More on women’s sexuality
I am positive person of 16 years, having lived with the same partner since
the age of 19. After he died I found myself with little experience in the
dating world.
Little did I know I would be rejected by men once my status was disclosed.
Sexuality with HIV needs to be destigmatised. Nobody talks about it and info
on the internet is so scary and clinical no one in their right mind who is
HIV negative would consider having a relationship with someone that is HIV
positive. People are still ignorant about how HIV can be transmitted. This
isolates people living with the condition who are condemned to getting old
on their own. We need more info on how to protect partners from infection.
As a heterosexual woman, we are often forgotten about Please include a section
in your new Sex Pages on women’s sexuality and the risks or otherwise
of various sexual practices.
MM
In praise of Paul
I am a nurse at the Charleson Day Centre at the Royal Free hospital who really
looks forward to Paul’s column each issue. I am always amazed how his
writing gets me thinking. In praise of talking cures and When the shoe doesn’t
fit were particularly interesting and relevant, not only for patients but
also for friends and colleagues. I find myself reading and re-reading the
columns, then passing them around work and discussing them with friends and
patients. It’s refreshing to read articles on gay men and mental health,
topics often not discussed openly. They are well thought out and written by
a man who is honest and very considered.
I find them personally relevant too and a helpful resource to instigate discussions
with patients when appropriate. I hope Paul’s columns continue in PN
Please note these views are mine and not those of the Charleson Day Centre.
Keep up the good work
Matthew Hains, London
A column that speaks to me
As an non-signing HIV positive deaf person, I rely heavily on the written
word for help and advice. Paul Bakalite’s column was profound for me
personally as it chimed with all my experiences. I too was on a destructive
path as an HIV negative person who was beaten up by an ex and let down badly
by the authorities. I was infected with HIV and over time I suffered a breakdown.
Things are still difficult and I have just started medications. I was at a
low point until I read Paul’s article. It’s incredible to read
such an honest view of the harsh realities out there. I hope one day to reach
the same point as Paul. His article has made me more determined to protect
my life and to continue to fight discrimination. Keep publishing these view
points as it is so important to know we are not alone.
Name and address supplied
Beware mega-doses
As a doctor, I read with concern the uncritical feature on mega-dose vitamins
as an adjunct to HIV treatment (PN125). The safety of long-term megadose vitamin
treatments in HIV has not adequately been explored.
Take vitamin B6; I would not put all my faith in only one article from the
East African Medical Journal, whatever the bona fides of its authors. There
are reports of small case series for over 20 years of sensory (peripheral)
neuropathy arising in people from doses of vitamin B6 as low as the recommended
K-Pax dose of 200 or 400mg (100 or 200 times the recommended daily allowance).
Once present these deficits are sometimes difficult to reverse but can be
prevented from progressing by stopping the megadose of vitamin B6.
These reports agree it was either the vitamin; a metabolite or an impurity
that caused the problem. Once megadoses of vitamins are taken, relatively
low levels of impurities reach potentially significant levels. As I understand
it, the usual ‘acceptable’ level of impurities in vitamins is
2.5 per cent. More research into micronutrition in HIV is needed but I caution
against people becoming guinea pigs in the current days of ARVs.
Dr Ian Thompson MRCP, South London
Dr Kaiser responds
Several studies show vitamin B6 does not cause toxicity unless the dosage
level exceeds 500 mg per day. The Institute of Medicine of the US National
Academy of Sciences concluded that reports and studies showing neuropathy
symptoms at doses of B6 less than 200mg per day were weak and inconsistent,
with the weight of evidence indicating sensory neuropathy was unlikely to
occur in adults taking B6 at doses less than 500mg a day.
The double-blinded, placebo-controlled clinical trial of the K-Pax formula
found that, over 12 weeks, the incidence of peripheral neuropathy symptoms
declined in the micronutrient group by 42 per cent. While the clinical trial
only studied this formula for 12 weeks, I have been prescribing this exact
formula, at these dosage levels, to over 200 patients in my clinic for over
five years. During this time, there has never been a case of new onset peripheral
neuropathy in a patient taking this formula.
The maximum dosage of Vitamin B6 in the K-PAX Immune Support Formula is 200mg
per day. Based on the above studies, National Academy of Sciences recommendations,
and my clinical observations. I maintain this dosage over an extended period
of time is extremely safe.
Jon D Kaiser MD, HIV Specialist/Clinical Faculty, University of California
Medical School
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