HIV+ and med school

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
There hasn't been a single case of a healthcare provider catching HIV in the course of work since the mid-90s (>20 years). Between universal precautions and post-exposure prophylaxis, while the odds aren't zero, they're pretty damn close. Close enough that universal pre-exposure prohylaxis isn't indicated.
Actually there has been exactly one case since 1999.

Members don't see this ad.
 
  • Like
Reactions: 1 user
It was pretty disappointing to see this thread unfold as it did. I was hoping to see a combined effort to help and support OP. I have no idea how being HIV+ will affect your med school experience or ability to practice, but either way I think it's bull that it matters at all. Modern HIV medication is beyond great. I would not be concerned if a surgeon with HIV was operating on me. Good luck to you OP
 
  • Like
Reactions: 1 user
As someone who has been on PEP, I wouldn't recommend it unless you're at a high risk of exposure. Granted, I was on a triple drug PEP cocktail several years ago and can't say whether PrEP is any better. Regardless, PEP is highly effective and can be used on a case-by-case basis as need.
I was on it last year. It's just one pill now. No side effects for me, just burned a hole in my wallet.
 
  • Like
Reactions: 1 user
Members don't see this ad :)
I was on it last year. It's just one pill now. No side effects for me, just burned a hole in my wallet.
PEP or PrEP? PEP should be covered by the hospital unless you're a student. I was on the old cocktail eight years ago, it made me quite sick. GI distress and vomiting for weeks and weeks.
 
  • Like
Reactions: 1 users
PEP or PrEP? PEP should be covered by the hospital unless you're a student. I was on the old cocktail eight years ago, it made me quite sick. GI distress and vomiting for weeks and weeks.

PrEP usually is pretty well tolerated by most from what I've heard. It's expensive, though recently a generic came out that should theoretically be over half the price.

Generally I am curious about this all though. People on medications who have low viral load generally are pretty uncontangious from most studies. Though whether that's a combination of proper condom use with increased medical supervision or a legitimate inhibition of the virus I'm not entirely sure.
 
If you require mandatory reporting, restrict a doc from performing "invasive procedures" (either categorically or without formal panel review), and require mandatory disclosure to patients, you've killed a surgeons career. That's the point you responded to.

Do you think the laws on the issue are outdated though? Like lets say an HIV+ surgeon has a non detectable viral load and is compliant with their HAART drugs. They're certainly pushing the edge on being non-infective by most studies on sexual transmission, let alone needle sticks.
 
  • Like
Reactions: 1 user
PrEP usually is pretty well tolerated by most from what I've heard. It's expensive, though recently a generic came out that should theoretically be over half the price.

Generally I am curious about this all though. People on medications who have low viral load generally are pretty uncontangious from most studies. Though whether that's a combination of proper condom use with increased medical supervision or a legitimate inhibition of the virus I'm not entirely sure.

Worked in a HIV clinic and mothers with consistently low viral loads were having planned children with HIV negative partners with no recorded maternal transmissions (baby received AZT for about 4--6 weeks and was done after that). If you have an undetectable viral load (which the people I met who were consistent on their meds did), your chance of transmission was pretty much zero. It's not the 1990's anymore and treating HIV like that towards patients who have consistently low viral loads is pretty silly and draconian.
 
  • Like
Reactions: 5 users
Do you think the laws on the issue are outdated though? Like lets say an HIV+ surgeon has a non detectable viral load and is compliant with their HAART drugs. They're certainly pushing the edge on being non-infective by most studies on sexual transmission, let alone needle sticks.

There has NEVER been a documented case of HIV transmission using a suture type needle. Only rarely a few cases involved open bore type needles as the source.

An ED doc once simplified it this way when I had a scare: If you were stuck with a suture type needle which had HIV positive blood on it, 99/100 times you would not even seroconvert.

You have to TRY to become HIV seropositive...this along with universal precautions and HAART...pretty much impossible to transmit to a patient.

Hell yes the laws are outdated. But hey, who wants to have an HIV positive doctor operate on them? Not in my back yard, Mr.!

The Reagan-like draconian laws by states regardging HIV positive doctors try to isolate and single out an already stigmatized group so we can all put on an amazing public relations face.
 
  • Like
Reactions: 2 users
How many times is this thread going to derail from the original question
 
  • Like
Reactions: 1 user
There has NEVER been a documented case of HIV transmission using a suture type needle. Only rarely a few cases involved open bore type needles as the source.

An ED doc once simplified it this way when I had a scare: If you were stuck with a suture type needle which had HIV positive blood on it, 99/100 times you would not even seroconvert.

You have to TRY to become HIV seropositive...this along with universal precautions and HAART...pretty much impossible to transmit to a patient.

Hell yes the laws are outdated. But hey, who wants to have an HIV positive doctor operate on them? Not in my back yard, Mr.!

