 | Safer Sex | Why Get Tested? GUIDE |
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| ANTI-HIV DRUGS | ||||||||||||||||||||||||||
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| NUCLEOTIDE ANALOG REVERSE TRANSCRIPTASE INHIBITORS appear potent against HIV. Unknown penetration of blood-brain barrier. |
| DRUG/DOSAGE | SIDE EFFECTS | RECOMMENDATIONS |
|---|---|---|
Preveon  (adefovir dipivoxil, bis-POM PMEA) Gilead. 120 mg/day. Dose reduction to 60 mg/day recommended after 16-20 weeks. (more) | Kidney toxicity, nausea, diarrhea, elevated liver enzymes. Preveon depletes the body of a natural substance called L-carnitine. | Gilead has halted Preveon development. No new patients will be enrolled in clinical trials. Only patients in trials will be allowed in expanded access program. Still under development for treatment of hepatitis B. |
| Tenofovir (tenofovir disoproxil fumarate; PMPA) Gilead. 200 mg/day | Limited data. Well-tolerated in short-term studies. Elevated creatine phosphokinase and transaminases. | Take with food. Available through expanded access program. To enroll, call 800-276-0231. |
| NON-NUCLEOSIDE ANALOG REVERSE TRANSCRIPTASE INHIBITORS (or non-nukes) may interact with other cytochrome p450-processed drugs. NNRTIs have a mixed ability to penetrate the blood-brain barrier. Common side effect: mild rash. Some doctors build up drug doses slowly to avoid rash; others worry that dose building increases risk of drug resistance. (more) |
| DRUG/DOSAGE | SIDE EFFECTS | RECOMMENDATIONS |
|---|---|---|
| Rescriptor (delavirdine) Pharmacia & Upjohn. 400 mg three times a day. Under study for pediatric use. (more) | Rash (possibly indicating life-threatening Stevens-Johnson syndrome in rare cases). | Take with or without food. Take with cranberry or orange juice if you have low stomach acid. If rash develops, call your doctor; Benadryl or topical corticosteroids may relieve rash symptoms. One study shows women may have higher blood levels of Rescriptor. |
| Sustiva (efavirenz) DuPont Merck. 600 mg once a day. Approved for pediatric use. (more) | Light-headedness, dizziness, body ache, rash, diarrhea, nausea, flu-like symptoms. | Take before bedtime to avoid light-headedness; split dosage between a.m. and p.m. if sleeplessness is a problem. Warning: Not for use in early pregnancy (caused birth defects in some newborn monkeys). Take with or without food. |
| Viramune (nevirapine) Roxane Laboratories. One 200-mg/day dose for 14 days then two 200-mg doses/day. Approved for pediatric use. (more) | Fever, muscle soreness, elevated liver function, rash (possibly indicating life-threatening Stevens-Johnson syndrome in rare cases). | If rash develops, call your doctor; Benadryl or topical corticosteroids may relieve rash symptoms. Drug crosses the placenta. Take with or without food. |
| PROTEASE INHIBITORS are very potent and may interact with other drugs that induce the cytochrome p450 metabolic pathways—such as Saint John's-wort; the FDA has issued a warning against mixing this herb with protease inhibitors, specifically indinavir, because it may result in suboptimal levels of PI in the bloodstream, leading to possible PI cross-resistance. Common side effects: liver toxicity, hypoglycemia, flatulence, bloating, lipodystrophy (fat distribution). (more) |
| DRUG/DOSAGE | SIDE EFFECTS | RECOMMENDATIONS | |
|---|---|---|---|
| Angenerase (amprenavir/141W94) Glaxo Wellcome. Two 1,200 mg/day. Under study for pediatric use. (more) | Nausea, gas, headache, neuropathy, rash, diarrhea, mouth numbing, fatigue. Rare: Stevens-Johnson syndrome. | Can be taken with or without food. Agenerase capsules contain high levels of vitamin E. Consult with your doctor about possible interactions with Vitamin E supplements or blood-thinning drugs. | |
