Doctor Battles AIDS in Bay Area, Zimbabwe

About six times a year, Robert Scott leaves his private medical practice in the Bay Area -- where he has specialized in HIV/AIDS for the past 20 years -- to travel to Zimbabwe. There, he sees 170 HIV/AIDS patients. "I never intended to do this practice," said Scott, who visited Zimbabwe about six years ago intending only to collect art.

In the Bay Area, Scott works with many people who have contracted HIV from using intravenous drugs. Most of his patients are gay men. And testing is routine enough that Scott can diagnose patients with HIV before they progress to AIDS.

In Zimbabwe, none of Scott's patients use drugs; all are heterosexual; they are men, women and children; and Scott sees patients for the first time when they lose weight and grow sick -- the later stages of AIDS Scott.

With generic Indian AIDS drugs, which cost $300 per patient per year, and AIDS medicines from colleagues and patients who have extra pills, Scott treats patients in Zimbabwe. His Bay Area patients sometimes skip doses of medicine, said Scott. His Zimbabwe patients never do. "Their medicines are so precious to them."

Scott sees a bigger problem in a sense of complacency among younger Bay Area patients. More than a decade ago, people would see friends or acquaintances die from AIDS, or passersby with advanced AIDS. Now that medicines can treat people and keep them healthy longer, Scott said, people with AIDS are less visible. "The newer generations don't know about any of that," he said. And many patients over 50, having survived the era that killed their friends, now practice unsafe sex with an assumption that if they get sick, they can take medication.

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