My Gf Has Hiv - Shattered

[stevenjm]

Hey, last couple of months have been going crazy trying to get good medical for my girlfriend here in Phnom Penh, fever , bad cough etc etc.

Went through several doctors with various diagnosis over several months before getting a decent thourough doctor who finally found she had hiv.

We were both totally shattered and it left me in tears as we have been discussing marriage and how good the future was looking. anyway - I have decided I love her too much to abandon her and will stick by her and hopefully still have some good times ahead of us - we have been together about a year and have had some really good times and are very compatible - its not a paid situation but a genuine relationship with a great girl.

I now have her on gpo-vir a thai gov hiv drug(3 days ago) and am wondering if anybody can give me any sort of optimistic words for the future - I have not a clue on what to expect and am in the dark as to her life expectency etc etc.

btw test results show me as negative but one more test needed in 3 months

[Abandon]

Very sorry to hear this news. Best of luck for you both.

Can't offer any advice, but there are lots of forums on this topic with people who have lots of experience and advice, for both the sufferer and the family.

[cdnvic]

Good on ya for sticking by her, that's what the real thing does to you. There's alot of people living near-normal lives with HIV if its properly taken care of, and treatments are getting more effective all the time.

Take good care of her, and take care of yourself too.

cv

[chuchok]

Very sorry to hear this news.I hope somebody from this forum can help you with some good sound advice regarding treatment etc.

[taxexile]

get yourselves to a country (maybe your home country) where the diagnosis , advice and availability and quality of medication is perhaps better than cambodia.

[Boo]

Wasn't scouser in a similar situation with his wife?? Maybe read back on some topics in this section on HIV & you'll find a few people in a similar situation.

Best of luck & I hope your g/f gets back in good health. The advances in the drugs & hiv care these days means that sufferers can live realtivly healthy & normal lives, it just take some effort with diet & finding a good doctor.

[chuchok]

Wasn't scouser in a similar situation with his wife?? Maybe read back on some topics in this section on HIV & you'll find a few people in a similar situation.

Best of luck & I hope your g/f gets back in good health. The advances in the drugs & hiv care these days means that sufferers can live realtivly healthy & normal lives, it just take some effort with diet & finding a good doctor.

<{POST_SNAPBACK}>

Yep Boo.I'm sure Scouse can give some sound advise.

[stevenjm]

Thanks for the replies - I'll head back in the posts and see what I can find. Just spoke to her on the phone(had to come to aus for 4 days unavoidably) and she is feeling a lot better so hopefully is responding to the antivirals - best I can gather at the moment is stories from phnom penh pharmacies who have been telling me they have customers who have been coming for 10 years or so and are still healthy however I have no idea if 10 years is all to expect or if its indefinate with the new drugs.

BTW the antivirals are from the government pharmacuetical organisation of thailand, available in pharmacies here for 45us - would be interested to hear what price is paid for them in thailand - named "gpo-vir"

get yourselves to a country (maybe your home country) where the diagnosis , advice and availability and quality of medication is perhaps better than cambodia.

<{POST_SNAPBACK}>

Thanks - the goverment of my country, Aus, has in its usual brilliant wisdom, decided that a positive hiv result is reason to make a visa extremely difficult to obtain and also after speaking to an aus doctor yesterday now feel pretty comfortable with the doctor we now have in Phnom Penh looking after her - Naga clinic for anybody ever needing half decent medical at reasonable costs in PP.

[dr_Pat_Pong]

Thanks for the replies - I'll head back in the posts and see what I can find. Just spoke to her on the phone(had to come to aus for 4 days unavoidably) and she is feeling a lot better so hopefully is responding to the antivirals - best I can gather at the moment is stories from phnom penh pharmacies who have been telling me they have customers who have been coming for 10 years or so and are still healthy however I have no idea if 10 years is all to expect or if its indefinate with the new drugs.

BTW the antivirals are from the government pharmacuetical organisation of thailand, available in pharmacies here for 45us - would be interested to hear what price is paid for them in thailand - named "gpo-vir"

get yourselves to a country (maybe your home country) where the diagnosis , advice and availability and quality of medication is perhaps better than cambodia.

<{POST_SNAPBACK}>

Thanks - the goverment of my country, Aus, has in its usual brilliant wisdom, decided that a positive hiv result is reason to make a visa extremely difficult to obtain and also after speaking to an aus doctor yesterday now feel pretty comfortable with the doctor we now have in Phnom Penh looking after her - Naga clinic for anybody ever needing half decent medical at reasonable costs in PP.

<{POST_SNAPBACK}>

The Oz Government won't let her migrate to Australia and be a burden on the health system.

[stevenjm]

Thanks for the replies - I'll head back in the posts and see what I can find. Just spoke to her on the phone(had to come to aus for 4 days unavoidably) and she is feeling a lot better so hopefully is responding to the antivirals - best I can gather at the moment is stories from phnom penh pharmacies who have been telling me they have customers who have been coming for 10 years or so and are still healthy however I have no idea if 10 years is all to expect or if its indefinate with the new drugs.

BTW the antivirals are from the government pharmacuetical organisation of thailand, available in pharmacies here for 45us - would be interested to hear what price is paid for them in thailand - named "gpo-vir"

get yourselves to a country (maybe your home country) where the diagnosis , advice and availability and quality of medication is perhaps better than cambodia.

<{POST_SNAPBACK}>

Thanks - the goverment of my country, Aus, has in its usual brilliant wisdom, decided that a positive hiv result is reason to make a visa extremely difficult to obtain and also after speaking to an aus doctor yesterday now feel pretty comfortable with the doctor we now have in Phnom Penh looking after her - Naga clinic for anybody ever needing half decent medical at reasonable costs in PP.

<{POST_SNAPBACK}>

The Oz Government won't let her migrate to Australia and be a burden on the health system.

<{POST_SNAPBACK}>

Hit the nail right on the head.

Aus can give billions in tsunami relief when the eyes of the world are watching but is not interested in saving the life of a partner of one of its own citizens.

[gburns57au]

Thanks for the replies - I'll head back in the posts and see what I can find. Just spoke to her on the phone(had to come to aus for 4 days unavoidably) and she is feeling a lot better so hopefully is responding to the antivirals - best I can gather at the moment is stories from phnom penh pharmacies who have been telling me they have customers who have been coming for 10 years or so and are still healthy however I have no idea if 10 years is all to expect or if its indefinate with the new drugs.

BTW the antivirals are from the government pharmacuetical organisation of thailand, available in pharmacies here for 45us - would be interested to hear what price is paid for them in thailand - named "gpo-vir"

get yourselves to a country (maybe your home country) where the diagnosis , advice and availability and quality of medication is perhaps better than cambodia.

Thanks - the goverment of my country, Aus, has in its usual brilliant wisdom, decided that a positive hiv result is reason to make a visa extremely difficult to obtain and also after speaking to an aus doctor yesterday now feel pretty comfortable with the doctor we now have in Phnom Penh looking after her - Naga clinic for anybody ever needing half decent medical at reasonable costs in PP.

