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Bob Frascino, M.D.

Life, Love, Sex, HIV and Other Unscheduled Events

2010: A Reappraisal Reveals a Turning Point in the Pandemic
December 28, 2010

A few weeks ago the friendly folks at Body Central asked if I would be interested in blogging about HIV/AIDS developments of 2010 from my unique perspective as a positively charged HIV physician specialist. The thought of a 2010 retrospective didn't immediately appeal to me, as there really weren't any major treatment breakthroughs this year. So I blogged about common condom conundrums instead.

However, sitting here at my favorite coffee shop with my steaming nonfat vanilla cappuccino in hand in a post-Christmas haze and discussing HIV/AIDS developments over the past year with my lawfully wedded spouse, fellow HIV specialist physician, fellow expert in TheBody.com's forums and partner in life, love and the pursuit of happiness, I've now come to realize that I may have been a bit too hasty in my initial assessment of what 2010 will mean when the history of HIV/AIDS is eventually written. In fact, I now believe 2010 may well be a pivotal year in the AIDS pandemic, despite the lack of major treatment breakthroughs! How can that be? Glad you asked. I'll make three quick points.

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Condoms: Papal Pontifications, a Quicker Quickie and CCCCs (Common Condom Complaints and Conundrums), Part Two
December 17, 2010

CCCC #1: Condoms break.

Many folks writing in about HIV-transmission risk often tell me their condom broke, when in reality they actually never used one. It is just less guilt inducing to report their risk as a condom failure rather than a judgment failure. When used properly, condoms very rarely fail.

I just did a quick survey of the folks posting questions to my inbox over the last few days claiming to have had a condom break. There were over one hundred! I'd be willing to wager that if I cross-examined this group or gave them a dose of Professor Snape's Veritas potion (truth serum from the Harry Potter series), the vast majority would admit they never used the condom. So point number one: condoms will always "fail" if you choose not to use them!

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Condoms: Papal Pontifications, a Quicker Quickie and CCCCs (Common Condom Complaints and Conundrums), Part One
December 2, 2010

So, a few years back a dude named Sergio-Gaylord (really, that's how he signed his post) wrote to me in The Body's forum Safe Sex and HIV Prevention concerning the subject of "man-bag condoms"!

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Three Scary Beliefs That Defy Fact, Reality and Common Sense
November 29, 2010

Did you ever notice that some survey statistics just seem outrageously stupid, such as "24% of Americans believe Obama is a Muslim"? Other surveys' statistics seem downright scary, such as "47% of Republicans think Sarah Palin is qualified to be president." I recently came across another survey statistic I found equally as shocking -- and concerning! An overwhelming majority of HIV-negative and untested men in the United States (70% and 69% respectively) support criminalization of HIV nondisclosure! WOWZA! Obviously these folks have not read my last few blogs ("A Telling Tale of Trick or Treat: Remember to Spit, Don't Swallow," October 20, 2010; and "It's a Virus, Not a Crime!" October 31, 2010).

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It's a Virus, Not a Crime!
October 31, 2010

In my last blog entry, "A Telling Tale of Trick or Treat," I mentioned a gaggle of horned-up hotties in a Jacuzzi who might very well wind up exchanging bodily fluids prior to exchanging detailed medical information, such as HIV status. I discussed some of the reasons disclosure is such a thorny issue: rejection, stigma, possible dissemination of confidential information, etc. So what could happen to those hotties if they chose not to disclose -- or to delay disclosure until mutual trust was established with a partner?

Well, that would depend on what state or country the hot hot tub of hotties was located. In Iowa, an HIVer who had an undetectable viral load was sentenced to 25 years in prison following a one-time sexual encounter during which he used a condom! WOWZA! An HIV-positive woman in Georgia was given eight years for failing to disclose her viral status even though her HIV status had been published on the front page of the local newspaper (how's that for disclosure?!) and two witnesses testified her sexual partner was well aware of her HIV-positive status.

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A Telling Tale of Trick or Treat: Remember to Spit, Don't Swallow!
October 20, 2010

Earlier today I noticed a preponderance of pumpkins, Costco-sized bags chock-full of small boxes of Milk Duds and other dental cavity inducers, and munchkin-sized costumes fit for either a mini Lady Gaga or a Tea Party Rally for Christine "I am not a witch" O'Donnell! With my keen sense for the obvious, I realized Halloween (or a GOP takeover of Congress) was fast approaching. Both are scary propositions.

