A new tradition: give a gift in October

Timothy Kincaid

July 18th, 2012

This October I propose a new tradition: give a gift to someone. Not just any gift, but one very specific gift. And not to your mom or that lovely family across the street.

In October the OraQuick home HIV test will show up at your local drugstore. Instead of taking an afternoon off of work to go down to the local clinic and give your ever-professional local government representative your name, social security number, sexual orientation, and a count of everyone you’ve had sex with – along with what position you used, how you met them, how many times you had sex with them, and explicit details about the sexual encounter – you can test yourself at home. Privately. And you won’t even need to takes notes about yourself on a clipboard or enter data into a database that is “confidential” until a civil servant leaves it on the bus.

The test takes 20 minutes, is 99% accurate, and involves nothing more invasive than running a lightly swab over your gums. You can make an omelet, go for a jog, watch TV, or even say “please God no” over and over for 20 minutes – but when it’s over you will know whether or not you were infected with HIV as recent as three months ago (in some rare cases six months ago). If you want assurance about more recent events, you can get a nucleic acid test which looks for the virus itself and shortens the window of uncertainty to two or three weeks – but then you’re back to dealing with blood and people with a clipboard and a little lecture at the ready.

And the cost is not prohibitive. It has not yet been publicized, but is expected to be somewhere between $18 and $60 (And listen up, OraQuick, unless you want a whole pile of ill will, you’d best keep it closer to $18 than $60). But even at the upper end, you have three months to save up. So buy two.

Perhaps you believe that you already know that you are negative. Test anyway. It won’t kill you to have more information (and it might just save your life) and if you can’t think of another reason, it gives you bitching rights when you coerce your friend (you know the one) who you really think needs to be tested and is making up excuses.

I say buy two because the second one should be a gift. But a special gift, one you give to a total stranger that you will never meet. Because while you probably can afford to buy a home HIV test, many people cannot. In fact, those who most need to be tested are often those who have the least ability to buy a test. And, in many many cases, they are also those who are the most afraid to go to be seen going to the clinic.

The biggest contributor to the spread of HIV is ignorance about one’s own status. And while there are testing centers aplenty, clearly that isn’t working. Between a quarter and a third of all HIV positive people in this country are unaware that they are carrying the virus, a number that doubles once you get into less affluent communities. And while there are many outlets for testing that are funded by federal or state grants, there are plenty of people who need help – or want to give it – for whom institutional bureaucracies or a trip to the gay community center are not the solution.

So buy a test and give it to a the health science teacher at a high school located in an economically disadvantaged community. Give it to the storefront church that serves an immigrant population. Find a coach for an after-school program for troubled teens. Or a soup kitchen. Or get really brave and walk into the local Church of God in Christ and tell the pastor, “Reverend, I know and you know that someone in your congregation needs this. Pray about it.”

Let’s make this a tradition. Let’s be creative. Let’s find a way to reach the people who are still outside the net, who still don’t have access, who still live in a paradigm of fear. If there is someone they trust – even if it is someone who doesn’t trust you – give that trusted person a testing kit. It will reach the right hands.

And then set yourself a reminder for next October.

Muscat

July 18th, 2012

Neat idea!

Hue-Man

July 19th, 2012

Great minds…Globe & Mail headline
“B.C. launches massive program to wipe out HIV/AIDS”
http://www.theglobeandmail.com/news/national/bc-launches-massive-program-to-wipe-out-hivaids/article4426690/

jpeckjr

July 19th, 2012

This test is very similar, and by the same manufacturer, as the one used at my local LGBT center for free, confidential HIV testing. I don’t know how they do it where you live, but our center does not ask all those invasive questions. However, the testers are trained in providing counseling and referrals for HIV positive results. That will be missing in the home test — someone to talk to if the test is positive.

Andrew

July 19th, 2012

And for those with insurance who are out in the dating world… get them the antiviral Rx now available for hiv-negative folks at risk. approved by the fda this past week.

Eli

July 19th, 2012

I love the sentiment behind this post. That said, the comments about the invasive nature of getting tested at a clinic — exaggerated though they were — are irresponsible.

The clinic where I got tested for the first time was free, anonymous, confidential, had no one in the room except for me and a counselor, and did not require me to give any information other than consent to be tested. (My experience was so positive that I ended up becoming a test counselor at the same site.)

jpeckjr is right that this is, in fact, the exact same test used at many clinics in the U.S. It’s great that people now have the option of a highly accurate rapid test that they can take when and where they are most comfortable.

But plenty of people do value the experience of being tested in person, with a counselor there to support them, and with access to the resources that a clinic can provide (from medical referrals to free condoms). They should know that they can choose whichever testing option is best for them without having deeply personal information forced out of them and then left on the bus by a civil servant.

While I understand that the comments were somewhat tongue-in-cheek, they do nothing to combat the stigma and privacy concerns that keep many people away from testing sites and clinics when they need them the most.

Timothy Kincaid

July 19th, 2012

I last tested for HIV on July 3rd at The Spot in West Hollywood. Though affiliated with the Gay and Lesbian Center, funding was through the County of Los Angeles and data was entered directly into the County’s database system. Anonymous testing is no longer provided and a picture ID is required in order to receive testing.

