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Health Held Hostage?
May 18, 2009

I was tested a couple of years ago and came back negative. About 8 months ago I came up positive. Because of finances, I hadn't seen a doctor. I finally got signed up for health care in February, right before I was arrested on an old warrant. I told the police I had HIV and was given a blood test. They lost the blood test and I finally received my CD4 count 2 weeks ago and my viral load last Friday. CD4 218 VL 11,000. I finally saw a doctor and she said it would probably be a couple of months before I could see a specialist. Should I not be concerned or is my health in danger because of a minor violation?

Response from Dr. Frascino

Hello,

Your brief post points out several major problems with the health care system in the United States. First of all you tested HIV positive eight months ago but did not have the "finaces" to seek medical care. Presently we have 47 million Americans without any health care insurance and an additional 25 million who are underinsured. Second, the HIV care in our penal system is far from optimal in many locations. Certainly with a CD4 count of 218 and elevated HIV plasma viral load you should be seen by an HIV-knowledgeable physician immediately and be started on combination antiretroviral therapy. When CD4 counts fall to the 200-cell-count range you have an increased risk for opportunistic infections, such as Pneumocystis carinii pneumonia. Waiting "a couple of months" is unreasonable in my opinion and could indeed further compromise your health.

Dr. Bob


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