premed and HIV?

[dopaminophile]

Blood screens are the same as requiring drug tests and criminal background checks. It's an invasion of privacy, but it's absolutely required for the safety of patients and the hospital is liable if the worst happens. I would want to know my wife's OB isn't positive and to know that my kid's surgeon isn't positive. It's a terrible discrimination, but it's a matter of safety. Really, I would think that a person that is positive would take themselves out of the possibility of harming a patient.

This isn't the only place that discrimination or self exclusion are sadly necessary. Epileptics shouldn't fly airplanes and I don't think they can operate either (I might be wrong on the latter). Diseases impair peoples' lives, unfortunately. With physicians, disease often precludes them from ethically treating patients. Incidentally, medical schools also have conditions of acceptance that require students to be physically able to perform the tasks required by the education. This is discrimination against the handicapped point blank. Sadly, the nature of the occupation requires it.

I wish there were a sure way HIV+ medical students or those who are sexual partners of HIV+ people could absolutely guarantee the safety of their patients. Right now, I don't think it's possible.

edit: I just realized that I've been spelling "discrimination" as "descrimination." How annoying. Sorry.

---

Members don't see this ad.

 

[myodana]

I understand this is SDN and everyone is trying to be idealistic, but there needs to be a line drawn. Having sex with an HIV victim is F*****' CRAZY! I feel bad for the man because he doesn't deserve it and the OP's friend is a sweetheart for showing love. I just can't believe I'm the only one here who thinks it's attempted murder even if it is protected sex. I hope they do get happily married, but I pray she just doesn't do anything dangerous.

so don't have sex with a person with HIV! but attempted MURDER? COME ON. have you ever heard of consent? i'm not saying it's a smart idea, but please. ATTEMPTED MURDER? are you serious?

and by the way, most people with HIV that i know resent being referred to as "victims." the appropriate term is "person living with AIDS" or PWA.

 

[dopaminophile]

so don't have sex with a person with HIV! but attempted MURDER? COME ON. have you ever heard of consent? i'm not saying it's a smart idea, but please. ATTEMPTED MURDER? are you serious?

and by the way, most people with HIV that i know resent being referred to as "victims." the appropriate term is "person living with AIDS" or PWA.

While I don't agree that consented, informed sex is murder, the idea isn't all that far-fetched. Knowingly infecting people with HIV (as I vaguely recall) has been prosecuted as murder to some degree. Only in Oregon is homicide legal with a consenting victim. So, in the other 49 states, such wilfull infection might techncially be murder. I dunno... I divert to Law2Doc.

Incidentally, on the correct terminology front, the people I worked with didn't use the term AIDS at all because you can move in and out of the 200 CD4 count now and the term "AIDS" creates subclasses when they're already fighting enough stereotyping and dIscrimination. The people that I worked with preferred the terms "positive" or "negative." That way, if there were a workplace accident, people would know. Sounds reasonable to me.

 

[tigress]

Look, I want to know why everybody immediately assumed these people are having sex. First off, it's NONE OF OUR BUSINESS. Second, people can agree to live in a relationship and be abstinent (there are other ways to show love; and there are ways to be sexual without having sex of any sort...use your imaginations).

The question asked was whether this girl should talk about the situation in her PS. Not whether she should have sex with the guy. As I mentioned in an earlier post, I really truly think it's not our business. All of the advice about the PS is great. I can see both sides of the issue, and some people have some very intelligent things to say. So why can't we leave our personal judgements about this relationship (which we know absolutely no details about) and continue to discuss the wisdom of including risky information in a PS?

 

[dopaminophile]

Look, I want to know why everybody immediately assumed these people are having sex. First off, it's NONE OF OUR BUSINESS. Second, people can agree to live in a relationship and be abstinent (there are other ways to show love; and there are ways to be sexual without having sex of any sort...use your imaginations).

The question asked was whether this girl should talk about the situation in her PS. Not whether she should have sex with the guy. As I mentioned in an earlier post, I really truly think it's not our business. All of the advice about the PS is great. I can see both sides of the issue, and some people have some very intelligent things to say. So why can't we leave our personal judgements about this relationship (which we know absolutely no details about) and continue to discuss the wisdom of including risky information in a PS?

That's kindof the beauty of these forums though; we can take a question that one person has and explore the issue fully, with hypotheticals and tangents that have little to do with the OP. A lot of the things that are brought up in this thread and elsewhere are important for pre-meds, med students, and world of medicine in general. Clearly we can't know the nature of an anonymous poster's friend's private relationship, but we can explore the general issues brought up by the scenario. I think the topics brought up in this thread have been important and relevent.

 

[tigress]

That's kindof the beauty of these forums though; we can take a question that one person has and explore the issue fully, with hypotheticals and tangents that have little to do with the OP. A lot of the things that are brought up in this thread and elsewhere are important for pre-meds, med students, and world of medicine in general. Clearly we can't know the nature of an anonymous poster's friend's private relationship, but we can explore the general issues brought up by the scenario. I think the topics brought up in this thread have been important and relevent.

I agree that these are relevant and interesting topics to discuss. What's getting to me is the personal attacks. Discussing something as a hypothetical situation is great. Attacking people we don't even know for something we don't even know they are doing just bothers me.

Although, dopaminophile, I would like to thank you for your thoughtful posts; and I have learned some things in this thread, and I have some new things to think about. Many people are being quite reasonable and simply discussing the issue. It is the people who are making personal attacks that I would like to consider the fact that you know nothing about the situation at hand.

You mentioned HIV testing in med schools. Do all schools do this? Do they start as soon as 3rd year starts? I think it's a pretty good idea, actually. Do practicing doctors have to get tested? You're right, the risk of doctor-to-patient infection is real, albeit small. Even if there weren't rules to stop me, I personally wouldn't want to perform procedures on somebody if I knew I had a communicable disease. I wouldn't feel comfortable with that.

 

[dopaminophile]

I agree that these are relevant and interesting topics to discuss. What's getting to me is the personal attacks. Discussing something as a hypothetical situation is great. Attacking people we don't even know for something we don't even know they are doing just bothers me.

Although, dopaminophile, I would like to thank you for your thoughtful posts; and I have learned some things in this thread, and I have some new things to think about. Many people are being quite reasonable and simply discussing the issue. It is the people who are making personal attacks that I would like to consider the fact that you know nothing about the situation at hand.

You mentioned HIV testing in med schools. Do all schools do this? Do they start as soon as 3rd year starts? I think it's a pretty good idea, actually. Do practicing doctors have to get tested? You're right, the risk of doctor-to-patient infection is real, albeit small. Even if there weren't rules to stop me, I personally wouldn't want to perform procedures on somebody if I knew I had a communicable disease. I wouldn't feel comfortable with that.

I don't know if there are standards for testing employees and students or if it varies from institution to institution. I wouldn't be surprised if you could find it on most medical schools' websites.