They asked me the following questions:

Name
Date of birth
Social security number (or maybe just last four digits – I’m not certain)
Phone number
Address
Sexual orientation
Number of times tested before
Date of last test
Sexual encounters in the past six (I think) months
Did I top in the last six months
Did I bottom in the last six months
Do I ever use drugs before sex
Have I ever used any of the following drugs (listing)
Do I ever drink before sex
Do I drink alcohol and how frequently
Date of last sex
His age
Where did I meet him
What is his ethnicity
Did i top
Did I bottom
Did I give fellatio
Did I receive fellatio
Condom use with each question
Does he use drugs
How well do I know him
Is he a regular partner
At what online sites do I have a membership
Have I ever met anyone online
Have I ever hooked up with anyone from online

There were more but you get the idea. I, for one, will never again use their services now that I no longer need to provide the County with a full recounting of the extent of my sexual, social and dating history.

Michael C

July 19th, 2012

The American Indy posted an interesting article yesterday. It posits that the laws criminalizing the knowing spread of the HIV virus has negative effects on the push to get people tested.
http://americanindependent.com/217077/hiv-criminalization-may-discourage-testing-study-shows
This home test definitely helps some of the problems discussed in that article.

jpeckjr

July 19th, 2012

Timothy, thank you for the additional post about your test experience. The testing program I referred to has a completely different approach.

I was last tested through my doctor’s office, so, yes, my name is attached to the test results. But neither my doctor nor the lab asked any of the behavioral questions. I have a great relationship with my doc, and would not have found it intrusive if he had asked behavioral questions. He knows I’m gay and sexually active so all he said was: “Sure. Let’s add that.”

None of those questions are pertinent to having an HIV test. I hope your answer to all of them after name and date of birth was: “None of your business.”

Did they make answering them a condition of getting tested?

Could this be a BTB investigation in the making?

Timothy Kincaid

July 19th, 2012

Jpeckjr

Yes, the questions were a condition of testing.

But, of course, I felt no necessity to give Los Angeles County any information that I felt was not in my best interest and answered accordingly. It really pissed off the counselor who told me that I was ruining his attitude for the next patient.

I wouldn’t have minded giving a fully detailed history were it not tied to my identity. When anonymous, I always tried to give them the information that was needed to do epidemiological analysis.

But this was info attached to my name and provided to the county… and I trust them less than I trust Eugene Delgaudio.

I have history with the County.

Once upon a time, many years ago, a guy contracted an STI and gave the County a list of people with whom he had been in contact. I was on his list. The County decided to drop by one day while I was at work and, as I wasn’t home, proceeded to tape a form to my front door (I lived in an apartment complex) requesting that I contact the County Health Department – for all my neighbors to read.

When I went down, they asked if I wanted an HIV test. As it was not anonymous I declined. They insisted, I declined.

Then the doctor came in and pulled out a vial and began the tourniquet and alcohol swab process. I asked what it was for and he was evasive. I demanded that he tell me if it was for HIV and he admitted it was.

When I told him that I had declined, he started with, “Well, we always test for HIV because we need…”

I informed the doctor – at the top of my rather considerable vocalizing ability, just in case any other patients needed to hear it – that it was against California state law to test for HIV without the full consent of the patient and that if he proceeded any further I would be seeking criminal prosecution against him personally.

He decided that – as I happened to know the law (I had actually lobbied for it) – he wouldn’t violate my civil rights this particular time.

Since that day I have been less than fully confident in the Los Angeles County Health Department. Nothing I’ve heard since from anyone has countered my opinion.

Jim Burroway

July 19th, 2012

Timothy,

Wow. I would never consent to that kind of invasive questioning either. Luckily my (straight) doctor never asks. I just remind him during my annual exam to add it and he just says okay.

(Except the last time when I requested an HIV test, he excitedly told me about a colleague/researcher in Australia who believe that they may be onto a technique to actually cure AIDS. He was so excited that he decided to invest in their start-up. My doctor’s a very smart guy and I don’t doubt that whatever he’s investing in is promising. But of course I have trouble getting excited myself because we’ve all seen too many other “promising” pathways to curing AIDS fail to pan out. But despite my skepticism, I was happy to see him excited.)

Dave H

July 19th, 2012

This new home testing product is both a good and a bad thing.

Yes, people should get tested and know their status. This will probably appeal to many people who won’t go into a testing facility for whatever reason, so that’s great.

But I agree with jpeckjr: What about people who find out that they are positive at home? There are no counseling or referral resources readily available. Finding out that you are positive can be traumatic.

Timothy Kincaid

July 19th, 2012

OraQuick is setting up a 24/7 bilingual call center with information and which also can give local referrals.

jpeckjr

July 19th, 2012

I’m aware they are setting up a call center. That is not the same as counseling. Being alone when receiving difficult news is, well, difficult. Even having a friend present can be helpful.

That said, my prediction is this home test will be used by people wanting to regularly confirm their negative status rather than those concerned they might be positive. I consider that an appropriate use.

Again, Timothy, thanks for the further information about LA County. I’m really startled by that. I live in another California county where that is not the way HIV testing is handled at all.

AlexH

July 20th, 2012

That’s a terrible experience to have to go through, Timothy. I bet a lot of people end up giving false information because of this. And who can remember all that stuff anyway?

When I was sexually active, I never knew most of my partner’s last names or even their first names for that matter.

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