HIV positive

Tina and HIV
Considerations for HIV+ men
Tina and meds
Tina and seroconversion
Multiple infections

Tina and meds

Monitor the liver

Our liver helps clean our bodies of toxins. The more drugs we ingest, prescription and otherwise, the greater work our livers have to do to process them. This stress can lead to liver damage and greater susceptibility to hepatitis. For HIV+ men who may need to maintain drug treatment for many years, protecting the health of our liver is paramount. It is a good idea to have our doctors monitor our liver functions regularly to check for indicators of liver stress. It is also a good idea to protect ourselves from hepatitis infection, get tested regularly for Hepatitis, and to get vaccinated. Vaccinations are available for types A and B.

HIV meds can increase the levels and effects of Tina

Some HIV meds are cause for specific concern. They multiply the effect of crystal meth in the bloodstream. These meds compete with Tina in enzyme pathways and don’t allow Tina to leave our system as easily. Protease inhibitors in particular need to be emphasized in this regard. Amprenavir (Agenerase) and Ritonavir (Norvir, Kaletra) increase the amount of Tina in our bloodstream by 2 or 3 times. This can give us either a stronger or cheaper high. It also puts us at significantly greater risk of overdose.

The following HIV medications increase the levels and effects of Tina:

• protease inhibitors (especially ritonavir and amprenevir)

• delaviridine

• itraconazole, ketaconazole (anti-fungals)

• erythromycin, clarithromycin, azithromycin (antibiotics)

If you are on any of these drugs it is recommended that you check with our doctors to learn more.

Be alert to any changes in your high after we start a new HIV medication. Do you feel ‘higher,’ stay up longer, have more paranoia, or crash harder? These experiences could signal drug interactions. Tell your doctor about them.

Tina can impact the efficacy of our HIV meds

The specific impacts of crystal meth use on the effectiveness of specific HIV meds are not well known. The quality and ingredients in the Tina we use varies from batch to batch and it’s difficult to carry out research on illegal substances.

We do know that guys often have a harder time maintaining their meds schedule when using. Missing doses because of Tina use could allow our viral loads to increase and provide a ‘window’ for drug resistance to develop. Remember that when we become resistant to one drug in a class, we are usually then resistant to all other drugs in the same class. There are currently only 4 major classes of drugs. The complications resulting from becoming resistant to one or more classes of drugs can be significant on many aspects of our lives.

Do whatever it takes to maintain adherence to your prescription schedule. Make sure you have your meds with you. Have food like a meal replacement bar available for meds that need to be taken with food. Some guys find bananas and yoghurt sit relatively well in our stomachs when high. It’s easy to lose track of time. Use a timer. Remember that a break is a good idea anyway. Investigate options like newer meds that require less frequent intake with your doctor.

If you’re going to use tina anyway, reduce the risk:

• Use half or less than you would otherwise.

• Delay second or subsequent hit.

• Consider switching to a drug that has less potential for OD.

• Switch to a less risky method of use.

• Be more careful with the screening of the Tina you use.

• Use less often.

Other potential interactions

It also may be important to monitor kidney function and in particular to be on the alert for kidney stones. Tina and some HIV meds cause a cumulative dehydration that can lead to severe kidney stones. Drinking lots of water is recommended.

TIP: Check out the ‘Kidney Page’ for more information and tips.

Caution is also recommended when taking Tina in conjunction with mono anamine oxidase inhibitors (MAOIs). MAOIs include harmine, harmaline, harmala, nardil, parnate, moclebemide, as well as many anti-depressants. When combined with crystal meth, MAOIs can cause fever, hypertension, and arrhythmias (abnormal heart rhythms). Check with your doctor to determine if any medication you are taking contains MAOIs.

Heart and blood pressure medications can also interact with Tina and have adverse effects.

TIP: When we use other illegal and/or prescription drugs in combination with Tina and our HIV meds, there are further complications and dangers. To learn more please click here.

Non-pharmaceutical interactions

While the focus in harm reduction information is often on pharmaceutical interactions with crystal meth and other drugs, there may also be issues with herbal or nutritional supplements as well. Regardless of who our health care providers are, we advise informing them of our drug consumption, prescription and otherwise. Naturopaths, herbalists and nutritionists can then also advise on immune boosting and nutritional supplementation that may mitigate some of the damage caused by Tina and other drug use.