Tuesdays With Lori Have ofiicially changed to tuesdays at the infusion center with all these different Nurses

So for the Last Oh six or so months I have been going to the CCU for infusions at the Wesley Critical Care Building its officially been changed to the Infusion center after 1 long year they finally have me thier first CHF patient well that it how it goes C'est La vie Such is life. So the Holidays are comeing up dont have any Idea what I am going to do I am well far reaching to think of what to Cook what to bake so Ill Be needing Ideas Yes even though I am as sick as I am I am still Providing Family Meals for everyone i love it it makes me feel useful I feel Like I am being a productive member of my family even though I am really such a burdon especially according to one of my sibs she who must not be named. Life is what it is I feel good today for now so I will sign off and get back to my meds on this machine have a wonderful day everyone Be well be blessed

 Dear Blog Followers,

  Its been one rough year . Year Fifteen has definitely done a number on me. I have been through the wringer this year with all the craziness. the health issues aren't getting better My HIV is but one of my issues. Today was A good day though. I spent all day with my loving sister it was such a blessing. you know so many are still Lacking in education about this Virus so many are very confused at how you contract this virus and there is still so much stigma. THANK YOU AMERICAN PUBLIC SCHOOL SYSTEM AND YOUR LACK OF EDUCATIONAL PROGRAMS AND FUNDING. Yes I believe many of these problems could be avoided with a little bit of education. well Namely the high rate of new infection in teens and young adults. you can not teach strict abstinence to kids teach them to properly use condoms for one you know they are going to go out and have sex damn it arm them with their biggest weapon against this virus. i know we all want to think that our children are innocent but look back on your teenage years and think about it what the hell were you doing at 15 16 years old I know what I was doing and it sure wasn't knitting. So take a moment to educate your kids there are so many helpful websites out there you can get pamphlets from the cdc directly mailed to you and there are lists and list of organizations all over the country that do free testing and Do education invite them to your kids school do an education day so they can learn where they can go to get tested for free. Arm them with the knowledge the weapons of defense and most likely they will be OK.

  Yes its a human Virus anyone can be infected HIV does not discriminate based on age sex sexual orientation race ethnicity its a HUMAN i repeat HUMAN virus.if you cannot get the message out to your kids yourselves well use someone else there is so much information out there so many educators speakers. 

 So that is my rant for today I am tired I am going to try to get a little bit of rest before I go to the hospital today treatment days suck ass what can I say its my life its not a lot its just my life be well 

Moving Day Coming Soon

SO I have been moving my sister into my house its been gradual but its coming along its really going to be great to have my little sister in my house we are so close and i love it.I am really doing better my health has been truly improving greatly. I am feeling so much better these days there of course is still stress in my life but its not a bad thing. We all need a little stress in our lives it keeps us motivated Yes I am still Single but that is Life. I was blessed to celebrate the Birth of My first grandchild Adryan David Ford A good strong Name for a good healthy warrior Grandchild.
 Well its great that my younger sister has finally changed the topic of her Blog from me to herself my family is doing better and now its better with out her lying to the world about us and this is great. She has learned to focus on herself and not the rest of is who have never done anything to her but try to be there for her.
 Life is all in all great life is well and I am doing wonderfully. My days are filled with the chemo like therapy I get for my heart and I am usually trying to just keep up on a daily basis. the house is coming along I am doing what I can just getting through each day as it comes there could be more to do if I was really slacking but I am not slacking My art is coming along more and more every single day I am feeling truly great about myself and My art people are already asking for me to commission pieces for them Ive been offered an undermined amount of money to paint for people I never thought I was really talented but I find more and more that I am sought after for my art and that makes me very very happy; Life is beautiful so it is high time to stop selling myself short I am also a great and amazing human being and that makes me feel so utterly wonderful about myself, so many people forget that I am just an average human so many people will but me on a pedestal that i am surly to fall off of and I am not going to sit here and be Idolized as I am just me.I have many talents but I am and always will be just a human I have my faults I have fallen many times and I will fall but I am human and Make mistakes to learn the lessons of this life. I am here I am going to be healthy for as long as Life allows it. And come the day I be called home it shall be a day to celebrate and not mourn but rejoice knowing I am in the arms of tankasila wakonda. Home at last.
 so as my life gets better every single day I am doing more and more to be walking a better path in this life. I am going to continue to walk in this good way and pray more and more continually helping those who need to have someone be there for them. So remember I am here still remember i am not going anywhere and remember if you need me I will always try to be there.

The Last few months and Drama

In the Last few months I have been going through a whole lot of health Issues.I have been seriously worried about whether or not I am going to make it to my next Birthday I am afraid of allot of things No I really dont want to Die but should that happen that shall happen. I guess life has its ups and downs every single day it just so happens that My life has more downs than Ups But I am dealing with each day as it comes. I have no choice but to push forward everyday. Yes its a scary road but I live each day one day at a time.
I Dont wish the Issues I have On anyone else in this world. Now it has been said I have AIDS more than once I do not have an AIDS diagnosis and Never have I have come close to being low enough to have one But I started medication and then my numbers came up it took ten years or better to go on medication I was so afraid of the medications that I feared I would Die NO I am not a denialist but I knew the full ramifications of medications at the time of my diagnosis I had been on a few of them before they were used as AIDS drugs for cancer treatments I never wanted to be on chemo therapy again yet here I am 20 years later and On something just as strong as Chemo therapy.this life was never going to be easy I know there is nothing in this world promising an easy life. Yet I wonder what life would be like if I had it a little easier but I doubt it will ever be any easier for what I go through shapes the man I am today and in the future the compassion I have learned from the very things that have shaped my life from day one.
 It often amazes me the different experiences I had from those of my siblings yes we all came from the same parents yes we all went through the same craziness and yet it remains that I am so strong where my siblings are different from the experiences. Yes we all suffered severe emotional abuses in our house we all suffered some very violent abuses from our parents and their friends and we all were hurt the thing of it is I forgave and my parents forgave themselves our family went through some very hard times and some very emotional pains and through it all we came out stronger. It although deeply saddens me that my one sibling is so emotionally stunted for all of it It saddens me that I constantly forgive and I constantly pray for those who do me so very wrong. It seems it makes me so week to forgive them all the time.I have to forgive for me not for them I do not have to allow them in my life but I also do not have to sit here and allow them to slander my name and what I do for others.
 I am always feeling now like I have to defend myself it is so frustrating that I have to defend My honor and my work. I've been educating for more than 15 years but I am in the wrong I will never stop educating I will never stop advocating the use of condoms and I will never stop advocating HIV awareness and HIV stigma.
 I will be here for a good long time advocating awareness.I just hope the stigma will end one day and one day soon I hope there will be an all out end to HIV and AIDS and a Full Cure.....
 So to end My babbling today I will close with protect yourself protect your partner  Love is Using a condom not treating your Partner like a Used Condom....Love light and Peace

MY HIV AND ME

It has been said more than once I have AIDS and am dying from it it has been said that I do not have HIV it has been said I Chased the Virus it has Been said IF I do Have HIV ive only been Pos for about two years it has finally been said I am only saying I am HIV positive because I want some kind of notoriety. Well all these stories have been published By a blood relative whome I am gracious enough not to name personally yet still finds the time to try to dispell all I am doing to help I am truly sorry for your attitude I pity you I am sorry for you but I dont have time to defend myself. I am HIV positive and have been since I was rather young I did Not chase the virus and I am living with the virus today and everyday of my life. I have come to a decision that I would co-exhist with my virus keep my self in symbiotic state with my virus and sometimes I even talk to my virus to tell my virus to cool down cause if I die So too does my virus. I am aware of my health I am aware of what I must do to live. I am not dying Of AIDS no matter what you would like to believe. I have to say if you are intent on trying to hurt me with words and get me to stop blogging and endorsing safer sex practices then you wont get any where. I am set on helping the community as much as I can and I can attest to the fact that I do not have unprotected sex. I will not be called a Liar My first diagnosis was August 5th 1998 I was re-diagnosed in order to get my Ryan White tranfered to Kansas In 2003 in those days yes just 9 years ago you had to get diagnosed over and over to prove you were positive and did not get a false diagnosis and get services fraudulently according to the system i think its mostly about trying to keep people from thier meds long enough to get them sick and keep them from services.
I dont cry positive for notoriety why would i do something like this who wants fame for being sick? that is just rediculous. SO now you know one of the few things holding my blogs back I have been writing them and then being to scared to publish them for this Family member SHE WHO MUST NOT BE NAMED . Well she is a bit off and well she is scary at times she is utterly evil to the point of psychotic so we shall from here on out either call her she who must not be named or Lady famille de la mort  for she has killed our family through deciet and dissention.

so this is the reason I haven't posted in so long so I have been praying on whether to post this or not

