My World AIDS Day Story

Patient calls me Monday morning:

Max: Doctor I need to see you. It’s urgent. I had unprotected sex with someone yesterday morning.

Doctor S: Come in right now.

Max arrives several hours later. He is anxious, tearful and short of breath.

Doctor S: Come inside. 

He sits down on the exam table. I wait for him to begin.

Max: I had sex yesterday morning with someone I know. I got drunk and slept over his house. The next day we fooled around and had unprotected sex.  He ejaculated inside me. I’m freaking out.

Doctor S: This happened yesterday morning, less than 36 hours ago?

Max: Yes.

Doctor S: Did you ask him if he is HIV positive?

Max: He swore that he is negative. I asked him if he would get tested today, but I haven’t heard back from him. I’m really nervous. You see, I have a boyfriend.

Doctor S: Did you have sex with your boyfriend after this happened?

Max: No! But he’s going to break up with me after I tell him, and I have to tell him.

I discuss beginning Max on HIV Post-Exposure Prophylaxis (PEP) in the hopes that after taking anti-retroviral medication for 28 days, he will not contract HIV if he was exposed. During his visit he receives a call from the guy he had sex with. He tells Max that he was diagnosed with HIV today. Max hangs up and begins to cry.

Max: This is terrible. He was just diagnosed with HIV. He must have a high viral load, right?

Doctor S: If he was just diagnosed then he probably does have a high viral load. How high? I can’t be sure. The most important thing right now is that you begin PEP immediately.

Max leaves and calls me later.

Max: I took the pills. My boyfriend is visiting his parents. I’ll talk to him later this week. Would it be good for us to know what my friend’s viral load is? I could ask him to forward you the results.

Doctor S: That’s a good idea.

Later that week I receive a call from a colleague who happens to take care of Max’s friend.

Doctor D: Hi, my patient asked me to call you because he is ashamed.

Doctor S: Thank you for calling me. I want to know if you have his viral load yet?

Doctor D: He is undetectable.

Doctor S: He’s undetectable and newly diagnosed?

Doctor D: Let me explain. He’s not newly diagnosed. He’s been HIV positive for 5 years. After he had sex with Max, he was too ashamed to tell him that he’s been HIV positive. That’s why he asked me to call you. The good news is that his viral load is undetectable. I know Max is going to be upset with him for lying.

Doctor S: I don’t know what to say. Thank you for calling.

When I tell Max the truth he doesn’t speak. Finally he says, “I guess all I can do now is wait?”

Today is World AIDS Day. There are over 1.1 million Americans living with HIV today. 1 in 5 do not even know they have it. The fastest rising group of individuals contracting HIV are African American youths, and by 2015 more than 50% of HIV infected gay men will be over the age of 50.



  1. Lair
    Posted December 1, 2010 at 6:34 pm | Permalink

    What would we do without you??

  2. Mich
    Posted December 2, 2010 at 7:01 am | Permalink

    fingers crossed!!

  3. FortWorthGuy
    Posted December 5, 2010 at 4:17 pm | Permalink

    Would it be a violation of the doctor-patient relationship if you disclosed the ages of the people you mention above?

  4. spinellimd
    Posted December 10, 2010 at 1:50 pm | Permalink

    42 years old.

  5. Posted December 10, 2010 at 11:37 pm | Permalink

    Here is the most important part of the story, “I got drunk.” Why are these gay men geting intoxicated by alcohol and then having unprotected sex later than night? Larry Kramer would frown upon these gay men. Have we not learned anything from gay history? Sorry to past judgment, but this behavior is unacceptable. Another aspect of the story that bothers me is the probability of internalized homophobia being manifested (i.e., getting drunk and then having unprotected sex). In my opinion, psychotherapy is a good intervention, and of course, medical is an absolute (thanks to you Frank).

    P.S.: I use to be one of these gay men.

  6. Posted December 13, 2010 at 11:58 am | Permalink

    I don’t advocate drunkenness or being high. I think they are just excuses.

    There are enough examples of purposeful dangerous behavior going on out there, in fact seemingly a whole culture of it.

    I do not understand how people practice “bare backing”.

    That said, in this day an age, unless your intentionally trying to “seed” yourself or someone else, which thankfully has been proven to be a punishable crime, why on earth would safe sex NOT be a common habit drunk or not, by BOTH parties.

    I cannot understand the stupidity of ONE adult let alone TWO adults.

    I have been drunk before but I have never been so drunk that I didn’t really know I was doing something danger, I don’t believe or obviously I don’t know it.

    It is hard to see why someone would do this.
    I hate pharmacutical companies and I don’t trust “the system” and illness for profit does suck but as an individual… my life is NOT worth the RISK!

    Peace to all and please put on a condom or just beat off! It’s only a feeling and it’s only temporary, Gosh! THINK!


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