And I agree... flaming really blows and can make these forums unpleasant.

 

[GuyLaroche]

Forget mentioning it in her personal statement; I think she needs to get her head on straight first. No matter how much she may be in love with this person, she is going to be posing a definite risk to her own health, her children, etc.

You'll probably make a very, very bad doctor if one is to go by this post unedited.

 

[GuyLaroche]

Why does she need to include the detail that this man is her (hope-to-be) fiancee? Why not simply describe him as a good friend. She could still talk about how watching his struggle has affected her.

I would think that would be a better solution for describing the situation without hurting her in her med school process.

"Good friend," does not make for a compelling story. Besides, it won't be the truth and just will not resonate. Trust me, admissions personnel are tired of "friend" stories. I am concerned why you think admitting to having an intimate connection with an HIV+ person should be lied about. It should be applauded. It would be applauded. You strike me as a very careful, very boring, very judgmental person. I am the latter, but certainly not the first two.

 

[hello23]

from a patient point of view, I don't want my doctor, especially a surgeon, to be HIV+, and I don't even want to think that there is a high chance my doctor will have HIV. Adcom will most likely think that way. Don't you worry if you are the patient who is going to be operated by a surgeon who might have HIV?

 

[GuyLaroche]

Would I even want to attend a school that would discriminate against me based on my fiance's HIV status?

Probably not.

She should be honest about who she is and the people in her life who have touched her. If her partner's HIV status was one of the reasons that is leading her into a career in medicine, she should by all means include it in her PS.

You deserve Harvard! You've been the smartest poster thus far. I am willing to bet reading further won't prove me wrong. We should talk about marriage in Nashville.

 

[GuyLaroche]

writing about her relationship doesn't have any place in a personal statement. It would bring up alll sorts of questions of judgement. Most physicians these days don't discriminate against the HIV+ population; but they don't date them either. In the context of a romantic relationship, transmission is virtually unavoidable.

if she wants to date this dude -- that's her business. but sharing this in a personal statement won't go over too well with most readers on that adcom.

You're missing the point of a "personal" statement. I bet you were terribly boring to interview.

 

[doc05]

"Good friend," does not make for a compelling story. Besides, it won't be the truth and just will not resonate. Trust me, admissions personnel are tired of "friend" stories. I am concerned why you think admitting to having an intimate connection with an HIV+ person should be lied about. It should be applauded. It would be applauded. You strike me as a very careful, very boring, very judgmental person. I am the latter, but certainly not the first two.

what you don't realize is that physicians are largely a very conservative group. "very careful, very boring, very judgmental"?? -- that describes the vast majority of physicians, especially those in academics. I would think that the OP has some other interesting topic to write about without shooting herself in the foot.

 

[papertools2003]

you need not to mention this situation. the admissions committee do not want to read another paper on "oh this changed my life around or I learned to..." your statement should address and discuss issues pertaining to your character from past/past to present not identified on your application. if so she chooses to write about it, the admissions staff has to have no bias, nor prejudices to the subject. i hope this helps

 

[doc05]

You're missing the point of a "personal" statement. I bet you were terribly boring to interview.

what you've failed to realize is that the great majority of physicians are very conservative. the typical physician will read about her situation and think -- "what poor judgment; she's committing pseudo-suicide", or perhaps "interesting, but why write about this in a personal statement?"

could her relationship be interesting to discuss? yes. write about? maybe in a book. for a personal statement that deals with such a touchy subject, it must be incredibly well-written -- most med school applicants can't do this -- and well-received (there's no telling who will read your PS).

 

[Ambs]

really? all schools? isn't that an invasion of privacy?

I was tested for HIV & Hep C as standard "pre-employment" at the cardiology practice I work at.

 

[mercaptovizadeh]

Addressing the OP's question: no, she shouldn't write about it. It could be taken wrong even a conversation, much less a personal statement, where the author is not present to fully explain and defend her stance/feelings/etc.

Second: why all the outrage over HIV+ people spreading the virus. I think it outrageous that people who are HIV+ can just go around and have sex with tons of people and KNOWINGLY infect them.

Recently, there was a case in the northeast of some guy who infected 100+ people, KNOWINGLY. I would sentence such a person to several life sentences in prison. Unless it is consensual (and even then, it's kind of messed up), I would sentence persons who knowingly transmit ANY untreatable terminal illness to others (who don't know), to life in prison.

 

[LVDoc]

Recently, there was a case in the northeast of some guy who infected 100+ people, KNOWINGLY. I would sentence such a person to several life sentences in prison. Unless it is consensual (and even then, it's kind of messed up), I would sentence persons who knowingly transmit ANY untreatable terminal illness to others (who don't know), to life in prison.

I wrote about that in a prior post in this thread. The guy had some crazy super-resistent, super-virulent strain that only one drug could combat (out of 20 other possible medications). That guy should be on death row, not life in prison. 100+ people are going to die because of him. It's sick. The other thing that's sick was back in the day when HIV-infected people were putting their syringes in gasoline stations at the pumps. I remember that was a hot topic on the news back then.

I don't think anyone should be allowed to spread this virus, consentual or not. There is no good in the long-run that can come from it.

 

[GuyLaroche]

what you've failed to realize is that the great majority of physicians are very conservative. the typical physician will read about her situation and think -- "what poor judgment; she's committing pseudo-suicide", or perhaps "interesting, but why write about this in a personal statement?"

could her relationship be interesting to discuss? yes. write about? maybe in a book. for a personal statement that deals with such a touchy subject, it must be incredibly well-written -- most med school applicants can't do this -- and well-received (there's no telling who will read your PS).

To restate: I bet you were a terribly forgettable interviewee. I see white. I see pale. I see porridge. I see vanilla. I see...

 

[NPursuit]

You'll probably make a very, very bad doctor if one is to go by this post unedited.

I disagree. What LVDoc says is a hard dose of reality.

No matter how much you want to avoid stigmatizing those who suffer from the disease, AIDS is a disease poses a serious risks to patients, and I for one would not want to be treated by a doctor who had the disease, particularly not in a surgical setting.

I would avoid directly conveying this situation in a personal statement. As others have said, projecting this as a best friend or as someone in a past relationship would allow the same message to be conveyed without raising the ethical considerations. I would certainly question this individual's commitment to her patients and her career if I knew she was involved in such a relationship. There is essentially no chance of her not contracting this disease if she does decide to enter a long-lasting relationship outside of a fully abstinent relationship. That's a risk to patients. An unacceptable one in numerous settings.

 

[GuyLaroche]

You guys - a large proportion of you - are wholly pathetic. I'll actually move to scold the OP for trying to obtain opinions from a bland, scared and plain lot. I think the OP's personal statement, if done well, would be very memorable and very interesting. Who says a personal statement has to conform to your horrid variations on the tired theme of "why I want to be a doctor ?" I'll encourage the OP to go for it, and to write a thoroughly compelling essay that leaves the reader stunned and interested in meeting the author. These people asking the OP to be as similarly plain as they are should not be heeded. Color is a good thing, though my conservative colleagues might think differently.

