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A Man With Alcoholism and HIV Infection

Steven E. Hyman, MD
JAMA. 1995;274(10):837-843. doi:10.1001/jama.1995.03530100077038.
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Dr Delbanco:  The patient is a 39-year-old single man who is unemployed, in large part because of chronic problems arising from alcoholism. He came to the primary care practice at Beth Israel Hospital in 1991 seeking care for newly diagnosed neurosyphilis and has been cared for by Dr U since then. He has recently acquired stable health insurance by applying for and receiving Supplemental Security Income. His doctors supported his application, feeling he was disabled by his use of alcohol.The patient grew up in Boston, Mass, in a family with a strong history of alcoholism and emotional abuse. His father left home when the patient was 2 years old. His mother drank heavily, and two of his brothers have problems with alcohol. In his early teens, the patient experimented with multiple drugs, including cocaine, speed, LSD, and "uppers and downers" of various sorts. He took heroin intravenously on rare


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