So, you have HIV. How does that make you feel? Usually the answer to that ranges from numb to shock, anger to despair. Whatever your reaction has been, its probably been shared by others. You are not alone.

I remember my own. It was 1989 and I received a call from my doctor suggesting I have an HIV test. Me!! There I was, 30, living in the suburbs, a middle management job in the Health Department. Life was about to change. When I received the call I felt as though I had plugged my body into a 240 volt socket.

I ended up seeing a locum for the antibody test, and when it returned after 2 terrible weeks of uncertainty, it returned positive. The locum’s 'post test counseling' remains a blur. The only thing I can remember is a continuing reference to fatal. I had already been infected five and a half years, so he thought I was a goner, and soon. Fourteen years later I am still here, and healthy.

Many others have stories like this, if not quite the same in detail. For heterosexual men and women there was, and to a large extent, still remains, an additional burden of being on the margin of the HIV community. Knowledge of and access to resources has remained limited, often through a service being perceived as unfriendly to straights, or never really having considered heterosexual HIV+ or their children and families as an issue.

In this kit we have tried to pull together details of services and issues which those of us who have been positive a long time would have liked to have seen many years ago. We have also endeavoured to make it easy to update, and simpler to post on the internet, both in English, and other community languages.

In later additions to this kit we plan on adding some of the experiences others have had in dealing with their infection and the reactions of others to that infection.

HIV is a part of our lives, but it is not the only or defining part. We are more, much more than a home for a nasty little virus, or a research tool. We are individuals, we are parents, we are partners. We have aspirations and goals, dreams and dreads. We come from all backgrounds and are not limited by other people’s stereotyping, ignorance and bias.

We hope you find this kit useful.

INDEX

1. SUPPORT SERVICES
2. HOUSING
3. DISCRIMINATION
4. THINGS THAT GO BUMP IN THE NIGHT
5. CHILD CARE
6. FINANCE
7. LIVING WITH CHANGE AND TRANSITION
8. DEPRESSION
9. AIDS COUNCILS AND ORGANISATIONS
10. TREATMENT FOR HIV
11. CONSIDERING TREATMENTS - TREATMENT OFFICERS
12. COMPLEMENTARY THERAPIES
13. HIV & HEP C COINFECTION - A GUIDE
14. TRANSMISSION AND PEP
15. MEDICAL CENTRES
16. SELECTED HIV WEBSITES
17. ACKNOWLEDGEMENT

1. SUPPORT SERVICES

Straight Arrows

Formed in 1995, Straight Arrows is run by and for HIV Positive heterosexuals and their families. Straight Arrows provides services and support including:

• Treatment information from a Treatments Officer (in conjunction with Positive Women) fortnightly;
• Medical and paramedical services information;
• Legal services referral (HALC);
• Social contact;
• Assistance with housing needs, and referral to AHAG;
• One-to-one peer support;
• Massage;
• Hospital/ward visits;
• Outreach/home visits;
• Monthly lunch (free of charge);
• Speakers for education in wider community;
• Drop in space for coffee and/or a chat;
• Financial relief and Child Care reimbursements.

Fairfield House
The Alfred
Moubray Street
Prahran 3181
Hours: Monday – Friday 9.30am – 4pm
Tel: (03) 9276 3792
Fax: (03) 9276 3817
Email: support@straightarrows.org.au

People Living With HIV/AIDS (PLWHA - Vic.)

PLWHA provides advocacy, representation, information and support for all HIV/positive people in Victoria. It focuses its attention and energies on advocacy, particularly in the areas of health service delivery, treatments activism, housing, anti-discrimination and quality of life issues for people living with HIV/AIDS.
Membership in PLWHA also entitles a person to a free regular newsletter, notification of upcoming events (including social functions) and gives the right to vote at the AGM or any special meetings of the organisation. PLWHA has a variety of ways in which HIV+ people can be active, including the Speakers Bureau, Treatments Action Group, HIV+ Radio or the Board of Management.

Ground Floor
6 Claremont Street
South Yarra 3141
Tel: (03) 9865 6772
Fax: (03) 9804 7978

HIV Support Services – Victorian AIDS Council

Services offered include:

• Support for partners, family and friends;
• Information and advice in relation to your health care;
• Referral to other agencies;
• Social and emotional support and outings;
• Financial assistance;
• Legal assistance;
• Advocacy on behalf of clients;
• Personal care in your home;
• Assistance with gardening, shopping, washing and other domestics tasks;
• Transport to medical appointments.

Check you eligibility with the Victorian AIDS Council on
(03) 9865 6700 and speak to a Regional Support Officer (RSO).
An initial assessment will be made over the phone. If eligibility is probable then an appointment will be made for a formal assessment.
If appropriate a Care Team Coordinator will be assigned who will then discuss your support needs, and develop a care plan.
All client records are maintained confidentially, and the program is non-discriminatory. Services are targeted to those PLWHAs most in need. Straight Arrows has always found the service to be a boon to HIV+ people, and the RSO's friendly and approachable.

Positive Women

This is a State-wide service in Victoria offering confidential information and support group for women with living HIV/AIDS. Positive Women offer:

• one-to-one contact in person or by phone;
• group support;
• a monthly newsletter;
• a drop-in centre twice a month;
• information and referrals;
• retreats and social events;
• hospital and home visits on request.

Positive Women also:

• advocates and lobbies for the rights of women with HIV/AIDS.
• provides speakers for educational purposes in the wider community and networks with other women’s and HIV/AIDS groups in Australia and overseas.

Fairfield House
Alfred Hospital
Moubray Street
Prahran 3181
Tel: (03) 9076 6918
Fax: (03) 9076 6092
Email: info@positivewomen.org.au
Web site: http://www.positivewomen.org.au

Lifeline Australia

This is a telephone counseling service that is available 24 hours a day, 365 days a year.
Calls are connected automatically to the nearest available Lifeline centre for the cost of a local call, from anywhere in Australia.
Tel: 13 11 14
Web: http://www.lifeline.org.au

Country Awareness Network (CAN)

CAN is a statewide organisation which represents regional and rural interests.
Its aim is to be a resource for people affected or infected by HIV/AIDS or other blood borne diseases, and it can be accessed by agencies or individuals across Victoria.
CAN also acts as a facilitator for education, training and events, support and care to be run by local communities for local communities in rural Victoria.
34 Myers Street Bendigo 3552
Tel: (03) 5443 8355
Email: can@can.org.au
Web: http://www.can.org.au

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2. HOUSING

Access to appropriate and safe housing is an extremely important link in the management of HIV. Housing authorities recognise this and HIV+ people can apply for priority if they are eligible for public housing. Housing options can also include private rental, share accommodation and community housing.

The principal housing service for HIV+ people is AHAG:

AIDS Housing Action Group Vic. Inc.