 

[LVDoc]

This isn't about being conservative or liberal. It's about being logical, having common sense, and the ability to think things through as to what the potential ramifications of any actions might be.

I have provided more than enough evidence to substantiate my arguments that she is very likely to contract HIV, and dependant on whether or not she plans to have any biological children, there is a good possibility of also transmitting it to them. Not only will her husband pass away once the onset of the disease occurs, but she will as well. I have a hard time understanding why this lady wants to commit herself to death, and her children to that very same fear. How sad is that?

If she wants to enter any discipline in medicine at all, she will become a great risk for her coworkers and patients, regardless of whether or not PEP is used. Where are the ethics here? Why is this moral, valid, or just? I can't understand what you find appropriate about this situation. A person knowingly infected that continues to pursue this dream is acting on a bout of selfishness, when s/he is exposing his/her colleagues and the very dear people s/he trained so long for to help.

You think the admissions committees want a martyr on their hands? Do they want to train a doctor that they know will eventually die faster than his/her counterparts? Can they trust someone with this kind of judgment to make wise decisions on behalf of his/her patients?

Saying that she is going to get married only in the name of love is like living in a fantasy world. Just why has she decided to write her personal statement about her fiance's HIV+ status and its effects on her? Is that a true motivation? Why was there no underlying factor from before she met this man? Does she think that by declaring in her personal statement that she will be the savior of everyone and anyone, even amid her own risk of harm, the admissions committee will be more inclined to accept her?

These are questions I pose to you. Some may sound far-fetched, but I am surprised that any individual would put themselves in this position in the first place. I don't know the answers to these questions either. I do think however, that anyone in their logical right mind would clearly think about the implications her activity with this partner will have on her personal and professional life.

Why is this so hard to understand? What is so colorful about this? This is a portrayal of a bleak picture. Any admissions committee member that finds this out about her will not look favorably upon it. It is not something that will leave you stunned or interested in meeting the author - it will leave you perplexed why this person has chosen her fate ahead of its years, the fate of not being able to hang around long enough to see her grandchildren, having her parents and siblings outlive her, and leaving this world in a misery full of pain, physically and mentally.

 

[mercaptovizadeh]

I wrote about that in a prior post in this thread. The guy had some crazy super-resistent, super-virulent strain that only one drug could combat (out of 20 other possible medications). That guy should be on death row, not life in prison. 100+ people are going to die because of him. It's sick. The other thing that's sick was back in the day when HIV-infected people were putting their syringes in gasoline stations at the pumps. I remember that was a hot topic on the news back then.

I don't think anyone should be allowed to spread this virus, consentual or not. There is no good in the long-run that can come from it.

Aside from the fact that I do not support the death penalty for other reasons, I agree with you. I agree with you, even if it IS consensual. However, I wasn't in the mood to go down the path of "government controlling what goes on in the bedroom" in my post. But certainly, if they can quarantine you if you have TB, why should HIV be any different. Afterall, TB does have a *potential* cure, i.e. antibiotics, despite the possibility of MDR. Anti-retroviral drugs help but they are no cure.

Also, the prevailing mood of outrage (on this forum) at ANY commentary *against* continued HIV transmission in this country (isn't this logical?), probably stems from a fear of offending the homosexual community. At some point, I don't care who I offend, because people who are so sex crazed that they are infecting others knowingly with deadly diseases are criminals of the worst kind - gay or straight.

 

[mercaptovizadeh]

This isn't about being conservative or liberal. It's about being logical, having common sense, and the ability to think things through as to what the potential ramifications of any actions might be.

I have provided more than enough evidence to substantiate my arguments that she is very likely to contract HIV, and dependant on whether or not she plans to have any biological children, there is a good possibility of also transmitting it to them. Not only will her husband pass away once the onset of the disease occurs, but she will as well. I have a hard time understanding why this lady wants to commit herself to death, and her children to that very same fear. How sad is that?

If she wants to enter any discipline in medicine at all, she will become a great risk for her coworkers and patients, regardless of whether or not PEP is used. Where are the ethics here? Why is this moral, valid, or just? I can't understand what you find appropriate about this situation. A person knowingly infected that continues to pursue this dream is acting on a bout of selfishness, when s/he is exposing his/her colleagues and the very dear people s/he trained so long for to help.

You think the admissions committees want a martyr on their hands? Do they want to train a doctor that they know will eventually die faster than his/her counterparts? Can they trust someone with this kind of judgment to make wise decisions on behalf of his/her patients?

Saying that she is going to get married only in the name of love is like living in a fantasy world. Just why has she decided to write her personal statement about her fiance's HIV+ status and its effects on her? Is that a true motivation? Why was there no underlying factor from before she met this man? Does she think that by declaring in her personal statement that she will be the savior of everyone and anyone, even amid her own risk of harm, the admissions committee will be more inclined to accept her?

These are questions I pose to you. Some may sound far-fetched, but I am surprised that any individual would put themselves in this position in the first place. I don't know the answers to these questions either. I do think however, that anyone in their logical right mind would clearly think about the implications her activity with this partner will have on her personal and professional life.

Why is this so hard to understand? What is so colorful about this? This is a portrayal of a bleak picture. Any admissions committee member that finds this out about her will not look favorably upon it. It is not something that will leave you stunned or interested in meeting the author - it will leave you perplexed why this person has chosen her fate ahead of its years, the fate of not being able to hang around long enough to see her grandchildren, having her parents and siblings outlive her, and leaving this world in a misery full of pain, physically and mentally.

Another point is that this is not some sort of inevitable self-sacrifice. This is not her husband/lover being led off to the execution and then she decides to die with him, which is arguably more about self-sacrifice than suicide. But getting into a sexual relationship with an HIV+ man is a virtual guarantee at some point of contracting the disease. It's not like he is her dying husband, and she's taking care of him to the bitter end; it's more like, let me do something (stupid and) romantic and get myself killed.

Btw, if the story is true at all (smells like troll), the guy is just a piece of crap - if he truly loves her, he should cut off the romance and make it quite clear that there'll be none of that - but as he's selfish and probably desperate for sex...

 

[imrep1972]

"Good friend," does not make for a compelling story. Besides, it won't be the truth and just will not resonate. Trust me, admissions personnel are tired of "friend" stories. I am concerned why you think admitting to having an intimate connection with an HIV+ person should be lied about. It should be applauded. It would be applauded. You strike me as a very careful, very boring, very judgmental person. I am the latter, but certainly not the first two.

Well, I would certainly agree with you that you are judgemental... sheesh.

I'm careful and boring? I was trying to offer a third option. It doesn't have to be she *does* talk about it, or she *doesn't.*

I don't recall saying in my post that an intimate connection should be lied about. I don't recall saying it was what *I* thought should be done. I was making a suggestion that might walk a cautious line between disclosing a controversial relationship or not.