I also quickly realized it was time to shed my full-tilt-boogie procrastination and generate another blog entry. While I fired up my trusty lap-Mac to tippy tap something out and take advantage of my current caffeine-induced craze, a myriad of potential blog topics raced to mind -- Life? Love? Sex? Coffee? . . . Coffee? How did that crop up into the list? Hmm. Well true, I was finishing my third large nonfat vanilla cappuccino of the morning; could it be I have a monkey on my back and his name is Juan Valdez?

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High Anxiety: AIDS Anxiety in the Worried-Wells and Worried-Sicks, Part Two
September 23, 2010

Recently I received the following post from "Apollo." It graphically demonstrates an AIDS-related panic attack as well as the anxiety that can be brought on by an HIV/AIDS diagnosis and disclosure worries.

HELP ... I don't know what's happening to me
Aug 20, 2010

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High Anxiety: AIDS Anxiety in the Worried-Wells and Worried-Sicks, Part One
September 3, 2010

Imagine being so frightened of contracting an illness that you begin believing God is sending you bad omens in the form of bird poop ...

SIGNS FROM HEAVEN (BIRD TURDS AS HIV SIGN FROM HEAVEN, 2009)
Nov 11, 2009

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Dr. Bob and Dr. Steve Have a Three-Way
August 23, 2010

OK, so I'm scanning my e-mail messages on Friday and come across one entitled "HIV News & Views: Dr. Steve & Dr. Bob's Magnetic Marriage ..." So I decided to double click and see whassup.

The link brings me to a pic of the devastatingly handsome Dr. Steve smiling back at me. Immediately I hear Streisand's voice in my head wailing, "Oh my man I love him so, he'll never know ..." The link is a transcript of a recent podcast of Dr. Steve discussing the "secrets" of our successful magnetic relationship. Steve mentioned he had given the interview but I hadn't had the chance to see it yet. I don't routinely read Steve's work on TheBody.com, because I don't habla español.

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Hocus-Pocus: Quantum Quackery, aka Alternative Medicines for HIV/AIDS
July 28, 2010

Simply put, alternative medicine (taking an alternate treatment in place of combination antiretroviral treatment -- as opposed to complementary therapies taken alongside antiretrovirals, and under the supervision of an HIV physician specialist) uses therapies that are unproven, usually anecdotal, frequently deceptive and often downright dangerous. The opposite of "alternative medicine" is sometimes referred to as "traditional medicine." That is a misnomer. "Evidence-based medicine" would be a more accurate term. It's important to note that the opposite of evidence-based medicine is not "alternative medicine," but rather "unproven medicine."

When it comes to incurable diseases such as HIV/AIDS, unproven therapies are rampant and have been present since the earliest days of the pandemic. These therapies have only served to worsen suffering, waste money and, in some cases, hasten death.

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In Sickness and in Health: Magnetic Marriage
June 23, 2010

June weddings are an American tradition. Well at least for those who are legally allowed to marry, like Rush Limbaugh, for instance. The spokesperson for family values just this week consummated marriage no. 4 to a woman barely half his age.

Meanwhile, a marital event of a different type was occurring in San Francisco this past Wednesday, where the Federal District Court heard closing arguments in Perry v. Schwarzenegger, challenging Proposition 8, California's same-sex marriage ban. Whatever the ruling, this landmark case is likely to ultimately land in the U.S. Supreme Court.

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A Fascinoma but No Hippopotomonstrosesquippedaliophobia
May 26, 2010

So here I am once again heading for the MRI scanner. Anyone who has had one of these scans knows that getting an MRI is just plain creepy. I arrive right on time with my Peet's triple shot nonfat vanilla cappuccino in one hand and my appointment slip in the other. Here at "St. Elsewhere's" Diagnostic Imaging Center no one knows I'm Dr. Bob or Dr. Frascino or Dr. Anybody. I'm just Patient #76896328963127.

I then begin filling out the requisite pre-MRI screening questionnaire, which includes questions about "claustrophobia" (nope, not me); "bullets, shrapnel, or birdshot" (birdshot???); "body piercings" (hey, why do they need to know that if we've already been instructed to remove all body jewelry before arrival?); "tattoos or tattooed makeup" (tattooed makeup? Apparently Tammy Faye Bakker may have been a previous scan-ee); "freakishly large sex organs" (OK, I made that last one up, but really, the check-off list is impressive. After all, I am only here for an MRI, not to be confirmed as the next Supreme Court justice).

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HIV Causes Accelerated Aging: Has AIDS Become Acquired Inflammation Disease Syndrome?
May 3, 2010

I don't plan to grow old gracefully. I plan to have facelifts until my ears meet.