The Oz Government won't let her migrate to Australia and be a burden on the health system.

Hit the nail right on the head.

Aus can give billions in tsunami relief when the eyes of the world are watching but is not interested in saving the life of a partner of one of its own citizens.

While the situation is unfortunate for the OP and his girl, it is with good reason that HIV positive people are denied entry to not only OZ but a lot of other countries. While some of you may say it is only about being a burden on the health system or that it is because she may not be able to contribute to society.....it is because that HIV is a high risk transmissable infection with numerous ways of accidental or incidental transmission.

But I must commiserate with the OP... He has found himself with the reality that many of us have thought about. And I must admire his courage in sticking by the lady...the temptation to cut and run would have been high. Good luck to you both.

[taxexile]

actually its not that easy to catch .

its the publics perception of the syndrome and the expense of providing a lifetimes treatment that scares the governments.

until the drug companies make the drugs cheaper and people become more accepting of the condition then emigration / immigration will always be difficult for the hiv+

Edited April 17, 2005 by taxexile

[gburns57au]

actually its not that easy to catch .

its the publics perception of the syndrome and the expense of providing a lifetimes treatment that scares the governments.

until the drug companies make the drugs cheaper and people become more accepting of the condition then emigration / immigration will always be difficult for the hiv+

I wont get into a debate here as it is not the place.....suffice to say I disagree Tax. It is easier to catch than most people realise.

Edited April 17, 2005 by gburns57au

[davethailand]

actually its not that easy to catch .

its the publics perception of the syndrome and the expense of providing a lifetimes treatment that scares the governments.

until the drug companies make the drugs cheaper and people become more accepting of the condition then emigration / immigration will always be difficult for the hiv+

<{POST_SNAPBACK}>

I wont get into a debate here as it is not the place.....suffice to say I disagree Tax. It is easier to catch than most people realise.

<{POST_SNAPBACK}>

I was also under the impression that it was harder to catch than what people thought, I was told this in hospital when i had blood tests.

I have a friend who worked in pattaya in a very well known gogo that has it.

Edited April 17, 2005 by davethailand

[gburns57au]

actually its not that easy to catch .

its the publics perception of the syndrome and the expense of providing a lifetimes treatment that scares the governments.

until the drug companies make the drugs cheaper and people become more accepting of the condition then emigration / immigration will always be difficult for the hiv+

I wont get into a debate here as it is not the place.....suffice to say I disagree Tax. It is easier to catch than most people realise.

I was also under the impression that it was harder to catch than what people thought, I was told this in hospital when i had blood tests.

I have a friend who worked in pattaya in a very well known gogo that has it.

One of the reasons so many people have it.

[davethailand]

actually its not that easy to catch .

its the publics perception of the syndrome and the expense of providing a lifetimes treatment that scares the governments.

until the drug companies make the drugs cheaper and people become more accepting of the condition then emigration / immigration will always be difficult for the hiv+

<{POST_SNAPBACK}>

I wont get into a debate here as it is not the place.....suffice to say I disagree Tax. It is easier to catch than most people realise.

<{POST_SNAPBACK}>

I was also under the impression that it was harder to catch than what people thought, I was told this in hospital when i had blood tests.

I have a friend who worked in pattaya in a very well known gogo that has it.

<{POST_SNAPBACK}>

One of the reasons so many people have it.

<{POST_SNAPBACK}>

What is?

[bambob]

important thing is regular blood tests to monitor the CD4 count etc. about 3-6 months apart . reliable tests too .possible in PP ?

even if you are HIV + its not advisable to start medication until the blood tests warrant it

as you can run out of options at a later date.

good diet is important ,clean boiled water , no smoking drinking or drugs .

the future looks optimistic as new drugs are coming along all the time ,so its just the costs of the drugs.

its unlikely you would have been infected from her .

are you circumcised ? circ is better for non infection .

[bambob]

How long does it take for HIV to cause AIDS?

Since 1992, scientists have estimated that about half the people with HIV develop AIDS within 10 years after becoming infected. This time varies greatly from person to person and can depend on many factors, including a person's health status and their health-related behaviors.

Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. As with other diseases, early detection offers more options for treatment and preventative health care

Source

US Centers for Disease Control and Prevention

[bambob]

Virus Load Testing

Clinical Utility of Plasma HIV-1 RNA Monitoring

Numerous studies have demonstrated the correlation of plasma HIV-1 RNA levels with stage of disease. Patients with AIDS or symptomatic HIV infection have significantly higher titers of plasma HIV-1 RNA than do those with asymptomatic infection. In addition, patients with higher virus loads are likely to progress more rapidly than patients with lower virus loads. For example, individuals with plasma HIV-1 RNA levels >100,000 copies/mL within six months of seroconversion are 10-times more likely to progress to AIDS within five years than patients with lower levels of plasma HIV-1 RNA (49). Plasma HIV-1 RNA levels are correlated with the rate of CD4 count decline and with the rates of progression to AIDS and death in untreated patients with established HIV-1 infection (50) (Table 4).

Most studies suggest that plasma HIV-1 RNA levels provide prognostic information even in late stages of disease (51). Similar results have been observed in children with perinatally acquired HIV-1 infection (52; 53). However, some studies suggest that the CD4 count is a better predictor of disease progression than is plasma HIV-1 RNA in patients with very low CD4 counts (below 50 cells/mm3) (54).

The rapid change in plasma HIV-1 RNA levels in response to treatment makes it possible to assess the effectiveness of antiviral therapy within a matter of weeks. The relationship between change in virus load and treatment benefit has been analyzed in several large clinical trials (55). These studies show that a decrease in plasma HIV-1 RNA confers a significant reduction in risk of disease progression, independent of baseline plasma HIV-1 RNA level and CD4 count, and independent of the increase in CD4 count due to treatment (56). Much of the benefit of antiretroviral therapy can be attributed to its effect on plasma HIV-1 RNA levels. A 0.3-log10 (2-fold) reduction in plasma HIV-1 RNA levels confers a 30% reduction in the risk of progression to AIDS or death (57); a 1-log10 (10-fold) reduction reduces the risk of disease progression by approximately two-thirds (58). Although initial studies suggested that HIV-1 RNA was a stronger predictor of response to antiretroviral therapy than the change in CD4 count, subsequent studies make clear the prognostic importance of improvement in both markers (59; 60).

4/15/01

Virus Load Testing

Sample Collection

Blood for plasma HIV-1 RNA testing should be collected into tubes containing EDTA as an anticoagulant, and the plasma separated and stored frozen at -70o C until testing. Studies show that HIV-1 RNA is stable for up to 48 hours at room temperature in the presence of EDTA, but ideally samples should be processed within 6 hours after collection (61; 62). Events leading to immune activation such as vaccination or acute infectious illness can transiently raise the plasma HIV-1 RNA level (63; 64). Therefore, plasma HIV-1 RNA testing should not be performed within four weeks of an intercurrent infection or immunization. Because of differences between assay formats and commercial laboratories, the same laboratory should be used for serial tests on an individual patient.

