Index

Page numbers in italics refer to tables.

abacavir (ABC, Ziagen): brain and, 173; fever and, 178; HAART and, S6,∙rash and, 146

abacavir hypersensitivity reaction, 95-96 abortion, 48

abstinence from sex, 13 accomplishment, and depression, 110 accreditation, 219

accuracy of blood test, 10-11 acetaminophen, 178 acquired, definition of, 1

acquired immune deficiency syndrome.

See AIDS

acute infection, 61- 62

acyclovir (Zovirax): herpes simplex and, 148, 155; herpes zoster and, 150; oral hairy leukoplakia and, 154

addiction, 133. See also drug use adherence to drug regimen: guidelines for,

76-77; improvements in, 12; missing doses, 77-78; “no detectable virus” and, 73-76; research on, 76; simplifi­cation and, 71, 310; substance abuse and, 133-34; treatment goal and, 69­70

advance directives: description of, 248, 267; DNR order, 270-71; durable power of attorney, 267-70; hospice care and, 273-74; living wills and health care instructions, 271-73; prop­erty and, 273

adverse drug reactions (ADRs), 223-24.

See also side effects

advice, dealing with, 290

AIDS (acquired immune deficiency syn­drome): challenges of, 309-11; descrip­tion of, 1-2; development of, 2-3, 11­12; history of, 306-9; as “reportable disease,” 7; time lapse between trans­mission of HIV and, 137

AIDS-advocacy organizations, as sources of support, 291

AIDS Clinical Trial Information Service, 244

AIDS Clinical Trials Groups, 315 AIDS-defining diagnoses, 2. See also com­plications

AIDS.org Web site, 318

AIDS physicians, 199-201, 217

AIDS Treatment News, 315-16

alcohol, and depression, 109 alcohol, isopropyl, 53, 54

Alcoholics Anonymous, 313-14

alcohol wipes, 50

allergic reactions: to drugs, 223 -24; to la­tex, 44

alternative medicine, 218

American Bar Association AIDS Coordi­nation Project, 246

American Foundation for AIDS Research, 316

Americans with Disabilities Act of 1990,

246

amikacin (Amikin), 184

amitriptyline (Elavil), 175

amoxicillin, 162 amoxicillin-clavulanate (Augmentin), 162 amphotericin B, 172, 178, 187 ampicillin, 162

anal intercourse, 37

anemia, 176

anger: dealing with, 106-7; depression and, 109-10; directing, 107; examples of, 103-4; expressing, 105-6; reasons for, 104-5

annual gifts, 273 antibiotics: diarrhea and, 162-63; yeast infections and, 166-67

antibodies, 62-63, 322 antihistamines, 162 antiretroviral agent, 3, 70, 222 anxiety, 114-15, 116, 158-59 aphthous ulcers, 155-56 appetite, loss of, 158 -60 Aptiva (tipranavir, TPV), 89 artificial insemination, 34, 40-41 asking questions, 298-99 aspirin, 178 asymptomatic period, 2, 63 -64 atazanavir (ATV, Reyataz), 74, 75, 87 athlete's foot, 150 atovaquone (Mepron), 141

Augmentin (amoxicillin-clavulanate), 162 Aventyl (nortriptyline), 99 azithromycin (Zithromax), 184 AZT (zidovudine, Retrovir): brain and,

173; clinical trial of, 68, 238, 239; cost of, 234; Data Safety Monitoring Board and, 242; fatigue and, 176; HAART and, 86,∙introduction of, 12; loss of ap­petite and, 158; as nucleoside analog, 222; pregnancy and, 48

bacterial pneumonias, 143

Bactrim (trimethoprim-sulfamethoxazole, Septra): adverse reactions to, 223; bac­terial pneumonias and, 143; diarrhea and, 163; fever and, 178; Pneumocystis jiroveci pneumonia and, 140-41; rash and, 145 -46; vaginal yeast infections and, 166-67

balancing: dependency and control, 123 - 24; living and dying, 284-85 barbiturates, 178

B cells, 60 benadryl, 155 benzodiazepines, 173-74 Betadine (povidone-iodine), 157 Biaxin (clarithromycin), 184 bill, for hospitalization, 213 -14 birth control, 45 birth control pill, 48

biting, 41

bleach (sodium hypochlorite), 53-54 bleeding, excessive, 151-52 blisters, 147-50, 154-56

blood: donation of, 4, 33, 40, 51,∙univer- sal precautions and, 213

blood fats, increase in, 94-95

blood spills, 54

blood test for HIV: accuracy of, 10-11; application for individual insurance plan and, 260; timelines for, 14; uses of, 321

Blue Cross/Blue Shield: description of, 255; group plans, 256; individual plans, 259; open enrollment policies, 261 blurred vision, 167-68 body fluids, 30, 33, 34-35 bonding with partner, 129 brain (central nervous system), 168, 169-70

BRATT diet, 165

“breaking the blind” in clinical trials, 241 breaks, taking, 297

breast-feeding: HIV infection and, 16; transmission of virus and, 33, 35, 39, 49

buddy systems, 314

bumps: in mouth, 156; on skin, small, col­orless, 150

bupropion (Wellbutrin SR or Zyban), 99

Candida albicans, 152-53, 160, 166-67 cardiopulmonary resuscitation (CPR), 270 cardiovascular disease, risk for, 94-95, 98 caregiving: addiction and, 133; control and, 125-26; dying person and, 282­84, 285 - 86; quitting work and, 267; responses to death and, 276.

case management services, 206-7

case managers, 205, 206 casual contact, 33, 50

CBC. See complete blood count

CDC. See Centers for Disease Control and Prevention

CD4 cell count: acute infection and, 62; complications and, 137-39; cost of medical care and, 253-54; definition of AIDS and, 2; description of, 66; di­arrhea and, 163-64; fatigue and, 176; interpretation of, 67; measurement of, 63-64; progress of HIV infection and, 11; purpose of, 65; raising, 81; shingles and, 148; starting treatment and, 71­72; viral load and, 66-67, 138

CD4 cells: body fluids and, 33; gradual loss of, 63 -64; transmission of virus and, 30, 60-61. See also CD4 cell count