So its been such a tiring experience I mean really its been truly exhausting this treatments over the last five months have taken so much out of me. Some days I truly wonder is it all worth it sometimes if its all worth it ..It often baffles me how much I go through for this .I am always so tired after these treatments.often times I just get this feeling of utter discouragement as I am so fatigued and then I see the news and what is going on in the world and I feel as though it is such a waste for me to be here shouldn't a good heart go to someone far more worthy ? I don't know life is just so confusing and I have so many conflicted feelings. I have not been blogging because Of a relative who has to continuously stalk me and say vicious and evil things about myself and the rest of my family and all she does is spread filth and lies so why the hell should i keep fighting ? I mean really when my own family is so fucking evil I know her kids are going to be like that kid who shot up that movie theatre in Colorado as fucked up as she is living in a motel these kids have never known anything other than homelessness but she is the stable and sane one in this family both of my sisters I live near own their own homes and I have a very stable living environment I pay my bills with out assistance but I am the fucked up one I don't live in the fantasy of a past she has dreamt up but I am the fucked up one it seems that all there is is jealousy and disloyalty and it tears at my spirit cause she is so blatantly hurtful and evil EVIL yes I have seen the face of EVIL and it is she.. She lacks Loyalty for her family and because she lacks said loyalty my other siblings would not do a damn thing for her and now because of her lies and such like TELLING  PEOPLE I STOLE FROM MY MOM I never took a dime from my moms account that lying bitch needs to get her facts straight I was putting money in my moms account every single paycheck upwards of 500 dollars a check what ever my mom needed I gave her.I took my mom to her dialysis every other day I was up with her at 5 am taking her to her appointments and then to her Chemo who do you think you are to lie like that when you were over a thousand miles away how dare you lie like that you say that you know My ex and I was abusive to him you were in Kansas when I was with him and in Vegas you weren't even around get your facts straight you lying little bitch this is the first time I am letting this out because I am tired of your unwanted viciousness there is so much more like how i robbed your bank account when we were kids and the fact we had a joint account and my checks were direct deposited into the acct and you stole my paycheck more then once and you opened credit accounts when you lived with me in my name and you ruined my credit you are the one who stole my dads credit card number and made illegal purchases against his banking account yet I am the Liar and what did my parents do and tell me to do not take legal action against you for being a thief cause your family. fuck that I should have prosecuted your ass to  the fucking ground you little lying bitch and for the record I have all my paper work from the CDC I have had HIV since before 1998 from date august 5 1998 was my diagnosis you keep telling people I am lying about this for fame you little ungrateful piece of trash I DON'T WANT TO BE FAMOUS FOR HAVING HIV  and if you knew anything you would know that I have HIV not AIDS you say your going to nursing school yet you don't even know the difference between the two, Lord knows your sick you have done nothing but tear this family apart from day one you are ungrateful for anything anyone has ever done for you and as for My aunt Liz who let you live with her rent free and you stole from her and Kenny those are Kenny's words not hers so you are going to call him a liar too . You made your bed I pray your kids get removed and get put into a better home then what you provide for them as they deserve so much better then you as a mother. My sisters take care of their kids and are loyal to their families and you I'm glad your so far away cause if I ever see you again I swear by all that is holy nothing will stop me from ripping your eyes from your head and cutting your tounge out for spreading such filth and hate about my sisters who were there for me while I lye dying in a bed how dare you you ingrate. your cursed because you are evil to others you will never rise above the shit hole and quagmire you live in because you are truly the lowest of the low you are just plain trash and I pity you and whats more I pity your children for having to be your children they are so unfortunate and oh yeah getting married will never make you better than my sisters one of whom has several kids with several different men and the other who has three babies daddy's but you know what their husbands are better men then you will ever have for yourself and my sisters are better than you will ever imagine you could possibly be. your hate is going to do nothing but lead you down a road of disaster.and yeah I'm dying from a birth defect in my heart not AIDS you idiot if you knew anything you would know that ..and this is why I don't blog anymore this is why I stay away this Is why I don't even want to do my treatments anymore cause of the evil in my own family who is she who must not be named why because at least I who tell the truth wont name her and put her on front street like that because i Know so many of the people who she manipulates read my blog and so does she and even though what I write is the truth I wont say her name out of grace because she knows who she is and what lies and deceit she has done and what evil havoc she has wrought onto herself and her children. how you manipulated a man who had had a vasectomy and made him believe Vincent was his son all the while you were cheating on him and then went back to your sons father who impregnated you again and left you again no one will ever help you why because they cant trust you no one in my whole family will so much as let you in their homes...but I am welcome in every ones home I am asked to visit people come from across the country to see me in my family because they love me and I have shown I am a good kind loving person and worthy yet you are nothing but a thief who has unsavory people looking for you I know they came to my house and I let them Know your in FIFE Washington yup you show know loyalty I show none in return when they came looking for you here at my door and at my uncles and cousins doors I told them to let them know your in Washington and to google you and yeah so when your kids get took by the state cause you have this crap going on you probably robbed the wrong person and they want their money back and they aren't using cops or hell it could be the kids dad trying to get his kids back who knows cause you never properly filed custody on them and you forgot their biological dad has legal rights so he could be after you too so yeah good luck with that......
So I debated on if I should post this and Have decided I will its important to clear the air and get these feelings out as I have been slandered more than once by total hate speech yes there is freedom of speech But to blatantly openly publicly print such filth that is called Liable its in print and I have full rights to take full legal action against you for printing in an open forum such filth and lies about me and MY FAMILY which you will never know.You have brought such feelings of angst and animosity into my heart when all any of us ever wanted especially MY MOTHER Not yours since you disowned her and slandered and defamed her character after her death you coward. you don't deserve to call MY PARENTS yours cause you are nothing you are not a member of this family any more you have nothing ever if you ever need anything I mean anything don't contact anyone in MY family EVER .. We will no longer ever help you and your phelpian ways. My the Good Lord Tankasila Love because you have blackened our hearts to you I pray My nephew and Niece will one day be better people then you ever could be Tankasila look after these two innocent children may they not suffer from the abuse of a paranoid schizophrenic mother with serious delusions who refuses to get help Now that said I just had to let it out to let go of it May she be at peace because she has finally hurt far to many of us for too long..

its been a while I know lifes been a bit crazy of late

So today was a great day it was Rosin's Birthday I went to Eva's Spot and dropped him off a cake I was so glad I was able to do that. I love doing for my family its such a precious gift to be able to give.Life isn't always about doing for yourself I know I cant do everything for everyone I just don't have the finances for all that but it feels so good to be able to do what I can. I cant wait till i can go back to work once I get a new heart I can go back to work i will be so much better off if i can just go to work. This 698.00 a month just doesn't pay all my bills and its just not enough I am so use to getting paid so much more and this is ridiculous. But one thing I can say is now I am doing a great job with what I have I have been able to help allot of people with what little I do have and that is an amazing feeling to be able to give back.
   Although I have been missing My birth mom Lately I have a great adopted mom who well is my biological aunt but she is now my mom in the Indian way so those of you who may get confused I have a living mom my birth mom did although pass away. I know its hard for many to understand My culture but its not hard for me I live on my path I love my traditional lifestyle and Yes I am who i am because of all of it .
  I must take a moment to apologize for not blogging in so long as many of you know I have an Internet stalker who happens to be my biological sister and who is a serious blight to me and My family she sits here and slanders us I know she will read this and then try to slam me on her blog she says things like I am not POS but turns around then says I have aids and doesn't even know the difference between the two. Then makes accusations against my entire family and well Its really hard to be a free speaker when you have a person with psychotic delusions tearing you down at every turn I am sorry she feels this way and has come to the point in her life that she is at but she made her mistakes and she turned her back on her family and used them up till every bridge was burned there is nothing that I can do to help her so I pray for her with that said I don't want anyone to be hurtful to her as she is living in a fallacy and a fantasy she can do no harm because she is a liar and cannot do any more to hurt me or the rest of my family she has at every turn gone to great lengths to do harm and she says she is going to school to be a nurse but one of the first things you learn is do no harm well she will not succeed as long as she is out to do harm so I pray for her she lives in a hotel motel or something like that she is homeless with her two children and her husband so I truly feel sorry for her me and my other family are all in our own homes and have it together even though I am ill she tries to diminish everything I do to help others and its just not working her jealousy over the fact that she has nothing and we have a whole lot more is what drives her hatred for us which is in fact hatred for herself because she has never been successful at anything she has tried her hand at because she cant get over her Idea of our families past. So that said I pray for my sister whom I do not mention her name because I am not like that I do not slander her I do not name her but when she reads this Of course she will know its she I am speaking of just know I pray for You i hope nothing but the best for you...  
     So now to let you know about my health I was in emergency on Friday for my heart the first time i had a real issue in months but i am OK no raised troponins my HIV is still undetectable and I still have yet to be given an AIDS diagnosis so all in all My health is doing OK I am rather sure of myself that I will make it through to my birthday in December and I am sure I will make it to my medicare date of April 1 once I get there i go on the list for a new heart so till then it is eat right keep my diabetes in check keep my kidneys and liver function good and then from there I am home free.I really cant wait till all this is behind me I am hoping for a functional cure to come soon for HIV there have been two patients who have so far to date been Cured of the virus I am praying for the day to come that it is a functional cure for all so one day that will come till then it is my obligation to teach ...

