Sep 22, 2002
dr. frascino, i know you mean well, and many times people are indeed plagued with guilt - not hiv, but i think its just as naive and uninformed of an hiv specialist to assume based on an email that people who manifest symptoms after a high risk exposure are really having emotional problems and need psychotherapy. is hiv the only possible reason for symptoms after high risk exposures? aren't there other things that can cause symptoms besides stress? what if one of these emails was from an unknowingly cancer-sick person who was confusing his symptoms with those of hiv? you're assuming right away that he needs to see a therapist when maybe you need to direct him to a more competent dr. (i dont mean more competent than you, i mean more than the one he is presently seeing - if any)
Response from Dr. Frascino
Point well taken. However, the vast majority of folks who contact me regarding possible HIV infection have seen one or several physicians and already have been thoroughly evaluated for other possible maladies. I have hundreds and hundreds of e-mails from worried-wells who had a wide variety of symptoms, which turned out to be anxiety-related and which resolved completely when they had their irrational fears tended to, either by getting negative HIV test results or by working with a competent therapist. Cancer should very rarely, if ever, be confused with HIV, if the appropriate blood tests and physical exams are performed. That said, I certainly think everyone should have a primary care physician they trust to evaluate any worrisome symptoms. Hope that helps clarify my position.
Thanks for writing.
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