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EDITOR'S CHOICE: Fiona Godlee Living dangerously BMJ 2006; 332: 0-f [Full text]

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Living dangerously

James E Parker   (13 March 2006)

Living dangerously 13 March 2006
James E Parker, Retired Paediatrician 289 McCallum Rd Abbotsford BC Canada V2S 8A1 Send response to journal: Re: Living dangerously	As your editorial states, it is indeed worrying to note that some people at risk of sexually transmitted HIV choose pre or post exposure chemoprophylaxis to protect themselves from infection. Such behaviour is irresponsible and not comparable to the judicious use of post exposure prophylaxis after needle stick injury in the emergency department. Cassell et al (BMJ 2006; 332:605-607 March 11 ) have it right when their final word states 'Programming to change the sexual behaviour will remain fundamental to preventing the spread of HIV'. It is good to see that the lessons from Uganda are receiving some attention. While one was a voice in the wilderness over 5 years ago (Rapid response BMJ 2000 November 27 - The problem is ignorance ),it is gratifying to note that the central importance of behaviour modification is now recognized. Those of us who graduated in the 40's and 50's can well remember when routine screening for TB and syphilis was part of every hospital admission. It seemed mind boggling later when similar screening for HIV was opposed on the grounds that this disease was unique and exceptional. James E Parker Competing interests: None declared