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Jul 20, 2006

Dear Dr. Ben,

Im hoping and praying that you will answer this post. Your profile said that you have traveled around the world to educate people about HIV do you know of any resources for people in Thailand beyond the ones found on this site in the HIV/AIDS Hotlines and Organizations section? Heres the situation:

I have a good friend in Thailand (a Thai) who told me last month over the phone that he is HIV positive. I am the only person he has disclosed to. He is not on meds - apparently, the hospital he went to gave him the positive diagnosis, then sent him on his way without any discussions about meds, CD4, viral load or anything else. I told him he should find out about this stuff, but he was in denial and said that he felt fine and would stave off the virus by exercising.

I just found out yesterday that he has been in the hospital in his town since July 15th. The doctors are mystified about whats wrong with him because he hasnt told them he is HIV positive. He is scared to tell them because hes a school teacher in a rural town with a small community where everyone knows each other. I gave him some phone numbers for a few HIV/AIDS Organizations in Bangkok listed on this website. I also told him he should tell the doctors at the hospital because they probably need to know about his status in order to best treat him. But hes highly reluctant to do so.

Hes in a very weak condition, and I dont know his symptoms, but Im wondering if he should go to Bangkok to get care. Someplace that has more experience dealing with HIV. The nearest reputable hospitals are a 3 or 4 hour drive away, in Bangkok and another city. What do you think?

Do you know of any programs that will help HIV positive people with the cost of meds and monitoring their virus and OIs? As a teacher, he only makes the equivalent of $200 a month.

I want to do anything I can to help him. Thank you so much for your advice. I really really hope you respond to this post.

- A worried friend

Response from Dr. Young

Thanks for your post.

Your friend's situation is indeed a very difficult one; but I cannot stress enough, that persons who know their HIV status and don't tell their healthcare providers about their HIV status (especially like your friend who's ill enough to be hospitalized) can seriously jeopardize their health and delay correct diagnoses and the initiation of treatment. Stigma and descrimination are serious issues, but I'd hate to see someone have additional complications or even death simply because of the fear of loss of confidentiality.

Yes, the Bangkok organization would be a key starting point to get contemporary local advice, both for help in his village and in the big city.

I'm not sure what is the better of the two options; to tell his local physicians (my first choice) or travel to Bangkok. Either way a medical team needs to know of his complete medical situation before things will get better.

Best of luck to you and your friend. Write us back anytime. BY

Can CD4 count bounce back

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