-- Rita Rudner

Inflammation is the hottest topic in HIV/AIDS research. We've known for many years that, left untreated, HIV disease produces widespread inflammation. The higher the HIV plasma viral load the more dramatic the inflammatory response. Treatment with potent combination antiretroviral therapy decreases not only HIV replication and consequently HIV viral load, but also HIV-associated inflammation. More recently we've learned that even when we drive the HIV viral load to undetectable levels, we don't completely turn off the inflammatory process.

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Time Warp?
April 20, 2010

So, recently Steve (my lawfully wedded spouse and also "Dr. Steve," the physician expert in The Body's Tratamientos forum) iPhoned me and calmly asked, "Honey, do you have any idea what your mother's pink satin pajamas are doing in our freezer?" Mildly shocked, but mostly amused, I responded, "Well, perhaps she ran out of room in our microwave?"

Perhaps I should back up a bit and advise my blogophilic buddies that in early December my octogenarian parents relocated from their home of 52 years in Upstate New York to California. They had been living with us for nearly three months at the time of the frozen jammies incident.

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Steaming Hot Monkey Fusion Sex!
March 20, 2010

I assumed the title of this latest blog-o-specimen would intrigue not only those with prurient interests, but also horn-dogs throughout the cyber universe. And here you all are! Welcome! (I'll leave it to each of you to decide in which category you belong.)

Before diving into today's x-rated featurette, I wanted to take just a moment to thank all those who took the time to post a comment on my first two blog entries ("Life, Love, Sex, HIV, and Other Unscheduled Events" and "A Chronic, Not Always So Manageable, Condition"), including the dude who so completely misinterpreted the intent of my last blog that he referred to me as "the prophet of doom" and the other fluffernutter who wanted to hold me personally responsible for "exacerbating the psychological collateral our community has been burdened with. ..." Hmm. Nonetheless, thanks to one and all for the lively interchange! Let's keep the conversation going.

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A Chronic, Not Always So Manageable, Condition
February 16, 2010

I'm undoubtedly the most optimistic guy in the galaxy, bar none! Really, I am. For instance, you know how some people are cup-half-full folks and others are cup-half-empty folks? Well, I'm a cup-runneth-over kind of fellow. Yet despite my unabashed and unbridled optimism about essentially everything in existence, I'm beginning to think the term "chronic, manageable condition," when applied to HIV/AIDS, may be overly optimistic or at least misleading, particularly for many of us who are positively charged and struggling to coexist with a virus that wants nothing more than to plant us six feet under!

While I freely admit that many of us who are virally enhanced no longer feel we have one foot in the grave and the other on a banana peel, I wonder: Do we really have a "chronic, manageable condition?" (I'm still new to this whole blogosphere thingy and commencing today's entry with a provocative prologue followed by an open-ended question suddenly makes me feel like Carrie Bradshaw at the start of a Sex and the City episode, typing away on her Mac in an uber-chic strapless fashion-forward empire-bodice camisole leotard and Prada cha-cha heels. But I digress. And besides, I'm dressed in trendy Rock and Republic jeans, Pumas, tank top and hoodie, just in case you were wondering. And before any of you ask, 2xist boxer-brief tighty-whities.) Now where was I? Oh yeah, chronic manageable conditions.

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Life, Love, Sex, HIV and Other Unscheduled Events
January 13, 2010

That's my topic (and my life story) and I'm sticking to it. Welcome to Dr. Bob's blog. I promise future posts will be positively teeming with life lessons, love stories and steamy sex, all focused through the unforgiving prism of HIV.

However, by way of introduction to the new kid on the blog, I thought I would begin with some of my life's "unscheduled events," which have led me to this very point in my excellent adventure on this wild and wacky planet.

First, by way of full disclosure (note to self: blog about disclosure sometime soon), I must admit I'm new to this whole blogosphere thingy. It's not that I tend to chisel my correspondences onto stone tablets, but rather that I'm not the kind of guy who readily tweets, Flickrs, LinkedIns or Facebooks.

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Life, Love, Sex, HIV and Other Unscheduled Events


Bob Frascino, M.D., is President and Founder of The Robert James Frascino AIDS Foundation. He is also an outspoken, popular expert in TheBody.com's "Ask the Experts" forums on safe sex and fatigue/anemia. A Fellow of the American Academy of Allergy, Asthma, and Immunology, and the American Academy of Pediatrics, Dr. Frascino has served as Associate Clinical Professor of Medicine, Division of Immunology, Rheumatology, and Allergy, at Stanford University Medical Center from 1983 until 2001. He is a member of the American Academy of HIV Medicine and has also been a distinguished member of the executive boards of numerous state and regional associations.


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