Somedays feel like forever

So I got upset with my family recently some of it was unwarranted but I had so much going on still do its not easy with all of every thing going on I really scared my family. Not because of my HIV but due to my other health issues yet through it all we were still a family now out doesn't feel so much like it my sisters are do damn over protective and shit  it just makes me feel extremely Emasculated and they don't understand it I am more than of age and this is my life yet they sit here and judge me or tell me to do things as they want them don't and when i lash out because its too much for me to bear its all yeah see what i mean so I am right your unstable and such I feel like the only reason my life has truly become unmanageable is because I have two sisters that act as though they are mothers to me and Ill be damned if that's the case My mom is my mom that's that my sisters are my sisters and need to stop trying to control my life. SO I finally spoke Via E-mail to one of them and she was telling me how what I said really hurt her well I ma sorry I never ever held her Choices against her never threw it in her face and I never told her she shouldn't try to find a relationship no matter her mental health yet these are things she did to me and when I pointed it out she said she would not own that she MADE me do anything but never once did she own the PRESSURE she put me under. her own choices affect me same as the other sister their choices and the pressure they put On me although out of love is sometimes very misguided and I can SNAP Under it I am after all only human yes I am writing about daily life things that just go on well this is my life my life living with HIV its all apart of one I can not separate the two I know there is discrimination I know there is stigma but this is my life. I have been on this earth for 34 years and more than half of that I have lived with this virus and so yes life goes on after HIV and all your other problems are still there your family Issues will be there your obnoxious siblings who think they know what is best for you.Your family will be there through the good and bad And yes I am still trying learning to communicate to my own about everything with out upsetting them you will find in allot of cases this is common families become ever protective especially if you come from a dysfunctional family Dichotomy where the older children took care of the younger children as in my very own family (hence why My sisters act like mothers too me) I do know the why the reason behind everything.
  Yeah I guess what I am saying is when your diagnosed sit with your family talk communicate tell them you are prepared for what comes next not be over worried or overburdened by the situations.just that when you speak to them use kind tones don't lash out cause you will be in my shoes where your not talking to your family and family is extremely important they will be your first lines of support .some days I feel like i lost mine sometimes I feel like i have nothing because i let my anger get the best of me cause I over react allot I am far from perfect I am only human I will only ever be human. So when I Lash out when I get angry at times remember I am just a person a normal feeling person I am just Human. Not super man not Jesus not some holy man but your average human being with human emotions and sometimes I do not know how to deal with them. SO thanks for today thanks for reading thanks for the time to see that life does go on all its mess and problems and know there are healthy solutions and we can all do well if we try. And for those who are Still HIV neg Stay that way Protect yourself protect your partner remember if you love someone you use a condom you don't treat them like a used condom.

trying to strengthen my self back up slow goes it everyday

So after My whole Ordeal I have found my voice is very week I am trying very hard to strengthen everything in my body once again. It has been a long tough road I am working so very hard at my healing process. I am strong and never knew how much strength I had in me and one day I will be much stronger.So many people are so glad I am still here I am so blessed to be allot of people will know me for my writing allot will know me for who I am allot will have seen me in town or all over the country I cant go anywhere with out knowing someone. That's the beauty of being me. i am grateful that I am who I am and that I have been where I have been even in the darkest places. I know I am loved by my family n friends.so now with all this pretty much past me I will get stronger i am a great candidate for a transplant according to all the doctors now its just a matter of getting on the right insurance.As for my HIV my viral load is undetectable My CD-4 levels are over 900 shit its amazing how well I am doing there I am just amazed my A1C which is my diabetes was like 5.9 which is High normal I mean really I am doing great just a little Pneumonia a little too much for my body at once but I am here I am strong I am alive and I am not going anywhere they said 6 months I say hell no I got my whole life yet.
 I don't know when I am going to be called home I am not scared to be called home not one bit but I am scared that what will happen when I leave here who will continue my personal work I am so very much needed I have grown so much I am just totally amazed my my spiritual growth at my growth as a person I am the Man I am today because I have learned to care more about others than myself. i suffer for those who cannot. I would rather suffer than have someone else suffer.but I believe I have the strength to suffer for those who cannot. I am who I am because of my suffering.I know compassion I know how to love completely with no need for reciprocation.
So I guess that is all for today I have said everything I really can say as I have updated you all on everything now its time for my message.Just for today remember who you are that it is your body keep it strong love your self protect your self all will be as it should be.Walk with me one day and you will know my whole story.

OK So I am at my milronone infusion. this a long hard tough Battle but I do it twice a week its longer than chemo not as long as dialyses but its worth the fight I am a strong warrior I fight to live I live to fight. I help so Many I need to continue to fight to help my journey along. I am loved by so many people I am strong I will continue to be who it is That I am.
  Life is not subjective nor introspective we must all take care of ourselves because in doing so we are taking care of others. we each have a purpose we are here for a reason I know I am no one was truly ready to let me go So I am here I am still fighting the good fight I will be for a long time.
  Life is too short to give up at such a young age so give up I will not I will fight till there is no breath left in me. My strength is not my own it is the strength of my people the blood that runs through these veins is the blood of my people they keep me they keep me strong the eagle keeps me the bear keeps me my mother and father they keep me we are strong and I will be here because of them my family is a strong bloodline, and I wish My mother could see my battle here today and watch me win it I will win it but my other moms are here to watch me beat all the odds I am blessed I am a gift and my Creator he keeps me. so this is going to be a really short post as I am about to get started and people are just blowing up my phone trying to figure out how I am dealing with all this and I am like I am dealing with it one day at a time sometimes that is all one can do...
     Just for today I will listen to the wind and hear my blessed grandfather tell me I am good I am loved I am going to be just fine he knows best. Mitakuye Oyasin

I would like to sit with you for a moment to take a breath to be a friend. I Promote Safe sex I have for years I have every bit of paperwork On my diagnosis since the first time I was diagnosed. I am a longtime survivor of the virus. But I am also a Long time survivor of hate and discrimination. yet I am constantly feeling as though I have to defend Myself and against a member of my own Family. Its time to truly cut all ties she isn't my sister she is a stranger to me this is last time I shall ever allow her free rent in my head she truly hurt me for the very last time and she is in every way dead to me I pray she have a great life but not at my expense not anymore I am done shedding tears for someone who lies with no remorse and justifies her own actions without recourse. I have died and come back I am a walking living breathing miracle but I am Human and will not be treated like I am less than and she is better than I do not deserve this I have been doing my part to contribute and educate and be an advocate now to be treated like I am crap by someone born into my own bloodline no no more.
 I am a good person Or people from all over the world and people from all over would not have come literally to pray over me day in and day out while I was in my Coma. How dare someone call me a liar I never lie whats the damn point in it you always get caught. Life is a blessing we all take for granted yet I am here feeling the need to defend myself no no no more this will happen no more. For someone without even a GED to claim they are working On a BSN then quotes YouTube and other non reputable sites for they're information rather than an actual text book to cite as to what is wrong with everyone else well its laughable the sad thing is people actually believe the crap the lies not many but a few and that's enough. It pisses me off that people have shown up and my aunts and uncles houses looking for this relative she must have really done someone dirty to have people looking up who her relatives are and its kinda scary as well.Its hard to believe we were raised by the same people I turn out to be the man I am today while well we wont go there I pray for you is all i can say I'm done ever thinking we could be friends when every word that comes out of you is dripping with disdain and lies when your venomous and heartless at least I can Say I have a heart because I just had several surgeries on mine and people prayed for it to start working again people prayed I could breathe on my own again thousands of people litter ally so I know I am loved I have been hurt so much but i will never let you hurt me or my sisters again enough is enough I will not mention your name I know you stalk my blog I know you do your just that way but you know I have a better reason as to why I stopped blogging I wasn't going to fake school I wasn't lying to people I was in a Coma Fighting for my life and I am here and everyone is glad I am here my brain took a hit a hard one my heart my kidneys every single one of my organs I now have a pacemaker defibrillator in my chest but I am here and I have true people who love me so much they stayed with me round the clock praying for me or in the lobby or waiting rooms and even when the doctors were giving up they didn't they prayed over me they prayed for me they cried and said I am not ready to let you go Brother nephew friend I am here I love you please please stay with me I need you and I know you don't know that feeling why because you have never been there where you have people who really care for you that much to be at your side 24 hours a day if you rally needed them I have good friends and great sisters who never left me not for a second my little sister when she thought I wasn't going to make it she got so depressed but i came through and she kept going that's a sister someone who is there for you 24 hours a day if you need them they don't make up stories they love you unconditionally and that's why I have to let you go forever because you will never ever be that I let my love for you go I release you to no longer be my relation I will live on without you I have real family that loves me more than you ever could love anyone other than yourself yet I am the crazy one id rather be crazy that a Liar...
   Now as for today's message let those people go that are hurtful let those people go who want to do you harm love yourself more than anything and love will come to you in droves and never ever take anything for granted life is too precious a gift. Your body your decision make the right one Use a condom every time all it takes is one.. many blessings to you all mitakuye Oyasin 

