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Beginning treatment if I live overseas
Oct 21, 2012

I have something of a dilemma on my hands here. I guess compared to a great many people I am pretty lucky, but still have a bit of a tough situation (I think).

I live overseas (forgive me for not saying exactly where) and have a great job that I love, great insurance that will cover the cost of medication (which can be mailed to me) and a supportive family who are the only ones who know about my diagnosis.

The problem is that I've not yet started the medication and am not sure how to proceed. The only doctor I've talked to in the States does not want to start my meds until I have a medical professional here in the country where I reside, even though I can make it back to the States frequently to receive follow up medical care there. The problem is that I live in a country where it is not entirely clear that I won't be deported if I make my status known and there is no HIPAA in place to protect my privacy. My job, while a dream come true, is also somewhat "high profile" so I'd rather protect my privacy.

When I asked about traveling and living abroad during my initial consultation I was advised that it is really no big deal and that several of the patients live abroad. Apparently I just have to actually get started on the meds and have an initial assessment after a few weeks to make sure I am handling them ok. After than all I would need is to follow up a couple of times a year.

I know from a purely medical perspective I would be a bit better off if I moved back to the States, but emotional well-being is an important facet of physical well-being and I am very happy where I am and would rather stay here if at all possible.

Any thoughts on my situation?

Response from Dr. Young

Hi and thanks for posting.

While a lot of the details of your care depends on the specifics of your health situation, it is entirely possible to receive your HIV medications and periodic care here in the States while "commuting" back and forth to your work location.

It is a good idea to start medications before any travel, since while the risk of side effects is generally low, you'd like to be sure of this before you leave the US for a while.

Certainly once one is on a stable, well tolerated and toxicity-free drug regimen, the need to monitor your clinical, symptom and laboratory health is really only every 4-6 months. For many of my patients who live here in the US, this is the frequency that I see them in the clinic and in between visits, there's little need for them to see their "HIV doctor". Indeed, I too care for several people who live abroad using just this strategy.

I hope that helps, BY



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