Case 2 Love, Marriage, Sex and Family
George L. Tipoe, Harry Hui and Benny Tai
Mr. Edmond Wong is a 35 year old business executive working with a multi-national
company based in Hong Kong. He has been with the company for almost eight years. He
obtained his business degree from a reputable international business school in the United
States.
He is very aggressive in his business approach and managed to generate a substantial
profit for the company in the last few years. His performance has impressed the directors
of the company so his career was on a fast track. The company expanded the operation in
China somewhere in Guangzhou. At this time, Edmond has been working with the
company for three years. The company has set up a factory and he was appointed to
oversee this project. The setting up and supervision of the factory demanded a lot of his
time. So Edmond has to stay five days and a half in China. He returns to Hong Kong over
the weekend.
Prior to his work in China, Edmond has been socially involved with Ms. Zara Lee. They
have been seeing each other very frequently after work. The friendship later developed
into a more serious relationship. After a year of dating, they have decided to get married.
This was hard for Edmond because Zara had to remain in Hong Kong while Edmond
worked in China. A year after their marriage, Zara got pregnant which was accidentally
conceived and was not part of the plan. This news caused more stress on Edmond.
The stress and demand of Edmond’s work in China have been mounting. In addition to
activities during daytime, Edmond has to maintain an active night life at his client’s
request. Most of the deals and contracts are finalized during the evenings in Karaoke bars
and night clubs. This seems to be the modus operandi of this type of business.
During the weekends, Edmond returns to Hong Kong to spend time with his wife. Zara is
also a working and a career-oriented person. She is working as an executive secretary in
one of the foreign firms in Hong Kong. So this couple’s weekend arrangement seems to
barely fit their current needs of the relationship.
A year into their marriage, Edmond consulted a general practitioner in Hong Kong
because he was concerned about some genital symptoms. He complained of tingling
sensation during urination and a yellowish discharge (or fluid) for about six days.
Edmond admitted that he had unprotected sex with several partners in the last two months
in China. He met these girls in the Karaoke bars. He went together with his business
clients on those occasions. He was drunk when he had sex with these women.
On physical examination, his vital signs, chest and abdomen were normal. After securing
Edmond’s permission, a genital examination was carried out. A whitish discharge from
the urethral opening was observed. There was no genital ulcer (lesion) and the scrotum
was normal with no palpable lymph inguinal nodes.
A sample of the urethral discharge was taken for Gram stain, culture and sensitivity.
Blood sample was also obtained for serological examination. Mr. Wong was briefed that
because he has engaged in unprotected sex, then it is important to screen some of the
important sexually transmitted diseases like HIV. Edmond agreed to this proposal.
Five days later, the results were available and Edmond returned to Hong Kong and
consulted his doctor. The urethral discharged was positive for Nisseria gonorrhea and
Chlamydia trachomatis. Syphilis serology was negative. However, a further blood sample
was taken for another HIV testing.
Edmond was given oral medication for his urethritis. He was asked to come back for the
next appointment to obtain the HIV results which would be available the following week.
A week later, Edmond came to follow up his HIV results. The HIV antibody test was
positive. He was given some counseling by his doctor who made an urgent referral to
Kowloon Integrated Treatment Centre. Mr. Wong cannot decide whether he should
reveal the HIV result to Zara.
Glossary:
1. Genital ulcers are breaks on the skin as a result of infection caused by
microorganisms.
2. Scrotum refers to male external genitalia that contain the testis. The testis
produces male sex hormone and sperms.
3. Lymph nodes are stations where lymph fluid passes and get filtered. They also
contain high concentration of lymphocytes (a type of white blood cells) which are
involved in the immune defense of the body.
4. Nisseria gonnorhea is a type of bacteria that infects the glands along the urethra
and causes infection with discharge (urethritis).
5. Chlamydia trachomatis is a type of bacteria that grows together with Nisseria
Gonnorhea. So treatment must be directed to both types of microorganisms.
6. Gram stain is a simple staining technique that uses a dye to identify bacteria.
7. Culture and sensitivity is a laboratory technique that grows bacteria in a Petri disc
with nutrients for diagnosis and testing of antimicrobials.