The only stigma around HIV should be NOT testing

With the recent news of Charlie Sheen’s HIV status and with world AIDS day less than two weeks away, now seem like an appropriate time to talk about HIV testing. Maybe you have never been tested or maybe your last HIV test was years ago. If it was, you’ll be pleased to hear there has been a huge amount of progress in testing and that pesky three month window period (the time between unprotected sex and HIV being detected) and the two week wait for results are usually a thing of the past.

I’m going to give you a run down of my experiences of HIV testing and hopefully you’ll be able to see that the scariest parts were the stigma of testing and my own lack of knowledge about HIV.

I’ve had more HIV tests than I can remember. Some people think that reflects negatively on me but I think it shows that I care about my health and the health of my sexual partners. Getting a HIV test shouldn’t be something we sneak off to do. It should be something we talk about openly. By knowing your status and taking about testing, you not only give yourself the best chance of staying/getting healthy but you also get to help your friends and sexual partners to do the same, and who doesn’t like helping friends?

First HIV Test: 2006 Third Generation Laboratory Test

The first HIV test I ever had was in 2006, when I was 16. I wasn’t sexually active at the time (I was tested after being raped) so HIV wasn’t something I’d given much thought to. I knew a bit about HIV but to be honest I thought it was something that pretty much only affected men who have sex with men, and sex workers. I was ignorant. There is no excuse for that.

I chose not to have Post Exposure Prophylaxis after the rape because my risk was low (for more information about PEP, click here) but the three month wait to be tested felt excruciatingly long, nevertheless. Back then the window period was three months as the tests only detected HIV antibodies but now there are tests available that detect antigens so the window period is greatly reduced.

I had to wait two weeks for the results and when I got called into the clinic to receive them (as was standard at that clinic at that time) I was a wreck. When I got the negative result I felt like I’d got a death row reprieve, after all, I believed being HIV positive was a death sentence.

Blood test
The old tests involved a lot of waiting

Second HIV Test, 2009: Third Generation Point of Care Test
I went to see my GP about chronically enlarged lymph nodes in my neck so I was in total shock when she suggested I should have a HIV test. She explained that as we hadn’t been able to find any other cause, it was sensible to at least rule out being HIV positive and, as she pointed out, my “lifestyle put [me] at risk”. When she said those words I felt my face burn with embarrassment. I don’t know if the judgment was a figment of my imagination but it hurt nonetheless. I knew the risk factors (I wasn’t quite as in the dark as I was a few years earlier) but part of me still didn’t believe I could be HIV positive.

She sent me away with the contact details for the Ian Charleson Day Centre at The Royal Free Hospital and I made an appointment to get tested.

When I arrived at the day centre I was nervous. I wasn’t just having a test to be on the safe side, I had symptoms that could potentially be related to HIV. As I sat in the clinic, I began to think about what I would do if the test came back positive. I worried about whether I would be able to keep it a secret. It never occurred to me that I might choose to tell people other than those I had slept with (and I was counting on an anonymous text service to do that for me).

I was called into a room with a nurse. She ran through some questions with me:
Yes, I had unprotected sex.
Yes, I had unprotected anal sex.
Yes, I had unprotected sex with people who used drugs intravenously.
Yes, I had unprotected sex with men who had sex with men.
Yes, I had unprotected sex with men who had grown up in Sub-Saharan Africa.
No, I had never had another sexually transmitted infection.
How many sexual partners had I had since my last test?

Despite the inventory of my promiscuity, it never felt as if she was judging me.

None of these things would have mattered at all if I had just been careful, if I had just used condoms. But there was another factor to consider… If I was HIV positive, someone would have passed it on to me. If I’d encouraged my ex boyfriend to get tested before we slept together (perhaps made a day out of it!) we would both have known our status much sooner.

The nurse asked for my finger. All she needed was a few beads of blood and I’d have my results in half an hour. I was impressed! In the years I had not been testing, things had progressed a lot. There was still a three month window period but a 30 minute wait was preferable to the two week wait of my first test.

I went back to the waiting room and began to think how my life would be over in half an hour. As I looked around the room, something struck me though. I was sitting in a day centre for people who are affected by HIV or who are getting a HIV test, and I was the only person who looked miserable. I was looking at a bunch of people, several of whom were probably living with HIV and some of them were laughing with one of the nurses, some of them were reading out of date magazines, some were in their 30s and some, wait for it…were in their 60s! I knew HIV treatment had come a long way but my idea of a person living with HIV really hadn’t.

The nurse called me back into the room. The HIV test was negative.

My Most Recent HIV Test, 2015: Fourth Generation Test

After my 2009 HIV test I began to take my sexual health much more seriously. That’s not to say I haven’t had unprotected sex since but, when I take risks, I make sure I get tested as soon as possible and I make sure I do not put anyone else at risk.

There are lots of reasons people engage in high risk sexual behaviours. Some of the reasons for my behaviour include alcohol abuse and bipolar affective disorder and, when I was younger, lack of confidence in saying no to someone when we didn’t have condoms available or when they told me they didn’t want to use them. We should encourage people to take care of their sexual health but stigmatising people for making mistakes isn’t helpful. Instead we need to help people to find ways to take better care of their health, whether that be by carrying condoms on nights out, reducing alcohol consumption, or by getting mental health conditions more under control.

Condoms
These little things are pretty amazing!

My most recent test was only a couple of months ago. I’d had unprotected anal sex with a friend of a friend who had been an intravenous drug user. He told me he had been tested since he stopped using but for my own peace of mind, and as I was considering having unprotected sex with a regular partner, I went to Dean Street Express to get tested. While I was there I also got tested for other STIs. When I usually get tested at Dean Street Express I have both a rapid test (a finger prick test that gives results almost immediately) and a blood test (to confirm the rapid HIV test result) but as it had only been a month since I had had unprotected sex, I just had the blood test. This test detects both antibodies and antigens so the window period is reduced to just a month.

When we went through the questions to assess my risk, I didn’t feel shame, and when I waited for my results (test results, including blood test results, only take six hours to be sent by text message at Dean Street Express), I wasn’t overly concerned. The majority of the fear I used to experience about getting tested came from lack of knowledge about HIV and my own fear of knowing my status.

Sexual risk taking has been a huge part of my life for many years but thanks to the encouragement of staff at sexual health clinics and seeing friends taking good care of their own sexual health, I feel like I am finally putting that behind me. There may be occasional screw ups in the future or condom breakages but if there are, I feel confident that I can get tested and, if necessary, receive treatment for any possible infections.

You don’t have to be a promiscuous risk taker to contract an STI. You might have only had one partner in your life but if they have had two (or had one who has had two), there is still a risk. Getting tested isn’t exactly most people’s idea of a fun day out but it is definitely worth it.

If you are in London, I can personally recommend Dean Street Express, and both The Ian Charleson Day Centre and The Marlborough Clinic at The Royal Free for confidential, non-judgmental HIV testing.

Most sexual health clinics offer HIV testing but you can also use the Terrence Higgins Service Finder to find places to be tested near you (click here)

If you live in England can also get a free home HIV test kit from Dr Thom (click here)

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