I was deeply touched by Jeff Berry’s “The Nebulous Spirit” (March/April 2005).

His account of the events in his personal spiritual journey is very similar to mine. I have been coming to terms with my own illness and my own life issues (I am not gay nor am I HIV-positive). Writing can be a powerful tool and this article offers hope to people where there may not have been any. He said what I have not been able to express. Thanks, Jeff.

Name withheld, via the Internet

I just want to express to you how much of an effect this article has had on my emotional and spiritual feelings, or lack of feelings. I was diagnosed two years ago—it was from tainted blood—I have had it a very long time and it was by accident that it was discovered. I am a mother who raised three wonderful children and I thank God that I didn’t know at that time. I am craving spirituality and can’t seem to get out of this depression I am in—just still in shock, I think. Thanks. This is a moving article.

Name withheld, via the Internet

Bravo! Nice to hear from someone else on a similar path. Encouraging words.

Anonymous, via the Internet

I really enjoyed your article “The Nebulous Spirit.” It touches on a lot of the same issues I have also confronted—some of the same issues that are in a book I wrote about living with HIV. Please find attached information. I hope you will find it to be of use.

Thank you,Dan Gebhardt

From The Pilgrim Press: “I Am This One Walking Beside Me: Meditations of an

Excellent article (“Guys and Girls,” March/April 2005). However, you forgot to mention the only Hetero/poz group in the New York Metro area that organizes, hosts and arranges hetero positive club events and affairs.

The group is called Positive Relationships and has hosted an unprecedented number of well-attended parties in the past year. They got together and merged with an equally large group of Hispanic positives, and formed the largest positive singles group in the New York Metro area. No one told you! But please mention us in your next issue—a little more publicity can’t hurt!

Your recent post in TheBody.com

(http://www.thebody.com/tpan/marapr_05/hetero_resources.html?m94h) is missing Canada’s largest HIV-positive community. Feel free to consider it: www.pozcanadian.com.

Editor’s note: Thanks for your e-mail. The May/June issue of Positively Aware is already at the printer, but I will forward your information to our Readers Forum for the July/August issue. TheBody is great because it allows so many more people to read our writing who may not otherwise see it. —Jeff Berry

Dear Dr. Berger,

I just read your article titled Crystal Methamphetamine and HIV. Great article and thank you for addressing this issue. I work for the AIDS Support Group of Cape Cod in the Prevention and Education department and I am trying to identify tools that can be used in the recovery plan for a methaphetamine user. I read that certain antidepressants were able to stimulate the new growth of dopamine receptors and that this could be worth considering as part of a person’s recovery if the depression aspect is being treated with medication. Any information or suggestions you have would be greatly appreciated.

Sincerely,

Rick Shaw

Rick,

Thank you for reading the article and I hope you are able to focus on a successful approach. Regarding specifically using medications that may stimulate growth of receptors for dopamine: we do not completely understand the etiology of depression in methamphetamine use. If it can be shown that dopamine specifically is the etiology then this approach would have merit. Targeting treatment towards the source of the problem would be ideal. However, my gut feeling here is that the psychological problems are complex and probably multi-factorial. I think as a research project, your approach is worth studying, especially since most approaches are not successful for the majority of individuals.

In general the causes of depression have been argued. Serotonin is implicated in many depression problems. Second, cocaine administration in murine studies have shown that HIV replication is enhanced by cocaine itself together with increased trafficking of cytokines which mediate tissue destruction, increased with coke, can both contribute to brain pathology. Since methamphetamine is a close cousin of cocaine, this may be applicable here. Finally, does HIV have a specific tropism for particular areas of the brain or the basal ganglia. So do patients infected with HIV require a different approach for addiction than those negative?

I am not an addiction specialist nor a psychologist. My specialty is HIV treatment and research. The article I’ve written was based on my reading of current clinical studies and from my experiences firsthand in the clinic, which is not different from many HIV specialty clinics in the gay communities of most metropolitan cities in the U.S. that have become proficient at recognizing the problem. Our clinic (Northstar Healthcare in Chicago) cares for more than 2,500 HIV patients and I can tell you that crystal addiction has become the most common problem today.

Best of luck; let me know if you find something that works.

Dan Berger, MD