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a little information worse than none?
Apr 24, 2006

Hello once again Dr Bob: Thank you for answering my questions ("not another hypothetical risk question"). I thought I may add an additional comment regarding (mis)information about hiv/aids. My boyfriend had always practised safe sex before. He slipped up with a particular guy and then, equating exposure with transmission, thought "if this bloke's got it, then I've got it already, so I might as well continue to have unprotected sex". A little information can also be harmful; the message that hiv is somewhat difficult to get hardly ever gets across, so much effort going into campaigning for safe sex. It hurts to think that had my bf known that he probably wasn't infected that first time, he would have avoided further exposure. Now we've had the results of his blood tests. His viral load is 12300 and his T-cell count is 294. His doctor has recommended he should start treatment but he refuses to do so. It may be that this is still the "denial" phase (diagnosis was only two months ago). Thanks once again, I'm a true fan of yours. Martin.

Response from Dr. Frascino

Hello Martin,

"Equating exposure with transmission" is a common misconception that can lead to irrational HIV fears and, in your boyfriend's case, behavior that can ultimately be destructive. It highlights once again the failures of our current HIV/AIDS education program. The current neo-puritanical, sex-phobic, abstinence-only-sex-education policies being pushed by Bush and cronies aren't helping the situation. We must all continue to demand science-based HIV/AIDS education at all levels.

Your boyfriend may well be going through a period of adjustment to his new reality of being HIV positive. I agree that if his counts are consistently in the 300 range, he should consider beginning HAART. Encourage him to continue having regular follow-up visits with an HIV/AIDS specialist. Perhaps he'll even let you accompany him to the visits. A competent HIV/AIDS specialist should be able to help him understand his current situation including the risks/benefits of beginning HAART. Also, encourage him to spend some time reading the information on this site and related links. Ultimately, the decision if and when to start meds is his. You should just try to make sure fear and denial aren't abnormally influencing his decision-making process.

Good luck to you both. I'm here if you need me.

Dr. Bob



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