CD4 receptors, 60

CD4 slope, 72 CD8 cells, 63 celibacy, 128

Centers for Disease Control and Preven­tion (CDC): epidemiological studies and, 6; National Center for HIV, STD, and TB Prevention, 319; National Pre­vention Information Network, 316; re­porting requirements and, 7, 215 central nervous system, 168, 169-70 cephalosporins, 162 cervical cancer, 166 cesarean section delivery, 38, 48 changing: perspective on life, 121-22;

treatment, 80-83; usual tactics, 295-96 “cherry picking” patients, 195 chickenpox, 58, 148 children: fears and worries of, 131-32; fi­nancial help to care for, 265; HIV infec­tion in, 17; parent's worries for, 132­33; preventive treatment for, 49; telling about infection, 129-31; tests for, 49, 132

chills, 177 chlorhexidine (Peridex), 157 cholesterol, increase in, 94-95 choosing: hospital or care system, 208;

physician, 201-3 chronic hepatitis, 56, 92 chronic non-progressors: criteria for, 136;

description of, 3; rapid progressors compared to, 324-25; set point and, 64 cidofovir, 150 ciprofloxacin (Cipro), 100, 184 cisplatin, 175 clarithromycin (Biaxin), 184 clarithromycin plus ethambutol, 164, 184 class mutations, 84 cleaning: blood spills, 54; cut or other in­jury, 54; with disinfectant, 52-54; nee­dles and works, 47 clindamycin, 162, 171, 178 clindamycin plus primaquine, 141 clinical trial: advantages of participation in, 240; description of, 6, 7, 235; dis­advantages of participation in, 241; in­formed consent and, 242-44; partici­pation in, 238-39; patients' rights in hospitals and, 216; steps of, 235-38; supervision of, 242

clotrimazole (Lotramin), 150 clotrimazole troches, 153 clotting factor, 40 cluster headaches, 170 CMV.

Combivir, 86 comforts, finding, 302-3 community hospitals, 207-8 Compazine, 162 complaint, filing: federal, 246-48; state, 249

complete blood count (CBC), 151 compliance. See adherence to drug regi­men

complications: digestive system problems, 157-66; drugs to prevent, 222-23; eye problems, 167-68; gynecological problems, 166-67; HAART and, 135, 139; head and nerve problems, 168 -75; lung problems, 139-44; medical care and, 137-39; mouth problems, 152­57; overview of, 135-37; preventing transmission of, 55-58; skin problems, 144 -52; stages of untreated HIV infec­tion and, 188-92; whole body, prob­lems affecting, 175-87, 193 comprehensive care programs, 203 -6 condoms: alternatives to, 45 -46; break­age, dealing with, 45; failure rate of, 39, 48; storage of, 44; use of, 43-44 confidentiality: in clinical trials, 243 -44;

of diagnosis, 214-15; of medical records, 326-27; reporting require­ments and, 250-51

confronting possibilities gradually, 301 confusion, as reaction to death, 277 consent. See informed consent Consolidated Omnibus Budget Reconcili­ation Act (COBRA) of 1985, 258 constitutional symptoms: causes of, 181­87, 193; description of, 175; fatigue, 176-77; fever, 177-78; weight loss or wasting, 178-81

consultation, asking for, 203 contact, type of, 31-32, 33-36 contagion, principles of: efficiency of transmission, 36-42; incubation pe­riod, 42; overview of, 31-32; sources of HIV, 32; types of contact, 33-36 contagious disease: definition of, 31;

transmission of to HIV-infected person, 58

Continuation of Comprehensive Benefits laws, 258

control, sense of: balance between depen­dency and, 123-24; caregiver and, 125-26; dealing with loss of, 124-25; maintaining, 125; reframing/relabeling and, 126

controlled drugs, 221 control of life, taking: changing usual tac­tics, 295-96; confronting possibilities, 301; dealing with medical system, 298­99; dividing and conquering, 296; eat­ing well, 300; encouraging self, 300­301; finding comforts and interests, 302-3; giving feelings their due, 297­98; keeping positive attitude, 304-5; maintaining equilibrium, 303 -4; over­view of, 6, 294-95; positive denial, 301-2; relabeling negative, 299-300; taking break, 197

conversion policies, 258 co-pay, 256 coping strategies, 5, 19-21 corticosteroids, 151, 155-56 cortisone ointment, 151 cost: of drugs, 224, 225-33, 234; of med­ical care, 253-54

cough, shortness of breath, and fever: dry cough, 140-41; productive cough, 141-44

counselors, 294 CPR.

Cryptococcus neoformans, 172, 186-87 cryptosporidiosis, 57

Cryptosporidium, 163 cunnilingus, 34, 45 customary charges, 256 cuts, cleaning, 54 cytokines, 63, 176, 179 cytomegalovirus (CMV): as complication,

55; constitutional symptoms and, 185; diarrhea and, 164; lungs and, 143-44 cytomegalovirus (CMV) retinitis, 167-68 Cytovene, 168

dapsone, 178 dapsone plus trimethoprim, 141 Data Safety Monitoring Board, 242 ddC (HIVID, Zalcitabine), 87 ddI (didanosine, Videx): diarrhea and,

163; fatigue and, 176; HAART and, 87; lactic acidosis and, 90; loss of appetite and, 158; neuropathy and, 95, 174-75 death: acceptance of, 285-86; balancing

life with, 284-85; caregiver and, 282­84, 285-86; emotional responses to, 275-79; making decisions about rest of life, 279-81; other people's reactions to, 281-82

deductibles, 256 deep kissing, 35 delavirdine (DLV, Rescriptor), 69, 89 dementia, HIV-associated (HAD), 172­

74

denial, 21, 301-2 dental care, 96, 252-53 dental dam, latex, 45 dependency and sense of control, 123­

24

depression: adherence and, 77; anger and, 106, 109-10; causes of, 109-10; as cyclical, 22; examples of, 107-8; fatigue and, 113; loss of appetite and, 158-59; mild, dealing with, 110-11; severe, dealing with, 111-12; situational, 102; suicide and, 21, 112, 280; symptoms of, 108; treatment of, 21

d4T (stavudine, Zerit): fatigue and, 176; fat redistribution and, 93; HAART and, 86;increase in blood fats and, 94; neu­ropathy and, 95, 174-75 diabetes, 92-93 diagnosis: confidentiality of, 214-15; no­tifying others about, 4, 14-16; reaction to, 18-22, 27-28, 276. See also telling about diagnosis

diarrhea: as complication, 162-66; sup­plements and, 181; travel and, 100 didanosine. See ddI

diet, 97, 180, 300. See also malnutrition dietitians, 205

Diflucan (fluconazole): Candida albicans and, 160, 167; Cryptococcus neofor­mans and, 172; fungal infections and, 187; thrush and, 153-54

digestive system problems: diarrhea, 100, 162-66, 181; loss of appetite, 158-60; nausea and vomiting, 161- 62; over­view of, 157; painful swallowing, 160­61

