Dr. B.,

I did show your comments to my professor, and he shrugged his shoulders and said, "impressive credentials, but that still doesn't change the facts. Yes, different viruses have different transmission vectors, but they are inherently efficient at transmission and replication. Every physician should know that." What do you have to say about that?

1st year med student.

Hello First Year Medical Student,

I stand by my comments, which are backed up by fact and over a quarter century of epidemiological research on the HIV/AIDS pandemic. Your pathophysiology professor is most likely not understanding your concern about HIV transmissibility. (Either that or he should be taking a course in HIV pathophysiology rather than teaching one!)

An example to support my comments is provided by the CDC's published estimated per-act statistical risks for acquiring HIV via exposure route. The estimated per-act acquisition risk of unprotected insertive oral sex with a partner confirmed to be HIV positive is 0.5 per 10,000 exposures. The estimated per-act HIV-acquisition risk for insertive penile-vaginal intercourse with a partner confirmed to be HIV positive is 5 per 10,000 exposures.

Medical student rather than accepting someone's word about this issue, I would suggest you do your own research on the transmissibility of various viruses. You will find there is great variability. For instance Ebola virus is very contagious and transmissible; HIV is not nearly as contagious or transmissible. ("Every medical school pathophysiology professor should know that!")

Dr. Bob

Pathopysiology Class Mar 8, 2009

My professor said that a virus is much smaller than a bacteria. Hence, any virus is considered highly communicable when transmitting within species. I think it is absolutely irresponsible when you tell people that, "if HIV was transmitted that easily, it would have wiped out the entire planet." HIV is transmitted very easily and if you keep making those remarks, we will have a pandemic.

Response from Dr. Frascino

Hello,

1. It's pathophysiology, not "pathopysiology."

2. I'm delighted you are so enthralled by your professor's every word. His comment about viruses being much smaller than bacteria is correct. However, the "hence, any virus is considered highly communicable when transmitting within species" is not correct.

3. You think I'm absolutely irresponsible in my advice to questions. Fine. You can think whatever you like. That doesn't mean it has anything to do with reality.

4. HIV is not all that easy to acquire compared to, say, the common cold or flu viruses. If it were, it would have wiped out the entire planet long ago!

5. Finally, your comment: ". . . if you keep making those comments, we will have a pandemic." Sweetie, I hate to be the one to break the news to you, but HIV/AIDS is and has been for quite some time a global pandemic.

Please feel free to show my comments to your professor. I am an HIV/AIDS physician specialist with over a quarter of a century of experience in HIV/AIDS research, education and patient care. I am a board certified clinical immunologist and certified member of the American Academy of HIV Medicine. I am president of a not-for-profit charitable foundation that has raised over $1,250,000 for crucial services for HIVers worldwide. I have founded two medical clinics devoted to the comprehensive and compassionate care of those infected and affected by the virus. Finally, I am HIV positive and have been living with the virus since January 1991. I list these qualifications merely to point out that my "comments" are supported by science, fact and personal experience.

I suggest you get back to your books and keep studying. You obviously have much to learn.

Dr. Bob