It has been a while.. I think because I have been feeling overwhelmed. The number of newly diagnosed patients that i have been caring for has been unbelievable. It seems that every week I am seeing at least 2 newly diagnosed patients. The really hard part is that in the last month I have acquired 4 patients that are younger than my son Eli, who is 19. I dreaded the day and now it has arrived.. and the sad part is that they are not shocked or surprised. Primarily young gay boys who for the most part say that they just expected it would happen. When I asked one what he thought of this and how he was feeling, he said "oh, I am fine, thinking I will become and HIV counselor". He is 18. He is already experiencing weight loss, fatigue, rashes.. Needed to start meds that day as his numbers weren't great.

I have another patient that we will call Kiddo. He is 18 years old from South Sacramento. African American. He came in with his new girlfriend so that they could get tested before they became sexually active. He actually had no identifiable risk, NO sex, no Drugs. Mom is HIV negative.

His test at first was inconclusive so I thought that perhaps it was a false positive as we could not find a risk factor.

So because of that I ordered an actual HIV viral load. (this looks at actual viral particles per ml of blood).

To my dismay his viral load was near 400,000. This is quite high. At this time he officially became my patient. During the time from the result and getting him in for his official intake appointment he ended up at Kaiser hospital with Pneumocystis Pneumonia. An opportunistic infection that can kill.

At this time more labs were drawn and it was determined that his CD4 count was ZERO. I had never seen this before. ZERO.. this means that he had to have been infected for quite some time. After many discussions it still was not clear how he was infected. I had also run an additional test which showed he actually had a more virulent strain that we refer to as X4.

This story has many of us providers talking about how this happened. He states that he was sickly as a younger kid.. He travelled to Cuba.. to Vietnam but no risky things that the patient could identify.

Somewhere along this boys life he was exposed to HIV..

He has touched me. He is quite sweet and quite innocent.

I have yet to meet his mom, which makes me crazy too. It appears that he is alone in this but never says a bad word about his mom. I get angry because I think if this was my boy.. I would be right there at appointments to understand and help my son.

It has been about 2 months since I met Kiddo. He calls me frequently to check in. His CD4 has risen to 10 and his viral load has dropped to undetectable. I think he will be fine if he stays on track with his treatment.

I have been crying recently when i leave the room on these young boys... I feel the challenge of keeping them well for a long and productive life. They are young and vital and I stress to them that they are the same kid they were the day before their HIV test and diagnosis. The challange of today....

An update on my lovely family from the Philippines.... the baby is doing really well. Mom and Dad are great and they finally tested their teenage son and he is HIV NEGATIVE.. we were all relieved. This family is an example of unconditional Love and a team that will face all of the challenges of life together. I have great admiration for them and feel honored to be a wittiness to their power.