Dilantin (phenytoin), 175, 178 diphenoxylate (Lomotil), 165 directing anger, 107

Directory of Legal Resources for People with HIV/AIDS, The, 246

disability: definition of, 264; going off, 117; Rehabilitation Act of 1973 and, 246; Social Security Disability Income, 264-65

discharge plan, 212 discharging-against-advice right, 216 discharging anger, 106-7 disclosure, obligation for, 251 discrimination, 214, 246-48 disease.

dishwashing, 54

disinfectants, 52-54

disposal of waste, 54

disulfiram, 175

dividing and conquering problems, 296

DLV (delavirdine, Rescriptor), 69, 89

DNR (do not resuscitate) order, 270-71 donation of blood or organs, 4, 33, 40,

51

Donnagel, 165

do not resuscitate order. See DNR order dose of common drugs, 225-33 double-blind comparison, 239 douching, 45

Dramamine, 162

dread disease policies, 259 driving, stopping, 174 drug holiday, 80, 159 drugs: adverse reaction to, 145 -46; anti­retroviral, approved by FDA, 70; ap­proved, 221; changing, 82-83; claims made by, 218-19; common, 225-33; cost of, 224, 234; dementia and, 173­74; for depression, 111-12; experimen­tal, and clinical trials, 235-44; FDA and, 220-21; future of, 311; goals of treatment with, 78 -79; guidelines for use of, 71; for hepatitis B, 57; history of, 307-8; interactions of, 75, 81-82; introduction of, 12; Medicaid reim­bursement for, 262-63; missing doses of, 77-78; names of, 74, 221; nonoccu- pational exposure prophylaxis, 58 -59; one-month course of for accidental ex­posure, 45; paying for, 234; pregnancy and, 48 -49; prescribing beyond label­ing limits, 237; resistance to, 3, 12, 68, 69, 73, 83-84; third-party payer limits on coverage for, 257; traditional medi­cine and, 219-21; types of, 222-23;

unapproved, 221; usual first regimen of, 79, 80-81. See also adherence to drug regimen; HAART; side effects

drug use, illegal: adherence and, 77; avoiding injection, 46-47; inhibitions and, 47; interpersonal relationships and, 133-34; telling about diagnosis and, 26

dry cough, shortness of breath, and fever, 140-41

durable power of attorney: assigning, 267-68; for finances, 269 -70; for health care, 268 -69

“duty to warn,” 15

eating well, 300

Ecstasy, 75 efavirenz (EFV, Sustiva): brain and, 173;

central nervous system complications of, 96; dose of, 89; introduction of, 69; K103N mutation and, 83; missing doses of, 78; pregnancy and, 48, 49, 59; time in body of, 75

efficiency of transmission: biologically im­possible, 42; biologically plausible risks, but unlikely and unconfirmed, 41-42; likely risks, 39-41; very likely risks, 36-39

Elavil (amitriptyline), 175 emotional health: coping strategies, 5, 19-21; cultivating, 5-6; maintaining, 101-2, 287-88; sources of support for, 288-94; taking control and, 294-305.

emotions, giving in to, 297- 98 employment: continuing, 100; group in­surance plans and, 255-58; HAD and, 174; quitting work, 117, 266-67; rights and, 246, 249-50

emtricitabine (FTC, Emtriva), 87, 92 encouraging self, 300 - 301 endoscopy, 160, 164

energy: anemia and, 176; from anger, 107; fatigue and, 113-14

enfuvirtide (T20, Fuzeon), 89, 222 entry inhibitors, 222 epidemiological study, 6-7, 30-31 Epivir (3TC, lamivudine), 84, 86, 92 Epzicom, 87

equilibrium, maintaining, 303 -4 erythromycin, 163 esophagitis, 160-61 esophagus, thrush in, 153 exercise, 97, 180

experimental drugs and clinical trials, 235-44

exposure to HIV infection: health care worker and, 50; immediate treatment for, 45, 58 -59

expressing anger, 105 - 6 eye problems, 167- 68

famciclovir (Famvir), 148, 149-50, 155 family, as source of support, 289-90 fatigue: accommodating to, 113-14;

causes of, 113; as constitutional symp­tom, 176-77; effects of, 113; loss of ap­petite and, 159

fat redistribution, 93 -94

FDA. See Food and Drug Administration fear: anxiety and, 114-15; children and,

131-32; dissipating with information, 115; of dying in pain, 276-77; parents and, 132-33; realism and, 114; of what happens before death, 277 federal laws, 246-48 feeding tube, 160 fee-for-service medical care, 194-95, 196

feelings. See emotions, effects on

feet, numbness, tingling, or pain in, 174­75

fellatio, 34, 35, 41 fellows, 209-10 female condom, 45 fever, 101, 177-78, 179 fever blisters, 147, 154-55 fiber, soluble, 165 filing complaint: federal, 246-48; state, 249

financing medical care: overview of, 253 - 55; public programs for, 261- 64; third- party payers, 255-62

fisting, 41

Flagyl (metronidazole), 157, 175 floaters, 168

fluconazole (Diflucan): Candida albicans and, 160, 167; Cryptococcus neofor­mans and, 172; fungal infections and, 187; thrush and, 153-54 fluids, drinking, 160, 165 fluoroquinalones, 163 focal neurologic symptoms, 171 focusing on positive, 299-300, 304-5 food: diarrhea and, 164-65; eating well, 300; pain in mouth and, 152; taking drugs and, 78, 81, 180; when nauseated and vomiting, 161-62. See also diet; nutrition

Food and Drug Administration (FDA): clinical trials and, 235, 236; Medicaid reimbursement for drugs and approval by, 262-63; New Drug Application, 237; regulatory process of, 220-21; streamlining process and, 238; super­vision of clinical trials and, 242 food poisoning, 163 fosamprenavir (FPV, Lexiva), 88 foscarnet (Foscavir), 148, 150, 164 friends, as sources of support, 289-91 frustration, and anger, 104-5 FTC (emtricitabine, Emtriva), 87, 92 fungal infections, 150, 186-87 Fuzeon (enfuvirtide, T20), 89, 222

ganciclovir, 154, 164, 168 gastroenteritis, 163 gastroenterologist, 164 gastrointestinal intolerance, 85, 90 gatekeepers, 211

Gay Men's Health Crisis, 46, 316 General Public Assistance (GPA), 265 genetics, 310-11 genital herpes, 147-48 genital itching, severe, 166-67 genital sores, 36-37 genotypic resistance test, 83-84 gingivitis, 156-57 glossary, 8 gloves, latex, 46, 52 goals of treatment, 78-79 going public: alternatives to, 28-29; chil­dren, 129-31; dealing with others' re­actions after, 27-28; decision about, 22-23; drug use and, 26; homosexuality and, 25-26; reasons to keep silent, 26­27; whom to tell, 23 -26