Life as I see it

So I was in the Hospital for the last three weeks I had people from the world over Praying for me I had people come in round the clock to pray for me I was so blessed I am so blessed I have a good long life ahead of me I will be here A long long time. It was touch and go it wasn't nothing to do with my HIV it was my heart I have such a myriad of health issues well with my health issues and all i am going to be just fine I found out just how strong I am and how strong my Family is they prayed they needed strength for me and they found it within themselves through the creator you don't know how strong you are till you need strength you never though you had I have been here 34 years and by god I got through some really rough shit never once knowing that I could actually get through it. But I have managed every time they say I am a survivor no I'm not ready to go no where yet. and some people aren't ready for me to go yet so well as long as I am needed I am going wind up being here. So many people look for love like romantic love so much all the time well I haven't looked for that in years I don't need it. I got the best people in the world I got family friends amazing people in my life I got love I am not alone I am here I am strong I am healthy I am all that I am period and I am grateful for that which I have .Love the romantic kind isn't any damn thing i really need not now not ever I got more love in my life than I know what to do with trust I am gifted with nothing but Love.people don't know the blessings I have I have been so utterly blessed in my life that I know there  is no way I need anything else if it happens then it does ill be doubly and triply blessed.
 So for those people who have doubted in the past me and my strength my religious views or anything our ways are strong our people stronger they wouldn't let me go love is a powerful thing you need to know about and just how powerful love is its the most precious gift one can give my people showed tremendous love and support and prayed from all over to tell the truth you don't need physical locality to be there its a presence that is in the heart and the people who love me were with me in some way small or large there is the presence of those special people who love you more than anything .
so I have been on and off the phone today trying to figure a few things out I can tell you that I am doing what I always do thinking of others before myself why because that is who i am and will always be life is one amazing process I am going to be here a very goods long time and I can say allot of good things about so many people. In fact as its going to be a while till i can drive again I gifted my vehicle to my Aunt who really needs one. So as for being a saint no Ill never be that but a good person yeah that's something I can claim I am. I have spent a good deal of my life helping others and I will continue to do so every day of my life I will not take people and things for granted I will continue to live life to the very fullest and I will know that I have angles on my side life is not about self its about how you can benefit this world how you can continue to make it a better place for future generations as we do not inherit this earth from our ancestors but borrow it from our Children. so each day and every day I will be a good Child to my moms and aunts and family and I will be a good uncle to my nephew's nd nieces I will continue to be the good person I am for the rest of my life and if people can not handle my honesty my verver my good heart then screw them because this life is far too short to take anyone or anything for granted.

So today is canada's Pink Shirtday SO I am going to wear a pink shirt for canada here is my short post going to spend time with my support network my family

Its been a while allot has Been Going on

So well i thought I would post its been some time and so much has happend. I have been dealing with allot. I lost some family members recently. I have had new family members come into the world. I celebrated my sisters wedding which was amazing. I was in the hospital. all in the course of the last month and a half. Its been Life. It just Happens you know. People ask me sometimes things like what do you do now that your Positive? Sometimes I want to say um I live. Life goes on no matter what if your HIV pos or not. But i just say the truth i have been pos so long that it really is just one of those things that yeah I live with it we are here for the duration and well its like this I am here i am Pos like it or not take me for who I am not what I have. i mean really is it so hard to answer that question? yes and no. Cause I do I just live I often forget that some people dont know about my status cause I am so Open about it I assume everyone does.I have not even been concerned about My HIV I am more concerned about my diabetes my heart my asthma and things like that.
So yeah here is what happend with my hospital dealio I couldn't breath I felt like it was my asthma acting up real bad its how it starts everytime. I knew what it was I just was in denial and I hate the hospital. So I come out and say sis I need to go to the hospital I cant breathe I know its pneumonia. She is like your just having an asthma atack I am like no its pneumonia no ifs ands or buts so she is like do you want me to wait I am like nope just drop me off cause they will admit me guaranteed. and sure enough it was pneumonia. I was admitted. Then to top it off I had another attack of CHF and Tachycardia with RVR and then once I got to my floor omg new residents god I hate New residents i dont like change and Doctors that dont know me piss me off they did all kinds of test saying they thought the ER doctors were wrong and I said OMG R U SERIOUS.. they were like what I said I have been dealing with this for so long I know whats what.. This isnt my first walk in the Park I knew what it was before I even came I know its tahc I know its CHF I KNOW ITS PNEUMONIA. They were like how do you know I said look I know you went to school and all but trust me I know what I am talking about I get Pneumonia 4 times a year and have since I was 4 I get attacks of CHF and Tach and have forever I know what it feels like they took fucking arterial blood Do you have any clue how much that shit hurts? yeah they ran troponin tests they ran an Echo 2D they did every expensive test possible I was like what the hell they said we have to rule all this out I said No you dont. It is what it is. Do you know what its like to argue with a fucking doctor fresh out of school oh god yeah I wasnt happy... not one bit...
So then with every thing I am totally freaked of Course due to well no meds and wll but yeah read this and watch the Vid trust me its crazy but yeah I love you I am living its going to be ok life happens man Life happens ...

First Video Blog here is the New media

OK today I decided to ramble a bit on camera on my Hiv pos you tube Channel here is the link and hopefully Video http://www.youtube.com/watch?v=0keVs7pjWBY I am really Passionate So here it is please take a bit of time on my Ramblings I know it seems totally random but if you follow my Blog you Know I am random this is a start of many they will get better over time everything does thanks for reading and watching

this is just some of the evolution of HIV testing over the past 27 Years

Responding to the facts that (a) the AIDS epidemic is occurring among black and Hispanic populations disproportionately to their percentage of the U.S. population and (b) effective human immunodeficiency virus (HIV) prevention programs are racially, ethnically, and culturally relevant and sensitive, CDC in 1988 initiated a 5-year grant program for HIV prevention efforts by national racial and ethnic minority organizations and regional consortia of racial and ethnic minority organizations. A total of 33 organizations received first-year funds. Of the 32 grants that are ongoing, 15 primarily target blacks, 12 Hispanics, 4 Native Americans and Alaskan Natives, and 1 Asian Americans and Pacific Islanders. Some grants are for more than one racial or ethnic population. Programs may be categorized as (a) education programs within national non-AIDS organizations and their respective affiliate networks to increase their understanding, support, and community out-reach for HIV prevention; for example, National Urban League, Inc.; (b) programs providing specific HIV prevention expertise and technical assistance to community-based and other organizations; for example, National Minority AIDS Council; (c) HIV prevention programs emphasizing communications and media; for example, Hispanic Designers, Inc; and (d) prevention programs targeted to a specific racial or ethnic group within a geographic area; for example, Midwest Hispanic AIDS Coalition. As a result of these grants, substantial resources are being invested in prevention programs developed by and for racial and ethnic minorities. Other overall benefits include an expanded foundation of organizations to address AIDS and other health problems affecting these populations, strengthened interrelationships among HIV-focused and broader-based minority organizations, and extensive collaboration of private sector organizations with Federal and State public health and education agencies.




Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings


Prepared by 
Bernard M. Branson, MD1 
H. Hunter Handsfield, MD2 
Margaret A. Lampe, MPH1 
Robert S. Janssen, MD1 
Allan W. Taylor, MD1 
Sheryl B. Lyss, MD1 
Jill E. Clark, MPH3 
1Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed) 
2Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed) and University of Washington, Seattle, Washington 
3Northrup Grumman Information Technology (contractor with CDC)
The material in this report originated in the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), Kevin A. Fenton, MD, PhD, Director; and the Division of HIV/AIDS Prevention, Timothy D. Mastro, MD, (Acting) Director.
Corresponding preparer: Bernard M. Branson, MD, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), 1600 Clifton Road, N.E., MS D-21, Atlanta, GA 30333. Telephone: 404-639-0900; Fax: 404-639-0897; E-mail: bbranson@cdc.gov.
Summary


These recommendations for human immunodeficiency virus (HIV) testing are intended for all health-care providers in the public and private sectors, including those working in hospital emergency departments, urgent care clinics, inpatient services, substance abuse treatment clinics, public health clinics, community clinics, correctional health-care facilities, and primary care settings. The recommendations address HIV testing in health-care settings only. They do not modify existing guidelines concerning HIV counseling, testing, and referral for persons at high risk for HIV who seek or receive HIV testing in nonclinical settings (e.g., community-based organizations, outreach settings, or mobile vans). The objectives of these recommendations are to increase HIV screening of patients, including pregnant women, in health-care settings; foster earlier detection of HIV infection; identify and counsel persons with unrecognized HIV infection and link them to clinical and prevention services; and further reduce perinatal transmission of HIV in the United States. These revised recommendations update previous recommendations for HIV testing in health-care settings and for screening of pregnant women(CDC. Recommendations for HIV testing services for inpatients and outpatients in acute-care hospital settings. MMWR 1993;42[No. RR-2]:1--10; CDC. Revised guidelines for HIV counseling, testing, and referral. MMWR 2001;50[No. RR-19]:1--62; and CDC. Revised recommendations for HIV screening of pregnant women. MMWR 2001;50[No. RR-19]:63--85).
Major revisions from previously published guidelines are as follows:
For patients in all health-care settings
HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
Persons at high risk for HIV infection should be screened for HIV at least annually.
Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
Prevention counseling should not be required with HIV diagnostic testing or as part of HIV screening programs in health-care settings.
For pregnant women
HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women.
HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
Repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women.
Introduction


Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) remain leading causes of illness and death in the United States. As of December 2004, an estimated 944,306 persons had received a diagnosis of AIDS, and of these, 529,113 (56%) had died (1). The annual number of AIDS cases and deaths declined substantially after 1994 but stabilized during 1999--2004 (1). However, since 1994, the annual number of cases among blacks, members of other racial/ethnic minority populations, and persons exposed through heterosexual contact has increased. The number of children reported with AIDS attributed to perinatal HIV transmission peaked at 945 in 1992 and declined 95% to 48 in 2004 (1), primarily because of the identification of HIV-infected pregnant women and the effectiveness of antiretroviral prophylaxis in reducing mother-to-child transmission of HIV (2).
By 2002, an estimated 38%--44% of all adults in the United States had been tested for HIV; 16--22 million persons aged 18--64 years are tested annually for HIV (3). However, at the end of 2003, of the approximately 1.0--1.2 million persons estimated to be living with HIV in the United States, an estimated one quarter (252,000--312,000 persons) were unaware of their infection and therefore unable to benefit from clinical care to reduce morbidity and mortality (4). A number of these persons are likely to have transmitted HIV unknowingly (5).
Treatment has improved survival rates dramatically, especially since the introduction of highly active antiretroviral therapy (HAART) in 1995 (6). However, progress in effecting earlier diagnosis has been insufficient. During 1990--1992, the proportion of persons who first tested positive for HIV <1 year before receiving a diagnosis of AIDS was 51% (7); during 1993--2004, this proportion declined only modestly, to 39% in 2004 (1). Persons tested late in the course of their infection were more likely to be black or Hispanic and to have been exposed through heterosexual contact; 87% received their first positive HIV test result at an acute or referral medical care setting, and 65% were tested for HIV antibody because of illness (8).
These recommendations update previous recommendations for HIV testing in health-care settings (9,10) and for screening of pregnant women (11). The objectives of these recommendations are to increase HIV screening of patients, including pregnant women, in health-care settings; foster earlier detection of HIV infection; identify and counsel persons with unrecognized HIV infection and link them to clinical and prevention services; and further reduce perinatal transmission of HIV in the United States.
Single copies of this report are available free of charge from CDC's National Prevention Information Network, telephone 800-458-5231 (Mondays--Fridays, 9:00 a.m.--8:00 p.m. ET).
Background


Definitions
Diagnostic testing. Performing an HIV test for persons with clinical signs or symptoms consistent with HIV infection.
Screening. Performing an HIV test for all persons in a defined population (12).
Targeted testing. Performing an HIV test for subpopulations of persons at higher risk, typically defined on the basis of behavior, clinical, or demographic characteristics (9).
Informed consent. A process of communication between patient and provider through which an informed patient can choose whether to undergo HIV testing or decline to do so. Elements of informed consent typically include providing oral or written information regarding HIV, the risks and benefits of testing, the implications of HIV test results, how test results will be communicated, and the opportunity to ask questions.
Opt-out screening. Performing HIV screening after notifying the patient that 1) the test will be performed and 2) the patient may elect to decline or defer testing. Assent is inferred unless the patient declines testing.
HIV-prevention counseling. An interactive process of assessing risk, recognizing specific behaviors that increase the risk for acquiring or transmitting HIV, and developing a plan to take specific steps to reduce risks (13).
Evolution of HIV Testing Recommendations in Health-Care Settings and for Pregnant Women


In 1985, when HIV testing first became available, the main goal of such testing was to protect the blood supply. Alternative test sites were established to deter persons from using blood bank testing to learn their HIV status. At that time, professional opinion was divided regarding the value of HIV testing and whether HIV testing should be encouraged because no consensus existed regarding whether a positive test predicted transmission to sex partners or from mother to infant (14). No effective treatment existed, and counseling was designed in part to ensure that persons tested were aware that the meaning of positive test results was uncertain.
During the next 2 years, the implications of positive HIV serology became evident, and in 1987, the United States Public Health Service (USPHS) issued guidelines making HIV counseling and testing a priority as a prevention strategy for persons most likely to be infected or who practiced high-risk behaviors and recommended routine testing of all persons seeking treatment for STDs, regardless of health-care setting (15). "Routine" was defined as a policy to provide these services to all clients after informing them that testing would be conducted (15).
In 1993, CDC recommendations for voluntary HIV counseling and testing were extended to include hospitalized patients and persons obtaining health care as outpatients in acute-care hospital settings, including emergency departments (EDs) (10). Hospitals with HIV seroprevalence rates of >1% or AIDS diagnosis rates of >1 per 1,000 discharges were encouraged to adopt a policy of offering voluntary HIV counseling and testing routinely to all patients aged 15--54 years. Health-care providers in acute-care settings were encouraged to structure counseling and testing procedures to facilitate confidential, voluntary participation and to include basic information regarding the medical implications of the test, the option to receive more information, and documentation of informed consent (10). In 1994, guidelines for counseling and testing persons with high-risk behaviors specified prevention counseling to develop specific prevention goals and strategies for each person (client-centered counseling) (16). In 1995, after perinatal transmission of HIV was demonstrated to be substantially reduced by administration of zidovudine to HIV-infected pregnant women and their newborns, USPHS recommended that all pregnant women be counseled and encouraged to undergo voluntary testing for HIV (17,18).
In 2001, CDC modified the recommendations for pregnant women to emphasize HIV screening as a routine part of prenatal care, simplification of the testing process so pretest counseling would not pose a barrier, and flexibility of the consent process to allow multiple types of informed consent (11). In addition, the 2001 recommendations for HIV testing in health-care settings were extended to include multiple additional clinical venues in both private and public health-care sectors, encouraging providers to make HIV counseling and testing more accessible and acknowledging their need for flexibility (9). CDC recommended that HIV testing be offered routinely to all patients in high HIV-prevalence health-care settings. In low prevalence settings, in which the majority of clients are at minimal risk, targeted HIV testing on the basis of risk screening was considered more feasible for identifying limited numbers of HIV-infected persons (9).
In 2003, CDC introduced the initiative Advancing HIV Prevention: New Strategies for a Changing Epidemic (19). Two key strategies of this initiative are 1) to make HIV testing a routine part of medical care on the same voluntary basis as other diagnostic and screening tests and 2) to reduce perinatal transmission of HIV further by universal testing of all pregnant women and by using rapid tests during labor and delivery or postpartum if the mother was not screened prenatally (19). In its technical guidance, CDC acknowledged that prevention counseling is desirable for all persons at risk for HIV but recognized that such counseling might not be appropriate or feasible in all settings (20). Because time constraints or discomfort with discussing their patients' risk behaviors caused some providers to perceive requirements for prevention counseling and written informed consent as a barrier (12,21--23), the initiative advocated streamlined approaches.
In March 2004, CDC convened a meeting of health-care providers, representatives from professional associations, and local health officials to obtain advice concerning how best to expand HIV testing, especially in high-volume, high-prevalence acute-care settings. Consultants recommended simplifying the HIV screening process to make it more feasible and less costly and advocated more frequent diagnostic testing of patients with symptoms. In April 2005, CDC initiated a comprehensive review of the literature regarding HIV testing in health-care settings and, on the basis of published evidence and lessons learned from CDC-sponsored demonstration projects of HIV screening in health-care facilities, began to prepare recommendations to implement these strategies. In August 2005, CDC invited health-care providers, representatives from public health agencies and community organizations, and persons living with HIV to review an outline of proposed recommendations. In November 2005, CDC convened a meeting of researchers, representatives of professional health-care provider organizations, clinicians, persons living with HIV, and representatives from community organizations and agencies overseeing care of HIV-infected persons to review CDC's proposed recommendations. Before final revision of these recommendations, CDC described the proposals at national meetings of researchers and health-care providers and, in March 2006, solicited peer review by health-care professionals, in compliance with requirements of the Office of Management and Budget for influential scientific assessments, and invited comment from multiple professional and community organizations. The final recommendations were further refined on the basis of comments from these constituents.
HIV Screening for Pregnant Women and Their Infants