365 Hoddle Street, Collingwood, 3066
(Collingwood Community Health Centre, Cnr Sackville & Hoddle St's)
Tel: (03) 9417 4311
Email: info@ahag.org.au
Web: http://home.vicnet.net.au/~ahag/

Public Transport

Tram 86, Stop 17 Smith Street
Train – Victoria Park Station
Buses – 246 (Hoddle Street), 200, 201, 203, 205, 207, 257-262, 264-266, 276-281, 299, 300 (Johnston Street)

Wheelchair Access: Yes
Appointments: Yes, there is no drop in facility.

Services are for those with HIV/AIDS include:

Housing Advice and Referral

Staff are able to discuss housing options, including assistance for private rental may include information regarding Housing Establishment Funds (HEF) for rent in advance and the Bond Loan Scheme (Office of Housing).
Referrals to other housing agencies will also be arranged where appropriate.

Transitional Support Program

This program supports those that are homeless or at risk of becoming homeless. People will need to be assessed by staff as suitable for the program and be willing to receive support whilst in the program.

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3. DISCRIMINATION

Over the years, particularly early in the epidemic, people with HIV have faced some significant hurdles. One of these has been in relation to discrimination, and other legal areas where their status has been an issue.

There is Federal and State legislation dealing with equal opportunity and discrimination generally.

In Victoria, the Equal Opportunity Act (1995) makes it unlawful to discriminate directly or indirectly against someone because of their:

• Age;
• Carer status;
• Disability;
• Lawful sexual activity/orientation;
• Personal association with a person who could be discriminated against;
• Physical features;
• Political or industrial activity or beliefs;
• Pregnancy, parental or marital status;
• Race;
• Sex.

In particular, this means it is unlawful to discriminate against a person who is living with HIV, assumed to be living with HIV, or is an associate of a person living with or assumed to be living with HIV. (This also applies to Hepatitis C)

It is unlawful to discriminate against a person with HIV in the areas of:

Accommodation

including buying, renting, providing temporary or permanent accommodation such as business premises, a house, flat, hotel or motel room, boarding house or hostel, caravan, mobile home or campsite.

Clubs

covering social recreational sporting or community service clubs that are located on Crown Land, or receive any financial assistance from the State Government or a municipal council.

Employment and Sport

Goods & Services & Disposal of Land
which includes refusing to supply a person with goods and services, or on less favourable terms. It does not matter if the goods and services are provided for money or not.

Discriminatory requests for Information

If you feel you have been discriminated against, you can:
Contact an HIV Support Service or HALC, see below.

Contact the Victorian Equal Opportunity and Human Rights Commission
Level 3 380 Lonsdale St Melbourne
Tel: (03) 9281 7111
Fax: (03) 92817171
Web: http://www.humanrightscommission.vic.gov.au

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4. THINGS THAT GO BUMP IN THE NIGHT

Everyone has things sometimes that seem to spin around in their minds keeping them from sleeping. And, in the middle of the night, things can also feel overwhelming. Often, in daylight hours, we can take some positive action to fix these worries, but we often put them off only to have them return and keep us awake.

The things can cause us concerns often relate to what may happen many years from now – things like the need for a Will, finding out what continuing care is available if needed, etc. These sheets will look at some of the things that can be done making it easier to just get on and live life with fewer sleepless nights! The funny thing is, everybody should have a grip on these issues, not just people with HIV. If you deal with them, whatever your situation, they are done with and you can get on with life.

MAKING A WILL

Everybody needs a will! If a person dies without a Will, their assets are divided up according to a statutory formula. If you want a choice in what happens to your assets, you need to make one.
There are many ways to organise this. Most of them simple!

1. Contact your local AIDS Council for free legal assistance.
2. Speak with any private lawyer/solicitor who will usually be able to prepare a Will for less than $100.
3. Attend a local Community Legal Centre who will assist you for a small fee.
4. The Public Trustee or State Trustee will prepare your Will for free as long as they are appointed as your Executor. They deduct fees from estates for carrying out the duties of the Executor.

POWERS OF ATTORNEY

What are they?

There are 3 types of Power of Attorney:

• A general power of attorney;
• An enduring power of attorney;
• An enduring power of attorney for medical treatment.

To ensure that any Power of Attorney is prepared and witnessed correctly it is best to follow the guidelines for advice and preparation given previously under the ‘Wills’ section of this document.

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5. CHILD CARE

There may be times when your circumstances mean that a sudden and unexpected need for childcare arises. The following are some guidelines as to who to approach at these times:

Straight Arrows

Straight Arrows has limited financial resources available for emergency care of children. That is, when circumstances arise other than regular arrangements. An example of this would be when you are required to attend a medical appointment at short notice, or if requiring admission, again at short notice, whilst you make firmer arrangements. Straight Arrows also endeavours to assist with childcare when running an adult function.

Phone: (03) 9276 3792

Victorian AIDS Council

The Council has a Child Care policy that states its commitment to:

• Facilitating the access of parents and guardians to the processes and services of VAC, and also to;
• Providing parents and guardians who have HIV/AIDS, or whose children have HIV/AIDS with access to occasional respite child care.

Requests for childcare will be assessed on a case-by-case basis with reference to the level of demands on the service.
Phone: (03) 9865 6700

Hospital

The Social Work department of your treating hospital may be able to help with arrangements through local councils, etc, and at times infants have been accommodated in the hospital with a parent. You might want to make enquiries at the hospital to plan for such a contingency.

Remember, you can contact Straight Arrows at almost anytime to discuss possibilities.

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6. FINANCE

Good financial planning, and knowledge of the resources available, can provide a sense of security for anyone, and particularly people with HIV. The planning needs of HIV+ people depend on their personal circumstances, their current resources, and future needs. A person working full time, for example, has different resources and planning needs to a person who is unwell and unemployed. People can also have circumstances which can include periods of employment mixed with periods of inactivity:

Long Term

For people who are well and/or working, particularly those with children, there is the issue of medium to long term savings and planning.

Cash

Usually cash, such as a bank account, is considered to be a very short term investment. The interest rates paid on savings accounts and the like is extremely low, and term deposits, whilst having a better rate, lock money up for a fixed period. On the other hand, cash in accounts is readily available.

There is an alternative to these, however – Cash Management Trusts. These are usually run by large investment companies, and offer a reasonable rate together with good access to funds, including cheque access. The catchs with CMTs are they often require a minimum deposit, or a minimum balance. If you have some savings they are a good place to park money with a 12 month to 2 year horizon.

Shares and the stock market

The roller coaster ride. The stock market can offer good returns in the medium to long term if you pick a good company or portfolio of companies. The market has two factors affecting your investments – risk and volatility. Risk is the possibility of your investment going belly up, like some of the new technology companies. Volatility, on the other hand, relates to the rise and fall of the market, and, providing there is a general upward movement in your investment, not such an issue for medium to long term investors.

