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Mar 26, 2007

Dr. Frascino, I don't know if you could answer my question or even if this question belongs in this email. But I tested positive for HIV about 7 months now and on the inside I haven't been the same. It's hard for me to find someone to talk to about HIV and thoughts of suicide have been running through my mind. My family, especially my father, thinks this is a curable disease and pretends I don't have it. My only support is my ex. So far my visits with my ID doctor have been great. My CD4 count is going up and my viral load is going down. That is good right? I always get the two confused. I am thinking about the time when it is time to take meds to not take them at all. Please help. I don't know what to do anymore. Can you point me to the right direction if there is one?

Sincerely, KL

Response from Dr. Frascino

Hello KL,

Receiving an HIV diagnosis is a life-altering experience, but it should not be a life-ending one. A period of adjustment to your new reality as a "virally enhanced" person is normal; however, persistent thoughts of suicide are not. I strongly urge you to immediately contact your HIV specialist, discuss your thoughts of suicide and ask for a referral to an HIV-knowledgeable psychiatrist for counseling and treatment.

Your father probably means well, but his unrealistic attitude is not helping. You need to widen your support network, perhaps by confiding in other friends or relatives or by joining a support group. You should not have to try to cope with the challenges of a new HIV diagnosis alone.

Regarding your progress, yes, a rising CD4 count and declining viral load is good news. The CD4 count is a measure of your immune competence. HIV can destroy CD4 cells, leading to immunodeficiency. That's the "I" in HIV and AIDS. HIV medications leading to an increase in CD4 cells demonstrate that the immune system is improving. The plasma viral load is a measure of HIV activity. We want that to decrease as much as possible to prevent any further deterioration of the immune system. The goal is to drive the viral load to "undetectable" levels. You can read more about these tests by accessing the chapter on HIV monitoring tests that can be found under "Quick Links" on The Body's homepage. In fact, there is a wealth of information there, including a chapter entitled "Just Diagnosed." Check it out!

KL, please note the virus found me in January 1991. If I had committed suicide then, not only wouldn't I be here to answer your question, but I also would have missed the best 16 years of my life on this planet. There is indeed a way to be positive about being positive. Just as your CD4 and viral load values are improving, so too can other aspects of your life. Get the psychological help you need now without delay, OK?

I'm here if you need me.

Dr. Bob

Bob, you are the only voice I trust. Will donate for the 3rd time...plz comfort me!

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