Universal Opt-Out Screening
All pregnant women in the United States should be screened for HIV infection.
Screening should occur after a woman is notified that HIV screening is recommended for all pregnant patients and that she will receive an HIV test as part of the routine panel of prenatal tests unless she declines (opt-out screening).
HIV testing must be voluntary and free from coercion. No woman should be tested without her knowledge.
Pregnant women should receive oral or written information that includes an explanation of HIV infection, a description of interventions that can reduce HIV transmission from mother to infant, and the meanings of positive and negative test results and should be offered an opportunity to ask questions and to decline testing.
No additional process or written documentation of informed consent beyond what is required for other routine prenatal tests should be required for HIV testing.
If a patient declines an HIV test, this decision should be documented in the medical record.
Addressing Reasons for Declining Testing
Providers should discuss and address reasons for declining an HIV test (e.g., lack of perceived risk; fear of the disease; and concerns regarding partner violence or potential stigma or discrimination).
Women who decline an HIV test because they have had a previous negative test result should be informed of the importance of retesting during each pregnancy.
Logistical reasons for not testing (e.g., scheduling) should be resolved.
Certain women who initially decline an HIV test might accept at a later date, especially if their concerns are discussed. Certain women will continue to decline testing, and their decisions should be respected and documented in the medical record.
Timing of HIV Testing
To promote informed and timely therapeutic decisions, health-care providers should test women for HIV as early as possible during each pregnancy. Women who decline the test early in prenatal care should be encouraged to be tested at a subsequent visit.
A second HIV test during the third trimester, preferably <36 weeks of gestation, is cost-effective even in areas of low HIV prevalence and may be considered for all pregnant women. A second HIV test during the third trimester is recommended for women who meet one or more of the following criteria: 
--- Women who receive health care in jurisdictions with elevated incidence of HIV or AIDS among women aged 15--45 years. In 2004, these jurisdictions included Alabama, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Louisiana, Maryland, Massachusetts, Mississippi, Nevada, New Jersey, New York, North Carolina, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Tennessee, Texas, and Virginia.† 
--- Women who receive health care in facilities in which prenatal screening identifies at least one HIV-infected pregnant woman per 1,000 women screened. 
--- Women who are known to be at high risk for acquiring HIV (e.g., injection-drug users and their sex partners, women who exchange sex for money or drugs, women who are sex partners of HIV-infected persons, and women who have had a new or more than one sex partner during this pregnancy). 
--- Women who have signs or symptoms consistent with acute HIV infection. When acute retroviral syndrome is a possibility, a plasma RNA test should be used in conjunction with an HIV antibody test to diagnose acute HIV infection (96).
Rapid Testing During Labor
Any woman with undocumented HIV status at the time of labor should be screened with a rapid HIV test unless she declines (opt-out screening).
Reasons for declining a rapid test should be explored (see Addressing Reasons for Declining Testing).
Immediate initiation of appropriate antiretroviral prophylaxis (42) should be recommended to women on the basis of a reactive rapid test result without waiting for the result of a confirmatory test.
Postpartum/Newborn Testing
When a woman's HIV status is still unknown at the time of delivery, she should be screened immediately postpartum with a rapid HIV test unless she declines (opt-out screening).
When the mother's HIV status is unknown postpartum, rapid testing of the newborn as soon as possible after birth is recommended so antiretroviral prophylaxis can be offered to HIV-exposed infants. Women should be informed that identifying HIV antibodies in the newborn indicates that the mother is infected.
For infants whose HIV exposure status is unknown and who are in foster care, the person legally authorized to provide consent should be informed that rapid HIV testing is recommended for infants whose biologic mothers have not been tested.
The benefits of neonatal antiretroviral prophylaxis are best realized when it is initiated <12 hours after birth (110).
Confirmatory Testing
Whenever possible, uncertainties regarding laboratory test results indicating HIV infection status should be resolved before final decisions are made regarding reproductive options, antiretroviral therapy, cesarean delivery, or other interventions.
If the confirmatory test result is not available before delivery, immediate initiation of appropriate antiretroviral prophylaxis (42) should be recommended to any pregnant patient whose HIV screening test result is reactive to reduce the risk for perinatal transmission.
Similarities and Differences Between Current and Previous Recommendations for Pregnant Women and Their Infants
Aspects of these recommendations that remain unchanged from previous recommendations are as follows:
Universal HIV testing with notification should be performed for all pregnant women as early as possible during pregnancy.
HIV screening should be repeated in the third trimester of pregnancy for women known to be at high risk for HIV.
Providers should explore and address reasons for declining HIV testing.
Pregnant women should receive appropriate health education, including information regarding HIV and its transmission, as a routine part of prenatal care.
Access to clinical care, prevention counseling, and support services is essential for women with positive HIV test results.
Aspects of these recommendations that differ from previous recommendations are as follows:
HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women. Patients should be informed that HIV screening is recommended for all pregnant women and that it will be performed unless they decline (opt-out screening).
Repeat HIV testing in the third trimester is recommended for all women in jurisdictions with elevated HIV or AIDS incidence and for women receiving health care in facilities with at least one diagnosed HIV case per 1,000 pregnant women per year.
Rapid HIV testing should be performed for all women in labor who do not have documentation of results from an HIV test during pregnancy. Patients should be informed that HIV testing is recommended for all pregnant women and will be performed unless they decline (opt-out screening). Immediate initiation of appropriate antiretroviral prophylaxis should be recommended on the basis of a reactive rapid HIV test result, without awaiting the result of confirmatory testing.
Additional Considerations for HIV Screening
Test Results


Communicating test results. The central goal of HIV screening in health-care settings is to maximize the number of persons who are aware of their HIV infection and receive care and prevention services. Definitive mechanisms should be established to inform patients of their test results. HIV-negative test results may be conveyed without direct personal contact between the patient and the health-care provider. Persons known to be at high risk for HIV infection also should be advised of the need for periodic retesting and should be offered prevention counseling or referred for prevention counseling. HIV-positive test results should be communicated confidentially through personal contact by a clinician, nurse, mid-level practitioner, counselor, or other skilled staff. Because of the risk of stigma and discrimination, family or friends should not be used as interpreters to disclose HIV-positive test results to patients with limited English proficiency. Active efforts are essential to ensure that HIV-infected patients receive their positive test results and linkage to clinical care, counseling, support, and prevention services. If the necessary expertise is not available in the health-care venue in which screening is performed, arrangements should be made to obtain necessary services from another clinical provider, local health department, or community-based organization. Health-care providers should be aware that the Privacy Rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits use or disclosure of a patient's health information, including HIV status, without the patient's permission.
Rapid HIV tests. Because of the time that elapses before results of conventional HIV tests are available, providing patients with their test results can be resource intensive and challenging for screening programs, especially in episodic care settings (e.g., EDs, urgent-care clinics, and STD clinics) in which continuing relationships with patients typically do not exist. The use of rapid HIV tests can substantially decrease the number of persons who fail to learn their test results and reduce the resources expended to locate persons identified as HIV infected. Positive rapid HIV test results are preliminary and must be confirmed before the diagnosis of HIV infection is established (111).
Participants in HIV vaccine trials. Recipients of preventive HIV vaccines might have vaccine-induced antibodies that are detectable by HIV antibody tests. Persons whose test results are HIV positive and who are identified as vaccine trial participants might not be infected with HIV and should be encouraged to contact or return to their trial site or an associated trial site for the confirmatory testing necessary to determine their HIV status.
Documenting HIV test results. Positive or negative HIV test results should be documented in the patient's confidential medical record and should be readily available to all health-care providers involved in the patient's clinical management. The HIV test result of a pregnant woman also should be documented in the medical record of her infant. If the mother's HIV test result is positive, maternal health-care providers should, after obtaining consent from the mother, notify pediatric care providers of the impending birth of an HIV-exposed infant and of any anticipated complications. If HIV is diagnosed in the infant first, health-care providers should discuss the implications for the mother's health and help her to obtain care.
Clinical Care for HIV-Infected Persons
Persons with a diagnosis of HIV infection need a thorough evaluation of their clinical status and immune function to determine their need for antiretroviral treatment or other therapy. HIV-infected persons should receive or be referred for clinical care promptly, consistent with USPHS guidelines for management of HIV-infected persons (96). HIV-exposed infants should receive appropriate antiretroviral prophylaxis to prevent perinatal HIV transmission as soon as possible after birth (42) and begin trimethoprim-sulfamethoxazole prophylaxis at age 4--6 weeks to prevent Pneumocystis pneumonia (112). They should receive subsequent clinical monitoring and diagnostic testing to determine their HIV infection status (113).
Partner Counseling and Referral


