Life, Love, Sex, HIV and Other Unscheduled Events

Life, Love, Sex, HIV and Other Unscheduled Events http://www.thebody.com/content/art55031.html A blog by Bob Frascino, M.D., at TheBody.com. http://www.thebody.com/images/blog/bfrascino_biobox.gif Dr. Bob http://www.thebody.com/content/art55031.html 115 144 The Ultimate Unscheduled Event http://www.thebody.com/content/64478/the-ultimate-unscheduled-event.html This blog entry was written by Steven Natterstad, M.D. ("Dr. Steve"), Dr. Bob's husband and partner of 18 years.

The conclusion to Dr. Bob's obituary read: "In addition to his husband (Steve) and sister (Linda), Bob is survived by his parents, Jennie and Angelo Frascino ... and by many friends, colleagues and 'eyeballs' around the world." You, Dr. Bob's global online family, have suffered an immeasurable loss. He was truly a larger-than-life persona, and so he leaves a huge void in our lives. However, because of the great man he was, he also leaves us with a giant presence, one that will continue to guide, reassure, educate and empower all of us.

]]> http://www.thebody.com/content/64478/the-ultimate-unscheduled-event.html Wed, 19 Oct 2011 15:36:00 GMT HIV Guidelines: Some Evolve; Some Don't. What's Up With That? Part Two http://www.thebody.com/content/64091/hiv-guidelines-some-evolve-some-dont-whats-up-with.html Gentle Readers, welcome to Part Two. Let's talk about detecting very recent HIV infections and emerging diagnostic guidelines. As we have learned more about the natural history of untreated HIV infection and the body's immune response to the virus, we've developed a better understanding of measurable events occurring during recent HIV infection. For instance, the HIV viral load spike that occurs shortly after acquiring the virus correlates in time with a corresponding spike in HIV p24 antigen level. As the body's immune response kicks into gear several weeks after infection, the immune system begins making specific anti-HIV antibodies. The first to appear is anti-p24 antibody. As that antibody increases, the p24 antigen and HIV viral load decline.

Read more ...

]]> http://www.thebody.com/content/64091/hiv-guidelines-some-evolve-some-dont-whats-up-with.html Fri, 23 Sep 2011 17:11:00 GMT HIV Guidelines: Some Evolve; Some Don't. What's Up With That? Part One http://www.thebody.com/content/63636/hiv-guidelines-some-evolve-some-dont-whats-up-with.html Among the most common questions cramming their way into my inbox at the HIV Prevention and Safer Sex Expert Forum are an impressively wide spectrum of concerns about HIV-diagnostic testing. Everything from the very basic -- "to test or not to test; that is the question" (a favorite of Shakespeare aficionados) -- to the ridiculous -- "Grandma farted getting out of the barcalounger. I think I smelled an HIV-charged fart. Should I get an AIDS test?" In between these extremes are HIV-diagnostic-testing conundrums, such as:

"Is the three-month window period calculated as 90 days (three months x 30 days per month) or 84 days (12 weeks x seven days per week)?"

"Which test should I take -- ELISA, EIA, Rapid, Western Blot, qualitative PCR DNA or quantitative PCR RNA?"

]]> http://www.thebody.com/content/63636/hiv-guidelines-some-evolve-some-dont-whats-up-with.html Thu, 25 Aug 2011 06:52:00 GMT Three Decades of HIV/AIDS, Part Three http://www.thebody.com/content/63212/three-decades-of-hivaids-part-three.html The HIV/AIDS wave crested in the mid-nineties and the once underground disease had now become mainstream. Most Americans were talking about condoms and safer sex without embarrassment. Greg Louganis disclosed he had HIV/AIDS.

Ordinary people put together quilt patches, each the size of a coffin, forming the AIDS Memorial Quilt, which ultimately became the largest piece of art ever created. It was displayed in Washington in 1996 where its 40,000 panels covered the entire National Mall.

Read more ...

