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re: need your advice- it really will affect my career and decision
Jul 29, 2008

Regards the law student. Why does he feel he will need to hang out a shingle that say "HIV + Attorney at Law"? His status is no one else's business except his sexual partners and his doctor.

Secondly concerning insurance. Why not consider a job in the federal government? He would be covered even with a pre-existing condition, the prescription coverage can be very good (I know from experience), and he could do a service to his country, or at least his fellow citizens.

Just my two cents.

Response from Dr. Frascino

Hi,

This fellow only recently learned he is HIV positive and I'm assuming since he's still in law school that he's relatively young. He's still learning the ropes. I'll pass on your comments and repost his original question below.

Thanks, on his behalf, for your two cents! (I think lawyers change more than that per nanosecond don't they?)

Dr. Bob

need your advice- it really will affect my career and decision :-)))) Jul 24, 2008

Hi Dr. Bob, I am a law student who recently found out that i have what you have. Yes, even law students make stupid mistakes- and i feel sooo guilty and ashamed. I am not sorry for myself but i am sorry for those i will hurt around me- such as relatives, friends, and people who will not be able to look at me ever the same. I didnt really how bad the stigma is with the disease. The people in the US are still in 2008 too ignorant its unbelievable. I am in a second year law student. My concern obviously i could finish law school but i worry about who will hire me with my hiv + status- i dont mind working for hiv service organizations and devoting my life to make a difference- but i will have alot of bills to pay about over $150,000 when i finish school- will be in alot of debt and might even need to pay for medications without a job or insurance. I bet you see my situation. I would like to know a few things- which probably you living with the virus for some time might have some more knowledge to answer.

1. I am 26 - i would finish my the time i am around 27-28- would this most likely give me enough time to finish school without having to start medications? What is the average time people take to need medications. I see posts on this site which states that people needs meds about 2 years after they are diagnosed usually coming back with low cd4 counts and that scares me. How long did it take you until you had to start meds- i know its personal and everyone is different but i would like to know in general what i might be up against.

2. Being 26, do you think it is realistically possible i might live to be able to work, stay healthy, look healthy (not have hiv look) until i am over 50 to near 60 years of age. Is this even realistic today?

3. I read that hiv drugs today do work but they are poisonous cause way too much side effects -and are quite expensive...i dont have health insurance - with this virus will i ever qualify for health insurance and more importantly prescription coverage.

I dont want to bomb you with questions- i just am wondering what realistically you would do in my shoes. Career change or make a difference in life.

Thank you. Stay strong and best in health. You are a true hero and inspiration. Its people like you- that offer people like me a little hope today - a very hard and sad time in my life.

hiv poz law student

Response from Dr. Frascino

Hello Poz Law Student,

Sorry to hear about your recent HIV diagnosis. It's a good reminder to all our readers that HIV doesn't discriminate. It can affect and infect people from all walks of life. Neither law students nor HIV specialist physicians are immune. As for not realizing how significant the stigma is surrounding HIV/AIDS, I doubt anyone who is not infected realizes this. It indeed reflects the level of ignorance, myth and misunderstanding that has haunted this illness for over a quarter of a century. It's also a sad commentary on our HIV/AIDS-awareness programs.

Regarding your specific question:

1. There is no "average time" from the time of diagnosis to the time antiretroviral medications would be recommended. This is due to many factors, the most important being that the time of diagnosis often is quite different from the time of initial infection. Many people have been HIV infected for years before getting tested and being formally diagnosed HIV positive. There are also differences based on host immune integrity and concurrent illnesses. In addition, there are specific viral factors, such as viral strain. Your HIV specialist, after monitoring your CD4 counts and HIV plasma viral load tests over a period of months, will be able to better answer your question regarding a general time horizon for possibly starting antiretroviral therapy.

2. Again, without knowing much more about you and your HIV disease, I cannot give you a specific assessment. If I were to give a general reply to the question "could a recently infected healthy 26 year old realistically be able to work, stay 'healthy' and 'look healthy' until the age of 50 or 60?" my response would be yes, absolutely.

3. Antiretroviral drugs are not "poisonous" per se, but they are potent and they can cause significant toxicity and side effects. Will you ever qualify for health insurance and prescription coverage? That depends entirely on whether Senator Obama becomes President Obama. I would suggest you do everything in your power to get Obama elected and also to elect as many Democrats as possible to Congress. That's your best hope for coverage. Certainly if you were hired by a law firm that had a group health insurance plan that included preexisting conditions, that would be another way to possibly get coverage.

4. What would I do if I were in your Jimmy Choos? I would definitely not let HIV alter my life plans or dreams. I personally know many HIV-positive lawyers (and butchers, bakers, candlestick makers, etc.).

One final comment: I would suggest you consider counseling, as it appears you are having a very difficult time adjusting to your new reality as an HIVer. You also sound depressed. Counseling could help you to become more positive about being positive. Don't let HIV ruin your life.

Good luck.

Dr. Bob



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