GPA. See General Public Assistance group insurance plans, 255-58 growth hormone, 180 guilt, 118-20 gums, bleeding, 156-57 gynecological problems, 166-67 Gyne-Lotrimin, 167

HAART (highly active antiretroviral ther­apy): abacavir hypersensitivity reaction and, 95-96; adherence to, 76; blood fats, increase in, and, 94-95; complica­tions and, 135, 139; cost of, 12, 196, 234; description of, 3; diabetes and, 92-93; drugs of, 86-89; efavirenz- associated side effects, 96; fat redistri­bution and, 93 -94; gastrointestinal intolerance and, 85, 90; goal of, 325; history of, 68-71; HIV-associated de­mentia and, 173, 174; immune reconsti­tution syndrome and, 187, 193; indi­navir-associated side effects, 96; lactic acidosis and, 90; liver disease and, 91­92; missing doses of, 77-78; neuropa­thy and, 95; pregnancy and, 48; side ef­fects, or toxicities, of, 84-85; skin rash and, 90-91; smoking and, 98; success of, 308 -9

HAD. See HIV-associated dementia

Haemophilus influenzae, 143 handwashing, 50 headaches, 170 -72

head and nerve problems: headaches, 170-72; numbness, tingling, or pain in feet, 174-75; overview of, 168-70; slowed mental processes or dementia, 172-74

health care. See medical care

health care agent, 268 -69

health care instructions, 271-73

health care worker: blood splash on, 40; exposure of, 50; home care, 41; infec­tion from, 35-36, 40; needlestick in­jury to, 34, 39-40; nucleosides and, 58-59

Health Insurance Portability and Account­ability Act (HIPAA), 250, 252

health maintenance organization (HMO): coverages under, 257; description of, 194-95, 198; gatekeepers and, 211; Medicaid and, 262, 263

HEET cream, 175

hemophilia, 40

hepatitis B, 56-57, 92

hepatitis C, 92

herpes simplex, 57, 147-48, 154-55 herpes virus 8, human, 145

herpes zoster, 57-58, 148-50

highly active antiretroviral therapy. See HAART

HIPAA. See Health Insurance Portability and Accountability Act

Histoplasma capsulatum, 186-87 historical control, 239

HIV (human immunodeficiency virus): description of, 2, 30; influenza virus compared to, 31-32; people affected by, 8; sources of, 32; tests for, 322, 324-25; test for antibodies to, 322, 323-24

HIV-associated dementia (HAD), 172-74

HIV centers, 203 -6

HIV counselors, 204

HIV Drug Registry, 49

HIVID (ddC, Zalcitabine), 87

HIV infection: in children, 17; exposure to, 45, 50, 58-59; prognosis, 11-12;

HIV infection (continued}

sources of, 51-52; stages of, 2; stages of, and commonly associated complica­tions, 188-92;studies of, 6-7; unique feature of, 306-7. See also natural his­tory of HIV infection HIVInSite Web site, 318 HMO. See health maintenance organiza­tion

home care: preventing transmission dur­ing, 49-54; risk of transmission during, 41. See also caregiving

home kits, 323

home therapy programs, 204-5 homosexuality, talking about, 25-26, 130-31

hope, and depression, 108 hospice care, 273 -74 hospital indemnity policies, 259 hospitals: admitting privileges to, 202;

alternatives to, 196; choosing, 208; costs of stay in, 213-14; patients' rights in, 214-17; refusal to treat and, 252; rounds, 212-13; staff of, 209­12; types of, 207-8; universal precau­tions, 213 hospital-surgical policies, 259 hotlines, 292, 314, 317, 319-20 housing, rights to, 249-50 How We Die (Nuland), 281 human papillomavirus (HPV), 166 hydrogen peroxide, 53

ibuprofen, 178 idiopathic thrombocytopenic purpura

(ITP), 151-52, 156-57 immune deficiency, 1-2 immune reconstitution syndrome (IRS),

184, 187, 193 immune response, differences in, 64 immune system: diet and, 97; HIV and,

307; maintaining, 79; quality of, 325 immunosuppression, 137 Imodium (loperamide), 162, 163, 165 inactive tuberculosis, 142 income, help with, 264-65 incompetent, definition of, 252, 268 incubation period, 32, 42 indigence, definition of, 262 indinavir (Crixivan, IDV), 88, 96, 173 individual insurance plans, 258 -61 infections, diarrhea and, 163 infections, preventing transmission: of herpes zoster, 149; to HIV-infected per­son, 58; of MAC, 184-85; of those other than HIV, 55-58, 141-42 infectious disease: definition of, 31; in de­veloping countries, 101; physician spe­cialists in, 200 - 201 influenza virus, 31-32, 307 informed consent: for clinical trials, 242­44; as medical right, 251- 52 inhibitions and drug use, 47 INH. See isoniazid injection drug use, 46-47 injury, cleaning, 54 inoculum size, 32 inpatient facilities, 196 Institutional Review Board, 242 insulin resistance, 92 insurance plan: drugs and, 217, 234;

group, 255-58; individual, 258-61 interests, finding, 302-3 Internet resources, 318-19 interns, 209-10 interpersonal relationships: with children, 129-33; with drug users, 133-34; feel­ings about sex, 127-29; helplessness, dependency, and control, 123-26; overview of, 123; resolving, 280 Investigational New Drug (IND) status,

236

Invirase (saquinavir, SQV), 89 iodine, 53

irritable bowel syndrome, 162 irritation, and fatigue, 113 IRS. See immune reconstitution syndrome isoniazid (INH), 142, 175

ITP. See idiopathic thrombocytopenic pur­pura

itraconazole (Sporanox), 153, 167, 187

jock itch, 150 Johns Hopkins AIDS Service Web site, 318-19

Kaiser HMO, 257

Kaletra (lopinavir), 88, 162, 163 Kaopectate, 165

Kaposi's sarcoma, 144-45, 156 keeping silent, 26-27 kidney stones, 96 kissing, deep, 35 knockout mutations, 83, 84

K103N resistance mutation, 83 K65R resistance mutation, 83-84 Kubler-Ross, Elisabeth, 275-76

lactic acidosis, 90, 176

Lactinex, 165 lactose intolerance, 162

Iamivudine (3TC, Epivir), 84, 86, 92 latex, allergy to, 44

laundry, 54 lawsuits, 253 lawyers, finding, 245 leaving hospital against medical advice,

216

legacy, 279 - 80

legal issues: federal laws, 246-48; law­suits, 253; state laws, 248-53. See also discrimination

