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Aug 21, 2006

Dear doctor bob,

I found my brother reading ur site for months on end.

The other day i walked into the bathroom to find that he had slit his wrists. He is alive, he is still in ICU though. I understand why he did it, we live in saudi arabia, muslim parents, etc. If he were positive, he would put the whole familly to shame and destroy my fathers business that he has been working so hard for for over 20 years. The thing is, he is a brilliant ivy league student, he's so handsome, you should see all the mothers trying to introduce their daughters to him, so young, so full of life. i confronted him this morning about why he tried to kill himself. he told me his story which i repeat to you. He and his friends went to neighboring montreal for some good old fun, as he never drank and never been with a woman before due to our lifestyle in saudi arabia, he got ahead of himself. He got drunk, had sex with a stranger. he used a condom the first time. he decided to have sex with her again but there were no condoms, he said he barely remembers it, he says he only remembers pain. tihs unprotected sex lasted 15 minutes give or take 5 minutes.. he said the next morning he had a scab on his genitals head. he said he slit his wrists based on his lymph nodes that were numerous and havnt gone down in 4 months. I went to him with statistics it seemed to ease his mind for 5 minutes. Because i mean. montreal has a near 2.000.000 population, 1 in 160 are infected. which means only 12500 are positive, since montreal has a massive gay community lets say that 40% are heterosexual.. thats about 5500, about those lets say half are his age group. thats only 2250. half of which are females. Of the 1125 heterosexual girls in montreal in his age group that are positive and might of infected him. to add to this, there still a 1/1000 (or less because of the scab?)chance of getting it IF she was one of those girls.. HE TRIED TO END HIS LIFE BASED ON THIS!! PLEASE DOCTOR!! i dont want to tell him to get tested of fear that he might do something stupid again. PLEASE DOCTOR, I ask this of you, because psychiatrists are practically non-existant, and IF HE REALLY IS INFECTED, my family dies before Aids will take his life.. Please help me, help him. My older brother has allready died 4 years ago in a deepsea fishing accident. I cant stand to lvoe another brother.

-saadiya May peace be upon you, may god smile at you and eternal sunshine, long life, health and wealth shine down on you.

Response from Dr. Frascino

Hello Saadiya,

I'm sorry to hear about your brother and continue to find it appalling that if he were to be HIV positive it would result in shame for your whole family and destroy your father's business. Saudi Arabia should be ashamed of such a legacy a full 25 years into the HIV/AIDS pandemic! Whatever happens with your brother, I hope you will dedicate yourself to help end such stigmatization in your country.

Turning back to your problem, I'm a bit confused as to where you and your brother presently are. Montreal is not exactly Saudi Arabia's neighbor. If your brother is in Montreal and has had a suicide attempt that landed him in the ICU, he will definitely be seen by a psychiatrist. If he's in Saudi Arabia, I would still hope he would be evaluated by a psychiatrist, but if, as you say, they are "practically nonexistent" there, that may be difficult to arrange.

I'm not exactly sure how I can help over the Internet. You state that your brother has been reading my site for months and consequently he should be well versed on the potential risk of his one-night stand. Plus, you provided him with another statistical analysis as well. Personally I would very strongly encourage him to get HIV tested if it's been three months or more since his possible exposure. In fact he should get tested while in the hospital where he can be watched and monitored for any attempts to try to hurt himself again. The statistical odds are all in his favor that he is not HIV positive. He is most likely suffering from depression, anxiety and guilt related to his boys' night out experience. I find it sad and tragic that a strict upbringing can result in a "handsome and brilliant Ivy League student" attempting to destroy himself, merely because he fears the repercussions of his family and society resulting from a single episode of getting drunk one night and having an indiscretion.

Bottom line: get your brother the help he needs, including a psychiatric evaluation, if possible, and an HIV test. Finally, why not level with your family. Tell them exactly what happened. Surely their love for your brother will supersede concerns about family shame. Education and enlightenment have to start someplace if things are ever going to change and improve. As the old African proverb states: "The best time to plant a tree is 20 years ago. The next best time is now."

Good luck to your brother, you and your family.

Dr. Bob

Bush and IRAQ!!

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