HIV will sap the longevity of the community. Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1. N Engl J Med. The question of why patients take obvious health risks is as old as the Hippocratic oath, and the answers are limited only by the bounds of the human psyche. As HIV infection increasingly becomes viewed as a chronic rather than fatal illness, physicians should be prepared to renew strategies in advising patients who may have lapsed into unsafe behaviors and those who may be encountering HIV information for the first time.
Sex is so much a part of our popular culture, but in that context it is fantasized and idealized.
Katsufrakis says physicians should introduce discussions of sexuality and lapses in safe behavior in routine, non-judgmental ways. In his limited Los Angeles County medical practice, Katsufrakis says he has seen patients who insist they always used condoms but then eventually seek treatment for urethral discharge, a symptom of gonorrhea. Tom Coates of the AIDS Research Institute at the University of California at San Francisco offers some specifics. Physicians have got to use clear, frank language. Coates also advises regular sexual health check-ups that include screening for syphilis, gonorrhea and chlamydia for patients with more than one sexual partner per year.