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How do you decide what questions to answer? Do you only answer questions from patients who have HIV?
Sep 26, 2002

Hi Dr. Dezube, I was just wondering, if a person wrote in to your forum who was HIV negative but had AIDS symptoms (actual opportunistic infections) would you attempt to help him? Or does only help those who might benefit from the HIV drugs who's manufacturers sponsor your website? I don't mean to sound so conspiratorial, but I feel like this is a great opportunity for sick people to get expert opinions, but it seems there is a direct correlation between care and possibility to recommend HIV drugs. For example, if an HIV-2 positive person wrote in, would you have ANYTHING to recommend that person given the fact that the meds probably won't help him? Would you think of a strategy to prolong his life - one that included a certain diet and exercise, herbal possibilities, chinese methods? Or is it all or nothing with you white coat types? Either you can talk about meds, or take my problem elsewhere? and of course, you don't have to listen to this bombardment of accusations, but don't you agree that there is some truth to what i am saying?

Response from Dr. Dezube

Your question is a very reasonable one. Do I answer only questions of HIV-infected patients? The answer is a definite NO. I have lead this Question and Answer Forum for years on and have answered many, many questions from HIV-negative patients.

So how do I decide??

The first thing to say is that I'm human. There are not enough hours in the day, week, or month to answer all the queries.

I try to choose questions which have a generalizable nature to them- e.g. what makes one worried about a lymph node, who should get anal PAP smears, what can one do about residual Kaposi's, and so on, and so on.

I try to avoid posting too many sagas. This is an internet site and most readers do not appreciate reading a patient's saga that goes on for screen, after screen, after screen. I have posted some sagas if there was a key point in it.

I avoid posting anything related to "worried well". This is the one prohibition by told to all Forum Experts. An example of a "worried well" is a person who had unsafe sex (or even safe sex) and has some symptom, which makes him/her worried about HIV. The best thing to do is to get tested for HIV and not to aggrevate about whether you do or do not have HIV. I do feel sorry that I must delete all of these worried well, which often have in the subject line "can't sleep; super-worried; please answer; desparate for help; and so on, and so on".

I spend alot of time correcting the English in some of the queries. I recognize that English may not be the native language of all those who write. Sometimes I can simply not understand the query either because of poor English, or because of abbreviations which I can't recognize.

So, my advice is to make your query as generalizable as possible, keep it short and to the point, proof-read it, and realize that even if you write a perfect query, that I simply may not be able to answer it.

PS: Though I sit at Harvard and have done so for well-over 15 years, I still don't have a white coat as your note indicates.

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