Sex Ed, Graduate Level Courses

In case you have questions about what I do in my spare time, the current standby seems to be talking about sex. More specifically, I turn my research skills on exploring all the ideas people have about sex that just are not true.

USA Today published a fun article on our sexpert myth-busting on Sunday and even included a quiz where you can see what grade you would really get in Sex Ed. I love the fact that it is now recorded for posterity that I joke about sex like a sixth grade boy (true!) But since so many of the myths seem to come from fourth grade, I’m still not doing too bad…

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If you haven’t previously heard our explanations of why it’s ok to have sex the night before a big game or tearing apart the theory that men think about sex every seven second, you can listen to the show “Stand Up! With Pete Dominick” on Indie Sirius XM 102 tomorrow morning at 8am EST.

Of course, you should also buy our book!

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Wordless Wednesday: Fetching Water

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Dualities

Here is the duality of global health: You live every day with beauty and with brokenness pressed right up against your face. You cannot close your eyes to what it means to live in a world where 18,000 children under 5 die every single day, and this is both a precious privilege and a painful burden.

I thought this one was going to die. He came into my clinic in January terribly sick. His parents had both died, and it seemed likely that he would not live much longer either. But we fought for medicines for him and a place at the emergency shelter, and this week, I got this picture of him commemorating his finish of first grade. You cannot put a price on the light in his eyes.

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But even as I rejoice in being proved wrong in my predictions of death and in seeing a young one escape from those mortality numbers that almost included him, I get the news of a loss. A small boy with complicated health problems for whom we struggled to find an orphanage home after he was abandoned by his mother who just couldn’t handle the burden of his medical bills and needs. My housemate had fallen in love with him, and I tried to figure out what we could do for him. But our trying was not enough, and this little life ended this week.

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Hope and hurt. Faith and failure. Beautiful and brutal. Promise and pain. Global health up close.

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Michael and his Mother

Michael has been taking HIV medicines since he was 3 years old. He’s 10 now — and he is alive and growing — but the medicines are not doing what they should. The virus is multiplying in his blood, and he has virtually no immune cells. It’s clear that either the medicines are not working or he is not taking them.

At first, his mother claimed that they have no problem taking the medicines, but eventually she started to be able to tell me about how much of a problem it is getting him the medicines every day.

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Michael’s mother runs a small bakery. She leaves early in the morning, and she doesn’t get home most evenings until after Michael is in bed. This bakery is a one-woman success story. It is how she supports her three children, and her sister’s family besides. But her work to keep their family alive is inadvertently threatening Michael’s health.

Most of the time, Michael doesn’t take the medicines without her there to supervise. And so it turns out that he is missing a lot of doses of his HIV medicines. Without the medicines, the virus multiplies. Without the medicines, his immune system weakens again, and he gets sicker and sicker.

Michael’s mother doesn’t want to enlist the help of anyone else to give Michael these medicines because if anyone saw those medicines, they would assume that everyone in the family had HIV. And she knows what their community thinks about HIV. HIV means you are dirty. It means you have sinned and you should be avoided. It means you are going to die. She looks around her, and she only sees the potential for stigma and discrimination. If people knew that she had HIV, they would stop coming to her bakery.

“No one wants to eat food that is prepared by one with HIV,” she says.

She doesn’t want to risk losing the business that she has worked so hard to build. Her family’s survival depends on the success of her shop. Michael’s mother travels almost two hours to come to our clinic in Eldoret, rather than going to our clinic closer to her home. All because she never wants anyone to know that they come to a HIV clinic.

After our long talk, we planned together some new efforts to make sure that Michael gets all of his medicines. She agreed to try something new. And I had to tell her scary things. I had to repeat how we do not have any other alternatives left if the virus in Michael’s body becomes resistant to the medicines he is taking now. And if he doesn’t take them twice a day, every day, the virus will indeed become resistant.

They are hard words to say and hard words to hear, but they are true. Once these medicines stop working, then that’s it – there won’t be anything left to help the boy.  We don’t have any other medicine options for kids in poor places like Kenya. (I think that’s totally unacceptable, but it’s also true. My heart breaks. My heart vows to fight. )

I think she got it though, and so I give them another chance to make it work with the current set of medicines. And I am left with these reminders from my time with Michael and his mama:

How vitally important is our work to determine which families are having problems with their medicines.

How much we need to address the terrible and isolating views of the communities around our families.

How great is our need to make appropriate HIV medicines accessible to children in the poor places where 90% of the world’s HIV-infected children live.

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Wordless Wednesday: not just alive, but thriving

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(how I measure success)

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