]]> http://www.thebody.com/content/63212/three-decades-of-hivaids-part-three.html Wed, 27 Jul 2011 16:59:00 GMT Three Decades of HIV/AIDS, Part Two http://www.thebody.com/content/62791/three-decades-of-hivaids-part-two.html On October 2, 1985, a bombshell dropped on Hollywood. Rock Hudson died of AIDS. Now the deadly disease had a face.

Rock Hudson revealed he had AIDS and died less than three months later. The fear of this yet-to-be-understood killer suddenly could be seen and felt everywhere. A Life Magazine cover story raised awareness in the heterosexual community for the first time.

]]> http://www.thebody.com/content/62791/three-decades-of-hivaids-part-two.html Thu, 30 Jun 2011 15:10:00 GMT Three Decades of HIV/AIDS: Are You Ready to Dance? http://www.thebody.com/content/art62269.html Hello BBBs (Bob's Blogosphere Buddies),

The friendly folks at Body Central have asked if I would interrupt my regularly scheduled blog-o-rants to address the following "question-on-the-street" in preparation for an upcoming feature on this year's Gay Pride celebration.

]]> http://www.thebody.com/content/art62269.html Wed, 1 Jun 2011 16:00:00 GMT B-Tripla and a Bluey on Bondi Beach http://www.thebody.com/content/art61375.html Bronzed Aussie Surfer Dude: So, here in Oz (Australia), it's been like a century since we've had a new HIV drug. What's up with that?

Dr. Bob: Well, in reality it's been three years since the last new antiretrovirals hit the market. But I agree three years is a bit of a dry spell. The good news is that a new NNRTI is on its way to pharmacy shelves very soon, and there are a few other promising new drugs in phase 2 and 3 development.

Read more ...

]]> http://www.thebody.com/content/art61375.html Thu, 7 Apr 2011 04:27:00 GMT The Search for the Cure Heats Up! Part Three http://www.thebody.com/content/art60644.html As I mentioned in Part I of this three-part blog-a-thon, HIV is far more clever and cunning than any of us realized in the early days of the epidemic, when we all assumed that with the three Ts -- time, talent and treasure -- we could cure HIV in the not-too-distant future. Three decades later, despite billions of dollars and the best efforts of research scientists, HIV still has no cure and has prematurely snuffed out the lives of over 25,000,000 people.

]]> http://www.thebody.com/content/art60644.html Tue, 1 Mar 2011 10:22:00 GMT The Search for the Cure Heats Up! Part Two http://www.thebody.com/content/art60430.html There are a number of reasons the search for a cure for HIV has been not only reawakened, but also reinvigorated. These include:

1. There is now very sound and growing evidence that we cannot "treat our way out of this epidemic," as philanthropist Bill Gates stated at last summer's International AIDS Conference in Vienna. Even with improved access to testing and treatment, for every individual who starts antiretroviral therapy (ART), two additional people become newly infected with the virus, according to the UNAIDS report.

]]> http://www.thebody.com/content/art60430.html Wed, 9 Feb 2011 09:12:00 GMT The Search for the Cure Heats Up! Part One http://www.thebody.com/content/art60318.html Hey HIV. Yes, I'm talking to you HIV. You found me exactly 20 years ago today! Do you remember how when I was performing a procedure on Mr. X, a gentleman with advanced-stage AIDS, a myoclonic jerk of his leg caused a deep hollow-bore needle stick and nasty laceration in the palm of my hand? I certainly do. I also remember my first thought (expletives deleted), quickly cleaning the wound, and promptly popping an AZT (one of the only antiretrovirals available in 1991).

]]> http://www.thebody.com/content/art60318.html Sat, 29 Jan 2011 23:00:00 GMT 2010: A Reappraisal Reveals a Turning Point in the Pandemic http://www.thebody.com/content/art59973.html 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.

Read more ...

