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Not another stupid question
Jul 18, 2006

Hey Dr.Bob, I've been reading your answers for almost a year now and I have to say I find them very inspiring. I also admire your patience for answering people's stupid ass questions.My situation is briefly this. I was diagnosed with Hiv+ 6 months ago. I am healthy for now(t-cells 568, viral load 7000), not on meds.I am trying to learn to live with it, eat healthy, exercise, be hopeful and positive (literally). Zoloft helps my depression, and I am feeling much better than I used to.I dont think about death that often. I dont wanna kill myself and I dont have anxiety attacks anymore like I used to everyday. But on the other hand, I feel like I am numbing my thoughts and feelings by anti-depressants and I am not facing reality. No matter what I do, I cant stop the anger inside. I read here about all these people, doing irresponsible sexual things like unprotected sex and taking so many chances and not getting infected. On the other hand, I used condoms all my life, except once.I had unprotected anal sex with the guy whom I thought I was in love,(me being the bottom) for less than a minute. The next thing u know, I got non-stop diarrhea, swollen lymph nodes that still wouldn't go away, night sweats, white patches on tongue that still wouldnt go away...I was positive. It still feels unreal and I dont see hiv as a blessing (like that old woman told me in the elevator at the testing center).So my question is, If hiv is so hard to acquire, why and how did I get it in such a short period of penetration. and why these people who have unprotected sex so many times dont get it? I am soooo angry and I can't get over the question "why me?". All my friends tell me stories about how they took chances and bareback many times and never got it.And they are not lying, because I've seen their test results. Right now I feel fine and I can work.But I dont have family in this country ,so whats gonna happen when I get really sick and wont be able to work and take care of myself.I destroyed my life for one moment's pleasure.Will hate and anger ever go away?

Response from Dr. Frascino

Hello,

The old woman on the elevator of the testing center told you having HIV is a blessing?????? WOWZA, what the hell has she been smoking? If she considers HIV a blessing, I'd like to know what she considers a curse!

Being diagnosed with any significant illness cancer, Alzheimer's, HIV, Republicanism is a shock! Anger can be part of the acceptance process. A period of adjustment to your new reality is normal and to be expected. Since you were having suicidal thoughts and anxiety attacks prior to taking Zoloft, I agree the antidepressant is working. Is it "numbing" your thoughts? Perhaps, but if it's numbing your thoughts about harming yourself or your feelings of panic, that's a good thing. As for facing reality, it seems to me you are doing just that! You are not ignoring or denying your illness. You are confronting it and I'm confident you are well on the way to accepting your new reality.

As to your question, "why and how did I get it in such a short period of penetration . . .?" it's simply a matter of sexual Russian roulette. The estimated per-episode risk of acquiring HIV from unprotected receptive anal sex with a partner confirmed to be HIV is 50 per 10,000. Note that risk is per-episode. So each time someone has unprotected receptive anal sex, the risk is exactly the same. Like playing Russian roulette, each time you spin the cylinder and then pull the trigger, there's a 1 in six chance the gun will fire.

Regarding HIV transmission, yes, there are a wide variety of factors that can influence whether transmission occurs viral strain, viral load, host immune defenses, concurrent STDs, etc. however, the biggest factor, of courses, is whether you used a condom. To be blunt, the reason you became infected has nothing to do with whether your barebacking buddies have managed to dodge the HIV bullet or not, it has to do solely with your personal decision not to use protection. You ask, "Will the hate and anger ever go away?" Whom do you hate and why? You certainly can be pissed off and even hate the fact that you made a bad personal decision, but I certainly wouldn't direct that hate and anger elsewhere. We all make mistakes, even yours truly. Sometimes there are severe consequences to those mistakes; other times there are not. But whether there are or not, we all need to accept the consequences of our actions, including our indiscretions, and learn from those experiences. HIV found me while I was working; however, I don't harbor any hate or anger. Nor do I feel HIV has "destroyed" my life. Sure, the thought of "why me?" crossed my mind initially. After all, I was an HIV physician, helping a critically ill patient when I sustained my occupational exposure (hollow-bore needle stick and laceration). Why should I be the 1 in 300 who seroconverts after this type of exposure? But with time the "why me?" becomes "why not me?" I am no more innocent of guilty than anyone else who never wanted to have this scourge. HIV doesn't discriminate between those who are exposed occupationally and sexual risk-takers, nor does it discriminate between someone who "used condoms all my life except once . . . " and those who bareback as much as Jack and Ennis on a Brokeback Mountain fishing trip. Ultimately I think you'll come to understand this concept, much as the over 40,000,000 of us currently infected have done.

Finally, what's going to happen when you get really sick? First off, let's hope that with the help of a competent and compassionate HIV physician specialist and the ongoing improvements in HIV/AIDS management and treatment, you never will get really sick. However, I do suggest you begin building a support network, just in case. With or without family close by, you should confide in your close friends, attend HIV support groups and expand your network of people who rely on you and upon whom you can rely.

If HIV support groups and expanding your support network are not enough to help you cope with your anger and negative feelings about being positive, I would suggest you get some professional help, i.e. psychological counseling. Your HIV specialist should be able to refer you to a qualified HIV-knowledgeable therapist. I'd also suggest you read through the information on this site that can be accessed via the "Quick Links" section on The Body's homepage. Pay particular attention to the "Just Diagnosed" and "Inspiring Stories" sections.

HIV a blessing? No, certainly not. However, it doesn't have to be a curse either, OK?

I'm here if you need me.

Dr. Bob



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