Current treatment guidelines recommend obtaining two measurements of plasma HIV-1 RNA to determine the baseline or "set-point" virus load (65). Virus load testing should be performed immediately prior to initiating treatment and repeated within 2-8 weeks of starting treatment in order to assess the initial response to a regimen. A 1.0-log10 decline in plasma HIV-1 RNA level is expected for treatment-naïve patients within 8 weeks of starting an initial antiretroviral regimen, and plasma virus should fall to undetectable levels (below 50 copies/mL) by 16 weeks.

However, more than 24 weeks may be required for plasma virus titers to fall below the limit of detection in patients with high pre-treatment levels of viremia (above 100,000 copies/mL). Declines of 0.5-log10 or more within 8 weeks should be expected following a change in regimen due to treatment failure. Subsequently, plasma HIV-1 RNA levels should be repeated every 3-4 months in order to monitor the success of antiretroviral therapy.

4/15/01

Immunological Testing

CD4 Counts

The CD4 molecule is expressed on the surface of helper T-lymphocytes. CD4 interacts with HLA class II molecules on the surface of antigen-presenting cells to help stabilize the interaction between the antigen-specific T-cell receptor on the T-helper cell and the antigen-HLA class II complex on the antigen presenting cell. T-helper cell function can be significantly impaired by blocking the CD4-HLA class II interaction. CD4 also serves as the primary receptor for HIV-1 and HIV-2. It is the specific affinity of the HIV envelope glycoprotein (gp120) for CD4 that targets HIV to helper T cells and macrophages.

Even prior to the identification of HIV as the cause of AIDS, the progressive loss of T helper cells was noted to be a characteristic finding in patients with this disease. On average, there is a loss of 30-60 CD4+ cells per year, although in many patients, CD4+ T-lymphocyte counts may remain stable for several years followed by a period of rapid decline (66; 67). Natural history studies and clinical trials have demonstrated that the CD4+ lymphocyte count is an independent risk factor for progression to AIDS and death. The CD4 count provides an estimate of the immunologic status of the patient, and therefore, is an excellent marker of the immediate risk of opportunistic infection. Such complications are rare in patients with CD4 counts above 500 cells/mm3. As the CD4 count drops below 500 cells/mm3 patients may begin to experience recurrent minor infections such as herpes simplex virus or oral candidiasis. The risk of more serious opportunistic infections increases significantly as the CD4 count falls below 200 cells/mm3.

The CD4 count increases promptly in response to antiretroviral therapy. The rise in CD4+ cell count is related to the extent to which virus replication is suppressed. Even patients who do not achieve complete virologic suppression may show significant increases in CD4 counts. Cohort studies have shown that patients who achieve a significant CD4+ cell increase in response to potent antiretroviral therapy have a substantially lower risk of disease progression, whereas those patients who achieve viral suppression but do not have an increase in their CD4 counts remain at increased risk of developing an AIDS-related opportunistic infection (68). Thus, monitoring the CD4+ cell count is an essential component of patient evaluation.

The CD4 count is determined by "staining" patient blood cells with antibodies to various cell surface markers, including CD4. The antibodies are conjugated to fluorescent tags that emit light of a certain frequency when excited by a laser beam. In flow cytometry the stained cells are fed in a stream past the laser, and the proportion of cells that emit light at the right wavelength is determined. The number of lymphocytes circulating in the blood (determined by a blood count) is multiplied by the percent of cells staining positive for CD4 in order to calculate the number of helper T cells.

CD4 counts are subject to considerable inter-assay variation. Most of this variation is due to fluctuations in the total lymphocyte count, rather than any inherent inaccuracy of the flow cytometry portion of the test. CD4 counts are subject to diurnal variation (that is, counts are higher in the morning than in the evening), and may change as a result of an acute illness. The percentage of lymphocytes that are CD4+ (the "% CD4") is less variable than the absolute CD4 count. The % CD4 cells is comparable to the absolute count in predicting the risk of disease progression or in assessing the response to treatment (66).

Guidelines suggest that CD4 + T cell counts be measured at the time of diagnosis and generally every 3-6 months thereafter (65). CD4 counts can show considerable day-to-day variation. For this reason, any large unexpected change in the CD4 count should be confirmed by repeat testing a few days apart. The CD4 count trajectory over several follow-up visits may be particularly helpful.

4/15/01

[Digger]

Hey, last couple of months have been going crazy trying to get good medical for my girlfriend here in Phnom Penh, fever , bad cough etc etc.

Went through several doctors with various diagnosis over several months before getting a decent thourough doctor who finally found she had hiv.

We were both totally shattered and it left me in tears as we have been discussing marriage and how good the future was looking. anyway - I have decided I love her too much to abandon her and will stick by her and hopefully still have some good times ahead of us - we have been together about a year and have had some really good times and are very compatible - its not a paid situation but a genuine relationship with a great girl.

I now have her on gpo-vir a thai gov hiv drug(3 days ago) and am wondering if anybody can give me any sort of optimistic words for the future - I have not a clue on what to expect and am in the dark as to her life expectency etc etc.

btw test results show me as negative but one more test needed in 3 months

<{POST_SNAPBACK}>

I pay for a girls medicines who has HIV and have met her doctor many times and BKK and have done a fair amount of research on HIV.

First thought in my mind is how was the diagnosis undertaken? Was it a blood test only or blood test followed up by viral load and CD4 counts? If she has had viral load and CD4 tests what were her results? Viral load is refered to in thousands (i.e 30,000;60,000 etc) and CD4 in numbers ranging from 0-approx 800. Without having these tests you cannot be absolutely certain that the patient even has HIV. Many things can cause a false HIV positive reading and the sero-conversion timeline is generally about 2-6 days of sickness not months.

The results of these tests can confirm the HIV in the body by the fact that a viral load is actually measured and that the patients CD4 count (basically amount of infection fighting blood cells in the body in very simple laymans terms) will be reduced when compared to a normal person. Basically HIV attacks the CD4 cells killing them off. Once the virus has wiped out about 75% of your CD4 cells, you are vunerable to multiple illnesses that ordinarily would be beaten back by your CD4 cells - these are called opportunistic infections - basically taking advantage of your bodies weak imune system. The viral load test measures the amount of HIV in the bloodstream and is a good indication of how much virus is in the body.

In general terms a patient with a CD4 count higher than 200 is consider to have HIV. Below 200 they are considered to have AIDS. Once you drop below 200 CD4 cells, you are much stronger risk of developing illness that your body cannot fight.