Lexiva (FPV, fosamprenavir), 88 licenses, medical, 219

life: balancing death and, 284-85; chang­ing perspective on, 121-22; making de­cisions about rest of, 279-81; making sense of new, 120. See also control of life, taking

life support, decisions about, 215-16 lipodystrophy, 300

lips. See mouth problems listening, 126 liver disease, 91- 92 living wills, 271-73 local services, finding, 319-20 Lomotil (diphenoxylate), 165 long-term care and Medicare, 263 long-term survivors, 3. See also chronic non-progressors

loperamide (Imodium), 162, 163, 165 lopinavir (Kaletra), 88, 162, 163 loss: of appetite, 158-60; sense of, 277­78

Lotramin (clotrimazole), 150 lubricants, 44

lung problems: dry cough, shortness of breath, and fever, 140-41; infections, 98; overview of, 139; productive cough, shortness of breath, and fever, 141- 44 lymphocyte, 60 lymphocytic interstitial pneumonia, 144 lymphomas, 144, 171, 185-86

MAC. See Mycobacterium avium complex major medical policies, 259

making decisions about rest of life, 279­81

making sense of new life, 120, 121-22 malnutrition, 97, 176, 179 managed care: description of, 194 - 95, 198; gatekeepers and, 211; group plans, 257; Medicaid and, 262, 263

Marinol, 180

Medicaid: coverage by, 198, 217; descrip­tion of, 261-62; drugs and, 234; fi­nancing medical care and, 254

medical care: advertisements for, 202; case management services, 206-7; clinical trials and, 240; for complications, 137­39; comprehensive care programs, 203­6; cost of, 253 -54; cost savings and, 195; elements of, 197; financing for, 196; finding source of, 16; hospitals, 207-17; importance of, 4; limits on op­tions for, 197-98; overview of, 64-65; patients' rights, 214-17; physicians, 199-203; providers of, 196; second opinion, obtaining, 203; settings for, 196; as specialty, 71; traditional, 218­19; types of, 194-95. See also CD4 cell count; financing medical care; treat­ment; viral load test

medical care plan, 206

medical records: application for individual plan and, 260; confidentiality of, 250, 326-27; right to, 252; second opinion and, 203

medical rights, 251-52

medical system, dealing with, 298 -99 Medicare: description of, 263; eligibility requirements for, 261; financing med­ical care and, 254

medication. See drugs Megace, 160, 180 memory loss, 172-74 men, wasting and, 179, 180 meningitis, 172 menstrual blood, 45 mental activity, and depression, 110 mental health, maintaining: overview of, 101-2, 287-88; sources of support, 288-94; taking control, 294-305 mental health professionals, 205, 294. See also social workers mental health therapy: for anxiety, 115; for caregivers of drug users, 133; for depression, 112; guilt and, 120; overview of, 6, 20, 294

Mepron (atovaquone), 141 metabolic changes, 179 metabolic syndrome, 310 metronidazole (Flagyl), 157, 175 miconazole, 150

microbe: complications and, 55; diarrhea and, 165; infectious disease and, 31; transmission and, 30

Microsporidium, 164

midlevel practitioners, 210-11 migraine headaches, 170

missing doses of medication, 77-78

Molluscum contagiosum, 150 mononucleosis, 61

Montagnier, Luc, 30

M184V mutation, 84

mosquito, transmission by, 35

mouth contact, 35

mouth problems: aphthous ulcers, 155­56; bleeding gums, 156 - 57; bluish or purplish bumps, 156; herpes simplex, 57, 147-48, 154-55; overview of, 152; pain, 152; white patches, 152-54 multiply drug-resistant strain of tubercu­losis, 55-56

mutation, rate of, 307 mutations, resistance, 69, 70, 83-84 Mycobacterium avium complex (MAC):

as constitutional symptom, 182-85; di­arrhea and, 164; lungs and, 143; pre­vention of, 223

Mycobacterium tuberculosis, 55-56, 141-42

Mycobutin (rifabutin), 184

nails, thick, discolored, 150

National Association of People with

AIDS, 316

National Center for HIV, STD, and TB Prevention Web site, 319

National Institute of Allergy and Infec­tious Diseases, 317

National Institute on Drug Abuse, 317

National Library of Medicine Web site,

319

National STD and AIDS Hotline, 317,

319 natural history of HIV infection: acute in­fection, 61- 62; asymptomatic period, 63-64; definition of, 60; seroconver­sion, 62-63; transmission, 60-61 nausea, 161-62 navigating social service system, 266 needles, clean, 47 needle sharing, 33, 38 needlestick injuries, 34, 39-40, 56-57 nelfinavir (Viracept), 88, 162, 163 nerve problems. See head and nerve prob­lems

nervous system, 168 -70, 174 neuropathy, 95, 174-75 nevirapine (Viramune): brain and, 173; dose of, 89,∙introduction of, 69; liver disease and, 91, 92; liver toxicity and, 59; missing doses of, 78; rash caused by, 146; time in body of, 75

New Drug Application, 237

New England Journal of Medicine, 220 New York State reporting requirements, 326-27

nicotine replacement, 98 -99 night sweats, 177

NNRTIs. See nonnucleoside reverse tran­scriptase inhibitors

“no detectable virus”: getting to, 73-76; overview of, 72-73

nodules, itchy, 146-47 non-nicotine therapy, 99 nonnucleoside reverse transcriptase in­hibitors (NNRTIs): cross-resistance and, 75; description of, 222; drug inter­actions and, 75; introduction of, 12, 69; mutations and, 83

nonoccupational exposure prophylaxis,

58 -59. See also efavirenz; nevirapine nonoxynol 9 (spermicide), 44-45 nonprescription drugs, 221 nonsafe sex, 36, 39 nortriptyline (Aventyl, Pamelor), 99, 175 Norvir (ritonavir): dose of, 74, 88,∙drug interactions with, 75; loss of appetite and, 158; as PI booster, 79 notification, whom to tell, 4, 14-16. See also telling about diagnosis nucleoside backbone, 79 nucleoside reverse transcriptase inhibitors (NRTIs), 68

nucleoside analogs: description of, 222;

HAART and, 68-69; health care worker exposure and, 58-59; muta­tions and, 83-84. See also didanosine; emtricitabine; lamivudine; stavudine; tenofovir; zidovudine

Nuland, Sherwin, How We Die, 281 nurse practitioners, 210-11 nurses, 211

nutrition: diarrhea and, 165; digestive sys­tem problems and, 157; eating well, 300; fatigue and, 176; importance of, 97; loss of appetite and, 158-60; painful swal­lowing and, 160-61; pain in mouth and, 152; weight loss and, 179

NVP. See nevirapine

occupational risks, 101

Office for Civil Rights, filing complaint with, 246-48

open enrollment policies, 261 opium, tincture of, 165 opportunistic infections: description of,

