1. Why is it important for people with HIV to get medical care?

     New treatments that fight HIV have been shown to improve health and to help people with AIDS live longer, so receiving care from a doctor who is knowledgeable about HIV is important. Treatments are also available to prevent some illnesses, such as Pneumocystis carinii pneumonia (PCP) . And, there is a new blood test called a "viral load test" that measures the amount of virus in the blood. This test gives people with HIV and their doctors better information on when to start treatment, which may be before any symptoms appear. The viral load test can also tell how well treatment is working.

     People with HIV should seek early medical care from a doctor knowledgeable about HIV, to find out about drugs that fight HIV and to receive care for other HIV related conditions.

     Another reason to seek medical care is to have tests done for other infections, such as tuberculosis (TB) and sexually transmitted diseases (STDs) and to receive treatment as needed. These infections can hasten the progression from HIV infection to AIDS.

     It is especially important for pregnant women with HIV to get medical care, since they can take medication that will significantly reduce the risk of their babies being born with HIV. The progression of HIV infection in young children is frequently different from that in adults; some children become sick more quickly. It is important that children with HIV infection receive medical care as early as possible.

     Sex and needle sharing spouse/partners also need to know they have been exposed to HIV so they can get tested and benefit from early treatment, if needed.

2. Are there special reasons why women with HIV should get medical care?

     There are some medical conditions that are more common in women with HIV. Cervical abnormalities, including cervical cancer, seem to be more common in women who have HIV. Women with HIV need to have pelvic exams and a yearly PAP smear to look for these conditions. Also, women with HIV who have vaginal infections such as yeast infections may require more treatment than other women. Women with HIV should discuss family planning with their doctor, and be aware that oral contraceptives can react with some antiretroviral medications. A woman and her doctor need to review all her medications to make sure they can be combined without any problems.

3. Should people with HIV tell their health care providers, e.g., doctor, dentist, physician assistant and nurse practitioner?

     Yes. In order to receive appropriate medical care and monitoring, it is important for health care providers to know the HIV status of their clients. It is against the law for health care providers to deny care to people with HIV because of their HIV status.

4. What are the new treatments for HIV?

     A number of new drugs to treat HIV have been approved, including a group of drugs called protease inhibitors. When these newer drugs are combined with earlier drug treatments, the level of virus in the blood can fall so low that it cannot be detected by a viral load test. This does not mean that the virus is gone from the body, just that there is so little of it in the blood that the test cannot detect it. When the level of the virus is his low, treatments may work longer and the immune system can begin to repair some f the damage done by HIV. It is important to remember that even if a person with HIV as an "undetectable" viral load, he/she can still transmit HIV to others.

     While the new treatments are not a cure, they can extend life and improve health, specially for people with AIDS. It is very important that the new treatments be taken exactly as prescribed. Missing or delaying just a few doses can lead to resistance, meaning that the drugs will no longer work. People who become resistant to one drug may be resistant to other drugs they have never taken, so it' s important that people with HIV learn how to take their medications correctly.

5. How is HIV infection treated?

a. Antivirals (drugs that stop or slow HIV): Currently, there are 1 1 drugs approved that fight HIV. These include the "nucleosides:" AZT (or ZDV), ddC, ddI, d4T, 3TC; ale "non-nucleosides:" delavirdine and nevirapine; and the protease inhibitors: saquinavir, ritonavir, indinavir and nelfinavir. These drugs are used in combinations of 2, 3 or 4 to best fight the virus.

b. Preventive medications: If a person' s CD4 count falls below 200, drugs are used to prevent serious illnesses, such as PCP (Pneumocystis carinii pneumonia). PCP is the most common life threatening illness for people with AIDS, and can be effectively prevented with a common medication. Since the CD4 count can fall below 200 before any symptoms appear, it' s important that people with HIV get regular CD4 counts so preventive treatment can begin as soon as needed. Preventive treatment for other illnesses, such as MAC (Mycobacterium avid complex), is recommended if the CD4 count falls below 50.

c. Treatments for HIV related illnesses: Much progress has been made in treating the various infections and conditions that occur in people with HIV. New treatments for AIDS related cancers and other conditions have been approved. Combining these treatments with the new antivirals can mean better health for people with AIDS.

d. Healthy living: Good health practices can play an important role in the treatment of HIV. Proper diet with food safety precautions, appropriate use of vitamins, exercise (both aerobic and muscle building), regular sleep habits, stress management and avoidance of substance use are all important parts of living healthy with HIV.

6. What is the connection between HIV and TB?

     TB is one of the many diseases that can often be kept under control by the immune system. Only about 10% of people with a normal immune system who have the TB germ will get sick with active TB. But a person with HIV who has the TB germ and a weakened immune system is much more likely to develop active TB disease. That' s why it is very important for people with HIV to get tested for TB. Active TB can be prevented by taking medication before symptoms start. TB symptoms are similar to those of other HIV related diseases. They include: coughing, shortness of breath, weakness, feeling sick, coughing up blood, weight loss, fever and night sweats. TB is curable in most cases, but untreated active TB can be spread to others by coughing.

7. What do people with HIV need to know about hepatitis?

     People with HIV should ask their doctor to do tests for hepatitis A, B and C. Those who do not have hepatitis A, B or C should talk to their doctor about avoiding exposure to these hepatitis viruses through sexual practices or needle sharing. Hepatitis infection may increase the viral load of a person with HIV, so people with HIV should talk to their doctor about their risk for hepatitis, and whether they should receive vaccines to prevent Hepatitis A and Hepatitis B. There is no vaccine for Hepatitis C.