Email 32

Hello Pozziepinoy, 

First of all I would like to congratulate you on such a wonderful and informative blog. I am just so happy because I learned so much about HIV and AIDS all from your blog. My name is X and my boyfriend X of X years is probably HIV positive. I say probably because we do not yet have his official confirmatory tests from San Lazaro .....  X had Cryptoccocal Meningitis and he was confined for X weeks. As you know it is an opportunistic infection (OI) and he probably has AIDS already. He has been on Fluconazole for 5 weeks now (3 weeks IV in hospital and 2 weeks oral at home) and we just had his first check up today. We will be seeing Dr. Ditangco next week for the first time.

We are financially drained having spent almost all the savings we had treating his fungal infection (more than P800k) and knowing that we still have a long road ahead of us emotionally and physically drains me. However I'm just glad that he is alive and well, looks very healthy, eats well and has not lost weight at all. We spend almost P2,500/day on his meds for the fungus .... , it just scares me he might be on this for life. I do not know if we can sustain it considering there are other meds, tests and expenses to think about down the road.

We are still in the questioning/denial/thinking positive stage right now (we still do not have official results yet as it is with his attending physician whom we will see next week). Our dilemma is that I want him to start on HIV therapy ASAP but I know he needs his official HIV test results and CD4/Viral Load tests as well prior to starting it. ...it is very frustrating because I know every day we delay it, can cause his immune system to go lower and lower...it is driving me NUTS! He was off work for more than a month and his co-workers and managers have all been very supportive and understanding (he only told them he had XXX). He is back at work for a week now and aside from some slight headache, and feeling a bit feverish at times (he takes biogesic) he feels fine and well. Until his check up today we had actually completely denied his HIV status...but sadly his Infectious Disease MD jolted us back to reality.

I know it will entail a lot of adjustment on our lifestyle (like you, we loved to travel and shop) and sexlife as well as our eating habits (his MD has told him to avoid uncooked fruits and veggies). 

I suppose the main reason I am emailing you is to show support for your advocacy and let you know that your blog DOES HELP. I would also like to ask you a few questions which has been bugging me for a while now since this whole thing started. 

1. I am the BOTTOM and am HIV-, how is this possible? We have been together for over X years and have never used a condom except when we were new in the relationship (the first 6 months) wherein I wanted to get our HIV tests first and then remain monogamous. We were both negative as expected and even did repeat tests together every 4 years. All throughout having unprotected sex. Then now he is POSITIVE and I am NEGATIVE? 

2. We have talked and to this day he has denied having anything "extra-marital" .... he seems really sincere and I would like to think that this is a life or death situation and he would tell me if he did. Is it possible he had it all those years prior to us being together? It seems so absurd but is the only explanation I can think of. Please note we are a very conservative couple and hardly even go out (if he did have anything extra it would be very few and far between).

3. Can his CD4 count go up? How?

4. Do you have a doctor you can recommend as his MAIN DOCTOR? A doctor we can count on for emergencies, someone who is experienced with HIV and AIDS? Our infectious disease doctor from XX is a nice guy but not sure if he is the right one. He also has a very good neurologist who treated his meningitis but would like a "go to" type doctor who understands and can give us the right advice on treatment, lifestyle, what foods to eat and pretty much any thing HIV related.

I know I think I might be asking a lot but any help would be so appreciated. We live at the XXX by the way.

Thanks and Regards

X

POZZIEPINOY’S REPLY

Hi X,

Thanks for your email. I am so happy that my blog is reaching out and helping others. Initially it was only a diary of my experiences with HIV and ARV’s, however, lately it has been a notebook of my researches. It also has been a venue where I can ask for support for my advocacy which is the care of the my fellow poz living with HIV/AIDS who are seeking medical assistance for their medicines and hospitalization. I’ve been receiving a lot of emails not only from our country but all over the world and my blog it seems has also become a channel where others can ask questions about my disease.

I applaud you for really caring for your partner who, from your email, has gone through a lot. His experience was so much like mine when I was hospitalized with pneumonia, when my partner and I spent almost all our savings, when everyday during that time felt like a never ending journey of hardships and trials. But let me tell you, that like me and my partner, you guys can also soon overcome all the things that has been happening to both you.

I would like to address all the things that you mentioned in your email.

