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In contrast, Julio Collazos, ., of Hospital de Galdakao in Vizcaya and colleagues reported in the April 12, 2002 issue of AIDS that in a study of nearly 200 clinically stable HIV-positive men (average CD4 cell count 451 cells/mm 3 ; 64% with undetectable viral load ), most subjects had testosterone levels within the normal range. Men receiving no anti-HIV therapy had the lowest testosterone, while those using a regimen combining three classes of antiretroviral drugs had the highest levels. Among the 15 men who had both pre- and post-treatment testosterone measurements, levels increased after starting HAART. But because testosterone levels normally begin to decline around age 40 (a phenomenon known as "andropause"), the beneficial effects of HAART on hypogonadism may be offset as treatment enables HIV-positive men to live to older ages.


All specialty medications require Precertification. The process begins with a call to HealthSmart Specialty Drug Program at 1-888-440-7342. HealthSmart will review the drug for medical necessity, and if approved, will coordinate the purchase through an approved source. Many specialty medications have manufacturer programs which will financially assist patients in the purchase of the medication. PEIA requires that if a financial assistance program is available, you must participate in the program. Specialty drugs have the following key characteristics:

There are thousands of drugs prescribed every year for many different health problems. Tracking the most frequently prescribed drugs is one way to see what types of health problems predominate in the . You may see some familiar drugs on this list that you, your relatives, and friends may take. People may know what drug they take, but are not sure what the drug is supposed to do or what side effects may occur. Fortunately, the pharmacy industry provides a simple listing of the top 100 drugs prescribed (reference) and most of these drug s functions, side effects, precautions, dosages, and other information are detailed at . Listed below are the top 10 drugs prescribed in the . Click on the link to get additional detailed information on the drugs.

High-quality palliative care also requires special expertise in honest, compassionate communication. In addition to enhancing the patient's and family's experience, these skills help to establish trust and overcome barriers to adequate care and relief of symptoms. Several communication tasks are especially important: conveying accurate prognostic information while maintaining hope, eliciting information about symptoms, decision making about curative and palliative treatments, handling emotions, and dealing with requests from patients and families who have unrealistic goals [34, 35, 36] . The challenges of communicating effectively are discussed later in this course.

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High-quality palliative care also requires special expertise in honest, compassionate communication. In addition to enhancing the patient's and family's experience, these skills help to establish trust and overcome barriers to adequate care and relief of symptoms. Several communication tasks are especially important: conveying accurate prognostic information while maintaining hope, eliciting information about symptoms, decision making about curative and palliative treatments, handling emotions, and dealing with requests from patients and families who have unrealistic goals [34, 35, 36] . The challenges of communicating effectively are discussed later in this course.

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