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mom of romanian adoptee
May 5, 2007

Hi Doctor Bob, I contacted you hours after my daughter was diagnosed with HIV...I have followed your advice about have supporting her career dreams to be a physician. She was offered scholarships to UCLA, UCSB and Berkeley. She starts Berkeley in the summer session! We are both delighted. She has done geat with her health too... levels remain undectable. The fatigue gets her some days but she carries on. She will see you on the other side of the Stadium when CAl meets Berkeley. Thanks for everything, you are an inspiration! Concerned Mom

Response from Dr. Frascino

Hey Concerned Mom,

Welcome back once again to the forum. What a pleasure it is to read about your daughter's accomplishments and your support of her dreams. Scholarships to UCLA, UCSB and Berkeley? WOW! BRAVO!!!!

I'm absolutely confident she'll have a marvelous experience at Berkeley and will continue to flourish. And since she'll be "in the neighborhood," chances are quite good our paths will cross.

I'm going to print your previous posts sequentially, as I feel they present a heartwarming and inspiring story.

My warmest wishes, hugs and congratulations to you both.

Dr. Bob

Pediatric HIV Jul 2, 2003

Hi Doctor, About 3 hours ago my 14 daughter was diagnosed with HIV. The test was part of a routine blood workup prior to surgery for a deviated septum. I adopted her from a Romanian orphanage in 1991,she was age 2. An HIV test in Romania and another upon return to the US showed her to be negative for HIV. I am stunned and scared and bewildered by this news. She is not sexually active. The doctor ordered a Western Blot which he says is more sensitve. I have a million questions, but I want to know if you have any info regarding Romanian children contracting HIV years after being in the US? The doc also asked me about blood transfusions that were rumored to be routinely performed on the kids. Please share any info or suggestions. We live in the LA,CA area.What do I do next???? Thanks A worried mom

Response from Dr. Frascino

Hello Worried Mom,

First off, never believe a single test result. It might have been a "false positive." Although, here in the US, positive HIV ELISA tests should always be confirmed with Western Blot tests before test results are released! If your daughter is positive, youll need to get hooked up with a pediatric HIV specialist. There are excellent centeres in the LA area that can provide the very best care.

Modes of transmission first, are you certain your daughter has not been sexually active? It is, of course, possible at age 14. Second, yes, blood transfusions are a risk, but there should have been a report if she received a transfusion, and I doubt they would have given her one without a specific medical reason. Could she have been positive since infancy? Possibly. Her CD4 cell count would probably give an indication of long-standing infection, if that were the case. There is also the unlikely possibility that she contracted HIV in Romania, but was tested both there and here in the US during the "window period!" How long was the period between these two tests?

OK, Mom, I know you have a million questions, but first things first. Find out if your daughter is really positive or not. If she is, shell need T-cell tests and viral load studies among other tests to determine how well shes handling the virus. The involvement of a pediatric HIV/AIDS specialist is absolutely crucial; he/she will answer all or most of your million questions. For those remaining questions, Ill be here. Im also a board-certified pediatrician in addition to my immunology degree, and therefore would be happy to help in any way possible.

Good luck.

Dr. Bob

Mom of Hiv+16 year old Jul 11, 2005

Hi Doctor Bob, I wrote to you in June of 2003 a few hours after my then 14 year old daughter (a Romanian adoptee) was diagnosed. This mom clung to your every word...still do. At this she point she is undetectable;she is very compliant with her meds. She now visits LA Children's Hospital every 3 months. The care is great! I read your words regularly and enjoy your humor and wisdom. My nagging concern is that my daughter wants to go to med school. She is active in leadership,music,sports, is already taking some college level courses. I wonder if she can handle the stress of the demands made on med students. I do not want to damper her dreams but I do not want her health to suffer. Also, be honest, can universities discriminate in accepting HIV+ plus students especially in medical fields.And what is the job market like for HIV+ docs??? Must she reveal this info??? How would you approach this if this were your own kid??? Nothing like putting you on the spot. Also, wish we had a parents' forum...sometimes I feel like my head is going to explode.I have to ask myself is this OABAT= On accounta Being a teenager or OABATH=On accounta of Being a Teen with Hiv? Hiv surely adds to the teen roller coster ride. Thanks for all that you do. A Mom

Response from Dr. Frascino

Hey Mom,

Welcome back to the Forum! I'm delighted your daughter is doing so well. Music, sports, college-level courses, leadership . . . . You must be very proud of her! Plus, she's "very compliant with her meds." That, in and of itself, is a remarkable accomplishment for an active teenager. It's also critically important for her continued good health.

I must say you're the first mom (or dad) I've ever heard say they have a "nagging concern that my daughter wants to go to med school!!!!" Of course, I understand what underlies your particular concerns. Should you try to "damper her dreams" in an effort to protect her health? No, in fact I would strongly encourage her to follow her dreams. Can an HIV+ kid handle the stress of medical school? Absofrickinglutely! Sure, medical school is not for everyone, and there are plenty of HIV neggies who can't handle various aspects of the medical school curriculum; however, assuming your daughter remains compliant with her meds, continues to have regular follow-up with an HIV specialist and maintains a good CD4 cell count and suppressed viral load, I see no reason why she shouldn't' pursue any career for which she shows aptitude and passion.

What about disclosing her HIV status? HIV-disclosure laws vary from state to state. Can universities discriminate based on HIV status? Technically speaking, I believe that type of discrimination is illegal. Practically speaking, it probably could happen.

The job market for HIV+ doctors? Well, luckily we do not have to hang our HIV status on a sign along with our shingle, when we open or join a medical practice. In reality, do you have any idea if your doctor or dentist is HIV positive or not? A number of years ago, "universal precautions" were standardized. These measures protect against bloodborne diseases in both directions patient to doctor and doctor to patient.

What would I do if it were my kid? I would advise her to live, love, laugh and be true to herself. Dreams should not be dampened, but rather encouraged at every opportunity.

Mom, I think you and your daughter are both doing a fine job and should be commended. By the way, if you ever figure that OABAT thing out, could you let us know ASAP?

Stay well, Mom. Hug your daughter for me. OK? I would be honored to have here as a distinguished colleague someday.

Dr. Bob


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