First, regarding your desire for him to start his ARV’s, well no matter what he won’t be able to be prescribed yet with the meds because the HIV confirmatory result is really required. I know that you are worried, but like what I wrote in my previous entries, there are other things that you can do while waiting for the result which will take 2-3 weeks to come out. You can try to do what I did why waiting for my confirmatory. 

   

1. Have all the blood work done. Total cost usually ranges from P4,000 to P7,000 depending on where you get them. This is still a win-win situation as you guys are just trying to find out his health status as well as if he has other infections. You can ask your ID doctor what tests to take but below is a list of what I got:

    

a. CBC 

b. Creatinine

c. SGPT (ALT) / SGOT (AST)

d. Special Tests:

• Chest XRay
• TB Test
• Toxoplasma IgG
• HBsAg
• Herpes Simplex II (IgG)
• VDRL
• Anti-HCV

Like what I said, this is just an option while waiting. However, in case the confirmatory turns out positive, these are all the tests that will be asked of your partner.

2. If you still have the financial capability, you can ask your ID doctor for a prescription of a CD4 test and VL test. See CD4 & Vl Price List for the price list and which hospital you can get them. Once again these are optional however, once again these will be asked during the screening. If you have both #1 and #2 ready in case the confirmatory turns out positive, then everything is all set for screening in the hub.

3. While waiting, read all the precautionary measures on how to avoid illnesses and viruses. Your ID doctor was right in telling your partner as to what kinds of food to avoid. The reason for this is that in case of HIV, the immune system is down so any simple illness can be blown up to a more serious illness. 

Read my previous blogs: Things To Do While Waiting , Health Tips , Stay Strong , Don't Get Sick!  

Second, I am so happy that your partner is still healthy looking, has a good appetite and has not lost weight at all. Those are good signs. However, even the pozzies with a very low CD4 can have the same health and physical status so make sure that your partner watches out for illnesses and tries to avoid communicable diseases.

Third,  regarding your question about your personal HIV status which is negative, despite your sexual role with respect to your partner, well it is possible that your immune system is stronger as compared with that of  your partner. However, we can’t assume that you are already safe from being infected because the course and progression of HIV varies from person to person. One person may turn out positive within 2 years post infection while another one may turn out positive 5-10 years post infection. From what I have read there are a small percentage of the population all over the world that the virus has not been transmitted and a very small percentage, immuned to it.

I encountered an email asking for direction when it comes to this matter. I remembered what my ID doctor told my partner, Tag. She said that the best way to calm down his nerves is to get tested again. If it turns out negative, get tested after 3 months. If once again the result turns out negative, then get tested again after 3 more months. He followed her advice and all his HIV tests turned out negative. He will have to get tested on a yearly basis.

You too can do this if you want, just to be sure of your status.

Fourth, I know it is still bugging you as to where and how he got the disease, but you should go beyond that now. You have to accept that there was a mistake that had been made (or done), and it really doesn’t matter now. I know it is easy to question everything, but for me, just love your partner. You’ve been through a lot and that is the ultimate test of a lasting relationship. Your love and partnership has been through a lot and yet, look  you guys are still together.

Fifth, the CD4 indeed goes up. The CD4 is the state of one’s immune system and through healthy living, it can really go up. In people with HIV, if the CD4 is way above the 350 mark, it usually is slow in going down. However if it falls below the mark, there is a possibility that it will go down rapidly. But there is good news. If the CD4 is below 350, the poz will be prescribed with ARV’s fast which will slow down the replication of  the virus. In return, the immune system will be able to bounce back, thus resulting to a higher CD4.

There are so many factors that can depress the CD4 so you can try to avoid  them while the CD4 is recovering from the insult of HIV.

Read my previous blog: Boost Your Immune System

Sixth, at the moment while waiting for the confirmatory, you guys can stick to your ID doctor. However, in case the confirmatory turns out positive, you can get Dr. Ditangco as your attending doctor. 

I have nothing against your current doctor, as you had mentioned that he is a good guy, however, I would still opt for an ID doctor who specializes in HIV and AIDS. Anyways, you told me that you will be seeing her soon so you can weigh your options as it is necessary for you guys to trust your chosen doctor.

Weighing everything you emailed me, it still boils down to his confirmatory test. I will pray that he be off the hook, that he turns out negative. 

I know you guys can overcome this trial.

Email me again if you have other questions.

Stay healthy,

Pozziepinoy

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