Matt Jennings and Justin Roninger were doing OK on their meds—but felt they could do better. With their doctors’ help, they did.
Between working a full-time job, going to school and serving on the San Francisco HIV Prevention Planning Council, Matt Jennings occasionally missed doses of his twice-a-day HIV combo. He tried early mornings/early evenings and then late mornings/late nights in his campaign to find a steady 12-hour schedule, but neither worked.
“Taking my meds in the late morning meant I often forgot them,” he says. “Sometimes the dose came at an inconvenient time, such as in the middle of a staff meeting. But taking them early in the evening made me feel cloudy-headed at night school.”
Jennings tried using an alarm and taking pills during scheduled daily events—to little avail. “I still missed doses, making me lose faith that I would ever be able to maintain the required adherence,” he says. “I was sincerely trying, but I felt like a failure.”
The 34-year-old’s labs never wavered, but he worried that missed doses would create drug resistance. “I didn’t know how long my good luck would hold out,” he says. “I didn’t want to play with fire.”
In December, Jennings and his doctor decided he should switch to a once-a-day regimen—and he hasn’t missed a single dose since.
“I feel better about myself,” says Jennings, “and proud that I am actually able to achieve perfect adherence. I can’t promise that I will never miss a dose again, but this was a good choice.”
Justin Roninger didn’t go on meds until five years after his 1992 diagnosis—when his viral load suddenly skyrocketed. A combo of a boosted protease inhibitor (PI) and two nukes got his HIV to undetectable, with minimal side effects. Roninger finished massage-therapist training, and things were looking up—or so it seemed.
After an April 2005 back injury, however, a noticeable weight loss began to worry him. “I started to inspect myself in the mirror daily,” he recalls. “My face was getting significantly more wrinkled.” At first, he thought his sunken cheeks were a result of the overall weight drop. Then, he says, “Slowly I realized what was happening—my smile lines looked too much like those I saw on guys with lipoatrophy [fat wasting].”
Roninger read everything he could, then took the information to a heart-to-heart with his doctor. Their conclusion: It was time to switch one of his nukes, Zerit, for something else. Studies consistently link Zerit to fat wasting, so replacing it with a different nuke seemed to make sense. The decision wasn’t easy. “My meds had kept my viral load undetectable for years,” Roninger says. “Was I just being narcissistic in wanting to switch?”
Just two months post-switch, the effects are still hard to judge. But Roninger is already much happier knowing he has done something sooner rather than later about the lipoatrophy. “HIV looms over us and our loved ones,” he says. “I don’t need any more reminders of my disease.” What’s more, he says, “I can’t afford, nor would I wish to spend, thousands of dollars on temporary surgical solutions.”
Still recovering from his back injury, Roninger is otherwise happily ensconced in a new home and a new relationship, working on recording an album of his own electronic music. He’s pinning his hopes on clinical trials showing that fat wasting may be reversible. “In time, I’m hoping to see my chubby, rosy cheeks again,” he says. “Until then, I’ll keep smiling.”