Hello. Recently tested HIV1 positive. Further tests mark my C4 level a 11 (0.9%) and my viral load at over 400,000. Nurse says "If I were you, I'd begin taking pills right now." I say "I'd rather not." Doctor says "If you don't get started soon, you will die briefly." I collect my things to walk out of the room. Doctor continues "You will be brought here by an ambulance with pneumonia or worse, toxoplasmosis in your brain, coma, brain damage...." This doctor works for the Spanish Social Securty, a national health service. Perhaps he has a protocol that forces him to be direct and unpleasant in order to convince a difficult patient (like me). Two days thinking "You're going to die briefly; You're going to die briefly." Any thoughts, or suggestions as to how to get valid answers to my questions when I see him again next week to ask for a new analysis (I've only had one for C4 and VL). Thanks in advance for your attention to my query.

I agree that your doctor was extremely blunt and that his message was unpleasant. Perhaps, he needs some lessons in bedside manner, but I believe that his intentions were good. He was trying to persuade to start treatment because you are at a very high risk for developing an opportunistic infection. He is correct in his opinion that it is only a matter of time before you develop some serious complication. Treatment will prevent this.