If it is a bad suggestion, simply ignore it, as everyone else did.

Man, Guy... I have no idea who you are as a person, nor do you about me, but wow, I'm completely blown away how you have read so much into a couple original sentences.

 

[Psycho Doctor]

This is such a personal decision and none of our business. I wonder why the OP even posted it and not the girl herself. The OP doesn't need a whole bunch of our opinions to offer her friend; she should merely state her own unless the friend solicits opinions from prejudiced strangers.

 

[Psycho Doctor]

You deserve Harvard! You've been the smartest poster thus far. I am willing to bet reading further won't prove me wrong. We should talk about marriage in Nashville.

i didn't realize solicitation and requesting sexual favors was permitted here

 

[heech]

LVDoc points out that even with the careful use of condoms, there's a non-zero chance of male-female transmission between serodiscordant couples. The numbers specified are very low (less than 1 occurance every 100 people years), but still non-zero. LVDoc suggests that doctors exposed to non-zero chances of HIV transmission ethically must not come in contact with patients for some time (he quoted 6 months, which is the traditional number... newer generation antibody tests for infection are considered to be definitive by most of the US's public health departments at 8-12 weeks).

If that's his position... let me add another criteria. Any non-monogamous doctor that has unprotected sex with a non-monogamous partner must also refrain from contacting patients for 6 months. Such activity *definitely* carries non-zero risks for HIV infection. Actually, as we now know, even protected sex doesn't do it... so how about, any doctor that has sex must remove himself from patient contact?

Anyone still excited about getting into med school?

Yesterday, I was pleased to see the support out there for someone that asked whether they should give med school a chance, despite being partially paralyzed. Many pointed out there are arrangements that can be made during difficult rotations (like surgery or ob/gyn), and the person could ultimately go into a specialty where mechanical movement wasn't critical. Today, I'm told that even if you have some *chance* of catching HIV, you're far too high of a risk to go into medicine? Is there no arrangement, or no specialty, that would make sense for HIV+ doctors?

 

[dopaminophile]

LVDoc points out that even with the careful use of condoms, there's a non-zero chance of male-female transmission between serodiscordant couples. The numbers specified are very low (less than 1 occurance every 100 people years), but still non-zero. LVDoc suggests that doctors exposed to non-zero chances of HIV transmission ethically must not come in contact with patients for some time (he quoted 6 months, which is the traditional number... newer generation antibody tests for infection are considered to be definitive by most of the US's public health departments at 8-12 weeks).

If that's his position... let me add another criteria. Any non-monogamous doctor that has unprotected sex with a non-monogamous partner must also refrain from contacting patients for 6 months. Such activity *definitely* carries non-zero risks for HIV infection. Actually, as we now know, even protected sex doesn't do it... so how about, any doctor that has sex must remove himself from patient contact?

Anyone still excited about getting into med school?

Yesterday, I was pleased to see the support out there for someone that asked whether they should give med school a chance, despite being partially paralyzed. Many pointed out there are arrangements that can be made during difficult rotations (like surgery or ob/gyn), and the person could ultimately go into a specialty where mechanical movement wasn't critical. Today, I'm told that even if you have some *chance* of catching HIV, you're far too high of a risk to go into medicine? Is there no arrangement, or no specialty, that would make sense for HIV+ doctors?

haha! Maybe a vow of celebacy should be the latest addition to the Hippocratic Oath! Shoot, we could be the next priesthood. It wouldn't so inaccurately reflect my current sex life. :sad:

More realistically, the distinction comes with high-risk exposure. Normal protected sex in which you're reasonably aware of your partner's sexual history isn't an exceptionally high risk practice. Even then, there is some risk that requires periodic cautionary testing.

Sex, protected or not, with a HIV+ partner is a high risk endeavor. If the transmittence of the virus through condoms is around 10%, as was posted in the abstract on pg 2 or 3, then in a normal marriage the medical student is almost guaranteed to have transmittence. Even if infection occures in only 10% of transmittences, after the first 3 months of normal marriage (100 or so sexual contacts) the medical student is likely to be infected. Because that student must participate in surgical, EM, and OB rotations, I feel the risk to the patient is so much higher that it precludes them from ethically participating in the rotation. Change those number from 10% to 2% and it still would only take a few hundred sexual contacts to have a very high likelihood of infection.

The point you bring up is troubling to my argument though. Normal 20 somethings are a high-risk group of people regardless. My counterargument basically boils down to this: the medical profession accepts the risks to patients inherent to teaching young doctors because it is absolutely necessary for the future of the profession. Medical students and residents make mistakes and errors in care that attendings wouldn't; they carry a higher risk to their patients than do priests because they could be harboring certain diseases and don't know it. There just simply isn't any way around some of those risks if we want to train future doctors. We can, however, minimize the risk as much as possible. One way to do that is to regularly do periodic checks for these diseases. Another way is for people to excuse themselves from participation in procedures when they have a much higher than usual risk of carrying a disease undetected, as is the case with the sexual partners of HIV+ individuals. I don't think a medical student could skirt around surgical, EM, and OB rotations and still get through medical school.

I went to East Timor this past summer and spend a lot of time working with highly infectious, multi-drug resistant TB patients without the proper precautions as well as living in an environment in which p. falciparum malaria was rampant. TB can bring a negative skin test up to 8 weeks after infection and falcip malaria can be dormant for two weeks. As an EMT, I recused myself from any patient contact for 8 weeks after my return (the Red Cross won't let me donate blood for a year) because it was unethical to put my patients at that elevated risk. My chances of transmitting TB to them without showing any symptoms was almost zero, but it was higher enough than normal that I didn't feel it was appropriate for me to work.

 

[Psycho Doctor]

haha! Maybe a vow of celebacy should be the latest addition to the Hippocratic Oath! Shoot, we could be the next priesthood. It wouldn't so inaccurately reflect my current sex life. :sad:

More realistically, the distinction comes with high-risk exposure. Normal protected sex in which you're reasonably aware of your partner's sexual history isn't an exceptionally high risk practice. Even then, there is some risk that requires periodic cautionary testing.

Sex, protected or not, with a HIV+ partner is a high risk endeavor. If the transmittence of the virus through condoms is around 10%, as was posted in the abstract on pg 2 or 3, then in a normal marriage the medical student is almost guaranteed to have transmittence. Even if infection occures in only 10% of transmittences, after the first 3 months of normal marriage (100 or so sexual contacts) the medical student is likely to be infected. Because that student must participate in surgical, EM, and OB rotations, I feel the risk to the patient is so much higher that it precludes them from ethically participating in the rotation. Change those number from 10% to 2% and it still would only take a few hundred sexual contacts to have a very high likelihood of infection.