The Reagan-like draconian laws by states regardging HIV positive doctors try to isolate and single out an already stigmatized group so we can all put on an amazing public relations face.
Less than that.

It's estimated that you could have a 18g hollow needle full of HIV+ blood and jab it into your flesh, on average you'd have a 0.2-0.3% chance of converting. That's ~1/500-1/300 odds of seroconverting.

Solid needle is probably an order of magnitude even less likely.

HIV is really a wimpy virus. Hep C is 10x as contagious, and Hep B is 100x as contagious.
 
  • Like
Reactions: 3 users
NONONO. Just FYI, you've got this wrong. Tindr is straight Grindr. Grindr is the original.
I used to pronounce "teyender" because I assumed it was supposed to rhyme with grindr. Took several months before I learned it was tinder like fire starter.
 
  • Like
Reactions: 1 user
There has NEVER been a documented case of HIV transmission using a suture type needle. Only rarely a few cases involved open bore type needles as the source.

An ED doc once simplified it this way when I had a scare: If you were stuck with a suture type needle which had HIV positive blood on it, 99/100 times you would not even seroconvert.

You have to TRY to become HIV seropositive...this along with universal precautions and HAART...pretty much impossible to transmit to a patient.

Hell yes the laws are outdated. But hey, who wants to have an HIV positive doctor operate on them? Not in my back yard, Mr.!

The Reagan-like draconian laws by states regardging HIV positive doctors try to isolate and single out an already stigmatized group so we can all put on an amazing public relations face.
Patient has a right to know and refuse. It's not the doc's call to decide the risk is acceptable without patient consent
 
  • Like
Reactions: 1 user
Sheesh sometimes its really hard to tell if some of you guys are even medical students, "just take PrEP" Lmao ya okay, lets just ignore the side effects. After doing some clinical time I've worked with plenty of HIV pts and you'd be astonished at how many "stop because I started feeling better," or "can't take the sides anymore." Honestly the same stuff you hear from DM/HTN pts. I notice a lot of people downplay the sides of them, but after seeing people with lipodystrophy of the face, getting diabetes, ect I wouldn't put them into the category of something I'd want to take everyday for the rest of my life.

Anyways I can only talk about Texas, I will use a Derm that can do Mohs surgery as an example. If this derm also runs a normal derm practice on the side he/she wont be required to tell patients their status. If he/she does a procedure (the legal term of "procedure" is a topic of its own), they will be required to tell the patient and get a wavier. I personally see nothing wrong with this, as future doctors we are here for the patients and they have a right to know if their physician has HIV+. Just as we have a right to know if they have HIV and are our patients. Seriously who knows if they are even taking their Anti-virals correctly, plus anything can happen in the OR.
 
  • Like
Reactions: 1 user
I would also appreciate to hear your insight. What specialities would a student with HIV be able to still pursue (specifically, EM, derm, PM&R, IM, radiology). Will there be issues in obtaining a medical license? Will there be issues in securing a residency? Thank you in advance.

Allow me to first clarify that I'm NOT a Clinician yet.

I've met/worked with HIV+ clinicians, Docs, Nurses whom had disclosed that they were HIV positive to their employers/peers. I don't know if they were HIV+ before becoming clinicians so I can't speak to if being positive was a hindrance in their careers. I DO know that being HIV+ is considered a disability for employment purposes. I also don't know all the "rules" regarding whether or not an HIV+ person could be excluded from certain specialties and I imagine that may be state dependent ie different states have different rules for licensing.

For a Clinician whose HIV is well controlled, their chances of transmitting it to a patient is next to nil IF they keep their disease under control, <200 copies/ml.
 
It's not the 1990's anymore and treating HIV like that towards patients who have consistently low viral loads is pretty silly and draconian.

Yet the stigma that PLWH deal with is INSANE!! And INANE!!! :mad:
 
Bottom line with HIV is that you're FAR more likely to get if from whom ever you have s*x with, than from an HIV+ patient. And anal more than vaginal.
 
i thought it was two pills. im pretty sure i had two.
i think one was bid and the other qd.
 
  • Like
Reactions: 1 user
PEP or PrEP? PEP should be covered by the hospital unless you're a student. I was on the old cocktail eight years ago, it made me quite sick. GI distress and vomiting for weeks and weeks.
My mistake, I meant PrEP.
 
Can we please stick to the original question?

My sincere apologies for contributing to the derailing. As @hubbsbubbs said, I was hoping for a more helpful/supportive response. I believe the best approach will likely be to consult with mentors you trust while you are in training. Their input will be more valuable than that offered by those emboldened by the anonymity of the internet.

While it does not address the issues faced by an HIV+ physician, I found this story about a surgeon who chose to conceal her spina bifida from colleagues and patients' families for years quite interesting/moving: As she operated on babies' birth defects, a doctor hid her own diagnosis
 
Top