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Nov 27, 2006

Hi Dr. Bob, I want to second the author of this comment's sentiment regarding all those worried wells out there who literally are worrying over nothing. The whole 'I used a ladyboy's chapstick and now I think I have AIDS' is ridiculous, and if you've nothing better to do with your life than worry about a virus that hasn't FOUND you, then I suggest you take up sudoku. Regarding how to educate people about the pandemic, and the actual risk involved, I have thought about it so, so much since my own exposure 10 weeks ago. I think, first of all, that a lot of worried wells are almost as worried about passing on the virus to others than they are about themselves. I cheated on my girlfriend because our sex life was pretty much non-existent. I actually did use a condom the first time, but the second time we adopted the 'condoms schmondoms' perspective. Stupid, oh so stupid I know, but we all make mistakes. Anyways, I levelled with my girlfriend, eventually, and we're working through the problem. My own anxiety came from the fact that we continued to deep kiss - we've only had one bout of PROTECTED sex where I withdrew before ejaculation - and I have mild gingivitis which I'm now attending to. Trouble is, a few weeks later, she came down with a very bad flu like virus. Again I was worried, she wasn't. No one is. But here's my point. IT's scientifically accepted that unprotected penetrative sex is the riskiest SEXUAL activity one can undertake in terms of transmitting/contractinvg the virus. But everyone deep kisses and generally performs/receives oral before getting to that beautiful altar. How do we, or can we, know, where or when transmission occurs?

I'm not trying to scaremonger. Because the incidence of HIV in Ireland, where I'm from, isn't that high, I was aware of the AIDS pandemic but I never thought I had to worry about it myself. In terms of solving the world's problems, I've been more of an activist politically and economically. I now realise I was blind and stupid. I apologise to the world. But I'm trying to make amends. I know a lot of my friends practice drunken uprotected sex, and I've begged and pleaded with them to change their ways.

Regarding transmission, like I said I'm not trying to scaremonger, but in all the information I've looked up since I started worrying - what a fucking waste of time - dental hygiene has never been one of the things mentioned in terms of prevention. I know there has only ever been one document case of transmission via deep kissing. My response is that almost every sexual encounter starts this way, and if I'm right, a cut inside your mouth caused by your partner biting might often provide a transmission route? Especially if the other person has mild gingivitis?

Dr. Bob, with the help of this forum...and Xanax(!), I've stopped worrying and now I've only a couple of weeks to the test. The point I'm trying to make up above is convoluted and maybe even not worthwhile, but I believe in debate and, having read WTF and the 'condom schmondom' nurse's comment, I think everyone would be better served - your good, wonderful self included - by indulging in adult discussion about this terrible plague rather than worrying if you caught HIV from scratching your scabby arm after forgetting to wash your hands in that dirty public toilet.

Oh finally, I won $200 dollars at poker last night, so I'm donating 50 of it to your foundation. I'd donate more, but I'm the poor Kerouac loving student, and my car needs to be serviced!

Thanks again for all you do Dr. Bob. Here's hoping I'll be woo-hooing for Christmas

Kerouac Guy

Response from Dr. Frascino

Hello Kerouac Guy,

Thanks for your comments. Although much of my time in this forum is spent addressing what may seem like trivial risks to those who have a better understanding of HIV transmission, I can assure you that to the frightened individual frantically sending me their questions, the fears are indeed genuine. My purpose here is HIV/AIDS awareness, education and prevention. As for "indulging in adult discussions about this terrible plague," I spend considerable time doing just that at medical meetings, advocacy seminars and other venues where that is the purpose of the get-together. The purpose here isn't so much discussion as it is the provision of scientifically sound, factual information about HIV prevention, risk and safer sexual practices.

Thank you for your donation! In return I'll send my best good-luck karma that you indeed will be WOO-HOOing for Christmas! I'll reprint the post you reference below for our readers.

Be well. Good luck!

Dr. Bob

WTF? Nov 24, 2006

seriously doc,

im worried about this whole thing... people are seriously worried about getting HIV from a chapstick??! im positive and when i went to explain it to my younger brother for him not to be afraid of me, his reply: as long as you dont fuck me im safe, so shut up and watch the movie... my younger brother at the time was 14... seriously... how ever looking forward to a cure i am,(shit even if a preventive vaccine comes out ill be happy even if it wont help me), im very skeptic about it when people are so absurdly ignorant about HIV.. How is that possible?! i mean i met this foreign exchange student from saudi, real cool guy and i tend to be straight forward about my i offer the guy to sleep over one night kuz he's too shitfaced to drive home, and i tell him (he knows im gay), listen man im positive, and he says: i agreed to sleep over kuz your my buddy, im not having sex with you.. i say: who said anything about sex? and he said: if u wernt inviting why the hell did u tell me u were positive? IF THE SAUDI GUY KNEW ABOUT TRANSMISSION?!?! how can others not? I've learned alot of things about our world.. the shady part.. the prostitutes, escorts, infidelity, the porn video booths, be it hetero or homo culture they both have it... and i find it dissapointing that people will go and do such stupid shit.. like my mother told me once when i was much much younger.. dont use the word fuck.. u dont even know what it means.. same here.. do go sleeping with prostitutes, or video booths, or anything 'shady' without educating your self on the risks first! what do u think is the best way to fight this? as a previous poster wrote.. knowledge is power... and in the HIV spotlight, most people are totally and completly clueless... Also, on the ask a question page u should write something like : if u wiped ur self with a dry tissue, if u kissed someone, if u fingered someone U DONT HAVE HIV so dont post! i mean i feel great when people come here and write about their real woohoo, which are to me, u had unprocted sex, maybe the condom broke, someone cheated on you, and they end up negative, it just makes my heart sing... people wirting about using their gay fiends chapstick and being in a hot tub together and woohooing is not much of a woohoo! the doctors in the clinics running those tests should be like, listen go home ur not positive... serisouly... the positive population is doomed

Response from Dr. Frascino


Thanks for your comments!