When HIV infection is diagnosed, health-care providers should strongly encourage patients to disclose their HIV status to their spouses, current sex partners, and previous sex partners and recommend that these partners be tested for HIV infection. Health departments can assist patients by notifying, counseling, and providing HIV testing for partners without disclosing the patient's identity (114). Providers should inform patients who receive a new diagnosis of HIV infection that they might be contacted by health department staff for a voluntary interview to discuss notification of their partners.
Special Considerations for Screening Adolescents


Although parental involvement in an adolescent's health care is usually desirable, it typically is not required when the adolescent consents to HIV testing. However, laws concerning consent and confidentiality for HIV care differ among states (79). Public health statutes and legal precedents allow for evaluation and treatment of minors for STDs without parental knowledge or consent, but not every state has defined HIV infection explicitly as a condition for which testing or treatment may proceed without parental consent. Health-care providers should endeavor to respect an adolescent's request for privacy (79). HIV screening should be discussed with all adolescents and encouraged for those who are sexually active. Providing information regarding HIV infection, HIV testing, HIV transmission, and implications of infection should be regarded as an essential component of the anticipatory guidance provided to all adolescents as part of primary care (79).
Prevention Services for HIV-Negative Persons


Risk screening. HIV screening should not be contingent on an assessment of patients' behavioral risks. However, assessment of risk for infection with HIV and other STDs and provision of prevention information should be incorporated into routine primary care of all sexually active persons when doing so does not pose a barrier to HIV testing. Even when risk information is not sought, notifying a patient that routine HIV testing will be performed might result in acknowledgement of risk behaviors and offers an opportunity to discuss HIV infection and how it can be prevented. Patients found to have risk behaviors (e.g., MSM or heterosexuals who have multiple sex partners, persons who have received a recent diagnosis of an STD, persons who exchange sex for money or drugs, or persons who engage in substance abuse) and those who want assistance with changing behaviors should be provided with or referred to HIV risk-reduction services (e.g., drug treatment, STD treatment, and prevention counseling).
Prevention counseling. In health-care settings, prevention counseling need not be linked explicitly to HIV testing. However, because certain patients might be more likely to think about HIV and consider their risks at the time of HIV testing, testing might present an ideal opportunity to provide or arrange for prevention counseling to assist with behavior changes that can reduce risks for acquiring HIV infection. Prevention counseling should be offered or made available through referral in all health-care facilities serving patients at high risk for HIV and at facilities (e.g., STD clinics) in which information on HIV risk behaviors is elicited routinely.
HIV/AIDS Surveillance
Risk-factor ascertainment for HIV-infected persons. CDC recommends that providers ascertain and document all known HIV risk factors (115). Health-care providers can obtain tools and materials to assist with ascertainment and receive guidance on risk factors as defined for surveillance purposes from HIV/AIDS surveillance professionals in their state or local health jurisdiction. This risk-factor information is important for guiding public health decisions, especially for prevention and care, at clinical, local, state, and national levels.
HIV/AIDS case reporting. All states require that health-care providers report AIDS cases and persons with a diagnosis of HIV infection to the state or local health department. Case report forms are available from the state or local health jurisdiction.
Pediatric exposure reporting. CDC and the Council for State and Territorial Epidemiologists recommend that all states and territories conduct surveillance for perinatal HIV exposure and contact providers after receiving reports of exposed infants to determine the infant's HIV-infection status. Information concerning dates of maternal HIV tests, receipt of prenatal care, maternal and neonatal receipt of antiretroviral drugs, mode of delivery, and breastfeeding is collected on the pediatric HIV/AIDS case report form (115).
Monitoring and Evaluation
Recommended thresholds for screening are based on estimates of the prevalence of undiagnosed HIV infection in U.S. health-care settings, for which no accurate recent data exist. The optimal frequency for retesting is not yet known. Cost-effectiveness parameters for HIV screening were based on existing program models, all of which include a substantial counseling component, and did not consistently consider secondary infections averted as a benefit of screening. To assess the need for revised thresholds for screening adults and adolescents or repeat screening of pregnant women and to confirm their continued effectiveness, screening programs should monitor the yield of new diagnoses of HIV infection, monitor costs, and evaluate whether patients with a diagnosis of HIV infection are linked to and remain engaged in care. With minor modifications, laboratory information systems might provide a practical alternative for clinicians to use in determining HIV prevalence among their patients who are screened for HIV.
Primary Prevention and HIV Testing in Nonclinical Settings


These revised recommendations are designed to increase HIV screening in health-care settings. Often, however, the population most at risk for HIV includes persons who are least likely to interact with the conventional health-care system (47,116). The need to maintain primary prevention activities, identify persons at high risk for HIV who could benefit from prevention services, and provide HIV testing for persons who are at high risk for HIV in nonclinical venues remains undiminished. New approaches (e.g., enlisting HIV-infected persons and HIV-negative persons at high risk for HIV to recruit persons from their social, sexual, and drug-use networks for counseling, testing, and referral) have demonstrated considerable efficacy for identifying persons who were previously unaware of their HIV infection (117).
Regulatory and Legal Considerations


These public health recommendations are based on best practices and are intended to comply fully with the ethical principles of informed consent (67). Legislation related to HIV and AIDS has been enacted in every state and the District of Columbia (118), and specific requirements related to informed consent and pretest counseling differ among states (119). Certain states, local jurisdictions, or agencies might have statutory or other regulatory impediments to opt-out screening, or they might impose other specific requirements for counseling, written consent, confirmatory testing, or communicating HIV test results that conflict with these recommendations. Where such policies exist, jurisdictions should consider strategies to best implement these recommendations within current parameters and consider steps to resolve conflicts with these recommendations.
Other Guidelines


Issues that fall outside the scope of these recommendations are addressed by other USPHS guidelines (Box 1). Because concepts relevant to HIV management evolve rapidly, USPHS updates recommendations periodically. Current updates are available from the National Institutes of Health at http://AIDSinfo.nih.gov. Additional guidelines have been published by CDC and the U.S. Department of Health and Human Services, Office for Civil Rights (Box 2).
Acknowledgment


