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Why Fighting HIV/AIDS Is So Challenging

When I began work on this month’s project, I contacted a clinician, a case manager, and a scientist to get their perspectives on how we’re making progress fighting HIV and AIDS. I’ve introduced you to the clinician and the case manager, but not the scientist.

Dave Wessner doesn’t actually study AIDS, but he’s written a textbook supplement on HIV and AIDS and teaches a course at Davidson College on the subject. His students have even set up a blog discussing the history and science of HIV and AIDS. He also regularly lectures on the topic. I’ll be attending one of his talks tonight. Read more »

*This blog post was originally published at The Daily Monthly*

HIV, Stigma, And The Media

Last November, the National Football League devoted the entire month to breast cancer awareness. Players like Reggie Bush wore pink gloves, armbands, even shoes, to promote efforts to fight the disease.

There were some heartwarming moments. Players brought their mothers, grandmothers, and other women who’d battled breast cancer to the games, all of them wearing attractive pink game-day jerseys. Announcers told their own stories of “courageous” battles against the disease waged by friends and family members.

It’s powerful and inspiring, these overpaid hulks of manhood showing they’re secure enough in their masculinity to don feminine-ish garb to support their sisters and mothers.

But try to imagine the NFL — or any sports league — launching a similar campaign to fight HIV and AIDS. Which player would trot out a brother, sister, or father who’s HIV positive? Which television announcer would proudly point to the afflicted and speak of their “inspirational” battle with HIV?

In an NPR interview last week, Theresa Skipper talked about why she concealed her HIV diagnosis for 19 years: Read more »

*This blog post was originally published at The Daily Monthly*

Why Don’t More People Use Female Condoms?


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I first heard about the female condom in 2006. I was in Seattle to see what was happening at the Bill and Melinda Gates Foundation. One of the many impressive projects it was supporting was at PATH, a non-profit organization that was developing and promoting a new female condom. The sad, age-old reason: the health of millions of women around the world is threatened by irresponsible men. Read more »

AIDS In America: We Are Not Out Of The Woods Yet

Yesterday I introduced my friend Charles Roth. Charles was diagnosed with HIV/AIDS in 2003 and was already in bad shape. He had been tested as healthy the previous year, but the disease struck quickly, hospitalizing him for a week and keeping him out of work for a month and a half. He returned to work but repeated illnesses due to AIDS meant that by 2006, he was unable to work full-time. A bank executive, Charles still tries to find occasional contract work or odd jobs like résumé writing and tax preparation, but with the recession, these jobs are low-paying and hard to come by. For the most part he makes do with a tiny state disability check and food stamps.

So how typical is Charles’s case? We’ve all heard of success stories like Magic Johnson, who was diagnosed with HIV in 1991 and still has not developed AIDS. But clearly neither case tells the whole story. Read more »

*This blog post was originally published at The Daily Monthly*

Circumcision In 1908: Performed To Reduce Masterbation?

There has been recent debate over whether circumcision should be made mandatory as a way to prevent the spread of HIV, so I thought I would share the section on circumcision from the 1908 textbook, A Text-Book of Minor Surgery by Edward Milton Foote, MD.

Circumcision

This little operation can be performed in a number of ways.  The practice among the Hebrews when circumcision is performed as a religious rite is to draw the foreskin well forward, to cut it off with one stroke of a long knife, to immerse the penis in wine held in the mouth of the rabbi to stop the hemorrhage, and then to wrap it in linen rags.  It is not surprising that dangerous hemorrhage and infection sometimes follow this procedure, and a few lives have been lost in consequence.

Equally reprehensible is the practice among some surgeons of trying to perform this little operation in the shortest possible time.  For this purpose clamps have been devised to hold the foreskin so that both the external and reflected portions can be cut away by a single stroke of the knife.  It is obvious that the amount of skin thus removed cannot be controlled with certainty, and even if the line of incision be a perfectly smooth circular one, a thing which rarely happens, the adjustment in length of the external and internal portions of the prepuce is at best uncertain.  There is no part of the body concerning which most patients are more sensitive, so that the surgeon ought to be willing to give up a few minutes of his time in order to secure a perfect result. Read more »

*This blog post was originally published at Suture for a Living*

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It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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