Observer photo by Rob Creighton
American Observer reporter Nikki Schwab enjoying a jumbo slice on U Street

An uneasy reporter gets tested for the first time

by NIKKI SCHWAB

February, 28, 2:21 p.m.– I have never been tested before. That’s why I am going to do it. I pack up my school bag from class and hesitantly trudge across campus to the American University Wellness Center. I am going to get my first HIV test.

Washington D.C. is known to have an HIV/AIDS problem. In the metropolitan area there are between 22,000 to 24,000 people who have HIV or full-blown AIDS, according to the D.C. Department of Health Administration. Organizations throughout the city have been trying to raise awareness of the problem. Advertisements line the metro stations for the “Come Together D.C., Get Screened for HIV,” campaign, which encourages D.C. residents to get tested.

American University is doing its part by offering free testing throughout the year at the Wellness Center in McCabe Hall. Students can also get tested at the Health Center at any time, but the cost for that test is $30.

2:27 p.m.– A woman with a round face and a large smile greets me and gives me the paperwork to fill out. This stuff is easy: sex, age, reason why I wanted the test, was this my first test or had I had one before. Nothing that would identify me. To those administering the test, I was only a number. Number 49, to be exact. There were none of those invasive questions they ask you when you’re about to donate blood, such as, “Are you a male who has had sexual contact with another male, even once, since 1977?”

The Wellness Center at AU tests students for HIV anonymously, which is the most private type of testing. The subject is the only person who can access the results of the test. People can also get “confidential” HIV testing. This means that the results are kept private, but a person’s identity is attached to that test, and the results could appear on that person’s medical records.

2:32 p.m. — Edyth Cook, a patient service coordinator, brings me into a standard doctor’s office room. She asks me to sit in a chair rather than on an exam table, and rifles through a cabinet to grab a test for me. While I had visions of a large needle or a pointed pin, she gives me something less scary. It’s a cotton swab that is larger and flatter than a standard Q-tip and is coated in a special substance that will detect HIV antibodies from the mouth and cheeks in 20 minutes time. I rub it between my cheeks and gums on both the top and bottom of my mouth, give it back to her, and hope for the best.

While some HIV testing is done using blood samples, the test that the AU Wellness Center administers is called the OraQuick ADVANCE test and uses saliva. When an individual is infected with HIV, the body’s natural response is to form antibodies against the infection. The saliva test works because it reacts to the presence of antibodies taken from a subject’s mouth.

Once the saliva is collected, the tester puts the test into a developing solution for 20 to 40 minutes and then comes back and reads the results. There are two lines on the test: a control line and a test line (smartly marked “C” and “T”). Each test must produce a pinkish line next to the “C” to show it is working. If there is a reddish-purple line that appears next to the “T,” that means that HIV antibodies were detected in that sample.

The oral fluid OraQuick ADVANCE test was shown to be 99.8 percent accurate in a study completed at four clinical trial sites, according to the testing literature.

While testing is quick and easy, Cook told me she doesn’t think it will ever be sold over the counter like a pregnancy test because of the psychological counseling people need if they produce a positive result.

2:35 p.m. – Now it’s time to wait. Nobody is really talking. The girl next to me is glancing through a copy of the Eagle, the AU student newspaper, and the guy sitting on the other side of me is pretending to read, but is instead awkwardly staring straight ahead with a dazed look in his eyes. I guess no one is really in the mood to be chatty while waiting to get HIV test results. To me it still seems like there is a sort of stigma attached to getting tested for any sort of STD, whether it is something curable like Chlamydia or something much more serious like HIV. If you tell people you’re going to get tested, they tend to look at you and wonder how many people you’ve hooked up with.

Three or four testing sessions have been offered this year by the Wellness Center, and about 30 students have shown up for each, according to Cook. Luckily, they haven’t had anyone with an HIV-positive test result, she says.

“It’s something we are prepared to handle,” she said assuredly.

Cook says she believes it’s not necessarily the taboo of STD testing that keeps students from coming in for testing, but rather, hesitancy, combined with a student’s busy lifestyle makes HIV testing a low priority. Also, because HIV doesn’t usually have symptoms until it becomes full-blown AIDS, many times students won’t bother to get tested.

Of the million or more HIV/AIDS cases in the United States, about a quarter of people infected with HIV don’t know they have it, according to the Centers for Disease Control and Prevention Web site.

2:55 p.m. — Ugh–still waiting. This might just be the longest 20 minutes of my life!

Katherine Haldeman, a health educator for the Student Health Center at AU, later explained to me that when HIV comes into the body, it will try to increase its concentration in the body. The immune system will then attack the virus and fight it back down. HIV will then increase again. This is how the virus tampers with the immune system. She called this the “ebb and flow” of the disease. In order for it to be considered AIDS, certain symptoms and diseases have to exist alongside HIV.

Haldeman explained that the more HIV virus a person has in his body, the greater the chance that he will spread the disease.

“If the concentrates are really high in the fluid that’s being transferred to another person, then they have a greater chance of getting the disease,” Haldeman said.

But that’s not the only element, she explained. The health of the receiving partner’s immune system also plays a role in HIV transmission. If they have a weaker immune system they have a better chance of contracting the disease. Also, some types of sex have a greater transmission rate than others. For example, having unprotected anal sex is riskier than kissing.

3:00 p.m — Number 48 was just called–I’m 49! Oh no, oh no, oh no. I don’t want the nurse lady to take me into that little room. I don’t know why I’m freaking out. I have no good reason to freak out. I haven’t engaged in what they call “high risk” behavior. I need to get a grip.

Passing contaminated blood, semen, vaginal fluids or breast milk to another person spreads HIV. The way to avoid the disease completely is by practicing sexual abstinence and avoiding intravenous drug use. For those who are sexually active, Haldeman recommended using a condom every time, even for oral sex.

“That’s kind of a myth that if you practice oral sex, you can’t get HIV,” Haldeman said.

When students’ test results are ready, Haldeman brings each student into her office for a private discussion of the results and offers them free condoms.

3:08 p.m. — Haldeman brings me into her office and offers me a chair. She seems to notice that I seem antsy and delivers me the results right away. Phew! I’m safe, I’m clean. Now I don’t have anything to worry about…

While the test is very accurate, receiving a negative result doesn’t necessarily mean a person is in the clear. Because the test works by measuring HIV antibodies, which is the body’s response to HIV exposure, it could take up to six months for the body to develop enough antibodies for test detection. This “window period” is different for every person, but on average it takes 25 days for a person to develop enough antibodies for the test, according to literature from the AU Student Health Center. If a person has engaged in risky behavior, she should get tested three months after potential exposure, and retested after six months.

With D.C.’s high HIV rate, and with many people unknowingly spreading the virus, Haldeman recommended always practicing safe sex.

“For any sexual activity just always protect yourself,” Haldeman said. “Just assume that you have to protect yourself.”