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Recently tested Poz Update
Sep 11, 2005

I met with my HIV specialist today, but actually a team at this wonderful clinic( who by the way, never asked me why or how I, in this day and age of information, could possibly become HIV positive.) I only got smiles, support, and lot's of information.

I am going to say this once to Dr. Wohl and to everyone following this case: I did feel Dr. Wohl was insensitive to my situation. I do believe you made up after I went into a little of my background. There have been comments here and there concerning your comments towards me. Some in my defense, and some in praise of your comments. But basically it felt like a direct attack to my persona. You really had no idea how I contracted HIV. I could have gone through some act of violence, or simple betrayal(which is the case) I suggest you do not stand from the hiltop and make assumptions, shouting how? and why? when, what everyone needs at the point of contraction and going FORWARD is complete support and love.

My doctor has put me on Truvada and Sustiva. Let's see how it goes. I will start it tomorrow. I picked up the meds today, and I am terrified to start, so I am putting off till tomorrow. What a commitment. Everyday, two pills. I just have never been a good pill taker. Any suggestions on how keep up and on time?

Response from Dr. Wohl

First, at the risk of opening up this line of posting anew, allow me some clarifications:

Again, no personal attack was intended on you. I do not know you (although, after all these posts back and forth we are getting there). You wrote a simple question and stated you had been recently infected. I did not know if you were a man or a woman; if you were in the Ukraine, the UK or the Outer Banks of NC. I made no assumptions regarding how you in particular came to become infected (and stated in my original post that there are various ways people contract HIV, including through some of the circumstances you mention). I also completely agree that those infected with HIV need and should receive compassionate and non-judgmental care. I am glad this is what you received from your providers.

But, I am not your doctor. I am a doctor who sees a lot of people with HIV and hope one day to try to have to find another line of work because of a lack of business. After answering your original question and those posted by others who reported being recently infected, I felt it was time to put out to the universe a question: What is going on?

The chain of emails that followed reminds me of what happened after the famous NY case (a man becomes HIV infected with multidrug resistant virus and had rapid HIV progression). Some from the HIV community where bothered, even angered, at the actions of this individual, others were more fearful of a new strain of HIV run amok and a few came to the defense of this one person. For me, the tragedy was another human had become infected with a fatal viral illness that he had heard about and knew how to avoid. The tragedy for me was that yet another had become infected with HIV. I believe we can lovingly care for those who become infected (as I hope I do everyday) and at the same time ask the difficult question why people continue to become infected.

Your own post provided many of the answers I hoped to elicit. It has made clear that there are complex reasons why people find themselves in situations that risk their becoming infected. I have wanted to make sure all major comments on this important issue were heard and to that end most related emails have been posted. But, we have to move on and I will have to limit my response regarding this.

Second, the challenge of taking HIV meds daily is huge. For many it is difficult to integrate meds into their every day lives. Your docs have done you a favor by prescribing therapy that is once a day and that is currently two pills. Soon it is likely these meds will be formulated into a single pill. An important limitation of this combo is that most find it best to take the meds at night before bed to reduce/avoid the side effects of Sustiva.

I recommend you try to find something else you do every night before bed that you can tag the medications to. Brushing your teeth, putting out the cat, using a moisturizer - anything you do every night, can be come associated with the meds. Some of my patients will put the medications near their toothpaste, for instance. If there is a chance you will be away from home, put a dose in a small pill box and carry it with you.

These are practical measures. In addition, viewing therapy as a way for you to fight back against HIV may help you accept these as a powerful tool you wield rather than something to hold your nose and swallow. It is a potent combination that will work. Good luck.

DW



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