Gearing Up for HIV Treatment

by Cynthia Teeters, CSW

Today there are a number of effective therapies available to people living with HIV. There are a also number of things to think about during the initial search for the right treatment and the right doctor.

Social worker Cynthia Teeters has extensive experience counseling a diverse population of HIV positive patients in both private and hospital settings. Below, she offers some advice to those first diagnosed with HIV.

Finding an experienced doctor you can trust
The first thing to keep in mind as you consider an HIV treatment program is that you are the most important member of the treatment team. Be sure you find someone with whom you can work, ask questions, and address your concerns. When you begin to receive medical care for HIV, it is important to do your homework. Depending on your insurance plan, availability of physicians will vary. Learn about providers in your community that currently work with HIV patients. Most major hospitals will have physicians who specialize in treating HIV disease. You should look for a doctor who has experience with HIV, as treatments and medications change rapidly. Feedback from other patients can also help you choose a provider. If you are involved with a community organization or support group, ask other patients about their experiences with their physicians.

Depending on where you were tested for HIV, you may or may not be connected with a doctor. If you were tested at a health department or private testing site, their staff may be able to refer you to reputable HIV providers in your area. If you were tested at your family doctor's office, you may want to continue in his or her care. However, it is in your best interest to ask your doctor about the extent of his or her experience with treating HIV. It is important to receive medical treatment from an experienced HIV provider. When and if you and your doctor decide to begin treatment, it is very important to stick with the agreed-upon plan. If you are having any problems adhering to the plan (for example, taking medications as directed), contact your doctor as soon as possible.

Support for fighting drug and alcohol addiction
If you feel you may have a problem with drugs or alcohol, be proactive and ask for help. Fighting addiction to drugs and/or alcohol can be difficult. However, there are a variety of resources and support services available nationwide. Taking steps to address your drug and alcohol use will help you be more prepared to deal with your HIV diagnosis. The longer you put off dealing with substance abuse problems the more you may damage your body.

Investigating your health benefits for HIV
Medical treatments for HIV are very expensive. It is extremely important to be knowledgeable about your health insurance options. If you are currently covered by an insurance plan, investigate the limits of your policy. Explore whether or not you have access to an HIV specialist. Don't be afraid to speak with a customer service representative should you have questions about your policy. Some people worry about their insurance companies learning about their HIV status. By law, if you are currently insured and test positive, you cannot be discharged from your insurance plan. If you have specific questions about your policy and do not feel comfortable talking with your employer or company representative you should consider contacting the National AIDS hotline at 1-800-342-2437 (AIDS). Hotline staff will try to locate a local case manager in your area who can help you investigate your plan.

AIDS drug assistance program
You may find that your health plan has a cap on annual medication costs. For some people who do not have adequate prescription drug coverage, there is a federal program called the AIDS Drug Assistance Program (ADAP). ADAP was designed to provide access to expensive HIV medications for people who are considered to be underinsured or have no insurance. Eligibility for ADAP is determined based on your financial situation. Eligibility will also vary from state to state, as will the number of medications covered. States with larger numbers of people living with HIV tend to have a larger list of covered medications.

If you are currently unemployed or have a low income, you may be eligible for Medicaid. Medicaid is a federal program that provides health care for people who cannot afford to purchase insurance on their own. If you qualify for supplemental security income (SSI), you will automatically receive Medicaid.

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Protecting yourself and others
HIV is not easily transmitted. In order to transmit HIV, there must be an exchange of body fluids, blood, semen, vaginal secretions, or breast milk. HIV is often transmitted through unprotected sexual contact. This includes oral, anal, and vaginal sex. Using condoms will significantly reduce the risk of transmitting HIV to a sexual partner. If you are using intravenous drugs, do not share needles with others. HIV can be transmitted through breast milk, therefore new mothers are advised against breast-feeding. Women who are pregnant can take medications to reduce the risk of transmission to their child.

Educating yourself
We are learning more each day about HIV and its treatment. Try to educate yourself. Evaluate which methods of information gathering work best for you. Be careful not to overload yourself and don't forget to stop and take a breath. Most of all, ask for help when and if you need it. Many people living with HIV continue to lead active lives after they are diagnosed. By working closely with your doctor and leading a healthy lifestyle, you can continue to lead a happy and productive life.

Next: Managing HIV: A Life-Long Commitment

Last updated: 11/01. Last reviewed: 10/05

Cynthia Teeters is a social worker with The Center for Special Studies AIDS program at New York Presbyterian Hospital, Weill Cornell Center. Ms. Teeters has provided individual and family counseling to a diverse population of HIV positive patients, both in the hospital and in a clinic setting.

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