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Author Topic: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?  (Read 643 times)

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Offline SteveA

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It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« on: November 18, 2020, 04:09:57 pm »
It's not pertinent to how they set up your treatment plan! How you got it isn't their business is it?

Offline Snowangel

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #1 on: November 18, 2020, 08:07:40 pm »
ID Doc?

Not really but it helps them track how it is getting transmitted.
I've been poz 26 years and still get asked. 
JW


Of all the things you wear, your expression is the most important

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One thing you can give and still keep...is your word.

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Offline SteveA

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #2 on: November 19, 2020, 03:49:48 pm »
It's not just ID doctors though, it's Nurses in Emergency clinics, Urgent cares, general practitioners. I just moved back to Missouri from Texas and ever single medical professional has asked me how I got it! It's uncalled for and frankly none of their business. I've been Poz since 1987.

Offline Almost2late

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #3 on: November 19, 2020, 05:40:56 pm »
Damn that sucks!.. but I'm not surprised it happens in states like Missouri.. "Are they that ignorant or are they fucking with me?",  is what would be going through my head. That seems like harrassment and borderline discrimination.. I so empathize with you.

After moving to Oregon the only questions I was asked was, What med I was on, Did I have enough medication, How long have I been poz, Information about my previous doctors and lab results.. all reasonable questions. And before that in Florida, only the guy from the health department went into a bit of the personal stuff but he was quite polite about it, probably bc he was gay, so I wasn't offended.. I knew they were only trying to prevent further infections.

It's weird but I think bc I've been treated decent here, I've been more comfortable discussing my status with others without that stigma I'd put myself through. I really feel better about myself.

I'm so sorry you're going through this. How do you respond to them?

Offline SteveA

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #4 on: November 19, 2020, 09:54:03 pm »
I just tell them, you don't need to know how I acquired HIV to treat me. I chose not to answer that question. Or something to that effect. I'm polite but firm in telling them I believe it's an inappropriate question  as it has no bearing on how my treatment plan will be formulated. For what it's worth, I have no problem discussing my status, but my sex life is nobody's business.

Offline Matths

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #5 on: November 20, 2020, 05:35:01 am »
I don’t think, or at least very much hope, that asking this question is not serving the purpose to spy on anyone’s sex life, but rather exploring whether other ways of transmission, ie needle use, blood transfusion or alike could point towards comorbidities that are relevant. Relevant also for optimizing the treatment plan. I don’t think that any in-depth discussion on anyone’s sex life is of interest here.

Offline leatherman

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #6 on: November 20, 2020, 09:52:38 am »
exploring whether other ways of transmission, ie needle use, blood transfusion or alike could point towards comorbidities that are relevant. Relevant also for optimizing the treatment plan. I don’t think that any in-depth discussion on anyone’s sex life is of interest here.
Most HIV treatment providers receive some Ryan White funding. While most clinics will accept insurance, self-pay and/or Ryan white, because of the federal government requirements for RW funding, providers (the doctors and clinics) gather a lot of data about their patients.

Ryan white funding comes with a lot of restrictions, guidelines and data requirements (A lot of people think the government just passes out cash like candy; but anyone who has ever written a grant or had to fulfill the requirements of an RFP (A request for proposal (RFP) is a business document by the HIV treatment provider that provides details about a project, as well as solicits bids from contractors who will help complete the project.) knows that getting government funding is hard work and requires a lot of oversight.

The Ryan White program tracks a lot of data and uses that data to make improvements to the quality of care that HIV patients receive. (if only we were doing a portion of this along with contact tracing to stop the covid pandemic. sigh) By tracking age, race, gender, mode of transmission, medical visit frequency, medical visit gap, STD screening, antiretroviral prescription, etc. (see CDC HRSA HAB performance measures https://hab.hrsa.gov/clinical-quality-management/performance-measure-portfolio), Ryan White quality management programs are able to determine which groups of people are dealing with what disparities that prevent them from having quality HIV and general healthcare, so that those disparities can be eliminated or eased. By helping the people least likely to stay adherent to HIV treatment, the RW program has been shown to increase the quality of healthcare for all patients. for example, by creating or getting access to programs that could help a homeless transgender person of color stay adherent to HIV treatment, then the program makes sure that a working PLWH who has private insurance also has access to the same programs in case they ever need them. A rising tide lifts all boats.

but my sex life is nobody's business.
two points to consider
1) you weren't really asked about your sex life. You were asked about the mode of infection

MSM (men who have sex with men) is one Ryan White data category that's tracked. Knowing how many people in an area (city, county, state, zip code) fit into a certain category helps health department officials to target their limited state/federal funds to do the most good. For example, knowing that a large percentage of people in a certain area are MSM who are becoming HIV+ allows official health departments to target prevention funding and efforts, along with treatment access and outreach to venues and zip codes with high MSM populations.

Of course let's not forget that some people acquire HIV through heterosexual sex, some people through intravenous drug use. Those people are also asked about how they think or know that they acquired HIV. Whether you acquired HIV through homosexual sex, heterosexual sex, or drug use, your doctor can treat you more competently and the Ryan White program can provide better healthcare by knowing that data.

2) Your sex life isn't anything to be ashamed about. Sadly that's a societal norm that does a lot of damage. Parents don't discuss sex with their children or shame them about it. Schools are hampered in teaching age appropriate medically accurate sexual health care. Doctors don't talk to their patients...or worse doctors "shame" their patients.

