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Complex trauma is what led many of my patients to get HIV in first place and gets them to remain depressed, stay addicted and have trouble adhering to their meds, medicine and HIV primary care has not considered these health issues to be in their domain and their responsibility. I've heard many clinicians brag about having patients on crack be undetectable in their viral load, as if HIV was going to kill them in the first place. It's not. Crack is going to kill them.