One way of investing in shares, or property for that matter, is to spread your investments not just by number, but also within individual investments through managed unit trusts. There is a multitude of these unit trusts, offering a diverse range of investment options, such as Australian and International Equities, and with a variety of outlooks, including bias towards income or capital growth, lower or higher risk and volatility, etc. The investment company employs professionals to manage these investments, and their performance history can be assessed from a prospectus.

The best way of accessing these products is to find an experienced and reputable investment advisor. In particular look for an independent advisor, and one who discloses the initial and trailing commissions they receive, or an advisor who charges a consultation fee only. The Victorian AIDS Council has produced an excellent guide on managing finances, 'the Positive way to stay afloat'. You can obtain a copy from Straight Arrows or directly from the VAC

Centrelink

At various times, many of us need to access the social security system.
For advice as to Benefits to which you or members of your family are entitled it is best to directly contact Centrelink. Centrelink staff also visit the Alfred Hospital twice a week providing a very discrete link to the social security system.

The following are central numbers – Australia-wide – for the designated Benefits:

To make an appointment to see someone in your local office

131021

Disability, Sickness and Carers benefits

132717

Family/Parenting Payments

136150

For information in other languages

131202

Employment Services

132850

Youth Allowance

132490

Austudy Payment

132490

Freecall

1800 810 586

Teletypewriter Service

A TTY service for hearing and speech impaired people. A TTY phone is required to use this service.

Depending on your situation the following Benefits may well apply at various times:

• Disability Support Pension
• Mobility Allowance – not means tested
• Child Care benefit
• Parenting Payment
• Carer Allowance
• Sickness Allowance
• Telephone Allowance.

David Williams Fund -
Project of the HIV Services Unit of Victorian AIDS Council

This fund was established in 1987 by the friends and family of David Williams, and provides emergency financial assistance and relief to HIV+ people experiencing hardship.

To be eligible for financial assistance through the David Williams Fund you must:

• Provide proof of your HIV status;
• Demonstrate that you are in receipt of a Social Security Benefit or Pension;
• Demonstrate financial hardship, and
• Be a resident of Victoria for the previous 3 months.

David Williams Fund Application forms are available from:

• The Victorian AIDS Council, Positive Living Centre, 51 Commercial Rd, Prahran, 9863 0444;
• The Social Work Department of the Alfred Hospital, Prahran;
• Straight Arrows.

Straight Arrows

Straight Arrows provides a limited amount of emergency financial relief to people within our service category: HIV+ parents and HIV+ heterosexuals and their families. This is usually by way of voucher or utility assistance.

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7. LIVING WITH CHANGE AND TRANSITION
(and dealing with Loss and Grief)

Every person’s life contains change and transition. From our earliest months we experience (whether we are conscious of it or not) massive changes - physically, emotionally and mentally. Sometimes there is resistance to change and it is often expressed through crying. Any who have witnessed a small child being put to bed against their will understands this very well!

As we grow older we often feel the same emotions when faced with changes and transitions, but we have learned what is ‘appropriate’ or ‘inappropriate’ behaviour in our society at such times. However, we do still respond, despite what our public face shows.
Very often we don’t recognise the changes as being a cause of grief in our lives. We perhaps, although incorrectly, think that humans only grieve when a death occurs. Of course it is true that we do grieve when bereaved. However, there are many other changes and transitions that can arouse similar emotional and other responses.

Some common changes and transitions are:

• Finishing school
• Leaving home
• Breakdown in a relationship
• Lost dreams/hopes
• Divorce
• Loss of friendship
• Unemployment
• Ill health
• Infertility
• Loss of accommodation
• Loss of financial security
• Changes in role and sense of identity.

One of the realities of life is that we are all individuals with our own unique way of feeling and expressing ourselves. While responding to change and transition is a universal experience the way in which we respond is almost inevitably different to anyone else. Even when a similar change is experienced the responses may differ enormously.

So what are the various factors that help to create these different responses within us?

• Our age and previous experience in dealing with change and transition
• Our gender - with all the social pressures to conform to ‘male’ or ‘female’ ways of showing emotion.
• Our cultural background
• Our ethnicity
• Our belief system (religious and spiritual values)
• Our sense of personal identity
• Our current health situation
• Our current financial situation
• Our support systems
• Access to information that can assist us
• Our relationship with the person or thing that has been lost to us.

So how do we express our response to change and transition?

It is helpful to recognise the impact on our lives in all aspects of our experience, ie in the physical, emotional, sexual, economic, social, psychological and spiritual spheres. And so we may respond with tears, or we may not. We may experience physical aches and pains, headaches, digestive problems. We may withdraw socially or become hyperactive in our activities. We may feel abandoned by God, or may seek out spiritual support. We may seek casual and anonymous sexual encounters or we may long for a committed relationship. We may experience poverty for the first time and be ashamed or embarrassed to admit our needs.

Some strategies for coping with change and transition:

• Do not carry the burden alone. Find a trustworthy person with whom you can share your feelings.
• Seek out information to assist you with your specific needs. For example, financial counseling, spiritual guidance, medical attention. Whatever it is that will offer ease to anxiety and uncertainty.
• Recognise that whatever you are feeling is normal, that responding in these ways does not mean you are ‘going mad’ (which is how many people describe themselves as feeling when under stress). Your responses show you are in touch with the reality of the pain of the change.
• Utilise the phone book, the Internet and other resources to put you in touch with organisations, counselors, or other forms of support in the community. They are there to be utilised and their very existence is evidence that you are not the first to feel in need of their expertise.

Those around us grieve too.

When we are experiencing change and transition that brings with it loss and grief, then it is sometimes easy to forget that those who know us can also be feeling the impact of the changes we are experiencing. None of us lives without others in our lives. We may (or may not) have families; many have neighbours, friends, social groups, colleagues at work (ie in paid or voluntary work places), professionals who offer support and care. Any person with whom we share some sort of relationship will affect us by their attitudes and feelings just as we affect them with ours.

Experiencing grief can create feelings of isolation because we look around and see others who are behaving, acting, speaking differently to us even if they share a similar situation. But no two people are the same, and no two people’s circumstances are exactly the same.

It can be tempting to judge ourselves against others and think that we are not coping if, for instance, we shed tears and others do not. ‘Coping’ can mean that we feel angry, or cry, or feel sad, or happy. Coping is acting on our feelings. We are not coping when we hide our feelings – especially when we try to hide them from ourselves!

If you feel that you would like to access support as you work with the feelings arising from any changes and transitions in your life then contact a Social Worker/Counselor at your local HIV/AIDS service, your General Practitioner or a grief counselor.

Accredited grief counselors can be contacted through the National Association for Loss & Grief (Vic.) www.nalagvic.org.au on (03) 9650 3000 or Country Vic. Freecall 1800 100 023.

