“I’m HIV-positive: What should I do?”

The queries I find most troubling are from people told they are HIV-positive who ask for advice.
The central problem is that HIV/AIDS dogma has so dominated research that no universally applicable answer can be given — there are too many possibilities and too many unknowns. Sometimes “HIV-positive” stems from a health-threatening condition, sometimes from a condition like pregnancy that does not threaten health, and there’s no quick sure way to distinguish between those possibilities.
Because “HIV-positive” sometimes reflects the presence of some sort of threat to health, on average the rate at which people test positive increases as general fitness declines or ill-health increases:

Note that having TB virtually guarantees testing “HIV-positive”, as does drug abuse. That gay men tend to test poz so frequently can be explained at least in part by the intestinal dysbiosis hypothesis, with its ironic corollary that commonsense “hygiene” — douching — may actually be harmful. Some vaccinations (flu, hepatitis, rabies, rubella, tetanus) have been reported to produce a false-positive “HIV” result, as have blood transfusions, dialysis (or kidney failure), organ transplants, and some other medical interventions, as well as a variety of infectious and non-infectious illnesses (Christine Johnson, 1996).
It follows that the best advice for people newly testing “HIV-positive” is to have an unbiased physician do as complete a physical examination as possible, in order to identify any health-threatening condition that might be present. In the earliest days of the AIDS era, Dr. Josef Sonnabend cared for AIDS patients by treating their manifest illnesses and urging them to adopt a generally healthy lifestyle; under such care, even someone who already suffered “full-blown AIDS”, like Michael Callen (Surviving AIDS, HarperCollins 1990), could live for more than a dozen years without resort to antiretroviral drugs. In the modern era, Dr. Juliane Sacher (AIDS as intestinal dysbiosis) and Dr. Claus Köhnlein (Duesberg et al., “The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition”, Journal of Biosciences 28 [2003] 383-412) have attained excellent results by caring for “AIDS” or “HIV-positive” patients in similar fashion, treating the manifest illnesses; patients of Sacher and Köhnlein had far lower mortality than that reported in Germany overall for people treated in the conventional manner with antiretroviral drugs.

How many “HIV-positive” people are actually at some health risk?
If one tests “HIV-positive” in absence of any symptoms of illness, what are the chances that a health risk is actually present?
One answer comes in data from the Centers for Disease Control and Prevention for incidence of “HIV”, diagnoses of “AIDS”, and mortality from “AIDS” or “HIV disease”: something like 50% of “HIV” diagnoses are false-positive in the sense of not reflecting any health-threatening condition; or, one might regard these as what the mainstream calls “long-term non-progressors” or “elite controllers” (What numbers mean: 50% of “HIV-positives” are long-term non-progressors).
Another answer was published last year by Sighem et al. (“Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals”, AIDS 24 [2010] 1527-35): “The life expectancy of asymptomatic HIV-infected patients who are still treatment-naive and have not experienced a CDC-B or C event at 24 weeks after diagnosis approaches that of non-infected individuals”. “Asymptotic” of course already implies not having suffered a CDC-B or -C event, which are respectively “symptomatic conditions” and “AIDS-indicator conditions”. If there are no signs of any illness, in other words, no abnormal symptoms, then “HIV-positive” in itself is nothing to worry about. One great wickedness of HIV/AIDS dogma is that it instills great fear and inflicts great psychological harm on many people for no good reason; perhaps half of all those who test “HIV-positive” are worried needlessly.
Sighem et al. estimate that an asymptomatic 25-year-old “HIV-positive” individual not taking antiretroviral drugs can expect an additional more than 50 years of life: 52.7 for males, 57.8 for females. The numbers for the general population (the data are for the Netherlands) are 53.1 and 58.1 respectively. The deficit for “HIV-positive” people, 0.4 years in 53.1 and 0.3 years in 58.1, is meaningless given the assumptions and uncertainties in the calculations.
Sighem et al. — and a number of other articles on this and related topics — acknowledge the uncertainties inherent in comparing HIV-positive and HIV-negative people because there may be other characteristics that are not randomly distributed between those two groups; for example, smoking has been reported to be more frequent among “HIV-positive” people, as well as excessive use of alcohol. This sort of uncertainty underscores that differences like those estimated by Sighem et al. (between 52.7 and 53.1, or between 57.8 and 58.1) cannot be taken as significant.
Those of us who do not accept HIV/AIDS dogma will find more serious uncertainties in these articles. We would agree, of course, with the overall conclusion reached by Sighem et al., that an asymptomatic condition of “HIV-positive” predicts no significant shortening of life. But we might then go further, to extrapolate from this that deaths of symptomatic “HIV-positive” people are owing to a variety of causes other than “HIV”. Some of Sighem et al.’s data seems in accord with this. For supposed homosexual and heterosexual transmission respectively,  “HIV-positive” people died at rates of 4.6 and 7.2 per 1000, but those purportedly infected through injecting drugs died at 4 or 5 times that rate (32.7/1000); for alcohol abuse the ratio was about 2.5 (16.1 vs. 6.3). One might well argue that drug abuse, or alcohol abuse, were the salient reasons for those deaths, nothing to do with “HIV”.
Sighem et al.’s prognostication of no life-shortening for asymptomatic “HIV-positive” people not treated with antiretroviral drugs seems to be better than that for “HIV-positive” people treated with antiretroviral drugs. Lohse et al. (“Survival of persons with and without HIV infection in Denmark, 1995–2005”, Annals of Internal Medicine 146 [2007] 87-95) estimated that 25-year-olds diagnosed with HIV and undergoing HAART had a median survival of an additional 35 years, which is considerably less than the >50 years for asymptomatic untreated “HIV-positive” people.
AZT, of course, actively killed people in the years before monotherapy was replaced by HAART cocktails; the immediate drop in mortality when HAART was introduced indicates that AZT monotherapy treatment had been responsible for some 150,000 deaths  (HAART saves lives — but doesn’t prolong them!?). AZT (Retrovir, zidovudine) and other NRTIs (Nucleoside-analogue Reverse-Transcriptase Inhibitors) continue to be components of many HAART treatments; that the doses are smaller than with earlier monotherapy doesn’t make them non-toxic, it just means that they kill less rapidly or less surely or cause non-lethal damage. Indeed, the Treatment Guidelines issued by the National Institutes of Health acknowledge the toxicity of HAART in reporting that “In the era of combination antiretroviral therapy,  several large observational studies have indicated that  the risk of several non-AIDS-defining conditions,  including cardiovascular diseases, liver-related events,  renal disease, and certain non-AIDS malignancies . . . is greater than the risk for AIDS in persons with  CD4 T-cell counts >200 cells/mm3” (p. 13, 1 December 2007 version).
Incidentally, the universal resort to CD4 counts as a measure of the stage of “HIV disease” or “AIDS”  is not supported globally by the evidence. Some articles report a correlation between CD4 counts and clinical prognosis, others do not. Some report correlation of CD4 counts with “viral load”, others do not. Sighem et al., for instance, report that CD4 counts are “only associated with minor changes in mortality rates”.

The HIV/AIDS research literature
accords with the Rethinking AIDS position
that “HIV-positive” does not in itself define or detect a state of disease.
“HIV” doesn’t kill.

Antiretroviral drugs, on the other hand, may kill, and they certainly decrease the quality of life in a number of ways — lipodystrophy (“buffalo hump” and other distortions), premature aging, and more.

The best advice for people newly testing “HIV-positive”
is to have an unbiased physician do as complete a physical examination as possible,
in order to identify any health-threatening condition that might be present.