Dr. Bob

I would like to commend the work that you and your colleagues do and the service you provide at this website. I was just diagnosed positive for HIV a couple of weeks ago and the reality is starting to sink in. My first concern is for my son who is four years old. I had him tested and thankfully he came back negative. Every thing I have read said that HIV cant be transmitted through casual contact but like all parents I worry about all the hypothetical scenarios like him scraping his knee or busting his lip. Are there any lifestyle changes that I need to implement on a day to day basis? Will I be able to care for him safely and what precautions should I take?

My second concern is that I still havent seen a specialist yet. I have no idea what my Tcell count is, nor do I know what my viral load is. My primary doctor referred me to a specialist but Im still four weeks away from that appointment. Since being diagnosed, I have a persistent case of oral thrush and despite taking Nyastatin it still hasnt cleared up. And last night Ive developed a skin rash all over my arms, chest, back, and legs. It doesnt hurt or itch as long as I keep hydrocortisone cream on it, but its kind of scary to be covered from the neck down in red spots. Im really starting to get overwhelmed by all the information and stigmas surrounding HIV. Its Good Friday and the clinic in my town is closed and the ER is probably packed. Should I just keep using hydrocortisone cream to keep the itching in check until I can see the HIV specialist or is there something specific I can do in the next four weeks to help keep this stuff at bay?

Thanks for all that you do, Scared Single Dad

Hello Scared Single Dad,

I'm sorry to learn of your recent diagnosis. Being HIV positive myself I absolutely understand how overwhelmed you must feel at the moment. First I would advise you that things will get significantly better and more manageable as you adjust to your new reality, learn more about HIV, and work closely with a competent and compassionate HIV specialist. I would suggest you take some time and read through the chapter titled "Just Diagnosed" that can be easily accessed on The Body's homepage under the Quick Links heading.

Regarding your son, you are correct: HIV cannot be transmitted by casual contact. If he scrapes his knee or cracks his lip, you dry his tears, clean up the wound and put a Band-Aid on it and comfort him with hugs and kisses, just like every other parent would do. No special precautions are warranted. No "lifestyle changes" are necessary. Can you care for him safely? Absolutely. All you need is common sense. For instance you would want to avoid getting your fresh blood into an open bleeding wound he might have. You can read through the chapter in the archives dedicated to nonsexual HIV transmission for additional information.

Regarding your second concern, it's difficult for me to comment on a rash without being able to examine it. There are a variety of rashes that itch for instance hives or eosinophilic folliculitis. An HIV specialist or dermatologist should be able to evaluate and treat this type of problem easily. I'm concerned you were diagnosed HIV positive several weeks ago and your first appointment with an HIV specialist is still four weeks away! What's up with that??? I'd suggest you contact your primary care doctor and strongly request he personally contact the HIV specialist and get that appointment moved up. A wait of several days would be reasonable for non-emergencies, but six weeks is totally unacceptable. You could also call the specialist's office and ask to be seen more urgently or be put on a cancellation or no-show list. You could also try contacting other certified HIV specialists in your area. The American Academy of HIV Medicine's Web site, www.aahivm.org, has HIV specialists listed by locale.

Good luck Dad. I suggest you become a squeaky wheel until you can access the medical care you rightly deserve in a more timely fashion.

I'm here if you need me, OK?

Good luck. Hang in there. Things really will improve.

Dr. Bob