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8. DEPRESSION

Depression can be a common reaction to a stressful event in life, especially loss. It may also be a symptom of a chronic medical illness, or a reaction to medication. It is not uncommon for people with HIV to experience depression.

The most important aspect of depression is that it can be effectively treated.

Signs of Depression

There are many signs associated with depression, though experiencing each of these things separately does not indicate that you have depression:

• A feeling of sadness lasting for an extended period of time;
• Loss of appetite, significant weight gain or loss;
• Irregular sleeping patterns and difficulty getting out of bed;
• Anxiety, irritability, impulsive behaviour;
• Feelings of worthlessness, helplessness or that there is no future;
• Finding you do not enjoy previously pleasurable activities;
• Suicidal thoughts;
• Frequent crying, or inability to cry;
• Difficulty concentrating and loss of interest;
• Loss of sexual desire or sexual difficulties.

Factors which can aggravate depression

If you are feeling depressed, you need to be aware of things that can increase feelings of depression. Some of these are:

• Drug use;
• Alcohol use;
• Certain HIV medications;
• Extra stress;
• Social isolation;
• Dwelling on the current feelings of unhappiness.

Practical ways that may ease depression:

• Seek supportive company;
• Try to achieve a small task each day;
• Take things one day at a time;
• Do something special for yourself;
• Mild exercise. Eat and sleep sensibly;
• Talk to a health professional.

Seeking Help

An accurate diagnosis is important to assist in treating and monitoring your depression. There are a number of services available to do this. Many that specialise in HIV and depression will be free of charge.

Your options include:

• Seeing a GP, counselor or a social worker who will refer you to the appropriate services if extra treatment for your depression is needed
• Seeing a psychologist or a psychiatrist is an option many people choose (a referral is usually required to a psychiatrist)
• There are other services that deal with these issues indirectly, by providing ongoing support, such as peer support groups
• There is more than one option available for you.

HELPFUL RESOURCES

The Alfred HIV Social Work Team

(03) 9276 3026

Positive Counselling Specialist HIV/hepC Service

(03) 9530 2311
info@positivecounselling.org.au
www.positivecounselling.org.au

Melbourne Sexual Health Centre Counselor

(03) 9347 0244

Victorian AIDS Council Counseling Team

(03) 9865 6700
(provides services for a minimal cost)

Beyond Blue

www.beyondblue.org.au

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9. AIDS COUNCILS AND ORGANISATIONS

AUSTRALIAN CAPITAL TERRITORY

AIDS Action Council of the ACT

(AIDS Council)
Tel: (02) 6257 2855
www.aidsaction.org.au

PLWHA/ACT

(PLWHA organisation)
Tel: (02) 6257 4985
www.aidsaction.org.au

NEW SOUTH WALES

ACON

(AIDS Council)
Tel: (02) 9206 2000, 1800 063 060
www.acon.org.au

Positive Life NSW

(PLWHA organisation)
Tel: (02) 9361 6011, 1800 245 677
www.positivelife.org.au

HIV/AIDS Information Line

(Telephone advice, information and referral service)
Tel: (02) 9332 9700

NORTHERN TERRITORY

NT Aids and Hepatitis Council (NTAHC)

(AIDS Council)
Tel: (08) 8941 1711
www.ntahc.org.au

PLWHA/NT

(PLWHA organisation)
Tel: (08) 8941 1711

QUEENSLAND

Queensland Assocciation for Healthy Communities (QAHC)

(AIDS Council)
Tel: (07) 3017 1777
www.qahc.org.au

Queensland Positive People (QPP)

(PLWHA organisation)
Tel: 1800 636 241
www.qpp.org.au

SOUTH AUSTRALIA

AIDS Council of South Australia (ACSA)

(AIDS Council)
Tel: (08) 8334 1611
www.acsa.org.au

PLWHA(SA) Positive Living Centre

(PLWHA organisation)
Tel: (08) 8293 3700
www.hivsa.org.au

TASMANIA

Tasmanian Council on AIDS, Hepatiitis and Related Diseases (TasCAHRD)

(AIDS Council)
Tel: (03) 6234 1242, 1800 005 900
www.tascahrd.org.au

VICTORIA

Victorian AIDS Council/Gay Men's Health Centre (VAC/GMHC)

(AIDS Council)
Tel: (03) 9865 6700
www.vicaids.asn.au

PLWHA Victoria

(PLWHA organisation)
Tel: (03) 9865 6772
www.plwhavictoria.org.au

Straight Arrows

(PLWHA organisation)
Tel: (03) 9276 3792
www.straightarrows.org.au

Positive Women

(PLWHA organisation)
Tel: (03) 9076 6918
www.positivewomen.org.au

WESTERN AUSTRALIA

West Australian AIDS Council (WAAC)

(AIDS Council)
Tel: (08) 9482 0000
www.waaids.com

HIV/AIDS Peer Advisory Network (HAPAN)

(PLWHA organisation)
Tel: (08) 9482 0000
www.waaids.com

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10. TREATMENT FOR HIV

Drug treatments for HIV offer some people the chance to control the virus and stay healthy for much longer. Treatment options have had a huge impact on the lives of people with HIV and those who care for then, due to reductions in AIDS illnesses, admissions to hospital and death rates. Treatment has also enabled some people with HIV to go back to work and plan for the future, Unfortunately, the drugs do not work as well for everyone, and they also have quite a lot of side effects. Deciding whether or not to take treatment is an individual decision which you should consider carefully and discuss all of the options with your doctor.

Types of Treatment

Drug treatment is usually called 'HAART' which stands for 'Highly Active Anti Retroviral Therapy'. HIV is a type of virus called retrovirus, so antiretroviral drugs are drugs which work against retroviruses.

There are three main groups of drugs:

• Nucleoside reverse transcriptase inhibitors (NRTIs)
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
• Protease inhibitors.

Usually, three different drugs from at least two of these group are taken together, two or four times a day.

How treatment works

The drugs control the virus by stopping it from making copies of itself inside the cells of the body. The virus gets into a body cell and starts to make more copies of itself, which then spread out of that cell and into another. Drug treatments interfere with the chemicals that the virus uses to make these copies. One of these chemicals is called ‘reverse transcriptase’, and the other is called ‘protease’. So reverse transcriptase inhibitors stop reverse transcriptase from working, and protease inhibitors stop protease from working.

The virus can become resistant to the drugs, which means that they won’t work as well. The treatment may then have to be changed to a different combination of drugs.

People taking drug treatment for HIV will probably need to take it for the rest of their lives. Stopping drug treatment even for short periods of time can cause the virus to become resistant to those drugs. A lot of research is being done in this area, to see if people with HIV will be able to take short breaks from treatment without harmful effects. This may be a possibility for the future, but at the moment, it is not recommended that anyone interrupt drug treatment without medical advice.