There are currently about 25 medicines that are used to fight HIv infection. None of them cure the infection however they can suppress the virus and prevent it replicating. In essence, there are 4 main types of medicine, which are designed to do different things and are used at different stages of treatment.

It is fair to say that with proper medical guidance and access to the whole suite of medicines that a person now contracting HIV is likely to end up dying of something other than HIV and to live a normal lifespan. Big ifs in this scenario is the medical care they receive and the access to medicines. Medicines are not cheap, have toxicity issues and numerous side effects. That is why a good doctor is such an important part of the equation. This is not something you can do yourself however you can arm yourself with a lot of info to ask the doctor the right questions and understand where they are headed with treatment options.

The aim of HIV medicines is to suppress the virus to levels where it cannot be measured in a patients bloodstream (known as being undetectable) and by suppressing the virus to allow your CD4 cells to replenish and fight of infections in the normal way.

Over the last 20 years doctors have learnt a huge amount about HIV. The current preferred method of treatment is to allow the CD4 level to fall to between 200 and 350 (depending upon where you are from, 200 -250 in Europe, 350 in the USA) and then start a course of HIV medicines. The reason for delaying the start is for a number of reasons:

1. Toxicity - the medicines are too a large extent toxic. The body can only take so much toxic materials. Therefore due to point 2, there seems little point in starting someone on medicines early.

2. Ability to fight the virus. Originally an idea that came from the US was to hit very hard on HIV in the hope of wiping it out. Study after study has shown that this approach has not produced signifigantly better results than by delaying treatment. It has been proven that in general terms someone starting HIV medicine with a CD4 count of 200 achieves the same benefit as someone starting with a CD4 count of say 500. Basically the end result with treatment is the same. Therefore due to toxic concerns, most doctors and government health bodies suggest delaying treatment until your CD4 is the range between 200 and 350. The exception to this is if the patient is currently undergoing the seroconversion illness. Use of HIV medicines at this point has acelerated the growth in CD4 count to near normal levels very quickly and to suppress the virus very effectively. This is why baseline testing and then regular testing for CD4 and viral load is very important. Generally this is done every 3-6 months.

3. Cost. These medicines cost a lot of money. Cost of course plays a part as one you are on HIV medicine, your pretty much on it for the rest of your life.

4. Preserving medicine options. OK so there are 25 medicines and loads more in the pipeline, however your body can and does reject some medicines, thus reducing the amount of choice your doctor has in the medication they can prescribe. Also some medicines do not work well together. Again this reduces the options for the doctor. Your HIV virus may also be resistant to some medicines, which again limits your options and HIV can also outwit the medicines and make some worthless. This can actually wipe out more than just the medicine being taken as many of the 25 medicines have similar characteristics. Therefore if the virus in the body can restrict one medicine, the doctors are also aware that XX many others would also not work.

So in a nutshell on options, you do not really have 25 medicines that you can go through even though thats about the number of medicines there are. Therefore it makes sense to preserve as many medicines as you can for future use as doctors are now looking ahead at how they are going to treat HIV positive patients 30 years ahead.

So thats why treatment is delayed until you really need it i.e once your CD4 count is down to between 200-350.

Now with patients living longer and longer with medicines the focus has switched to make the medicines easier to take, less pills, less side effects etc. Many medicines are being packaged together in the same pill, so that you take multiple medicines in just one dose. This is being done because one of the biggest problems in treating HIV is to ensure that the patient takes the medicines correctly. It is critically important NOT to miss doses as this will allow the HIV to develop resistance to the medicine and basically means its worthless.

The medicine you are using is a combination of 3 HIV medicines including D4T and Nevarapine. D4T is one of the first medicines for HIV and is not considered a 'first choice' medicine in the west anymore as their have been numerous cases of body fat loss with this medicine. However it is still used as a backup in case of resistance to other drugs. Its basically a bit like keeping a t-shirt in the back of the cupboard, just in case all your favourite ones are in the wash. Nevarapine on the other hand is a first rate medicine and used as a main stay of treatments in the west. There is one other medicine in the combination but I cannot remember what it is. This combination of drugs has proven to be extremely good and its fair to say that for its price it produces excellent results. It is not the best but at that price nothing else is so easily affordable.

My suggestions for you:

1. If not had viral load and CD4 test yet - GET THEM DONE - only these can tell how the virus is developing and what use medicines are. Get these re-done every 3 months for the first year and then drop back to every 5 months or so.

2. Check how expereinced your doctor is in treating HIV. YOU MUST use a specialist doctor. There knowledge and training is designed to look out for signs than an ordinary doctor would not be aware off. They are also well aware of the problems between different medicines.

3. Undertake CBC (complete blood count) test, Hep A,B,C tests as well and keep repeating CBC same time as viral load and CD4. CBC will show a multitude of illnesses through your blood work and importantly, HIV specialists can measure drug toxicity and other warning signs through this test. For example, some medicines can cause anemia. This is picked up through the blood test far easier than by any physical signs.

The hepatitus tests are very important. Most HIV medicine is funelled through the liver. Hepititus is a liver disease. the two do not go well together. Hep B is very common in Asia. Currently there are a couple of drugs that can treat Hep B - one of them is also a HIV drug. Your doctor would ideally not use this drug unless the liver is in trouble as if your body becomes resistant to this drug (its called 3TC), you cannot use it for Hep B infection. Again another critical reason to use a specialist HIV doctor. If your not comfortable with your doctor FIND ANOTHER. Its this doctor that will keep your friend alive. You must have a very good relationship with them - far more so than a traditional GP.

Hope this helps and if its any comfort, the girl I help has an undetectable viral load, normal CD4 count and is in superb health. With the right support and medicines this is a manageable illness not a death sentence anymore.

[Digger]

Thanks for the replies - I'll head back in the posts and see what I can find. Just spoke to her on the phone(had to come to aus for 4 days unavoidably) and she is feeling a lot better so hopefully is responding to the antivirals - best I can gather at the moment is stories from phnom penh pharmacies who have been telling me they have customers who have been coming for 10 years or so and are still healthy however I have no idea if 10 years is all to expect or if its indefinate with the new drugs.

BTW the antivirals are from the government pharmacuetical organisation of thailand, available in pharmacies here for 45us - would be interested to hear what price is paid for them in thailand - named "gpo-vir"

get yourselves to a country (maybe your home country) where the diagnosis , advice and availability and quality of medication is perhaps better than cambodia.

<{POST_SNAPBACK}>

Thanks - the goverment of my country, Aus, has in its usual brilliant wisdom, decided that a positive hiv result is reason to make a visa extremely difficult to obtain and also after speaking to an aus doctor yesterday now feel pretty comfortable with the doctor we now have in Phnom Penh looking after her - Naga clinic for anybody ever needing half decent medical at reasonable costs in PP.

<{POST_SNAPBACK}>

The Oz Government won't let her migrate to Australia and be a burden on the health system.

<{POST_SNAPBACK}>

Hit the nail right on the head.