The point you bring up is troubling to my argument though. Normal 20 somethings are a high-risk group of people regardless. My counterargument basically boils down to this: the medical profession accepts the risks to patients inherent to teaching young doctors because it is absolutely necessary for the future of the profession. Medical students and residents make mistakes and errors in care that attendings wouldn't; they carry a higher risk to their patients than do priests because they could be harboring certain diseases and don't know it. There just simply isn't any way around some of those risks if we want to train future doctors. We can, however, minimize the risk as much as possible. One way to do that is to regularly do periodic checks for these diseases. Another way is for people to excuse themselves from participation in procedures when they have a much higher than usual risk of carrying a disease undetected, as is the case with the sexual partners of HIV+ individuals. I don't think a medical student could skirt around surgical, EM, and OB rotations and still get through medical school.

I went to East Timor this past summer and spend a lot of time working with highly infectious, multi-drug resistant TB patients without the proper precautions as well as living in an environment in which p. falciparum malaria was rampant. TB can bring a negative skin test up to 8 weeks after infection and falcip malaria can be dormant for two weeks. As an EMT, I recused myself from any patient contact for 8 weeks after my return (the Red Cross won't let me donate blood for a year) because it was unethical to put my patients at that elevated risk. My chances of transmitting TB to them without showing any symptoms was almost zero, but it was higher enough than normal that I didn't feel it was appropriate for me to work.

since when do married couples have sex more than once a day? and in the stressful and busy life of a med student? what dream world do you live in?

and whereas what you did is extremely admirable, do you have any idea how many people have been exposed to communicable diseases and don't even know about it? why aren't they testing every medical person every single day for all these diseases "just in case" and "as not to expose patients unnecessarily"

 

[GuyLaroche]

i didn't realize solicitation and requesting sexual favors was permitted here

I didn't realize that I had made a solicitation or requested a sexual favor! You of all people should be cautious about equating the sacred institution of marriage with sexual favors and solicitation. I realize you think that gay marriage is an entirely different beast but still....

 

[heech]

dopaminophile,

I fully agree with your logic... as long as we agree, it's all a question of degrees... if the risks of HIV transmission for "average promiscious" individual (the luckier med students out there) was many, many orders of magnitude lower than the risks of transmission for the wife a HIV+ individual, then I'd agree with you. Common sense dictates she's an extraordinary risk in the medical profession.

But you misread the research from page 2. HIV transmission is actually much more difficult than you'd expect. Even long-term, unprotected sex between serodiscordant couples doesn't necessarily lead to infection. Based on past studies I've seen, I think the odds of transmission for an *unprotected* act of sexual intercourse is something like 0.1%. And the research presented here re-affirms this:

For 11 cohort samples of never-users, incidence was estimated at 6.8 per 100 person-years (95% confidence interval, 4.4-10.1) for male-to-female transmission,

For couples that *never* used condoms, you'd expect 6.8 HIV infections for every 100 person-years. And again, for couples that *do* use condoms, the number was down to 0.9 incidences per 100 person-years. This is nowhere near the 10% or 20% risks of infection/per unprotected act that you thought you read in the study. (And I don't blame you; mass media absolutely exaggerates the infectious nature of HIV.)

There's no doubt that even protected sex with a known HIV+ individual is very risky. Just as having promiscious unprotected sex is very risky. But if your partner is on meds, if you are *very* careful with protection, it's very, very possible to have a decades-long relationship without infection. And with that in mind, I don't believe the risks for the HIV- partner in such a relationship is of high enough risk that they should be cast out of medicine entirely.

 

[MadameLULU]

since when do married couples have sex more than once a day? and in the stressful and busy life of a med student? what dream world do you live in?

hahaha, i know plenty of married couples that have sex more than once a day...the frequency may decline soon though, but to think it doesn't happen is ignorant
also, i know med students who think having sex is a stress reliever...

 

[dopaminophile]

since when do married couples have sex more than once a day? and in the stressful and busy life of a med student? what dream world do you live in?

and whereas what you did is extremely admirable, do you have any idea how many people have been exposed to communicable diseases and don't even know about it? why aren't they testing every medical person every single day for all these diseases "just in case" and "as not to expose patients unnecessarily"

I thought I was being conservative on the sexing frequency for newlyweds, but let say they have sex once a week. That still means there's a very high chance of infection in the first year. Maybe once a month... the odds are still 1 in 4 that she'll be infected by the time she gets to clinicals.

Perhaps, I didn't communicate the second half of my post very well. While many health care workers have been exposed to communicable diseases without knowing it, the only thing that can be done about that is to take extra precaution around known exposures and to do regular, periodic testing for unknown infections. The fortunate thing about HIV is that health care workers are usually very aware when they've been exposed. With the scenario we're talking about here, assuming they would be consumating their marriage, the medical student would know she's regularly exposed but can't detect infection or the risk to her patients for several months. There's not much we can do about the risks health care workers take just by living outside a bubble, but we sure can act when we're aware we've been exposed.

 

[heech]

Let me just re-emphasize: the study isn't saying that the risk of HIV transmission even with "always" condom-users is 10% per sexual act.

It's saying that "always" condom-users are 10% as likely to contract HIV over the course of 100 people-years (no residency is that long, I hope) as those who never use condom protection at all. And as I pointed out before, even the risks for those who never use condoms at all aren't as high as many tend to believe (6.8 per 100 years).

 

[Psycho Doctor]

I thought I was being conservative on the sexing frequency for newlyweds, but let say they have sex once a week. That still means there's a very high chance of infection in the first year. Maybe once a month... the odds are still 1 in 4 that she'll be infected by the time she gets to clinicals.

Perhaps, I didn't communicate the second half of my post very well. While many health care workers have been exposed to communicable diseases without knowing it, the only thing that can be done about that is to take extra precaution around known exposures and to do regular, periodic testing for unknown infections. The fortunate thing about HIV is that health care workers are usually very aware when they've been exposed. With the scenario we're talking about here, assuming they would be consumating their marriage, the medical student would know she's regularly exposed but can't detect infection or the risk to her patients for several months. There's not much we can do about the risks health care workers take just by living outside a bubble, but we sure can act when we're aware we've been exposed.

do you have any idea how many people are walking around with Hep C and don't have a clue?

 

[dopaminophile]

dopaminophile,

I fully agree with your logic... as long as we agree, it's all a question of degrees... if the risks of HIV transmission for "average promiscious" individual (the luckier med students out there) was many, many orders of magnitude lower than the risks of transmission for the wife a HIV+ individual, then I'd agree with you. Common sense dictates she's an extraordinary risk in the medical profession.

But you misread the research from page 2. HIV transmission is actually much more difficult than you'd expect. Even long-term, unprotected sex between serodiscordant couples doesn't necessarily lead to infection. Based on past studies I've seen, I think the odds of transmission for an *unprotected* act of sexual intercourse is something like 0.1%. And the research presented here re-affirms this:


For couples that *never* used condoms, you'd expect 6.8 HIV infections for every 100 person-years. And again, for couples that *do* use condoms, the number was down to 0.9 incidences per 100 person-years. This is nowhere near the 10% or 20% risks of infection/per unprotected act that you thought you read in the study. (And I don't blame you; mass media absolutely exaggerates the infectious nature of HIV.)