The drugs cannot eliminate all of the virus in the body, but they can control it. People on treatment will still have HIV in their body, even when blood tests show the virus is 'undetectable'. Although an 'undetectable' result is good news, it means that as far as that test can tell, it can’t find virus in the blood. A more sensitive test could possibly still find some virus, and also the virus may still be found in the semen or in the lymph glands.

Treatment does not stop someone with HIV from being able to pass on the virus through unprotected sex or sharing needles.

Side Effects

Some of the most common side effects are:

• Nausea (feeling sick);
• Diarrhoea;
• Tiredness;
• Difficulty sleeping;
• Headaches;
• Peripheral neuropathy (problems with the nerves in the legs, such as pain);
• Lipodystrophy (changes in the way body fat is distributed around the body).

Side effects are a big problem with treatment, although it would be unusual for someone to get all of them at the same time. Sometimes the side effect can be controlled with other medication, or is not too severe and can be tolerated. Sometimes treatment regimes need to be altered because of side effects. There is some good advice about side effects available on the Internet from Project Inform, access through www.thebody.com

You could also talk to your doctor or a Treatment Officer at your State HIV/AIDS office.

Testing

The two blood tests which are used to see how well the treatment is working are the viral load test and the CD4 count.

The viral load test measures how much virus can be found in the blood. Usually, people who are just starting treatment will have high levels of the virus. One of the aims of the treatment is to reduce this level until it is ‘undetectable’, which means the test cannot fin any virus. It doesn’t actually mean that all of the virus is gone, but it does mean that it is under control.

The CD4 count measures how many of a certain type of white blood cell can be found in the blood. This is also sometimes called the ‘t-cell count’. The CD4 count is one way of seeing how well the immune system is working. The higher the CD4 count, the healthier the immune system is. This means that the risk of other infections, such as pneumonia, is much less. One of the aims of treatment is to see the CD4 count go up, showing that the immune system is getting stronger.

Some people with HIV use other types of therapy, either alone or with their treatments. (see Complementary Therapies information sheet)

For More Advice:

• A doctor who specialises in HIV
• Education and Resource Centre – Tel. (03) 9076 6993
• Melbourne Sexual Health Centre Treatments Officer – Tel. (03) 9347 0244
• Straight Arrows – Tel. (03) 9276 3792
• Treataware Line - a free telephone service staffed by trained HIV educators. Mon to Fri 2pm - 7pm - Tel: 1800 817 716 www.treataware.info
• Victorian AIDS Council (03) 9865 6700
• Victorian HIV/AIDS Service, The Alfred, Infectious Diseases Outpatient Clinic – Tel: (03) 9076 6081

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11. CONSIDERING TREATMENTS – TREATMENT OFFICERS

Over the past decade or so there have been many changes in the way HIV is understood and managed. These changes have led to great improvements in treatments and management and have greatly increased the options available to people today with HIV. As a consequence of these developments many people are living longer and staying well with HIV.

The changes which have led to these improvements include:

• A clearer understanding of how HIV works inside the body.
• A range of antiretroviral drugs which can act in different ways against the virus and are used in combination to treat HIV.
• The use of the viral load test measuring the amount of HIV circulating in your blood has become standard practice in Australia. The results of this test can help in making treatment decisions. It can also show how well the treatments are working against HIV.

Your principal source of information on treatments will be your specialist. People often find, however, that they want to discuss at length the various issues surrounding treatments, including how there lifestyle may impact on the sometimes very strict compliance required by the drugs. People are also often interested in how to deal with side effects, and other issues such as diet.

Treatment Information Officers available in the Straight Arrows/Positive Women Positive Edge Project, other HIV related organisations throughout Australia are able to discuss such issues as:

• When to start treatments;
• What combinations are best for you;
• Viral load;
• Antiretroviral treatments;
• Resistance;
• Tips to help stop the development of resistance;
• Compliance;
• Monitoring and changing combinations;
• Treatment breaks;
• Tips to help manage side effects;
• Nutrition;
• Complementary therapies;
• New developments;
• Other resources and support services available.

Some contacts

Jim Arachne
Victorian AIDS Council

Tel: (03) 9863 0444

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12. COMPLEMENTARY THERAPIES

What does the term ‘Complementary Therapies’ mean?

(def.) complementary… 'that which completes'

Complementary therapies are those that can be used to supplement or replace traditional medical treatments.

Complementary therapists are specifically trained practitioners who can assist you in assessing which of a wide range of therapies can be of benefit to you.

What are the most commonly used of the wide range of complementary therapies?

National surveys in recent years have highlighted the following as the most frequently utilised:

• Nutritional supplements, i.e. vitamins and minerals
• Massage
• Herbal therapies
• Meditation
• Acupuncture.

Detailed information can be accessed via the internet.

www.sfaf.org/beta
A Bulletin of experimental treatments for AIDS

www.treataware.info

www.thebody.com

www.hivresources.com

Organisations

Check if your local state or territory AIDS council or PLWHA organisation has a designated person to help you with treatment queries.
Victorian AIDS Council - Vince Boyd - Thurs, 4.30pm - 9pm by appointment - (03) 9863 0444

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13. HIV & HEP C COINFECTION - A GUIDE

The liver, hepatitis and viruses

Hepatitis means inflammation of the liver, a condition where the liver gets hot, swollen, red and painful. Many different things (alcohol, drugs, viruses, bacteria, poisons) can cause inflammation of the liver.

The liver is part of the digestive system. An adult’s liver is about the size of a football and is located behind and slightly below the right side of the rib cage. Millions of liver cells do the essential work of filtering poisons (including drugs and alcohol) from the bloodstream and changing the foods we eat and drink into chemicals that the body can use for energy, maintenance and growth.

A virus is a microscopic parasite. 5 different viruses can invade and reproduce inside the liver, causing hepatitis. The different viruses that inflame the liver are called Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, Hepatitis E and Hepatitis G. All 5 hepatitis viruses infect the liver, but all are completely different from each other in terms of how each virus is spread and the long-term effects for the person who is infected.

Hepatitis C is one virus that reproduces itself inside the liver cells of infected people. If the virus infection is long term the ongoing inflammation of liver cells can cause permanent damage to the liver.

In the liver of the person who has Hepatitis C, the virus is multiplying and damaging the cells, meanwhile the body is constantly repairing itself with new cells. Chronic Hepatitis C is like a marathon race between the Hepatitis C virus and the liver, with the immune system always trying to stop the virus.

You can assist your liver to win this race by treating your body well with good low fat diet, lots of fruit and veggies, little or no alcohol and a balanced combination of exercise, rest and relaxation. Getting vaccinated against Hepatitis A and B will also be useful (because it protects your liver from other invaders).

There is also the option of Interferon based treatment which aims to clear Hepatitis C out of the body altogether. (See information on treatments).