| Crixivan (indinavir) Merck & Company. Three 800-mg doses/day. Under study for pediatric use. (more) | Kidney stones, anemia, rarely elevates liver enzymes. | Take on empty stomach with water one hour before or two hours after eating. Drink at least six glasses of water daily to avoid kidney stones. Alternative liquids: juice, skim milk, coffee, tea. Eat with fat free snacks. | |
| Fortovase (saquinavir) Hoffmann-La Roche 1,200 mg three times a day. 400-800 mg twice a day with Norvir). Under study for pediatric use. (more) | Diarrhea, gas, nausea, stomach cramps, heartburn, fatigue, numbness, rash; elevated liver enzymes. | Take with food or within two hours of eating. Fortovase is more potent than Invirase. Invirase not recommended as first-line therapy due to poor absorption and resistance issues. | |
| Kaletra (lopinavir) Three 133 mg Kaletra/33 mg Norvir (coformulated) twice a day. (more) | Nausea, skin rash, diarrhea, loose stools, elevated triglycerides and transaminases. Do not take with Norvir or Rescriptor | Expanded access for those failing standard regimens. To enroll, call (888) 711-7193. | |
| Norvir (ritonavir) Abbott Laboratories. Six 100 mg. twice a day (400-mg doses twice a day with Fortovase). Available in pill and liquid form. Approved for pediatric use. (more) | Nausea, vomiting, weakness, diarrhea, rash, fatigue, numbness around mouth, changed taste in mouth, elevated liver enzymes. | Build up to optimal dose over a few days. Take with a full, high-protein meal. Yogurt may reduce side effects. | |
| Viracept (nelfinavir) Agouron Pharmaceuticals Three 750 mg doses/day. Approved for pediatric use. (more) | Fatigue, rash, nausea, stomach cramps, diarrhea, elevated liver enzymes. | Take with food. Use Imodium, Lomotil to control diarrhea. Women should consult with their doctors prior to use. Dose desensitization can work for patients experiencing rash. |
| OTHER DRUGS |
| DRUG/DOSAGE | SIDE EFFECTS | RECOMMENDATIONS |
|---|---|---|
| Hydrea (hydroxyurea/HU) Bristol-Myers Squibb. Two 500-mg doses/day. A chemotherapy drug; probably penetrates blood-brain barrier. Available for pediatric use. (more) | Mild nausea, bone-marrow suppression, hair loss, rare dry mouth. Reduces CD8+ cell activation. Possible: neuropathy. | Animal studies suggest possible toxicity for pregnant women. Monitor bone-marrow suppression, liver and kidney function. Drug attacks a cell enzyme (ribonucleotide reductase); may work against proviral HIV in resting T-cells and macrophages (latent infection). |
Kissing, hugging, mutual masturbation (ejaculate only on unbroken skin), "water sports" (urine on unbroken skin).
For anal or vaginal sex, use a latex condom with a water-based lubricant. Oil-based lubricants such as Vaseline weaken condoms, increasing the risk that they might break during intercourse.
During sex, men should pull out and avoid ejaculating inside their partner, even when using a condom. If a man does come inside his partner, he should hold the condom during withdrawal to keep the semen from spilling out.
If a condom breaks during sex, immediately replace it with a new one.
Avoid oral sex if you (or your partner) have open cuts or sores in your mouth or on your genitals, or if you have an active STD infection.
For oral sex with a man, use a latex condom. Avoid taking semen in your mouth, but if you do, make sure not to swallow any.
For oral sex with a woman, watch for cuts or sores in your mouth and avoid menstrual blood. Consider using a dental dam (a square of latex sold at drugstores) or a condom cut in half to use over the vulva.
Rimming, or oral-to-anal contact, is low risk for HIV transmission but high risk for transmission of a variety of parasites and hepatitis. For rimming, use a dental dam or condom that is cut in half.
Always use a fresh condom with sex toys. Clean toys with soap and water after every use.
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