Ida M. Onorato, MD, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), contributed to the writing and revision of this report.
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* To eliminate the risk for postnatal transmission, HIV-infected women in the United States should not breastfeed. Support services for use of appropriate breast milk substitutes should be provided when necessary. In international settings, UNAIDS and World Health Organization recommendations for HIV and breastfeeding should be followed (46).
† A second HIV test in the third trimester is as cost-effective as other common health interventions when HIV incidence among women of childbearing age is >17 HIV cases per 100,000 person-years (107). In 2004, in jurisdictions with available data on HIV case rates, a rate of 17 new HIV diagnoses per year per 100,000 women aged 15--45 years was associated with an AIDS case rate of at least nine AIDS diagnoses per year per 100,000 women aged 15--45 years (CDC, unpublished data, 2005). As of 2004, the jurisdictions listed above exceeded these thresholds. The list of specific jurisdictions where a second test in the third trimester is recommended will be updated periodically based on surveillance data.
Consultants 
Membership List, November 2005
Chairpersons: Bernard M. Branson, MD, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), CDC; H. Hunter Handsfield, MD, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed) and University of Washington, Seattle, Washington.
Presenters: Terje Anderson, National Association of People with AIDS, Silver Spring, Maryland; Yvette Calderon, MD, Albert Einstein College of Medicine, Bronx, New York; Carlos del Rio, Emory University School of Medicine, Atlanta, Georgia; Bambi Gaddist, PhD, South Carolina African American HIV/AIDS Council, Columbia, South Carolina; Roberta Glaros, MA, New York State Department of Health, Albany, New York; Howard A. Grossman, MD, American Academy of HIV Medicine, Washington, DC; Sara Guerry, MD, Los Angeles Sexually Transmitted Disease Program, Los Angeles, California; Scott D. Halpern, MD, PhD, University of Pennsylvania, Philadelphia, Pennsylvania; Kim Hamlett-Berry, PhD, Department of Veterans Affairs, Washington, DC; Scott Kellerman, MD, New York City Bureau of HIV/AIDS Prevention and Control, New York, New York; James H. Lee, Texas Department of State Health Services, Austin, Texas; Jason Leider, MD, PhD, Albert Einstein College of Medicine, Bronx, New York; A. David Paltiel, PhD, Yale University School of Medicine, New Haven, Connecticut; Liisa Randall, PhD, Michigan Department of Community Health, Okemos, Michigan; Cornelis A. Rietmeijer, MD, PhD, Denver Public Health Department, Denver, Colorado; Robert A. Weinstein, MD, Rush Medical College, Chicago, Illinois; Noel Zuniga, Bienestar Human Services, Inc., Los Angeles, California.
Moderators: John Blevins, Emory University School of Medicine, Atlanta, Georgia; William C. Page, William C. Page, Inc., Albuquerque, New Mexico.
Consultants: Chris Aldridge, National Alliance of State and Territorial AIDS Directors, Washington, DC; Terje Anderson, National Association of People with AIDS, Silver Spring, Maryland; Arlene Bardeguez, MD, University of Medicine and Dentistry of New Jersey, Newark, New Jersey; Ronald Bayer, PhD, Mailman School of Public Health, Columbia University, New York, New York; Guthrie Birkhead, MD, Council of State and Territorial Epidemiologists and New York State Department of Health, Albany, New York; Lora Branch, MS, Chicago Department of Public Health, Chicago, Illinois; Daniel Bush, North Jersey Community Research Initiative, Newark, New Jersey; Ahmed Calvo, MD, Health Resources and Services Administration, Rockville, Maryland; Sheldon Campbell, MD, PhD, College of American Pathologists and Yale University School of Medicine, New Haven, Connecticut; Suzanne Carlberg-Racich, MPH, Midwest AIDS Training and Education Center, Chicago, Illinois; Sandra Chamblee, Glades Health Initiative, Belle Glade, Florida; James Coleman, Whitman Walker Clinic, Inc., Takoma Park, Maryland; Kevin DeCock, MD, Global AIDS Program, Nairobi, Kenya; Andrew De Los Reyes, Gay Men's Health Crisis, Inc., New York, New York; Carlos del Rio, Emory University School of Medicine, Atlanta, Georgia; Marisa Duarte, MPH, Centers for Medicare and Medicaid Services, Atlanta, Georgia; Wayne Duffus, MD, PhD, South Carolina Department of Health and Environmental Control, Columbia, South Carolina; Enid Eck, Kaiser Permanente, Pasadena, California; Magdalena Esquivel, Los Angeles Department of Health Services, Los Angeles, California; Joe Fuentes, Houston Area Community Services, Inc., Houston, Texas; Donna Futterman, MD, American Academy of Pediatrics and Albert Einstein College of Medicine, Bronx, New York; Bambi Gaddist, PhD, South Carolina African American HIV/AIDS Council, Columbia, South Carolina; Roberta Glaros, MA, New York State Department of Health, Albany, New York; Howard A. Grossman, MD, American Academy of HIV Medicine, Washington, DC; Sara Guerry, MD, Los Angeles Sexually Transmitted Disease Program, Los Angeles, California; Scott D. Halpern, MD, PhD, University of Pennsylvania, Philadelphia, Pennsylvania; Kim Hamlett-Berry, PhD, Department of Veterans Affairs, Washington, DC; Celine Hanson, MD, Baylor College of Medicine, Houston, Texas; Wilbert Jordan, MD, National Medical Association and Drew University, Los Angeles, California; Scott Kellerman, MD, New York City Bureau of HIV/AIDS Prevention and Control, New York, New York; David Lanier, MD, Agency for Healthcare Research and Quality, Rockville, Maryland; James H. Lee, Texas Department of State Health Services, Austin, Texas; Jason Leider, MD, PhD, Albert Einstein College of Medicine, Bronx, New York; Elisa Luna, MSW, Washington, DC; Robert Maupin, MD, American College of Obstetricians and Gynecologists and LSU Health Sciences Center, New Orleans, Louisiana; Jenny McFarlane, Texas Department of State Health Services, Austin, Texas; Lynne Mofenson, MD, National Institute of Child Health and Human Development, Rockville, Maryland; Eve Mokotoff, MPH, Council of State and Territorial Epidemiologists and Michigan Department of Community Health, Detroit, Michigan; Susan Moskosky, MS, Office of Population Affairs, Rockville, Maryland; Doralba Muñoz, Union Positiva, Inc., Miami, Florida; George Odongi, Dorchester Community Health Center, Quincy, Massachusetts; Debra Olesen, JSI Research and Training, Denver, Colorado; A. David Paltiel, PhD, Yale School of Medicine, New Haven, Connecticut; Paul Palumbo, MD, Newark, New Jersey; Jim Pickett, AIDS Foundation of Chicago, Chicago, Illinois; Pam Pitts, MPH, Tennessee Department of Health, Nashville, Tennessee; Borris Powell, Gay Men of African Descent, New York, New York; Liisa Randall, PhD, Michigan Department of Community Health, Okemos, Michigan; Mobeen Rathore, MD, University of Florida, Jacksonville, Florida; Cornelis A. Rietmeijer, MD, PhD, Denver Public Health Department, Denver, Colorado; Sam Rivera, Fortune Society, New York, New York; Ruth Roman, MPH, Health Resources and Services Administration, Rockville, Maryland; Richard Rothman, MD, Johns Hopkins University and American College of Emergency Physicians, Baltimore, Maryland; Gale Sampson-Lee, National Black Leadership Commission on AIDS, New York, New York; John Schneider, MD, PhD, American Medical Association, Flossmoor, Illinois; Deya Smith-Starks, AIDS Healthcare Foundation, Los Angeles, California; Nilda Soto, PROCEED, Inc., Elizabeth, New Jersey; Alice Stek, MD, University of Southern California School of Medicine, Los Angeles, California; Monica Sweeney, MD, Bedford Stuyvesant Family Health Center, Inc., and National Association of Community Health Centers, Brooklyn, New York; Donna Sweet, MD, Wichita, Kansas; Wanda Tabora, Iniciativa Communitaria de Investigacion, San Juan, Puerto Rico; Mark Thrun, MD, Denver Public Health, Denver, Colorado; Robert A. Weinstein, MD, Rush Medical College, Chicago, Illinois; Carmen Zorilla, MD, University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Noel Zuniga, Bienestar Human Services, Inc., Los Angeles, California.
Peer Reviewers: Connie Celum, MD, University of Washington, Seattle, Washington; Daniel Kuritzkes, MD, HIV Medicine Association and Brigham and Women's Hospital, Cambridge, Massachusetts; Thomas C. Quinn, MD, National Institute of Allergy and Infectious Disease and Johns Hopkins University, Baltimore, Maryland.
CDC, Division of HIV/AIDS Prevention Revised Recommendations for HIV Testing in Health-Care Settings Project
Coordinator: Bernard M. Branson, MD, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), CDC.
Project Manager: Samuel A. Martinez, MD, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), CDC.
CDC Presenters: Brian Boyett, MS, Bernard M. Branson, MD, H. Irene Hall, PhD, Margaret A. Lampe, MPH, Sheryl B. Lyss, MD, Duncan A. Mackellar, MPH, Stephanie L. Sansom, PhD, Allan W. Taylor, MD, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed).
So that Is just for the past 27 years or so of how the Virus has been handled new steps and measures and such. I honestly believe that there is more education and the Measures for prevention and education should be set forth at as young an age as possible I really believe in the system of not lying to people and showing them the numbers letting them see the truth in the way things really are if you dont see it its not real I am happy to be able to put my face to this virus I am the face of HIV I have it I live with it everyday we have come to terms you see HIV and Me we are here sharing a space and when we get sick we both get sick. My virus My pain my heart all of it we have all decided that we must all coexhist together if not we all die.
14 years ago in 1998 when I was Diagnosed In california I was given 6 months to two years I was told I would be in a nursing care facility by the time I turned 22 and I would be dead by 25. what are the odds that I of all people would love this long with all of this what a miracle I guess maybe I dont know. What I do know is that in this day and age there are better testing and less of a window period less of a wait time to get tested and have good results.Today I could be diagnosed in less than 24 hours with a western blot method. It is important to get tested regularly and to take care of yoruself and your partner. Disclosure is also greatly important. Today there are actual disclosure laws but I find that a bit over the top I think it is still your right to disclose and when but I would never Not disclose my status I Have it and I cant go about not telling people.I understand the fear that some people would Have about discosing not being able to find someone who would be able to accept that and such but there is so much more out there a relationship isnteverything.
I have been blessed Having been able to whitness the changed over the Last 14 years and see so many huge changes in treatment options and well everything else I am still praying for a solution a cure. There are many things I will be Praying for for a long time to come these drug trials going on right now and everyone in them if you have questions about the possible fuctional Cure here is one Link http://www.medicalnewstoday.com/articles/234615.php I am unsure as to how to get into them yet but I am still working on it.