None of these are measures guaranteed to stop the progress of Hepatitis C liver damage, but for co-infected people all are worth a try.

What does Hepatitis C do to people who are co-infected with HIV?

If Hepatitis C reproduction continues unhindered, causing continual liver inflammation the outcomes are serious. Fibrosis is the scar tissue that forms in the liver after it has been inflamed for a while. Cirrhosis occurs when the liver has been inflamed and has been forming scar fibrosis for a long time. At this stage the liver cannot filter the blood due to loss of liver cells and scarring that blocks the flow of blood between the cells.
Cancer is the end product of years of inflammation, fibrosis and cirrhosis. Surgery to remove tumours does not extend life for long.

What happens if a HIV positive person also has Hepatitis C?

HIV causes immune suppression, this allows Hepatitis C to reproduce rapidly, increasing the rate of damage to the liver. Destruction of liver cells is indicated by abnormally high levels of ALT (Amino Alaninetransferase ) in the blood (revealed on Liver Function Tests). Some destruction (and replacement ) of liver cells is normal, but raised ALT levels indicate that more than the usual numbers of cells are being destroyed. The destruction of liver cells may (or may not) be caused by Hepatitis C; Other things like drinking too much alcohol can also destroy liver cells (and even too much coffee or stress can cause raised ALT levels, so can strong medicines such as anti-retroviral medicine for HIV).

But even if ALT levels seem to be continuously high, this does not measure the level of permanent damage that has been done by inflammation. It also important to know that once the liver is severely scarred (cirrhosis) ALT levels can read 'normal' even though the liver is quite damaged. People can feel very sick or fatigued with Hepatitis C but their ALT levels read 'normal'; this is quite common and reflects on the shortcomings of ALT readings as a precise diagnostic tool.

Some broken liver cells would have been replaced by perfect new liver cells, others replaced by scar tissue which eventually accumulates causing blockages between liver cells and the bloodstream. Only a liver biopsy (where a tiny piece of liver is pinched off by a needle) viewed under a microscope can show exactly how much damage (fibrosis) has accumulated. Liver biopsy results are graded on a scale of 0-4. 0= no damage 1=mild fibrosis (scarring) 2=medium fibrosis 3=bridging fibrosis 4=cirrhosis fibrosis. Cirrhosis is a serious illness. At that stage the liver is struggling to perform any of its vital functions.

One of the liver’s functions is to process medicines. People who are HIV positive may require combinations of Antiretroviral drugs to keep the HIV load down allowing their CD4 count to stay high. All medicines are processed by the liver in order to have the required effect in the body. Some antiretroviral drugs are especially difficult for the liver to process. If the liver is damaged its capacity to process drugs is also damaged. A scarred liver is severely impaired and that liver may not process medicine properly (thus preventing the body from getting the full benefit of the drug). The liver may even be poisoned by a medicine that would not be poisonous to a healthy liver.

Why look after my liver when I have HIV anyway?

People who are co-infected with Hepatitis C and HIV need to keep their liver intact so that their liver will be able to process any Antiretroviral drugs that can fight HIV to keep the immune system intact. Where possible, co-infected people may wish to take the chance (through Interferon based Treatments) to eradicate Hepatitis C from their system. There is no way to cure HIV, but there is a chance of getting rid of Hepatitis C.

Hepatitis C Helpline 1800 703 023 recommends that you consult with a doctor who is expert in co-infection and ask if there is any good reason why you should not be prescribed combination Pegylated Interferon with Ribavirin. If there is good reason (perhaps a heart condition or potential for bad interaction with your HIV drugs) then ask for the next most effective treatment.

Pegylated Interferon & Ribivarin

This medicinal drug treatment involves shallow injections (Interferon) once a week, as well as tablets (Ribivarin) for period of six months or a year. The success of any treatment is usually measured by the evidence of no Hepatitis C virus detectable in blood at the end of treatment and then 6 months later.

Interferon based treatments are often associated with serious side effects; up to 15% of people who commence these treatments stop taking them because of side effects. Some people experience few or no side effects. Because of the potential for severe depression, anxiety and mood swings, good clinics are ensuring that clients are not depressed before commencing treatment and monitoring patients carefully throughout the treatment.

It is highly recommended that people undergoing Interferon treatments have supports in place such as close and expert monitoring of depression, anxiety and irritability; access to good counseling and support groups for the person undergoing the treatment and also those who live with them.

Side effects of Interferon based treatment may include:

• 'flu like' symptoms (fevers/chills,muscle aches, joint aches, fatigue);
• headaches;
• nausea and/or vomiting;
• insomnia;
• hair loss;
• depression, anxiety, mood swings;
• thyroid disorders;
• blood disorders including serious anaemia;
• heart complications related to serious anaemia.

NB: It is strongly recommended that clients (male and female) do not attempt pregnancy while on Rebetron or for 6 months afterwards because birth defects are likely to occur.

Interferon is a neurotoxic drug; that means it is irritating of the brain. Depression, anxiety and irritability can be very serious side effects. Remember if you are freaking out on Interferon it is not you it is the drug- call the clinic or your counselor and get help immediately. If you are watching your partner freak out on interferon – get help. Side effects can be managed, but don’t try to do it alone.

Before commencing Interferon based treatments ensure that the Liver Clinic send you to a psychiatrist for expert assessment and/or treatment of depression. Even if you are assessed as 'not depressed' before commencing Interferon based treatments, it important to be aware of the signs of depression in case it overtakes you during the treatment.

If you are overwhelmed by such feelings, seek help immediately.
It is important to remember that Interferon induced depression does not mean that you are losing your mind; it is a side effect of Interferon and therefore can be quickly relieved with professional assistance.

Hepatitis C Transmission

Hepatitis C is transmitted only when the blood of a person with Hepatitis C gets out of their bloodstream and into the bloodstream of another person. Even tiny specks of blood can carry Hepatitis C into the bloodstream when there is an open break in the skin.

It is perfectly safe to live with a person who has hepatitis C. Hepatitis C is not transmitted by sharing cups, glasses, food, drinks, eating utensils, bathrooms, soap or towels with people. Hepatitis C is not transmitted through hugging, kissing or touching people. Hepatitis C is not transmitted through the semen, vaginal fluids, saliva, tears or sweat of people who have the virus. Hepatitis C is transmitted only when the blood of a person with Hepatitis C gets out and into the bloodstream of another person, this requires that both people must have open wounds, because hepatitis C must enter the second person through an open break in the skin.

Hepatitis C can be passed from person to person in any of the following activities:

• Injecting with un-sterile injecting equipment for example by sharing drug injecting equipment or through an accidental needle-stick injury where the needle has just been used;
• Un-sterile tattooing, body piercing, acupuncture needles;
• Receiving unscreened blood transfusion (in Australia before 1990);
• Use of un-sterile medical, surgical or dental instruments where blood is exposed;
• Ritual blood exchange, for example 'blood brothers';
• Sharing razors, tooth-brushes or manicure equipment with a person who has Hepatitis C;
• Hepatitis C positive mother delivering baby but ONLY if mother’s blood gets under baby’s skin.