The hot tub or even the gay "fiends" Chap Stick scenarios are indeed not much of a WOO-HOO to people who know and understand the facts about HIV transmission. Unfortunately there are far too many people who are indeed totally clueless about what constitutes a transmission risk and what unequivocally does not. Considering we are 25 years into this world pandemic and we have clearly understood how HIV is and is not transmitted for over two decades, this shocking lack of understanding speaks volumes about our woefully inadequate HIV awareness, education and prevention policies in the U.S. As you point out, many countries have much more effective programs in place. For a totally preventable disease, it is shocking that the rate of new infections per year in the U.S. has remained constant at 40,000 year after year after year! Let's hope the newly elected Democratic Congress will help reverse many of the policies that have hindered our HIV/AIDS education, prevention and awareness efforts, such as needle exchange programs and frank science-based sex education!

Hey, is it 2008 yet?

Be well. Stay well. Stay informed!

Dr. Bob

HIV: Life or Death? Nov 24, 2006

I'm not sure whether to post under the "Am I Infected?" forum or rather "Comments/Thanks," but here goes. . .

I am a 37-year old heterosexual, female nurse who has, heretofore been negligent in practising safe sex. "Condoms-shmondoms," I'd say, usually with a cocktail or two (no pun intended) under my belt, and with luck, all of my HIV tests have come back negative.

So why am I posting? Two reasons: a change in specialities (ER to Hematology/Oncology), and an epiphany gone wrong.

Sixteen months ago, I left my Emergency Medicine practice and began specializing in blood disorders and cancer treatment. Since then, I've met ten young, straight women and one heterosexual man who were diagnosed with AIDS only upon ending up in hospital with serious and, in three cases, life-ening illnesses.

Primary gut reaction? "That's _awful_! Just like the early eighties, when no treatment was available!"

My second thought?

"Sh#t, that could be me!"

The immediate upshot of my reality check is that, for the first time in my sexual life, I used a condom the next time I had sex with someone. Unfortunately, it broke.

And here I type, ten and a half weeks later, scared of acquiring a condition I have 0.1% of acquiring, assuming my partner was HIV+.

Assured that I'd test positive at 12 weeks, I'd begun uconsidering the myriad ways in which, as a registered nurse working in hospital, I could stockpile medications in order to end it around, oh, say New Years Day or so.

Until tonight. Honestly. I was assigned two female patients in their late forties who are dying of terminal cancers, both of whom have less than three months left to live.

"God," I thought, "I bet both of these women would rather have had new HIV diagnoses. . .at least they'd have years, decades even, to experience rather than just months."

I wrote earlier of my safe sex "epiphany gone wrong." I tried to be responsible and the damn condom broke. In writing this, I've started to reconsider.

HIV+ or not, we've all got to die sometime and, with early diagnosis and expert treatment, HIV can usually be managed as well as any other chronic medical condition, like diabetes, for instance.

If you're a "worried well," be WELL damn it, and direct your angst outward to help educate others and prevent the spread of HIV.

If you've been diagnosed with HIV, as I well may, be glad that you have access to first rate medical care and remember. . .it could always be worse.

I know that the patients I cared for tonight would envy your, and maybe our, position.

Sidebar: Dr. Bob, I've sent a donation to your website. Aside from my personal research, I've directed ALL of my AIDS patients to your website and, for those without internet access, to local libraries where they are able to access the wealth of information provided herein.

I've also given them my home telephone number in case they need outside assistance. . .I've always had a hard time with the professional boundary thing.

And BTW, thanks for the tireless efort and amazing work that you do. I'm floored!

Response from Dr. Frascino

Hello Epiphanized Nurse!

Thank you for taking the time to write and share your enlightenment from "condoms-schmondoms" to HIV/AIDS activist! BRAVO! BRAVISSIMO!!!

It's personal stories like yours that make other "condoms-schmondoms" folks stop and think. I have no doubt that you will save a number of lives just by personally relating your heartwarming story here.

Thank you for your donation and your compassion toward those in need. I, too, have always had difficulty with the professional boundary thing. A number of years ago many physician friends thought I was totally insane when I told them I was making home visits for AIDS patients too ill to travel to the office!

In return for your good deeds, I'm sending you my very best good-luck/good-health karma that your definitive three-month HIV test is negative. (I should also mention my good-luck karma has never failed so far!!!)

I'm honored and delighted to have you as a professional colleague in battling the pandemic.

Be well. Stay well. (And that's a doctor's order!!!)

Dr. Bob

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