Aus can give billions in tsunami relief when the eyes of the world are watching but is not interested in saving the life of a partner of one of its own citizens.

<{POST_SNAPBACK}>

While the situation is unfortunate for the OP and his girl, it is with good reason that HIV positive people are denied entry to not only OZ but a lot of other countries. While some of you may say it is only about being a burden on the health system or that it is because she may not be able to contribute to society.....it is because that HIV is a high risk transmissable infection with numerous ways of accidental or incidental transmission.

But I must commiserate with the OP... He has found himself with the reality that many of us have thought about. And I must admire his courage in sticking by the lady...the temptation to cut and run would have been high. Good luck to you both.

<{POST_SNAPBACK}>

To put this into context Hepatitus B is a far more dangerous disease than HIV in so far that its way easier to transmit and basically is untreatable in its most severe forms. HIV is treatable. Personally I think the issue around HIV is one based solely on cost of treatment and lack of understanding of it. It is spread for the most part through lack of knowledge and hysteria. Nobody ever talks about HEP B but I know 3 guys and 2 of their wifes who have it. 2 of the guys regularly as taking girls out of bars in Pattaya and BKK but nobody seems to think its as serious as HIV. Hep B can be spread by kissing someone who has not had an inoculation against it. Never seems to come up though in discussions as one of the things checked during a bar girls medical check up.

[Digger]

actually its not that easy to catch .

its the publics perception of the syndrome and the expense of providing a lifetimes treatment that scares the governments.

until the drug companies make the drugs cheaper and people become more accepting of the condition then emigration / immigration will always be difficult for the hiv+

<{POST_SNAPBACK}>

I wont get into a debate here as it is not the place.....suffice to say I disagree Tax. It is easier to catch than most people realise.

<{POST_SNAPBACK}>

I was also under the impression that it was harder to catch than what people thought, I was told this in hospital when i had blood tests.

I have a friend who worked in pattaya in a very well known gogo that has it.

<{POST_SNAPBACK}>

And if he is working with a good doctor with access to medicines he will probably live as long as you Dave. Make sure you invite him to your retirement party

[stevenjm]

Hey, last couple of months have been going crazy trying to get good medical for my girlfriend here in Phnom Penh, fever , bad cough etc etc.

Went through several doctors with various diagnosis over several months before getting a decent thourough doctor who finally found she had hiv.

We were both totally shattered and it left me in tears as we have been discussing marriage and how good the future was looking. anyway - I have decided I love her too much to abandon her and will stick by her and hopefully still have some good times ahead of us - we have been together about a year and have had some really good times and are very compatible - its not a paid situation but a genuine relationship with a great girl.

I now have her on gpo-vir a thai gov hiv drug(3 days ago) and am wondering if anybody can give me any sort of optimistic words for the future - I have not a clue on what to expect and am in the dark as to her life expectency etc etc.

btw test results show me as negative but one more test needed in 3 months

<{POST_SNAPBACK}>

I pay for a girls medicines who has HIV and have met her doctor many times and BKK and have done a fair amount of research on HIV.

First thought in my mind is how was the diagnosis undertaken? Was it a blood test only or blood test followed up by viral load and CD4 counts? If she has had viral load and CD4 tests what were her results? Viral load is refered to in thousands (i.e 30,000;60,000 etc) and CD4 in numbers ranging from 0-approx 800. Without having these tests you cannot be absolutely certain that the patient even has HIV. Many things can cause a false HIV positive reading and the sero-conversion timeline is generally about 2-6 days of sickness not months.

The results of these tests can confirm the HIV in the body by the fact that a viral load is actually measured and that the patients CD4 count (basically amount of infection fighting blood cells in the body in very simple laymans terms) will be reduced when compared to a normal person. Basically HIV attacks the CD4 cells killing them off. Once the virus has wiped out about 75% of your CD4 cells, you are vunerable to multiple illnesses that ordinarily would be beaten back by your CD4 cells - these are called opportunistic infections - basically taking advantage of your bodies weak imune system. The viral load test measures the amount of HIV in the bloodstream and is a good indication of how much virus is in the body.

In general terms a patient with a CD4 count higher than 200 is consider to have HIV. Below 200 they are considered to have AIDS. Once you drop below 200 CD4 cells, you are much stronger risk of developing illness that your body cannot fight.

There are currently about 25 medicines that are used to fight HIv infection. None of them cure the infection however they can suppress the virus and prevent it replicating. In essence, there are 4 main types of medicine, which are designed to do different things and are used at different stages of treatment.

It is fair to say that with proper medical guidance and access to the whole suite of medicines that a person now contracting HIV is likely to end up dying of something other than HIV and to live a normal lifespan. Big ifs in this scenario is the medical care they receive and the access to medicines. Medicines are not cheap, have toxicity issues and numerous side effects. That is why a good doctor is such an important part of the equation. This is not something you can do yourself however you can arm yourself with a lot of info to ask the doctor the right questions and understand where they are headed with treatment options.

The aim of HIV medicines is to suppress the virus to levels where it cannot be measured in a patients bloodstream (known as being undetectable) and by suppressing the virus to allow your CD4 cells to replenish and fight of infections in the normal way.

Over the last 20 years doctors have learnt a huge amount about HIV. The current preferred method of treatment is to allow the CD4 level to fall to between 200 and 350 (depending upon where you are from, 200 -250 in Europe, 350 in the USA) and then start a course of HIV medicines. The reason for delaying the start is for a number of reasons:

1. Toxicity - the medicines are too a large extent toxic. The body can only take so much toxic materials. Therefore due to point 2, there seems little point in starting someone on medicines early.

2. Ability to fight the virus. Originally an idea that came from the US was to hit very hard on HIV in the hope of wiping it out. Study after study has shown that this approach has not produced signifigantly better results than by delaying treatment. It has been proven that in general terms someone starting HIV medicine with a CD4 count of 200 achieves the same benefit as someone starting with a CD4 count of say 500. Basically the end result with treatment is the same. Therefore due to toxic concerns, most doctors and government health bodies suggest delaying treatment until your CD4 is the range between 200 and 350. The exception to this is if the patient is currently undergoing the seroconversion illness. Use of HIV medicines at this point has acelerated the growth in CD4 count to near normal levels very quickly and to suppress the virus very effectively. This is why baseline testing and then regular testing for CD4 and viral load is very important. Generally this is done every 3-6 months.

3. Cost. These medicines cost a lot of money. Cost of course plays a part as one you are on HIV medicine, your pretty much on it for the rest of your life.

4. Preserving medicine options. OK so there are 25 medicines and loads more in the pipeline, however your body can and does reject some medicines, thus reducing the amount of choice your doctor has in the medication they can prescribe. Also some medicines do not work well together. Again this reduces the options for the doctor. Your HIV virus may also be resistant to some medicines, which again limits your options and HIV can also outwit the medicines and make some worthless. This can actually wipe out more than just the medicine being taken as many of the 25 medicines have similar characteristics. Therefore if the virus in the body can restrict one medicine, the doctors are also aware that XX many others would also not work.