11; preventing transmission of, 55-58 opportunists, 2. See also complications oral hairy leukoplakia, 154 oral sex: condoms and, 45; risk and, 35,

41; transmission and, 34

organ transplantation, 4, 34, 40, 51 organizations: local, finding, 319-20; na­tional, 313-15; types of services offered by, 313-15

organ transplantation, 34, 40 outpatient facilities, 196

pain: fear of dying in, 276-77; in feet,

174 -75; in mouth, 152, 158; sexual in­tercourse and, 167; with swallowing, 160-61

painful sensory neuropathy, 174-75 Pamelor (nortriptyline), 99, 175 pancreatitis, 90

Pap smears, 166

paregoric, 165 parenteral hyperalimentation, 181 participation in clinical trial: advantages

of, 240; disadvantages of, 241; overview of, 238 -39

patent, drugs under, 224, 234 patient-physician relationship, and notifi­cation, 14-15

patient representatives, 212

Patient Self-Determination Act, 215, 248 patients' rights, 214-17 paying for drugs, 234

PCP. See Pneumocystis jiroveci pneumonia PDR for Nonprescription Drugs, 237 peer review process, 220 pelvic inflammatory disease (PID), 167 pelvic pain, 167 penciclovir, 155 penicillin, 163, 178 pentamidine, 141, 178 Pepto-Bismol, 162, 165 Peridex (chlorhexidine), 157 periodontitis, 156-57 peripheral nervous system, 168-69, 174 perspective on life, changing, 121-22 petechiae, 151 pets, 58, 290

Pharmaceutical Research and Manufac­turers of America, 317

pharmacy plan: cost of drugs and, 224; importance of, 196, 217; Medicare and, 263

phase four clinical trials, 237 phase one clinical trials, 236 phase three clinical trials, 236-37 phase two clinical trials, 236 Phenergan, 162 phenothiazines, 162 phenotypic test, 83 phenytoin (Dilantin), 175, 178 physical activity, and depression, 110 physical health, protecting, 5, 300 physician-of-record, 209 physicians: AIDS care specialist, 199-201, 217; choosing, 201-3; primary care, 199, 209; refusal to treat and, 252; re­lationship with patient, and notifica­tion, 14-15; residents, fellows, and interns, 209-10; second opinion, ob­taining, 203; specialists, 201, 204, 210; training of, 199 -200

physician's assistants, 210-11 Physicians’ Desk Reference (PDR), 74, 237

PID. See pelvic inflammatory disease pill boxes, weekly, 76 pill burden, 71 pilot trials, 239

PIs. See protease inhibitors placebo control trials, 238-39 pneumococcal vaccine, 143 pneumococcus, 143 Pneumocystis jiroveci pneumonia (PCP),

140-41, 223 pool policies, 261 positive, focusing on, 299-300, 304-5 positive denial, 301-2 post-herpetic neuralgia, 149 povidone-iodine (Betadine), 157 power of attorney, durable: assigning,

267-68; for finances, 269-70; for health care, 268-69 preclinical trials, 236 preexisting conditions, 196, 255-56, 260 Preferred Provider Organizations (PPOs),

256 pregnancy: avoiding, 48; cesarean section

delivery and, 38, 48; control of virus and, 17; drugs and, 48 -49; exposure to other infections during, 55; HIV care during, 48-49; sex partner with HIV and, 17; testing and, 49; transmission of virus and, 13, 16-17, 33, 38, 47-48 prescribing drug beyond labeling limits,

237 prescription drugs, 221 preserving mental health. See mental

health, maintaining preventing transmission: during home care,

49-54; of infections other than HIV,

55-58; of infections to HIV-infected per­son, 58; from injection drug use, 46-47; from pregnancy and breast-feeding, 47­49; safer sex and, 43 -46

prevention strategies, 222-23, 309-10 primary care physicians, 199, 209 primary HIV infection, 61-62 privacy, 214-15, 250-51 problems, dividing and conquering, 296 procedure, 251 productive cough, shortness of breath, and fever, 141-44

prognosis: overview of, 2-3, 11-12; viral load and, 65

Project Inform, 317 property, wills and, 273 protease inhibitors (PIs): blood fats and,

94; description of, 69, 222; drug inter­actions and, 75; insulin resistance and, 92; introduction of, 12; loss of appetite and, 158; missing doses, 77-78; muta­tions and, 84; ritonavir and, 79. See also atazanavir; lopinavir; nelfinavir; ritonavir

protein-calorie malnutrition, 176, 179 protocols for drug testing, 220 prurigo nodularis, 146-47 Pseudomonas aeruginosa, 143 psychiatric nurses, 294 psychiatrists, 205, 294 psychological issues: coping strategies, 19-21; emotional health, cultivating and maintaining, 5-6, 101-2, 287­88; mental health professionals and, 205, 294; quitting work and, 267; sources of support, 288-94; taking control, 294-305. See also anxiety; depression; emotions, effects on; men­tal health therapy

psychologists, 205

public accommodations, right to, 248 - 49

public programs for financing medical care: Medicare, 254, 261, 263; Veterans Administration, 263-64. See also Med­icaid

punishment, sense of, 119 purpura, 151 pyrimethamine, 171

quantitative plasma HIV RNA, 65. See also viral load

questions, asking, 298 -99 quitting work, 266-67

random assignment, 238 rapid test, 10-11, 323 rashes: fever and, 178; flaking, scaling, in patches, 150-51; red, 145-46

reaction to diagnosis: description of, 18­19, 276; by others, 27-28; strategies for handling, 19-21; turning point, 21­22

reasonable accommodations, right to, 246, 249-50

referral, asking for, 202 reframing/relabeling, 126, 299-300 refusal of treatment, right to, 251-52, 281

regulations, medical, 219 Rehabilitation Act of 1973, 100, 246 rejection, coping with, 28, 130-31 relabeling/reframing, 126, 299-300 relationships. See interpersonal relation­ships

relaxation exercises, 297

religion, as source of support, 291 reminder systems for taking pills, 77 reporting requirements: Centers for Dis­ease Control and Prevention (CDC) and, 7, 215; confidentiality and, 250­51, 326-27

Rescriptor (delavirdine, DLV), 69, 89 residents, 209-10

resistance test, 310

resistance to drug: HAART and, 3, 12; nonadherence and, 73; testing for, 83­84; viral load and, 69

resistant strains of virus, 69

resources: Internet, 318-19; local, finding, 319-20; national, 315-18; types of ser­vices, 313-15

rest of life, making decisions about, 279­81

resuscitate, definition of, 270

retinitis, 167-68

Retrovir. See AZT

retrovirus, 60 -61

reverse transcriptase, 60-61, 68

Reyataz (atazanavir), 74, 75, 87 rifabutin (Mycobutin), 184 ringworm, 150

risk: in clinical trials, 241, 243; definition of, 251

ritonavir (Norvir, RTV): dose of, 74, 88; drug interactions with, 75; loss of ap­petite and, 158; as PI booster, 79

