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Family Med Resident
Oct 6, 2008

Dr. Bob,

I am a family medicine resident in a city that has a very high infection rate per CDC stats. And as reported, the great majority of those infected are African American. As part of the complete H&P I always ask my patients social hitory which includes a sexual history, number of partners, safer sex practices, etc. Unfortunately, and I am not trying to be racist, not one of my African American female patients trusts their partner and almost all of them say that their partner has cheated on them. Being a white person, how do I convey the message of taking care of oneself, using condoms, getting tested along with the fact that the African American population has the fastest growing incidence of HIV/AIDS. I want my patients to be safe, strong, informed, and not add to the numbers. I hope I am making sense.

FM PGY2

Response from Dr. Frascino

Hello FM PGY2,

Although I know you are not trying to be racist, unfortunately in one way you are, but not in the way you might think. Certainly your message to African Americans that they must take care of themselves, use condoms and get tested, because the incidence and prevalence rates are shockingly high, is appropriate and right on target. This message should be given directly, forcefully and repeatedly. HIV/AIDS is 100% preventable. We know how to prevent it. Every new infection is a failure of our prevention, awareness and education efforts. That your black female patients do not "trust" their partners is, in many ways, helpful. It gives you the perfect introduction to discuss the need for STD prevention, safer sexual techniques and getting HIV tested. That said (and this is where you could be criticized as being "racist"), I must also point out you should be giving almost the exact same message to your non-African-American patients. They, too, are at risk for HIV/AIDS. Never assume the hip black chick in Room One is more at risk than, say, Sarah Palin's 17-year-old daughter in Room Two. Room One may be having lots of healthy condom-protected sex, while Room Two is having unsafe sex as a result of abstinence-only-until-marriage sex education and family that clearly lives in a dangerous parallel universe of denial.

Dr. Bob



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