So in a nutshell on options, you do not really have 25 medicines that you can go through even though thats about the number of medicines there are. Therefore it makes sense to preserve as many medicines as you can for future use as doctors are now looking ahead at how they are going to treat HIV positive patients 30 years ahead.

So thats why treatment is delayed until you really need it i.e once your CD4 count is down to between 200-350.

Now with patients living longer and longer with medicines the focus has switched to make the medicines easier to take, less pills, less side effects etc. Many medicines are being packaged together in the same pill, so that you take multiple medicines in just one dose. This is being done because one of the biggest problems in treating HIV is to ensure that the patient takes the medicines correctly. It is critically important NOT to miss doses as this will allow the HIV to develop resistance to the medicine and basically means its worthless.

The medicine you are using is a combination of 3 HIV medicines including D4T and Nevarapine. D4T is one of the first medicines for HIV and is not considered a 'first choice' medicine in the west anymore as their have been numerous cases of body fat loss with this medicine. However it is still used as a backup in case of resistance to other drugs. Its basically a bit like keeping a t-shirt in the back of the cupboard, just in case all your favourite ones are in the wash. Nevarapine on the other hand is a first rate medicine and used as a main stay of treatments in the west. There is one other medicine in the combination but I cannot remember what it is. This combination of drugs has proven to be extremely good and its fair to say that for its price it produces excellent results. It is not the best but at that price nothing else is so easily affordable.

My suggestions for you:

1. If not had viral load and CD4 test yet - GET THEM DONE - only these can tell how the virus is developing and what use medicines are. Get these re-done every 3 months for the first year and then drop back to every 5 months or so.

2. Check how expereinced your doctor is in treating HIV. YOU MUST use a specialist doctor. There knowledge and training is designed to look out for signs than an ordinary doctor would not be aware off. They are also well aware of the problems between different medicines.

3. Undertake CBC (complete blood count) test, Hep A,B,C tests as well and keep repeating CBC same time as viral load and CD4. CBC will show a multitude of illnesses through your blood work and importantly, HIV specialists can measure drug toxicity and other warning signs through this test. For example, some medicines can cause anemia. This is picked up through the blood test far easier than by any physical signs.

The hepatitus tests are very important. Most HIV medicine is funelled through the liver. Hepititus is a liver disease. the two do not go well together. Hep B is very common in Asia. Currently there are a couple of drugs that can treat Hep B - one of them is also a HIV drug. Your doctor would ideally not use this drug unless the liver is in trouble as if your body becomes resistant to this drug (its called 3TC), you cannot use it for Hep B infection. Again another critical reason to use a specialist HIV doctor. If your not comfortable with your doctor FIND ANOTHER. Its this doctor that will keep your friend alive. You must have a very good relationship with them - far more so than a traditional GP.

Hope this helps and if its any comfort, the girl I help has an undetectable viral load, normal CD4 count and is in superb health. With the right support and medicines this is a manageable illness not a death sentence anymore.

<{POST_SNAPBACK}>

thanks heaps guys for the comprehensive posts. I just replied in a similar manner and lost my post due to computer lockup so I will keep this one short.

I originally went to a clinic , after finding she was hiv positive, run by some australians and roche. After being told that they only look at one person a day and she was too busy to tell me anything I felt like breaking her obnoxious face open. This place had a staff of dozens and corporate backing yet would not even see my gf for six mnths because they were too busy with there one person a day evaluation.

anyway went to naga private clinic which has an hiv specialist and he did full blood counts as follows

cd4 70

and a couple of others slightly lower than normal.

he imediastely prescribed the gpo- vir and some vitamins , iron, bactrim and something for that white stuff on her tongue.

I told him to treat her as if she was his daughter so am hoping and praying that she is being well looked after.

of concern to me is your statement about it being considered aids if <200 cd4

Does this mean she is well advanced and that life expectancy is not very optimistic?

she seems to be responding well to the drugs and has her apetite back and is optimistic but I do not want to lie to her too much about her future and this would also mean that I would spend everyhting I have in a hurry to make sure she enjoys what time she has left. I would also like to prepare myself emotionally for what lies ahead so truth is essential.

[Digger]

Hey, last couple of months have been going crazy trying to get good medical for my girlfriend here in Phnom Penh, fever , bad cough etc etc.

Went through several doctors with various diagnosis over several months before getting a decent thourough doctor who finally found she had hiv.

We were both totally shattered and it left me in tears as we have been discussing marriage and how good the future was looking. anyway - I have decided I love her too much to abandon her and will stick by her and hopefully still have some good times ahead of us - we have been together about a year and have had some really good times and are very compatible - its not a paid situation but a genuine relationship with a great girl.

I now have her on gpo-vir a thai gov hiv drug(3 days ago) and am wondering if anybody can give me any sort of optimistic words for the future - I have not a clue on what to expect and am in the dark as to her life expectency etc etc.

btw test results show me as negative but one more test needed in 3 months

<{POST_SNAPBACK}>

I pay for a girls medicines who has HIV and have met her doctor many times and BKK and have done a fair amount of research on HIV.

First thought in my mind is how was the diagnosis undertaken? Was it a blood test only or blood test followed up by viral load and CD4 counts? If she has had viral load and CD4 tests what were her results? Viral load is refered to in thousands (i.e 30,000;60,000 etc) and CD4 in numbers ranging from 0-approx 800. Without having these tests you cannot be absolutely certain that the patient even has HIV. Many things can cause a false HIV positive reading and the sero-conversion timeline is generally about 2-6 days of sickness not months.

The results of these tests can confirm the HIV in the body by the fact that a viral load is actually measured and that the patients CD4 count (basically amount of infection fighting blood cells in the body in very simple laymans terms) will be reduced when compared to a normal person. Basically HIV attacks the CD4 cells killing them off. Once the virus has wiped out about 75% of your CD4 cells, you are vunerable to multiple illnesses that ordinarily would be beaten back by your CD4 cells - these are called opportunistic infections - basically taking advantage of your bodies weak imune system. The viral load test measures the amount of HIV in the bloodstream and is a good indication of how much virus is in the body.

In general terms a patient with a CD4 count higher than 200 is consider to have HIV. Below 200 they are considered to have AIDS. Once you drop below 200 CD4 cells, you are much stronger risk of developing illness that your body cannot fight.

There are currently about 25 medicines that are used to fight HIv infection. None of them cure the infection however they can suppress the virus and prevent it replicating. In essence, there are 4 main types of medicine, which are designed to do different things and are used at different stages of treatment.