RNA, 60-61

rounds, 212-13

Ryan White Act, 198, 217, 234, 254

safer sex: adjusting to, 128; alternatives to condoms, 45 -46; basic principle of, 46; condoms and, 43-45; description of, 4, 43; feelings about, 127; spermicide and, 44-45; transmission of virus and, 13, 39

safe sex, 3 -4, 43

saliva, 35, 41

saliva test, 323-24

Salmonella, 57, 300

San Francisco AIDS Foundation, 318 saquinavir (Invirase, SQV), 89 scabies, 147 seborrhea, 150-51 second opinion, obtaining, 203 Section 504, Rehabilitation Act of 1973,

246

selecting: hospital or care system, 208; physician, 201- 3

self-pay, 254 self-worth, 120 semen, 34, 35, 41 Seneca, Moral Letters to Lucilius, 285 Septra (trimethoprim-sulfamethoxazole,

Bactrim): adverse reactions to, 223; bacterial pneumonias and, 143; diar­rhea and, 163; fever and, 178; Pneumo­cystis jiroveci pneumonia and, 140-41; rash and, 145 -46; vaginal yeast infec­tions and, 166-67 seroconversion, 62- 63 set point, 64 sex, feelings about: dealing with, 128 -29;

overview of, 127; problems with, 127­28 sexual contact, 33, 36-37, 38. See also

oral sex; safer sex sexual intercourse, painful, 167 sharp instruments, disposal of, 54 sharps injuries, 39-40 shingles, 57-58, 148-50 sicca syndrome, 96 side effects: abacavir hypersensitivity reac­

tion, 95-96; adherence and, 77; ad­verse drug reactions, 223 -24; blood fats, increase in, 94-95; common, 225­33; constitutional symptoms, 187; de­pression, 109; diabetes, 92-93; diar­rhea, 162-63; drugs to treat, 223; efavirenz-associated, 96; fatigue, 176; fat redistribution, 93-94; fever, 178; fu­ture of, 310; gastrointestinal intoler­ance, 85, 90; of HAART, 84-85, 86­89; indinavir-associated, 96; intolerance of, 82; knowledge of, 74; lactic acido­sis, 90; liver disease, 91- 92; nausea and vomiting, 161; neuropathy, 95; skin rash, 90-91

simvastatin (Zocor), 75 sinus headaches, 170 skin contact, 33 skin problems: blisters, 147-50; excessive bleeding, 151-52; flaking, scaling rash skin problems (continued}

in patches, 150-51; itchy skin, 146­47; overview of, 144; purple or black spots, 144-45; rash, 90-91, 145-46; red, flaking circles, 150; small, colorless bumps, 150; thick, discolored nails, 150 slowed mental processes, 172-74 smoking, stopping, 98-99 social issues: disapproval and guilt, 118, 119; discrimination, 214, 246-48; overview of, 5 - 6

Social Security Disability Income (SSDI), 258, 264-65

social service system, 264-66

social support, 23-24

social workers: finding, 245; role of, 205, 211-12; training of, 294

social work plan, 206

sores on lips or in mouth, 154-56 sources of HIV infection, 51-52 sources of support: AIDS-advocacy organi­zations, 292; family, 289-90; friends, 290-91; mental health professionals, 294; overview of, 288-89; religion, 291; support and therapy groups, 292-93 specialist physicians, 201, 204, 210 spermicide, 44-45 sperm-washing, 17 spinal tap, 172

Sporanox (itraconazole), 153, 167, 187 spots on skin, purple or black, 144-45.

See also rashes

SSDI. See Social Security Disability In­come

SSI. See Supplemental Security Income

St. John's Wort, 75

starting treatment, 68, 71-72 state health departments, 215, 326-27 state laws, 248 -53

statins, 94

stavudine (d4T, Zerit): fatigue and, 176; fat redistribution and, 93; HAART and, 86;increase in blood fats and, 94; neu­ropathy and, 95, 174-75

stopping: smoking, 98-99; treatment, 80 streamlining clinical trials, 237- 38 substance abuse, 77. See also drug use suicide: making plans for, 280; thoughts of, 21, 112

sulfa drugs, 145-46, 171

Supplemental Security Income (SSI), 265 supplements, 181 support. See sources of support support groups, 204, 292- 93, 315 suppressing virus, 78, 80-81 surface, virus on, 35 susceptibility, 31

Sustiva (efavirenz, EFV): brain and, 173; central nervous system complications of, 96; dose of, 89;introduction of, 69; K103N mutation and, 83; missing doses of, 78; pregnancy and, 48, 49, 59; time in body of, 75

swallowing, painful, 160 -61 switch therapy, 93 -94 symptomatic period, 2, 11 symptoms, drugs to relieve, 223 syndrome, 2

tactics, changing, 295-96 taking control. See control, taking

TANF. See Temporary Aid to Needy Fami­lies

Tarasoff v. Regents of the University of

California, 15 target, separating anger from, 106 taste, altered sense of, 158

TB. See tuberculosis

T cells, 60. See also CD4 cells TDF (tenofovir, Viread), 87, 92 teaching hospitals, 207-8, 209-10 telling about diagnosis: alternatives to,

28-29; children, 129-31; dealing with others' reactions after, 27-28; decision about, 22-23; drug use and, 26; homo­sexuality and, 25 -26; reasons to keep silent, 26-27; whom to tell, 23-26 temperature, 177 Temporary Aid to Needy Families

(TANF), 265 tenofovir (TDF, Viread), 87, 92 tension headaches, 170 testosterone, 179 test results: indeterminate, 327-28; nega­

tive, 327; positive, 328

tests: for antibodies to HIV, 322, 323-24; for children, 49, 132; complete blood count (CBC), 151; for cryptococcal meningitis, 172; for dementia, 173; for fatigue, 176; future of, 310; for head

and nerve problems, 169; for HIV, 322, 324-25; for MAC, 184; Pap smears, 166; for PCP, 140; for pneumonia, 143; pregnancy and, 48, 49; recommenda­tions for, 325-26; for resistance, 83­84; for tuberculosis, 56, 142. See also CD4 cell count; viral load test thalidomide, 156, 178, 180 The Body Web site, 318 therapy groups, 292- 93 third-party payers: definition of, 254;

group plans, 255-58; individual plans, 258-61; reimbursement by, 255; unin­surability, 262