If you are co-infection with HIV and Hepatitis C, the risk of transmitting Hepatitis C greater because co-infection increases the HCV viral load in your blood.

What does this mean for sex

Co-infected people may pass on Hepatitis C through unprotected sexual penetration if blood gets out and into the bloodstream during sexual penetration. However HIV is the greater concern for sexual penetration. Correct condom use can prevent the spread of HIV.
If a person has both HIV and Hepatitis C, only safe sex barriers such as condoms can protect sex partners from transmission.

What does it mean for childbirth

A mother who is co-infected with Hepatitis C and HIV is more likely to pass HCV onto their babies during birth. While there are now are very effective drugs to prevent maternal transmission of HIV, only avoidance of breaking baby’s skin can prevent Hepatitis C transmission.

Prevention – how to stop the spread of Hepatitis C.

Because Hepatitis C is only a blood-borne virus, people with Hepatitis C pose no threat to anyone in the home or workplace as long as everyone is 'blood aware'. Blood awareness means always treating everyone’s blood as potentially able to cause infection:

• Cover up any open cuts and sores with band-aids.
• Do not share razors, nail files or toothbrushes with other people.
• Always wear disposable rubber gloves when giving first aid or cleaning up blood spills.
• When injecting drugs, do not share needles, syringes, swabs, tourniquets, filters, water or spoons.
• When injecting, clean the table and wash your hands before and after each hit.
• When you get a piercing, tattoo, acupuncture or dentistry; make sure the job is done by a professional who uses new needles, properly sterilised equipment, gloves, and (for tattoos) individual ink pots.
• Dispose of bloody needles or sharp instruments in a strong plastic sealed container such as a plastic drink bottle with a lid (or the yellow Sharps Disposal containers that are available free at the local Needle & Syringe Service).
• Dispose of soft blood stained material a leak-proof plastic bag.
• Clean up blood spills with paper towel; then wash area with warm, soapy water and finally, wipe area with bleach.

Testing for Hepatitis C

Who should get tested for Hepatitis C?

If you have:

• injected IV drugs;
• received un-screened blood-transfusion (Australian Blood Banks started screening for Hepatitis C in 1990, but in many other countries screening still does not occur);
• had un-sterile tattoo, body piercing or acupuncture;
• had surgical or dental operations in un-sterile conditions;
• shared razors, toothbrushes, manicure equipment with someone who has Hepatitis C.

If you think you have been exposed to Hepatitis C you can have blood tests to find out for sure. You must specifically ask for Hepatitis C blood tests. If you have HIV, it is possible that Hepatitis antibody may not show up in a blood test that looks for Hep C anti-bodies. Health care workers must use the PCR blood test for Hepatitis in order to get an accurate result.

If I have Hepatitis C can I drink alcohol?

Alcohol is toxic to liver cells and causes inflammation. If alcohol induced inflammation is continual, the ongoing damage will eventually lead to scarring of the liver.

In the liver of the Hepatitis C Positive person, the virus is slowly multiplying; this causes inflammation and eventually may do enough consistent damage to cause scarring. Partly Because Hepatitis C is slow and the liver repair is very fast, only a minority of people with chronic Hepatitis C will accumulate enough Hepatitis C related liver damage to cause life threatening illness.

Alcohol consumption damages liver cells; Hepatitis C replication damages liver cells; The combination of alcohol consumption and Hepatitis C means more liver cells are damaged (than by alcohol alone or by Hepatitis C alone) so this increases both the likelihood of and rate of serious liver damage (scarring, fibrosis and cirrhosis).

Some people need help with strategies for cutting down on alcohol or giving it up, Drug & Alcohol Helplines can refer to professionals who can help people to control their alcohol consumption.

Symptoms of Hepatitis C

Some people with chronic Hepatitis C experience some or all of the following:

• 'flu like' symptoms (fevers/chills, muscle-aches, joint aches, fatigue);
• indigestion -difficulty digesting food especially fatty/fried food;
• poor appetite, nausea or vomiting;
• pain under ribs on right side of abdomen;
• 'foggy brain' and poor concentration and/or headaches;
• psoriasis (patches of red, scaly flakey skin rash) and/or itchiness
• irritable bowel syndrome and/or diahorrea;
• hormonal imbalances including disruption of thyroid functioning and/or menstrual cycle;
• severe hang-over (disproportionate to alcohol intake);
• fatigue (severe and debilitating tiredness) which can be ongoing or occasional;
• depression, mood swings;
• social isolation related to labeling as 'IV drug user'.

Who do I need to tell about Hepatitis C?

A person with Hepatitis C is not legally obliged to tell anybody about having Hepatitis C. People with Hepatitis C do not pose any risk to their family, friends, workmates or health care workers.

Hepatitis C is a widely misunderstood condition: ignorance, fear, prejudice and discrimination are common. On Hepatitis C Helpline we hear many stories from callers who have told their employer, dentist, workmates even sometimes friends or family members only to find out later that they experience discrimination because of that disclosure. We advise callers to think very carefully before telling ANYBODY about their Hepatitis C status. Deciding who to tell or not tell can be difficult.

If you choose to confide in a trustworthy person who cares about you it is important to work out the details of HOW, WHEN and WHERE to break this often shocking news. Generally it is important to reassure the person that you pose no risk to them or to others (unless sharing injecting equipment).

Remember that many people do discriminate; so before telling anyone about having Hepatitis C, think very carefully about whether or not it will be good for you if they know.

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14. TRANSMISSION AND PEP

HIV+ ?

Concerned your partner or family member may have been accidentally exposed??? Sometimes people are concerned with transmitting the virus to others, for example in a domestic situation, or condom failure.

Many of these concerns are based on misinformation, media hype or outdated data. At Straight Arrows, for example, we still receive the occasional call regarding transmission via mosquitoes, when this has been accepted as not viable for many years. On the other hand, there are still some that believe the contraceptive pill will protect against sexually transmitted infections, including HIV.

In a domestic situation, particularly, these risks are nearly always virtually non existent. The concerns people have, however, are real, and should be dealt with. Discussion of what actually constitutes a risk in the real world is vital for your own well being as well as your family. Talking to an experienced HIV specialist is essential to having a general understanding of transmission, and particular situations as they arise.

Occasionally, there will be sufficient concern for a specialist to consider a preventative intervention to be appropriate. This is most often in the context of a sexual encounter and is called PEP.

Consider PEP (HIV Post-Exposure Prophylaxis).

What is PEP?

