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April 3, 1996

A Man With Alcoholism and HIV Infection, 1 Year Later

JAMA. 1996;275(13):1029. doi:10.1001/jama.1996.03530370067033

At the Psychiatry Grand Rounds held approximately 1 year ago, Dr Steven Hyman discussed the management of a 39-year-old man with active alcoholism and human immunodeficiency virus (HIV) infection.1 Dr Hyman discussed the pathophysiology of alcoholism and the nature of addiction, and how these influence the treatment plan. Dr Hyman and the audience also discussed the public health implications of the patient who is both self-destructive and potentially destructive to others. We asked the patient and his primary doctor to comment on the year that has passed.

Mr L, THE PATIENT: I still drink, but my patterns are different: I don't drink as often, and I don't have blackouts. With the friends I have now, drinking doesn't fit into my life as much. I talk to my therapist about how I don't like alcohol, but what do I replace it with? I have a stable living situation and I