The Guide to Living with HIV Infection A J O H N S H O P K I N S P R E S S H E A LT H B O O K The Guide to Living with HIV Infection Developed at the Johns Hopkins AIDS Clinic S I X T H E D I T I O N John G. Bartlett, M.D. Ann K. Finkbeiner The Johns Hopkins University Press Baltimore Note to the Reader This book is not meant to substitute for medical care of people with HIV infection, and treatment should not be based solely on its con- tents. Instead, treatment must be developed in a dialogue between the individual and his or her physician. Our book has been written to help with that dialogue. The author and the publisher have taken every step to make the in- formation in this book as up to date as possible. Drug information: The author and the publisher have made reasonable efforts to determine that the selection and dosage of drugs discussed in this text conform to the practices of the general medical commu- nity. The medications described do not necessarily have specific ap- proval by the U.S. Food and Drug Administration for use in the dis- eases and dosages for which they are recommended. In view of ongoing research, changes in governmental regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert or manufacturer’s patient infor- mation material of each drug for dosage and for warnings and pre- cautions. This is particularly important when the recommended agent is a new and/or infrequently used drug. © 1991, 1993, 1996, 1998, 2001, 2006 The Johns Hopkins University Press All rights reserved. First edition 1991 Sixth edition 2006 Printed in the United States of America on acid-free paper 9 8 7 6 5 4 3 2 1 The Johns Hopkins University Press 2715 North Charles Street Baltimore, Maryland 21218-4363 www.press.jhu.edu To purchase additional copies, call 1-800-537-JHUP Library of Congress Cataloging-in-Publication Data Bartlett, John G. The guide to living with HIV infection : developed at the Johns Hopkins AIDS Clinic / John G. Bartlett, Ann K. Finkbeiner. — 6th ed. p. cm. — (A Johns Hopkins Press health book) Includes index. ISBN 0-8018-8485-3 (hardcover : alk. paper) — ISBN 0-8018-8486-1 (pbk. : alk. paper) 1. AIDS (Disease)—Popular works. I. Finkbeiner, Ann K., 1943– II. Title. III. Series. RC607.A26.B376 2007 362.196⬘9792—dc22 2006009631 A catalog record for this book is available from the British Library. To Garey Lambert This page intentionally left blank Contents Introduction: About This Book / 1 1 When First Diagnosed: Understanding and Communicating about HIV / 10 2 Preventing Transmission of HIV Infection: Understanding How HIV Is Spread / 30 3 HIV Infection and Its Treatment / 60 4 HIV Infection and Its Effects on the Emotions / 103 5 HIV Infection and Its Effects on Interpersonal Relations / 123 6 The Complications of HIV Infection and Their Treatment / 135 7 Options for Medical Care: Medical Personnel and Procedures / 194 8 Traditional Medicine / 218 9 Practical Matters: Making Legal, Financial, and Medical Decisions / 245 10 On Dying: Preparing for and Accepting Death / 275 11 On Living: Tactics for Preserving Mental Health / 287 12 What’s Ahead / 306 viii • Contents Appendixes A. Resources: Where to Go for Help / 313 B. Understanding Tests for HIV / 321 Glossary / 329 Acknowledgments / 379 Index / 381 The Guide to Living with HIV Infection