It is a type of drug therapy for HIV that is designed to reduce (but not eliminate) the possibility of infection with HIV after a known exposure. PEP is primarily intended for the prevention of HIV in cases where there has been a KNOWN HIGH RISK of transmission.

It has been found that there may be a window of opportunity in the first few hours or days after exposure to HIV. During this time a course of medications may be able to prevent establishment of HIV in people who did not have HIV prior to exposure. We currently do not know how effective PEP is. Taking PEP will not guarantee that a person who has been exposed will not contract HIV.

For PEP to be most effective you will need to access it within 72 hours. The earlier it is accessed the more effective it may be. It is recommended that even after 72 hours you still contact your HIV specialist to discuss your options. A health care professional can assess your situation and determine the likely risk of exposure to HIV, and then a shared decision will be made if PEP is appropriate. This is not a simple drug treatment and needs to be taken for 28 days.

How to access PEP

A PEP program is available at the Alfred Hospital, some specialist GPs and emergency departments. Please call the PEP Telephone Information Line to talk to a nurse about your options and where to access PEP on 1800 889 887 (24 hours).

WHO CAN I TALK TO?

• Victorian NPEP Service - 1800 889 887
• Your GP if he or she is a specialist in HIV medicine.
• Specialist HIV Physician – The Alfred – (03) 9076 6081
• Counselor – Infectious Diseases Social Work Team – (03) 9076 3026

For written information:

Education and Resource Centre

(03) 9076 2995, (03) 9076 6993

You can also receive support from:

Positive Women

(03) 9076 6918

Straight Arrows

(03) 9276 3792

VAC

(03) 9865 6700

Connectline, HIV and Sexual health line

1800 038 125

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15. MEDICAL CENTRES

Often people make enquiries relating to appropriate, HIV+ friendly services. Listed below are some of the better known hospitals and group practices in Victoria and interstate. This is not an exhaustive list, nor is it a list of recommendations. There are many service providers that we have not had room to include. Contact Straight Arrows, another PLWHA organisation or the state AIDS Council for the details of other service providers.

VICTORIA

Alfred Hospital
Infectious Diseases Unit

Prahran 3181
Tel: (03) 9076 3009

Melbourne Sexual Health Centre

580 Swanston Street
Carlton 3053
Tel: (03) 9347 0244
Fax: (03) 9347 2230

Carlton Clinic

88 Rathdowne St
Carlton 3053
Tel: (03) 9347 9422

The Centre Clinic
VAC

77a Fitzroy St
St Kilda 3182
Tel: (03) 9525 5866

Middle Park Clinic

41 Armstrong St
Middle Park 3206
Tel: (03) 9699 4626

Monash Medical Centre

246 Clayton Rd
Clayton 3168
Tel: (03) 959 44564

Prahran Market Clinic

131 Commercial Rd
South Yarra 3141
Tel: (03) 9826 4500

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16. SELECTED HIV WEBSITES

Access Information Centre At The Alfred

http://www.hivhepsti.info
Provides up-to-date links to a range of useful HIV web sites. Use the HIV page instead of bookmarking all the sites! Includes an information request button for those who prefer to get information over the Net or who would rather be anonymous. Send your question and Gill Syres, the Centre’s Health Educator, will reply via email.

AFAO (Australian Federation of AIDS Organisations)

http://www.afao.org.au
If you have missed your copy of HIV Herald, back copies can be found on this web site. The latest AFAO treatments brochures are also here.

aidsmap/NAM (UK)

http://www.aidsmap.com
There’s all sorts of useful things on this web site. The information is very up-to-date and you can usually find fact sheets on any treatment or infection (use the search button). Some information can be a bit technical. It has a personal pill planner to help you think through treatment options. It also has the latest news on treatment issues such as lipodystrophy.

CATIE
(Community AIDS Treatment Information Exchange, Canada)

http://www.catie.ca
This web site has a range of fact sheets on treatments and infections. They are relatively short (1-2 pages) and well-researched. They have also produced some Plain and simple sheets on treatments, which are exactly what they claim to be.

HIV/AIDS Documentary (Australia)

http://www.hivaids.webcentral.com.au
If you want to read other people’s stories or contribute your own, this is a good web site to visit. It’s growing quickly and includes stories, discussion threads and articles from Talkabout.

Positively Aware Drug Guide

http://www.tpan.com/publications/drug_guide/drug_guide_2001.html
For straightforward information on new antiretroviral treatments. For each drug there is a description of the drug and short reports from the manufacturer, an HIV specialist doctor and an HIV activist.

Project Inform (USA)

http://www.projectinform.org
For detailed fact sheets on treatments and infections. It’s easy to find information on this site. The fact sheets are prepared by treatment activists and walk you through all of the issues to consider when thinking about going on treatments – or when you wonder what is happening to you. Fact sheets are based on current clinical trials. They are usually fairly detailed and can be a bit technical at times.

The Body (USA)

http://www.thebody.com
A very popular web site and full of little treasures. Many people find the Ask the experts section to be very helpful – you can send your own question to the specialists at The Body or just read other people’s questions and answers in the Q & A Forums. It has links to magazines like POZ in the Finding and getting help section. There are also a whole assortment of fact sheets etc linked under various subjects.

Hepatitis

Project Inform Fact Sheet, Oct 2000
http://www.projinf.org/fs/hepatitis.html

A detailed fact sheet on hepatitis with some of the recent research on hepatitis C co-infection and treatments for people who are co-infected. You need to read right down to the end of the fact sheet to catch all of the latest updates. Australia is currently participating in an international trial on Pegylated interferon/ribavirin therapy which is not discussed in this fact sheet as the results aren’t available yet.

Hepatitis C Treatment and Prevention page

http://www.thebody.com/treat/hepatit_c.html
This page has a long list of links to various fact sheets on the basics, treatments and prevention.

Also,

National AIDS Manual, UK web site

http://www.aidsmap.com
Use their Search box on the home page to search for hepatitis C and you will get a variety of fact sheets and treatments reports.

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17. ACKNOWLEDGEMENT

It is with gratitude that Straight Arrows thanks the following organisations and people for providing information/text and expertise to us in our preparation of this kit:

• AFAO – Aust. Federation of AIDS Organisations
• AIDS Housing Action Group Vic. Inc Positive Women Victoria Inc.
• AIDSLINE
• The Alfred Hospital – ID
• The Alfred Hospital – Access Information Centre
• The Alfred Hospital – Dr Ann Mijch
• Australasian Society for HIV Medicine
• The Sanctuary – Sydney - Mac McMahon
• Centrelink
• Country AIDS Network Victoria
• HALC (HIV/AIDS Legal Centre (Vic.)
• Life Line
• National Association for loss & Grief (Vic)
• People Living With HIV/AIDS
• Victorian AIDS Council
• Victorian AIDS Council – Jim Arachne, Complementary Therapist Treatment Officer

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