It is fair to say that with proper medical guidance and access to the whole suite of medicines that a person now contracting HIV is likely to end up dying of something other than HIV and to live a normal lifespan. Big ifs in this scenario is the medical care they receive and the access to medicines. Medicines are not cheap, have toxicity issues and numerous side effects. That is why a good doctor is such an important part of the equation. This is not something you can do yourself however you can arm yourself with a lot of info to ask the doctor the right questions and understand where they are headed with treatment options.

The aim of HIV medicines is to suppress the virus to levels where it cannot be measured in a patients bloodstream (known as being undetectable) and by suppressing the virus to allow your CD4 cells to replenish and fight of infections in the normal way.

Over the last 20 years doctors have learnt a huge amount about HIV. The current preferred method of treatment is to allow the CD4 level to fall to between 200 and 350 (depending upon where you are from, 200 -250 in Europe, 350 in the USA) and then start a course of HIV medicines. The reason for delaying the start is for a number of reasons:

1. Toxicity - the medicines are too a large extent toxic. The body can only take so much toxic materials. Therefore due to point 2, there seems little point in starting someone on medicines early.

2. Ability to fight the virus. Originally an idea that came from the US was to hit very hard on HIV in the hope of wiping it out. Study after study has shown that this approach has not produced signifigantly better results than by delaying treatment. It has been proven that in general terms someone starting HIV medicine with a CD4 count of 200 achieves the same benefit as someone starting with a CD4 count of say 500. Basically the end result with treatment is the same. Therefore due to toxic concerns, most doctors and government health bodies suggest delaying treatment until your CD4 is the range between 200 and 350. The exception to this is if the patient is currently undergoing the seroconversion illness. Use of HIV medicines at this point has acelerated the growth in CD4 count to near normal levels very quickly and to suppress the virus very effectively. This is why baseline testing and then regular testing for CD4 and viral load is very important. Generally this is done every 3-6 months.

3. Cost. These medicines cost a lot of money. Cost of course plays a part as one you are on HIV medicine, your pretty much on it for the rest of your life.

4. Preserving medicine options. OK so there are 25 medicines and loads more in the pipeline, however your body can and does reject some medicines, thus reducing the amount of choice your doctor has in the medication they can prescribe. Also some medicines do not work well together. Again this reduces the options for the doctor. Your HIV virus may also be resistant to some medicines, which again limits your options and HIV can also outwit the medicines and make some worthless. This can actually wipe out more than just the medicine being taken as many of the 25 medicines have similar characteristics. Therefore if the virus in the body can restrict one medicine, the doctors are also aware that XX many others would also not work.

So in a nutshell on options, you do not really have 25 medicines that you can go through even though thats about the number of medicines there are. Therefore it makes sense to preserve as many medicines as you can for future use as doctors are now looking ahead at how they are going to treat HIV positive patients 30 years ahead.

So thats why treatment is delayed until you really need it i.e once your CD4 count is down to between 200-350.

Now with patients living longer and longer with medicines the focus has switched to make the medicines easier to take, less pills, less side effects etc. Many medicines are being packaged together in the same pill, so that you take multiple medicines in just one dose. This is being done because one of the biggest problems in treating HIV is to ensure that the patient takes the medicines correctly. It is critically important NOT to miss doses as this will allow the HIV to develop resistance to the medicine and basically means its worthless.

The medicine you are using is a combination of 3 HIV medicines including D4T and Nevarapine. D4T is one of the first medicines for HIV and is not considered a 'first choice' medicine in the west anymore as their have been numerous cases of body fat loss with this medicine. However it is still used as a backup in case of resistance to other drugs. Its basically a bit like keeping a t-shirt in the back of the cupboard, just in case all your favourite ones are in the wash. Nevarapine on the other hand is a first rate medicine and used as a main stay of treatments in the west. There is one other medicine in the combination but I cannot remember what it is. This combination of drugs has proven to be extremely good and its fair to say that for its price it produces excellent results. It is not the best but at that price nothing else is so easily affordable.

My suggestions for you:

1. If not had viral load and CD4 test yet - GET THEM DONE - only these can tell how the virus is developing and what use medicines are. Get these re-done every 3 months for the first year and then drop back to every 5 months or so.

2. Check how expereinced your doctor is in treating HIV. YOU MUST use a specialist doctor. There knowledge and training is designed to look out for signs than an ordinary doctor would not be aware off. They are also well aware of the problems between different medicines.

3. Undertake CBC (complete blood count) test, Hep A,B,C tests as well and keep repeating CBC same time as viral load and CD4. CBC will show a multitude of illnesses through your blood work and importantly, HIV specialists can measure drug toxicity and other warning signs through this test. For example, some medicines can cause anemia. This is picked up through the blood test far easier than by any physical signs.

The hepatitus tests are very important. Most HIV medicine is funelled through the liver. Hepititus is a liver disease. the two do not go well together. Hep B is very common in Asia. Currently there are a couple of drugs that can treat Hep B - one of them is also a HIV drug. Your doctor would ideally not use this drug unless the liver is in trouble as if your body becomes resistant to this drug (its called 3TC), you cannot use it for Hep B infection. Again another critical reason to use a specialist HIV doctor. If your not comfortable with your doctor FIND ANOTHER. Its this doctor that will keep your friend alive. You must have a very good relationship with them - far more so than a traditional GP.

Hope this helps and if its any comfort, the girl I help has an undetectable viral load, normal CD4 count and is in superb health. With the right support and medicines this is a manageable illness not a death sentence anymore.

<{POST_SNAPBACK}>

thanks heaps guys for the comprehensive posts. I just replied in a similar manner and lost my post due to computer lockup so I will keep this one short.

I originally went to a clinic , after finding she was hiv positive, run by some australians and roche. After being told that they only look at one person a day and she was too busy to tell me anything I felt like breaking her obnoxious face open. This place had a staff of dozens and corporate backing yet would not even see my gf for six mnths because they were too busy with there one person a day evaluation.

anyway went to naga private clinic which has an hiv specialist and he did full blood counts as follows

cd4 70

and a couple of others slightly lower than normal.

he imediastely prescribed the gpo- vir and some vitamins , iron, bactrim and something for that white stuff on her tongue.

I told him to treat her as if she was his daughter so am hoping and praying that she is being well looked after.

of concern to me is your statement about it being considered aids if <200 cd4

Does this mean she is well advanced and that life expectancy is not very optimistic?

she seems to be responding well to the drugs and has her apetite back and is optimistic but I do not want to lie to her too much about her future and this would also mean that I would spend everyhting I have in a hurry to make sure she enjoys what time she has left. I would also like to prepare myself emotionally for what lies ahead so truth is essential.

<{POST_SNAPBACK}>

70 is a seriously low CD4 count however, there have been many cases recorded in US and Europe where people with CD4 counts as low as 5 have responded well to medicines and restored their CD4 counts. The most important thing is to ensure the medicines are taken on time, every time. NEVER forget a dose.