There's no doubt that even protected sex with a known HIV+ individual is very risky. Just as having promiscious unprotected sex is very risky. But if your partner is on meds, if you are *very* careful with protection, it's very, very possible to have a decades-long relationship without infection. And with that in mind, I don't believe the risks for the HIV- partner in such a relationship is of high enough risk that they should be cast out of medicine entirely.

You're right, I did misread the abstract. My numbers are way off in the last few posts because I didn't see your post until just now.

However, my point remains. If we can take from the study that a female's chances of infection with 100% condom use are 90% in 100 years of sex, we can say that in the 5 years before she can take on a risk-free specialty, her chances of becoming infected are still 4.5%, which is still pretty high. Compared to the chances of a med student in "normal" relationships carrying the disease, I would think that it's still prohibitively high.

You point, however, is well taken and I stand corrected.

 

[heech]

dopaminophile,

Don't blame you at all for misreading the numbers. Like I said, the "media" and popular education rightly emphasizes the risk of HIV infection... but they do so without discussing the numbers more accurately. How many out there would believe it if you told them that you can have unprotected vaginal sex with 500 different HIV+ positive people, and still have a less than 50% chance of HIV+ transmission? (And even more dangerously.. how many people would still use protection? Just remember you can win the HIV lottery on a single roll of the dice, guys.)

If we can take from the study that a female's chances of infection with 100% condom use are 90% in 100 years of sex, we can say that in the 5 years before she can take on a risk-free specialty, her chances of becoming infected are still 4.5%, which is still pretty high.

EDIT: Crap. My read was also wrong, and your second read is right. We can say that the chance of infection with 100% condom use is 90% in 100 years of sex. (Although I'm sure there are many statisticans out there that could put it more accurately.) I'm not sure your analysis of 4.5% is accurate or not, however. Just dividing by 20 doesn't seem statistically correct.

 

[dopaminophile]

Well, not to beat a dead horse, but the topic has piqued my interest. I looked up one of the schools I'm seriously considering (EVMS) to see what their policy is.

http://www.evms.edu/students/handbook/handbook.pdf

Basically what it says is that, prior to matriculation, you have to get a physical with a communicable disease workup. You don't, however, have to continue to be tested throughout your education. HIV+ medical students are allowed to do clinicals, but they are not permitted to participate in invasive procedures.

The only anual test that's required is the PPD skin test for TB antibodies.

Keep in mind, though, that's only at EVMS. The CDC's recommendations are humorously ambiguous for both HIV and HCV. Below is the link, table 3 provides their recommendations for health care personnel infected with all sorts of communicable diseases.

http://www.cdc.gov/ncidod/hip/guide/InfectControl98.pdf

That's all I can think of right now.

 

[dopaminophile]

Looking at a couple of other schools' websites, it's fairly apparent that schools do not deny admissions to people infected with HIV or HCV. Most schools don't require regular testing either except in the case of TB. Occupation health requires that students inform them of their health conditions when they participate in clinicals, but those records are kept confidential with a couple of exceptions including clinical supervisors. They will, however, disallow an infectious person from participating in invasive procedures.

My assumption earlier was that students couldn't complete medical school without taking part in invasive procedures. That doesn't appear to be the case.

 

[LabMonster]

The clinic I worked with told me the chances of transmittence from a needle stick were roughly 1/300. I'm sure that different studies have said different things.

As far as I know the incidence of positive HIV transmission from patient to caregiver is far less than 1% as dopaminopile has stated. HBV transmission is higher with no vaccination - and I'm not sure where HCV stands.

Regardless. The question was simple: Does this woman include this information on her personal statement? If she presents such information as to maintain anonymity of the HIV positive patient in question, it may not be the worst idea if it clearly depicts her reasons for becoming a physician. However, her selection of schools may be limited as a result of divulging this information.

I will agree, however, there is a severe moral and ethical problem here. Though she didn't ask, how can such a person - willing to risk HIV infection, become a physician? This is the problem inherent in mentioning any of this in her personal statement. Congruently, if she does not mention this fact, doesn't it speak volumes for her character?

Ultimately, I believe she should say what she needs to say and leave it up to the adcom to determine whether or not they should let her matriculate. I think honesty is indeed the best policy. Different universities will have different ideals.

 

[tigress]

Thank you everybody for this interesting discussion.

My husband did not have to be tested for HIV prior to entering med school, but he did have to have a PPD and proof of vaccinations (coincidentally, there are a certain percentage of people who are non-responders to the Hep B vaccine, and he seems to be one of them. I asked a vaccine expert why this is the case, and she said nobody is entirely sure! It has to do with HLA background, most likely, and the ability to make Abs to the appropriate epitope).

I might be scared of being exposed to HIV while in med school or practice if it weren't for the fact that it's so difficult to transmit. Now I am scared of Hep C and other communicable diseases like TB. HIV is terrifying, but the likelood of exposure is relatively small, and the likelood of transmission via exposure is smaller. I do think it would be dangerous if the population in general were to find out that transmission is so difficult, because it would probably provide less of an incentive to use protection.


On that note, I once read an article about men who want to get HIV, so they go around having sex with HIV+ men to try to get infected. I was struck by how long it takes some of them to actually get infected, even while intentionally engaging in this risky behavior. For some reason it reminds me of getting pregnant: it seems so many people get pregnant and don't want to be, but then tons of people struggle with infertility when all they want is to get pregnant. So it is with these people: they actually want HIV (for some sick reason), but even after multiple exposures they aren't infected, while so many people out there have sex once with an infected person, or use a dirty needle once, and end up with the virus.

And I have never personally known a person with HIV. That sounds strange to me, since it's such a wide-spread problem. Of course I very well may know somebody with HIV who simply doesn't tell people, or doesn't even know. But I want to imagine that if I were interacting on a daily basis with somebody I knew to be HIV+, I would treat them normally. I just don't know. I think it's a frightening disease. I can understand why there is an associated stigma, though I don't of course condone it. I would not be comfortable knowing my doctor had HIV, though, and that leads me to wonder if in fact somebody who is HIV+ should not go into medicine. I was discussing this with my husband, and I said I would still love him if, God forbid, he got HIV. But then I was thinking about it, and I realized that if I had HIV I would be reluctant to let him love me. I would want to protect the people around me.

It's a very complicated issue, but I'm thankful for the intellgent discussion here that is leading me to think about it more deeply.