]]> http://www.thebody.com/content/art59973.html Tue, 28 Dec 2010 09:51:00 GMT Condoms: Papal Pontifications, a Quicker Quickie and CCCCs (Common Condom Complaints and Conundrums), Part Two http://www.thebody.com/content/art59924.html 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!

]]> http://www.thebody.com/content/art59924.html Fri, 17 Dec 2010 18:11:00 GMT Condoms: Papal Pontifications, a Quicker Quickie and CCCCs (Common Condom Complaints and Conundrums), Part One http://www.thebody.com/content/art59703.html 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"!

Read more ...

]]> http://www.thebody.com/content/art59703.html Thu, 2 Dec 2010 22:31:00 GMT Three Scary Beliefs That Defy Fact, Reality and Common Sense http://www.thebody.com/content/art59615.html 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).

Read more ...

]]> http://www.thebody.com/content/art59615.html Mon, 29 Nov 2010 21:43:00 GMT It's a Virus, Not a Crime! http://www.thebody.com/content/art59215.html 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.

]]> http://www.thebody.com/content/art59215.html Sun, 31 Oct 2010 14:35:00 GMT A Telling Tale of Trick or Treat: Remember to Spit, Don't Swallow! http://www.thebody.com/content/art59023.html 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?

Read more ...

]]> http://www.thebody.com/content/art59023.html Wed, 20 Oct 2010 07:59:00 GMT High Anxiety: AIDS Anxiety in the Worried-Wells and Worried-Sicks, Part Two http://www.thebody.com/content/art58574.html 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

]]> http://www.thebody.com/content/art58574.html Thu, 23 Sep 2010 05:47:00 GMT High Anxiety: AIDS Anxiety in the Worried-Wells and Worried-Sicks, Part One http://www.thebody.com/content/art58321.html 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

]]> http://www.thebody.com/content/art58321.html Fri, 3 Sep 2010 22:22:00 GMT Dr. Bob and Dr. Steve Have a Three-Way http://www.thebody.com/content/art58156.html 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.

]]> http://www.thebody.com/content/art58156.html Mon, 23 Aug 2010 16:22:00 GMT Hocus-Pocus: Quantum Quackery, aka Alternative Medicines for HIV/AIDS http://www.thebody.com/content/art57787.html 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.

]]> http://www.thebody.com/content/art57787.html Wed, 28 Jul 2010 16:01:00 GMT In Sickness and in Health: Magnetic Marriage http://www.thebody.com/content/art57146.html 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.

]]> http://www.thebody.com/content/art57146.html Wed, 23 Jun 2010 06:47:00 GMT A Fascinoma but No Hippopotomonstrosesquippedaliophobia http://www.thebody.com/content/art56778.html 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).

]]> http://www.thebody.com/content/art56778.html Wed, 26 May 2010 07:46:00 GMT HIV Causes Accelerated Aging: Has AIDS Become Acquired Inflammation Disease Syndrome? http://www.thebody.com/content/art56491.html 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.

]]> http://www.thebody.com/content/art56491.html Mon, 3 May 2010 17:37:00 GMT Time Warp? http://www.thebody.com/content/art56335.html 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.

]]> http://www.thebody.com/content/art56335.html Tue, 20 Apr 2010 16:12:00 GMT Steaming Hot Monkey Fusion Sex! http://www.thebody.com/content/art55914.html 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. Something tells me it takes these guys at least two hours to watch an episode of "60 Minutes," if you know what I mean! Nonetheless, thanks to one and all for the lively interchange! Let's keep the conversation going.

]]> http://www.thebody.com/content/art55914.html Sat, 20 Mar 2010 11:35:00 GMT A Chronic, Not Always So Manageable, Condition http://www.thebody.com/content/art55438.html 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.

]]> http://www.thebody.com/content/art55438.html Tue, 16 Feb 2010 15:41:20 GMT Life, Love, Sex, HIV and Other Unscheduled Events http://www.thebody.com/content/art55030.html 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.

]]> http://www.thebody.com/content/art55030.html Wed, 13 Jan 2010 15:52:00 GMT