The Bactrim is used to stop I think PCP, its an anti biotic but very effective. Its standard practice to use it with all patients who have a CD4 count of less than 200. Once it rises over 200, they will take her off it. The Bactrim can cause a rash and itchiness on the body but its not so serious.

You really need to do a viral load test but they are expensive at about US$150 a time. This is what measures the virus in the body and is how they determine long term how successfull a medicine combination is. For example at such a low CD4 count, it will take time for this to recover. However the viral load will show how much of the virus is being destroyed by the drugs. The most critical thing at this stage is reducing the virus in the body and allowing her CD4 count to rise. The medicine could well suppress the viral load to near zero within 2-3 months but the rise in CD4 counts could trail well behind that. Once above 200, she is essentially out of the danger zone.

One thing to be aware off is the possibility of side effects - these tend to show themselves within the first couple of weeks of starting the medicines. This could include rashs, nightsweats, nausea, being sick etc. It is important NOT to stop any medicines without asking your doctor first. They will know specifically what side effects are dangerous and what are just inconvenient but not life threatening.

Not sure what use the vitamins are for, but iron tablets will probably be to treat anemia, which may have shown up as low on the CBC test. If the Hb level is below 8, iron tablets are not going to do anygood. She may actually need a blod transfussion if its much below that. There is a specific drug that lifts Hb levels but it may not be available in Cambodia.

A very usefull website is at www.thebody.com - look at the starting treatment forum. Basically people post questions and then specialist American doctors reply. It is very good to build up a picture and to ask specific questions if you want.

Its a long haul for both of you but certainly one that can be achieved with perseverance and hope. Keep a positive mindset and keep clear of anyone with any obvious illness such as colds, flu etc as these could really hurt her chances until she gets her CD4 count back up.

[johninbkk2000]

Steven,

another very good website: www.aidsmeds.com

Go to the forum, a lot of knowlegable people there.

Adherence is the most important thing. NEVER EVER let her skip a dose.

GPOvir is a very potent combination and as long as she does not develop side effects and she is 100% adherent she will be ok. In the first weeks watch for rashes, vomiting, abnominal pain, fever. If she develops severe rash do see her doctor right away.

And you are a great person by not running away from this. Stick with her and you both will have a bright future ahead of you.

John

[slimdog]

Hi stevenjm

Yes having a cd4 count <200 (or in some countries <250) does mean that she has AIDS.

The medication that the doctors have prescribed looks good. The gpo-vir will help in both reducing the viral load and increasing her cd4 count. Generally gpo-vir should start working quite quickly, which means that within 3 months her viral load will DROP considerably, possibly to below the detectable level of 50 or only just detectable. At the same time her cd4 count will not decrease further and should start going UP. It is quite normal to see the cd4 count rise by 15 - 20 per month. In the meantime the doctors have prescribed Bactrim which is a very good anti-biotic which will help her immune system.

The most important thing to remember is to take the medication on time, every day. There must not be any lapses. For this reason it is generally benificial if she can have a small "stock-pile" of say 2 months, remebering to use the older medication first (some of the medications only have 6 months shelf life). This will be even more important if she is in Cambodia and she is totally reliant on imported drugs from Thailand, it only needs the border to be closed for a short while.. The danger with not taking the medication for even a short period is that her body could very easily become resistant to the medication. This doesn;t seem to be happening with the people who take their medication as prescribed.

One of the things seldom mentioned in AIDS is the mental problems. Your girlfriend will be very vulnerable to depression. Whist medical advances in treatment of AIDS has been tremendous; Newspapers, Tv etc have only really shown the negative sides.( I think there is a real worry by the medical community, that people may start to think of AIDS as curable and therefore undo all the work they have done in the last 20 years). As a result of this people who are diagnosed with hiv/AIDS are really unaware of how far the medical community has progressed in the treatment of hiv/AIDS. No one knows exactly how long your girlfriend will live, but if she takes good care of herself, eats well, exercises, gets plenty of rest and takes her medication properly then it is entirely possible that she can live a full and active life. The major thing is to make sure she does not give up hope...

[The Gentleman Scamp]

Sorry to hear your news but fully admire your guts for sharing it with us.

My only advice is, as stated somewhere earlier, eat good food, drink plenty of water and if you're a smoker or regular drinker then use it as an excuse to quit both if you can.

I have heard from one doctor and one HIV counsellor back in England that it is very difficult for a man to catch and you have to have unprotected sex with a carrier quite a few times before picking it up - obviously this info isn't public knowledge otherwise people would get more complacent than they are already and it's certainly not an excuse to go bare back.

In your case, you won't know until three months anyway and the best thing to do (which won't be difficult if you're in love) is to think positive (no pun intended) -whatever the outcome, and if it did turn out that you had contracted it then you can still have a long life together, especially if you live healthy and are happy and have a will to live, can you imagine how advanced reatment and a possible cure would be in 10/20 years?

My very best to you both.

[stevenjm]

Thanks heaps everybody for all the info.

Digger - if by hb you mean hemoglobine yes it is 7.5 - is this something I should be concerned about about given that in your opinion the iron is not going to help?

will take a look at the sites mentioned.

also I agree - it seems hiv is, from what I have been told, very hard for a straight male to contract from a female unless anal sex is involved.

One more bit of trivia for everybody and a lesson learned by myself - the rate of hiv infected locals within asia is exremely high and complacency should be avoided, I would have never imagined she would have hiv but has and this is true with so many asians, do not resist testing just because you think it is not possible that somebody has it - chances are extremely high.

thanks to all for praising my sticking by her - what can I say, if love is real then nothing gets in the way and its a no brainer of a decision - I love her the same as before.

[The_Moog]

thanks to all for praising my sticking by her - what can I say, if love is real then nothing gets in the way and its a no brainer of a decision - I love her the same as before.

...remember this has to be a lifelong commitment, you can't put her on the expensive meds, then one day 'pull the rug'.

You weren't responsible for the original infection - and your Mum and Dad might feel aghast at your decision to take up responsibility for the caring.

I was in an absolutely identical situation 5 yrs ago in bangkok.

Good luck to you both.

[davethailand]

actually its not that easy to catch .

its the publics perception of the syndrome and the expense of providing a lifetimes treatment that scares the governments.

until the drug companies make the drugs cheaper and people become more accepting of the condition then emigration / immigration will always be difficult for the hiv+

<{POST_SNAPBACK}>

I wont get into a debate here as it is not the place.....suffice to say I disagree Tax. It is easier to catch than most people realise.

<{POST_SNAPBACK}>

I was also under the impression that it was harder to catch than what people thought, I was told this in hospital when i had blood tests.

I have a friend who worked in pattaya in a very well known gogo that has it.

<{POST_SNAPBACK}>

And if he is working with a good doctor with access to medicines he will probably live as long as you Dave. Make sure you invite him to your retirement party

<{POST_SNAPBACK}>

It's one of the ex gogo girls, only 20 years old, her thai boyfriend died a month ago.