 

[Brain]

Some people are expressing a concern that HIV+ (or infected with any blood borne pathogen) healthcare workers can transmit the virus to their patients. I've taken a hospital epidemiology course and I'm also employeed by the CDC Division of Healthcare Quality Promotion (formerly the Hospital Infections Program). Transmission of blood-borne pathogens directly from the healthcare provider to patient is either not or barely mentioned in guidelines. If you think about it, this type of transmission is not likely to occur and I'm not aware that it has even been demonstrated (I'll ask my bosses about it next week). Transmission of these agents requires the exchange of body fluids. If a healthcare worker stabs themselves with a needle or cuts themselves with a scapel, the needle should be discarded and the scapel sterilized regardless of the infection status of the healthcare worker because aseptic technique has been broken and the patient will be at risk of infection from organisms on the skin in addition to that of blood-borne pathogens. Anyone with any amount of sense would do this and I doubt that any physician would work with a patient while they have an open wound. Nosocomial transmission of blood-borne pathogens to patients occurs quite frequently indirectly via healthcare workers because they do not wash their hands (only about 30%(!) of healthcare workers wash their hands as often as they should), or by contaminated equipment or solutions.

In short, the risk of an HIV+ physician transmitting the virus to a patient is really small if it even exists. The major problem of HIV+ healthcare workers is that they are immunocompromised and are more likely to get infections from their patients such as tuberculosis. If a healthcare worker has active TB or another contagious disease and continues to see patients, then they can amplify the transmission of this disease to other patients. Just my $0.02.

 

[dopaminophile]

Some people are expressing a concern that HIV+ (or infected with any blood borne pathogen) healthcare workers can transmit the virus to their patients. I've taken a hospital epidemiology course and I'm also employeed by the CDC Division of Healthcare Quality Promotion (formerly the Hospital Infections Program). Transmission of blood-borne pathogens directly from the healthcare provider to patient is either not or barely mentioned in guidelines. If you think about it, this type of transmission is not likely to occur and I'm not aware that it has even been demonstrated (I'll ask my bosses about it next week). Transmission of these agents requires the exchange of body fluids. If a healthcare worker stabs themselves with a needle or cuts themselves with a scapel, the needle should be discarded and the scapel sterilized regardless of the infection status of the healthcare worker because aseptic technique has been broken and the patient will be at risk of infection from organisms on the skin in addition to that of blood-borne pathogens. Anyone with any amount of sense would do this and I doubt that any physician would work with a patient while they have an open wound. Nosocomial transmission of blood-borne pathogens to patients occurs quite frequently indirectly via healthcare workers because they do not wash their hands (only about 30%(!) of healthcare workers wash their hands as often as they should), or by contaminated equipment or solutions.

In short, the risk of an HIV+ physician transmitting the virus to a patient is really small if it even exists. The major problem of HIV+ healthcare workers is that they are immunocompromised and are more likely to get infections from their patients such as tuberculosis. If a healthcare worker has active TB or another contagious disease and continues to see patients, then they can amplify the transmission of this disease to other patients. Just my $0.02.

Great post. Certainly there's some concern over a HIV+ doctor's doing a needle stick or scapel knick in a patient's open wound or other portal for infection. Just off the top of my head I imagine a sloppy intern knicking his 3rd year's hand as they're both elbow deep in a thoracotomy. While the student can probably get his hand out before it starts to bleed and of course the scalpel won't continue to be used, both could be washed into the wound by irrigation or fluids that are already in there before they would be removed. Clearly there's some concern to be had over doctor to patient infection when the policy of medical schools, state laws, the CDC, and occupational health departments is that health care providers with these communicable diseases ought not participate in certain invasive procedures.

 

[LVDoc]

You bring up an interesting point about being immunocomprised and more susceptible to other infections; definitely something worthwhile to think about.

Where invasive procedures are being used, such as surgery, I would think there would be at least somewhat of a risk involved when operated by an HIV-infected physician.

Regardless of whether or not the physician-to-patient transmission is low, I think that this person is going to destroy her own health knowingly. I read the data on that paper I posted wrong as well, but it does clearly state there is a 4.5% transmission possibility within 5 years, or 9% within 10 years. At some point, this woman is likely to contract the virus, whether it be sooner by increased frequency of sexual activity, or years later down the line.

She is a risk to herself, and very delusional for not exploring what is going to happen to her or her husband later in the future. Both he and she should seek counseling; one for asking to be infected, the other for wanting to transmit it.

I would never understand what a happy marriage would be in this case. It would only be a viscious cycle. She will be with him while his taking his medications, and be at his beside when he is severely ill. Soon after, the same thing will happen to her, at the expense of her family and children.

People on this thread say that others should mind their own business. I ask you why? This kind of ignorance is analogous to letting a friend commit suicide without stopping them, for fear of interfering in their decisions. This kind of ignorance is one that allows murderers to get away with praying on victims. Sure, one case is civil, the other is criminal, what difference does it make? If no one here takes a stand, the world will be free to run rampant, people to illogically follow through with their ill-conceived actions, some that don't know any better, and others that are just cold-hearted anyway.

How can you not take a stand on something like this? There is only one positive outcome in this situation, which is that she has found someone she loves, and there are a million different things against it. Be logical.

 

[LVDoc]

Take a look at this:

S Afr Med J. 2003 Aug;93(8):621-4.

Occupational exposure to blood in medical students.

Rabbitts JA.

Faculty of Health Sciences, University of Stellenbosch, Tygerberg, W Cape.

OBJECTIVE: To determine the extent of occupational exposure to blood in medical students, details of the circumstances surrounding the incidents and the subsequent experiences of the student. DESIGN: Prospective cohort study. SETTING: Tygerberg Hospital, the Health Sciences Faculty of the University of Stellenbosch during a 15-week period from 4 February to 19 May 2002. SUBJECTS: One hundred and thirty-six student interns (SIs), i.e. final-year medical students. METHOD: All Sis received a questionnaire and a letter motivating them to participate in the study and explaining the procedure. Regular class meetings enabled continuous motivation and ongoing update. In the case of an incident during the 15-week period, the SI filled in the form and placed it in a sealed drop-off box. OUTCOME MEASURES: Specific focus on the preceding events and the situation in which the incidents occurred (department, time of day, procedure performed, and whether the student was on call), exposure to HIV (patient's retroviral status), use of post-exposure prophylaxis (PEP) (whether used, when initiated), and the consequences of the exposure (emotional, on sexual behaviour during the window period, and on career choice). RESULTS: During the 15-week period, 19 incidents were reported; the majority occurred while students were on call, almost half occurred after hours, and a disproportionate number occurred in three departments. CONCLUSIONS: Occupational blood exposure is a very real problem and poses a significant risk. SI suggestions should be considered in improving the prevention and management of such incidents.

PMID: 14531124 [PubMed - indexed for MEDLINE]

Am J Infect Control. 2003 Jun;31(4):226-30. Related Articles, Links


Needlestick injuries among medical students.

Patterson JM, Novak CB, Mackinnon SE, Ellis RA.

Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.

BACKGROUND: Concern about occupational exposure to bloodborne pathogens exists, and medical students, who lack in experience in patient care and surgical technique, may be at an increased exposure risk. METHODS: This prospective cohort study evaluated needlestick injuries and practices regarding the use of protective strategies against bloodborne pathogens in medical students. A questionnaire was developed and sent to 224 medical students. RESULTS: Of 224 students, 146 students (64%) returned questionnaires. Forty-three students (30%) reported needlestick injuries that most commonly occurred in the operating room; 86% of students reported always using double gloves in the operating room; 90% reported always wearing eye protection, and all but one student had been vaccinated against hepatitis B. A concern about contracting a bloodborne pathogen through work was noted in 125 students, although they usually reported that this concern only slightly influenced their decision regarding a career subspecialty. CONCLUSION: Medical students have a high risk for needlestick injuries, and attention should be directed to protection strategies against bloodborne pathogens.

PMID: 12806360 [PubMed - indexed for MEDLINE]

 

[denty]

i am also shocked by people's responses. first of all, the question was not "do you agree with my friend's relationship," but rather "should she write about it" and so many of the replies are people making judgments about her relationship.



well that's very noble of you. however, i fail to see how you can treat someone with HIV as less than human. one of my closest friends is HIV+, and i would like nothing more than to see her find someone she can spend the rest of her life with. we don't know her fiance's history... whether it's his fault that he contracted the virus. what if he got it from a blood transfusion in 1983? (i had another friend when i was growing up who contracted HIV that way - she died before her 13th birthday.) why should he be subjected to a life alone when they could potentially be happy together, just because you think that people have no idea how to protect themselves. have some compassion for HIM too. (on a side note, i don't know this guy, or anything about their relationship either... just giving an alternate point of view here)

now back to the topic. should she write about it? if HIV is one of her primary reasons for going into medicine, she should absolutely write about it. i would think that it's definitely awkward to put it in the context of her relationship with the guy, but if the subject of HIV (esp. research, or relating to HIV patients) is important to her, and she's comfortable backing it up in interviews, then definitely go for it.

I totally agree with you

 

[mercy4052]

Wow! I have so much going through my mind right now, I'm not sure where to begin. So, I am just going to throw in my 2 cents worth on this issue. First of all, I am a case manager for the HIV/AIDS population. I have been doing this for 3 years and it is what motivated me to become a doctor. I will be including my experiences in my personal statement. So many of you are naive to the reality of HIV/AIDS, but that's ok, I was too before working in this field. For the person who said an HIV person should go to prison for knowingly infecting someone, I say that you are an adult and have the right to choose whether to engage in sex or share drug needles, thus each person has a responsibility to question the status of that person they are engaging with and be cautious (both partners get tested, use clean needles, use condoms). Also, a lot of you commented that this guy with HIV would be taking meds the rest of his life and would die within 10-20 years. I have a client that has been diagnosed with HIV before the name HIV existed. This client has NEVER been on meds... NEVER! Why? Because his CD4 count is withing range and viral load is undetectable, even WITHOUT meds! The important thing to remember is that there are many diffferent strands of HIV and each person responds differently to the HIV virus. This is why it is difficult to find a cure. However, there have been several advancements in meds to treat HIV, thus HIV has become a chronic disease that can be treated and controlled just like hypertension and diabetes. Current data shows that if a person with HIV is adherent to their meds, it is more likley they will die from something else then AIDS. My oldest client is in his 80's and is the sweetest man I know. He is very sharp and is doing great! I also wanted to say that I have many HIV positive clients that are married to someone who is negative. Their relationships are strong and I applaud their spouses for their support. And in case you are wondering, their spouses have remained negative. Someone mentioned why a man would want to be HIV positive? This is actually a huge issue in the HIV/AIDS community. One big reason someone tries to get HIV is because there is federal and state monies set aside to help those with HIV/AIDS. Many of my clients receive free medical care, medications, dental, vision, food, and housing assistance. If someone can get infected with a mild HIV strain that they can contol for the rest of their lives, why not get the benefits of free medical and housing? I do not support this behavior, but that is what is going through the minds of someone trying to get infected with HIV. OK, that's enough for now. I have so much more to say, but will refrain. If anyone has any questions, feel free to ask me. Oh yeah, I do think it is ok for the friend to include her HIV experience in her personal statement, as long as it supports her reason to become a doctor and not her reason to pursue a relationship with an HIV infected person. Take Care!

 

[btowngirl]

Wow! I have so much going through my mind right now, I'm not sure where to begin. So, I am just going to throw in my 2 cents worth on this issue. First of all, I am a case manager for the HIV/AIDS population. I have been doing this for 3 years and it is what motivated me to become a doctor. I will be including my experiences in my personal statement. So many of you are naive to the reality of HIV/AIDS, but that's ok, I was too before working in this field. For the person who said an HIV person should go to prison for knowingly infecting someone, I say that you are an adult and have the right to choose whether to engage in sex or share drug needles, thus each person has a responsibility to question the status of that person they are engaging with and be cautious (both partners get tested, use clean needles, use condoms). Also, a lot of you commented that this guy with HIV would be taking meds the rest of his life and would die within 10-20 years. I have a client that has been diagnosed with HIV before the name HIV existed. This client has NEVER been on meds... NEVER! Why? Because his CD4 count is withing range and viral load is undetectable, even WITHOUT meds! The important thing to remember is that there are many diffferent strands of HIV and each person responds differently to the HIV virus. This is why it is difficult to find a cure. However, there have been several advancements in meds to treat HIV, thus HIV has become a chronic disease that can be treated and controlled just like hypertension and diabetes. Current data shows that if a person with HIV is adherent to their meds, it is more likley they will die from something else then AIDS. My oldest client is in his 80's and is the sweetest man I know. He is very sharp and is doing great! I also wanted to say that I have many HIV positive clients that are married to someone who is negative. Their relationships are strong and I applaud their spouses for their support. And in case you are wondering, their spouses have remained negative. Someone mentioned why a man would want to be HIV positive? This is actually a huge issue in the HIV/AIDS community. One big reason someone tries to get HIV is because there is federal and state monies set aside to help those with HIV/AIDS. Many of my clients receive free medical care, medications, dental, vision, food, and housing assistance. If someone can get infected with a mild HIV strain that they can contol for the rest of their lives, why not get the benefits of free medical and housing? I do not support this behavior, but that is what is going through the minds of someone trying to get infected with HIV. OK, that's enough for now. I have so much more to say, but will refrain. If anyone has any questions, feel free to ask me. Oh yeah, I do think it is ok for the friend to include her HIV experience in her personal statement, as long as it supports her reason to become a doctor and not her reason to pursue a relationship with an HIV infected person. Take Care!

thank you for writing this. i have been too frusterated to respond for the last few pages.

 

[myodana]

mercy4052 - CHEERS. well said.