3TC (lamivudine), 84, 86, 92 thrush, 152-54, 160 Title II funding, 234 tipranavir (Aptiva, TPV), 89 toxic reactions to drugs, 224 toxoplasma encephalitis, 171 Toxoplasma gondii parasite, 58, 171 toxoplasmosis, 223 traditional medicine, 218-21. See also drugs; medical care transfers between hospitals, 216 transfusions, 33, 40 transmission of virus: avoiding, 3 -4, 5, 13; body fluids and, 30; description of, 60-61; efficiency of, 36-42; genital herpes and, 148; incubation period, 42; influenza compared to HIV, 31-32; misunderstanding of, 31; risk of, 3, 14, 50; scientific evidence and, 30; sources, 32; time lapse between AIDS and, 137; types of contact, 33-36; viral load and, 325. See also preventing transmission travelers’ diarrhea, 163 travel risks, 100-101 treatment: after exposure, 58 -59; for aphthous ulcers, 155-56; changing, 80-83; for CMV, 185; cost of, 12; for cryptococcal meningitis, 172; for cy­tomegalovirus retinitis, 168; definition of, 251; for dementia, 173; for depres­sion, 111-12; for diarrhea, 163-66; failed, 70-71; for fever, 178; for gin­givitis and periodontitis, 157; health care agent and, 268 -69; for herpes sim­plex, 148, 155; high-risk behavior and, 37-38; for itchy skin, 146-47; for ITP, 151-52; for Kaposi’s sarcoma, 145, 156; living wills, health care instruc­tions, and, 272; for lymphomas, 186; for MAC, 184; for nausea and vomit­ing, 162; for neuropathy, 175; for PCP, 140-41; preventive, for children, 49; prognosis and, 2-3; refusal of, 281; for seborrhea, 150 - 51; set point and, 64; for shingles, 149-50; starting, 68, 71­72; stopping, 80; as success story, 67­68; for thrush, 153; for toxoplasma en­cephalitis, 171; for tuberculosis, 142; viral load and, 65 -66; for wasting, 179-81, 182, 183. See also drugs; HAART; medical care; mental health therapy

treatment arms of clinical trials, 238 Treatment IND status, 238 tricyclic antidepressants, 175 triglycerides, increase in, 94-95 trimethoprim-sulfamethoxazole (Bactrim,

Septra): adverse reactions to, 223; bac­terial pneumonias and, 143; diarrhea and, 163; fever and, 178; Pneumocystis jiroveci pneumonia and, 140-41; rash and, 145 -46; vaginal yeast infections and, 166-67

triple therapy, 79, 80-81. See also HAART

Trizivir, 87 trusts, 273 Truvada, 87

T20 (enfuvirtide, Fuzeon), 89, 222 tubal ligation, 48

tuberculosis (TB): constitutional symp­toms and, 182; discharging-against- advice and, 216; multiply drug-resistant strain of, 55-56; symptoms of, 141­42; travel and, 101

turning point, 21-22 typhoid fever, 101

ulcers, on lips or in mouth, 154-56 unapproved drugs, 221 uncertainty: children and, 130; managing,

117; reasons for, 115-16 unfairness, and anger, 104 uninsurability, 261 universal precautions, 41, 213 urine test, 324 vaccines: for chickenpox, 58, 149; for he­patitis B virus, 57; “live,” 101, 149; pneumococcal, 143; therapeutic, 311; travel and, 101

vaginal discharge, 166-67 vaginal intercourse, 37 vaginal secretions, 34 valacyclovir (Valtrex), 148, 149-50, 155 Valcyte, 168 varicella vaccine, 149

Veterans Administration (VA) medical ser­vices, 263-64

Videx (ddI, didanosine): diarrhea and,

163; fatigue and, 176; HAART and, 87; lactic acidosis and, 90; loss of appetite and, 158; neuropathy and, 95, 174-75 vinblastine, 145 vincristine, 175 Viracept (nelfinavir), 88, 162, 163 viral DNA, 61 viral infections, 307 viral load: CD4 cell count and, 66-67,

138;description of, 65; as predictor of success, 81; pregnancy, delivery, and, 47-48; resistance mutations and, 69; risk of transmission and, 37, 38-39, 325; set point and, 64; starting treat­ment and, 72; treatment and, 65-66 viral load test: description of, 12, 65 -66, 322, 324-25; history of, 308; “no de­tectable virus” and, 72; pregnancy and, 49; purpose of, 65; results of, 62 viral pneumonias, 143 Viramune (nevirapine, NVP): brain and,

173; dose of, 89;introduction of, 69; liver disease and, 91, 92; liver toxicity and, 59; missing doses of, 78; rash caused by, 146; time in body of, 75 Viread (tenofovir, TDF), 87, 92 virological studies, 6, 7, 30-31 virologic failure, 81 visceral fat redistribution, 93 viscous lidocaine, 155 vision, blurred, 167-68 Vistaril, 162 Vitrasert, 168 vomiting, 161-62 waiting period, 260, 263 waste disposal, 54 wasting syndrome: chronic diarrhea and, 164; as constitutional symptom, 178­81; drugs used to treat or prevent, 183; fatigue and, 176; nonmedicinal treat­ment of, 182

weight loss, 176, 178 - 81 welfare, 265

Wellbutrin SR (bupropion), 99 white patches in mouth, 152-54 whole body, problems affecting. See con­stitutional symptoms

wills, 273

women's health problems, 166-67 work: continuing, 100; HAD and, 174;

quitting, 117, 266-67; reasonable ac­commodations, right to, and, 246, 249-50

works: cleaning, 47; sharing, 38

yeast infections, 152-54, 160, 166-67 yellow fever, 101

Zalcitabine (ddC, HIVID), 87

Zerit (d4T, stavudine): fatigue and, 176; fat redistribution and, 93; HAART and, 86;increase in blood fats and, 94; neu­ropathy and, 95, 174-75

Ziagen (abacavir): brain and, 173; fever and, 178; HAART and, 86,∙rash and, 146

zidovudine (AZT, Retrovir): brain and, 173; clinical trial of, 68, 238, 239; cost of, 234; Data Safety Monitoring Board and, 242; fatigue and, 176; HAART and, 86;introduction of, 12; loss of appetite and, 158; as nucleo­side analog, 222; pregnancy and, 48

Zithromax (azithromycin), 184

Zocor (simvastatin), 75

Zostrix cream, 175 Zovirax (acyclovir): herpes simplex and, 148, 155; herpes zoster and, 150; oral hairy leukoplakia and, 154

Zyban (bupropion), 99