well, everything works.

We should always take of our body. We have a responsibility to check all signs and symptoms and report them to our doctors. Our doctors know best!

                                                                     


Credits:
http://www.aafp.org/afp/2000/0501/p2703.html
http://www.aidsetc.org/aidsetc?page=cg-627_seborrheic_dermatitis
http://hivinsite.ucsf.edu/InSite?page=kb-04-01-01
http://dermatology.about.com/cs/seborrhea/a/seb_aids.htm

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Email 17

I received another email yesterday.

"Hi Pozzie,

How are you? i happen to read your blog and decided that i would send you a message and inquiry.

I would like to know if it's free to have a cd4 test at viral load at RITM? I paid 2k for cd4 and 6k for viral load at SLH. 

I want to have a 2nd opinion at RITM have HIV test redone again...are the other test like tuberculosis, cd4 etc. are for free? how can i avail the free? or just for the first time clients at RITM. 

Where will i go if i am in RITM and who will i look for...

Hope you can help me out.

Thank u

K"

Pozziepinoy's Reply:

"Hi K.

Thank you for your email. First of all, I wish that you are in good health. I am doing great, thank you. I feel blessed for my good health, for my loving support system, for my partner Tag, for my friends, and for my job that I enjoy.

Regarding your question, I asked the staff of RITM-ARG if you qualify for a free retesting again. Ranz, the certified counselor said that they give free testing including CD4 and lab tests only to new patients but not to transferees. However, they would welcome you if you would opt to transfer but all the lab results and findings in SLH will remain.

If you want to go to RITM-ARG, look for Ranz, Ms. Maram or Ate Ellen and tell them I referred you. My name is XXX by the way. You can tell them that I referred you to them.

If you feel that you need a counselor who can talk to you, just let me know. 

Hope this clarified some of your questions. Feel free to email me again if you have other doubts.

Thank you, Pozziepinoy"

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