"nobody's business". See how that issue with doctors and shaming is tied in here. That wasn't "nobody" that asked about your sex life. That was your doctor. By knowing your gender and your sexual orientation, your doctor has more information to treat you better. As a male, your doctor might ask about prostate issues or sexual dysfunction. (Not that you have those problems, but a doctor is supposed to help if/when you have those  problems) Knowing that you're gay (ie MSM), your doctor would know to screen you for not only HIV but other STDs that are more prevalent among MSM, or would discuss PrEP and ways to not spread HIV.


As a consumer (ie a person living with hiv receiving health care) I have been involved in the Ryan White Quality Management programs in both North and South Carolina for the last decade. I have seen, and assisted, the program in using this data to better direct services to PLWH in our efforts to reduce the spread of HIV. I highly recommend that if PLWH have the time and interest to get involved in their local or state Ryan White programs to learn more about what RW does and how it does it.

But don't think I'm dismissing your concern. As a gay man however, I can certainly understand the reticence about answering this question though. It's kind of liking coming out all over again to have to confess up to gay sex. Sadly it's probably no easier answering this question in other ways either. I would imagine that people who got it through heterosexual sex worry that their doctor will wonder if they are lying or wonder who in the partnership was "on the down low". I know people who are misusing needles for substance abuse have a harder time accessing healthcare in the first place (either by not having insurance/funding or by simply having an addiction problem itself) and probably are loathe to answer the question because for them it's admitting the addiction problem.


so the TL;DR is this:
1) that question gives doctors better info to treat you and better info to the health dpt to track and treat HIV
2) don't be ashamed about your sexual orientation - especially in matters with your doctor. The more your doctor knows about your situation the more likely you are to get better healthcare.

leatherman (aka mIkIE)

Offline skeebo1969

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #7 on: November 20, 2020, 10:47:19 am »
It's not pertinent to how they set up your treatment plan! How you got it isn't their business is it?

My wife and I usually go together to see our doctor.  When we see a new doctor and they ask that I always act angry and say, "Please doctor, I haven't disclosed to my wife yet".   It's kind of an ice breaker.... especially since they know the wifey and I have been together for 15 years.
I despise the song Love is in the Air, you should too.

Offline abrokenman

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #8 on: November 21, 2020, 10:38:10 am »
SteveA.... I can understand your frustration in being asked that Question because I would be in disbelief if I were asked that. That being said your post about that being asked got me to think of how would I reply to that. I think for me I would rather be prepared with a come back answer rather than be hit out of the blue like that. So if I'm ever asked that my response is going to be " I got it from another Person" and let whoever interpret that in whatever way they choose. But what gets me frustrated is when I go to any other health care place outside of my ID - I have people who don't even know the meds that I take. Example: last Summer while being in the Hospital I had 1 Doctor, several nurses and health care technicians when asking me about medication that I take and I tell them Tivikay & descovy they say "huh, what are those for" Shouldn't they know what those Meds are? I reply, you are the health care professional look it up. At times I feel they only ask that to shame me into saying "HIV meds" which I won't do with a patient in the next bed. I may be wrong in how I feel but darn it, we shouldn't have to feel more embarrassed about Our status.
You put One foot in front of the other

Offline leatherman

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #9 on: November 21, 2020, 11:57:32 am »
Shouldn't they know what those Meds are?
there must be millions of medications on the market, much less dozens of HIV meds. (after 28 yrs, I've been on 25 different HIV meds myself) Doctors, nurses, etc can't remember every med much less the handful of HIV meds that are currently in use.

To be honest, HIV simply isn't that big of a medical issue. There are only about 1.2 million people living with HIV here in America and we're spread all across the States. Since not every PLWH will end up in the hospital, hospital staff would be pretty unlikely to come across enough patients using antiretrovirals to every remember these meds. Unless of course you live in an urban area with a high concentration of HIV positive people. If you consider that PLWH also take different antiretrovirals, there is no single HIV med that even has a million prescriptions, so it's actually very unlikely that many healthcare providers would have any clue about HIV or the medications available.

Of course, the hospital staff would probably be much more likely to know medications that are widely used like:
1. Lisinopril: 104 Million
2. Atorvastatin: 104
3. Levothyroxine: 101.9
4. Metformin: 78.6 Million
5. Amlodipine: 72.5 Million
6. Metoprolol: 68 Million
7. Omeprazole: 58.8 Million
8. Simvastatin: 56.7 Million
9. Losartan: 52 Million
10. Albuterol: 50 Million
https://www.drugreport.com/50-commonly-prescribed-drugs-in-america/


we shouldn't have to feel more embarrassed about Our status.
embarrassed about your status is hiding and not wanting to say what kind of meds you're taking. Not embarrassed about your status is thinking HIV is simply just another one of thousands of treatable illnesses. I can understand not wanting to talk about HIV and antiretrovirals out in the general public; but if you're in a hospital and provider's office, your doctor really needs to know your status and know your meds to provide the best treatment.

If you feel a health care provider has discriminated against you because of HIV, there are laws against that - sue their pants off. As far as the patient in the next bed, fk 'em. They don't pay your bills and since they are in the hospital too, they have enough issues of their own to worry about without worrying about the pills you're taking. ;)
leatherman (aka mIkIE)

Offline harleymc

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Re: It's 2020! Shouldn't Doctors stop asking you HOW you got HIV?
« Reply #10 on: November 26, 2020, 02:06:56 am »
I just brake questions like that as small talk to build rapport band understanding.  It certainly doesn't phase me.

Sex is usually a good answer.

 


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