Tracey's Interview

A conversation on HIV testing between Tracey, a MySistahs volunteer, and Melinda, an HIV counselor at a local clinic in the Washington, D.C. metro area.

:: Myths and Facts about getting tested ::

Tracey: What should I expect in an HIV testing counseling session?

Melinda: Well, at the local clinic where I work you are asked to fill out a form with an identifier code name that you come up with, if you choose anonymous testing (we'll talk about what this means later). This form includes questions about your sexual health, partner(s) information, and reasons for testing. After you have filled out the form, I will meet with you and we will talk about what an HIV infection is, the purpose of the test, how it is done, and what the results mean. We will also discuss your sexual behaviors and what changes you may want to make in the future. We will outline a variety of specific options available to a young woman for reducing her risk of HIV infection or transmission. A good counselor is always client-centered, which means that the focus is on you and what your needs and circumstances are and working together to create practical action steps to protect your health now and in the future.

Tracey: What is the difference between anonymous and confidential testing?

Melinda: There are two ways to enroll for tests, anonymously and confidentially. I will explain what they are separately. Anonymous HIV testing means that no name is given to the testing center. You have a unique identifier code, and you are the only one who learns the test results. Anonymous testing is available in many states. Confidential HIV testing means your name is recorded. It is important to know that confidentiality laws and regulations protect the information but other people, such as health care workers, employers, and insurance companies may learn about your results. Confidential testing is available in all states.

Tracey: What issues do you discuss before and after testing?

Melinda: Before testing, I think that it's important to discuss sexual behavior and reasons for testing. I like to discuss if there are any changes in behavior that the young women would like to put into practice in the future.

Tracey: Do I have to have a blood test?

Melinda: No, a blood test is not necessary. Urine and oral-fluid HIV tests offer alternatives for anyone reluctant to have blood drawn. The urine testing is not as sensitive or specific as blood testing. A physician must order these tests, and the results are reported to the ordering physician or his or her assistant. The oral-fluid HIV test is called Orasure©. It is currently the only federally approved oral-fluid test. It collects fluids from inside the mouth. Oral fluid tests are offered at many HIV testing locations.

Tracey: How long will the results take/ how long before I get the results back?

Melinda: The results can take about seven to fourteen days, depending on the type of HIV test you take.

Tracy: Are there any HIV tests that have a shorter waiting time period?

Melinda: Yes. There is an HIV test that involves drawing a small amount of blood from your finger and testing it for the HIV antibodies. You receive the test results in 20 minutes. This test is called ORAQUICK® Rapid HIV-1 Antibody Test.

Tracey: What if I test positive for HIV infection?

Melinda: If you test positive for HIV infection, I will talk with you about risk reduction, safer sex behavior, and about the importance of seeking immediate medical treatment. Support is also important, and if you do not have any one who can emotionally support you, I will recommend groups who may be useful. I will also discuss with you what antibodies are and what it means to be HIV positive. We will discuss the issue of partner notification and the concern to provide you with strategies to protect yourself, and to prevent infecting others.

Tracey: What if I test negative for HIV infection?

Melinda: If you test negative for HIV infection, we will discuss and reinforce behaviors that were addressed with the pretest and I will answer any questions you may have, along with your plans to maintain a healthy life.

Tracey: Do I have to pay for an HIV test?

Melinda: In some places you have to pay for an HIV test, but there are local clinics that offer the service anonymously and free. If you have health insurance, the HIV test may be free as well, but it may be confidential instead of anonymous.

Tracey: Do I need my parent's permission to get tested?

Melinda: That's a great question - it really depends on the state that you are in, but there are some places where age is not a restriction - there is more focus on your getting tested and knowing your status in order to live a healthy and fulfilling life.

Tracey: May I bring a friend (or partner) with me to the clinic for my test.

Melinda: Please do bring a friend or partner, if that helps you.

Tracey: What are some of the myths about getting tested?

Melinda: The myths that I have heard are that an HIV test is going to hurt…but if you don't like needles and find them painful, there is the option of the Orasure© test. I have also heard the talk that "Not knowing is easier to deal with" but the truth is that the sooner you know, the sooner you can protect yourself and start treatment if necessary.

:: Young Women and Risks to Health ::

Tracey: Why should a young woman consider getting tested?

Melinda: Why not? Knowledge is power. Taking control of your body and knowing what is going on feels healthy and responsible. Besides, you have a responsibility to let your partner know your status. Also, if you were to test positive, you can live WITH your status through medication. There are many reasons young women should consider getting tested for HIV. For me, one of the most important was peace of mind. I want to stay healthy, and not infect other people.

Tracey: How big of a problem is HIV and AIDS for young women of color?

Melinda: There are increasing numbers of HIV infection among young women of color, based on situations that place them at higher risk.

Tracey: What are some of the behaviors that put a young woman at risk of HIV infection?

Melinda: Any behavior that might result in contact with blood, semen, or vaginal secretions. Specifically, it is important to NOT have unprotected (without a condom) sex, even if you are on birth control pills. Also, do not inject drugs by sharing needles or syringes, and make sure that if you decide to get a permanent tattoo or body piercing that a new needle is used (unwrapped in your presence) and new container of ink, too, to prevent Hepatitis C virus infection.

Tracey: Can a young woman become infected with HIV through oral sex?

Melinda: Yes. Oral sex may put you into contact with blood, semen or vaginal secretions. If you have, for example, open sores, cuts or burns in your mouth, and/or bleeding gums, I recommend that you use a latex condom for oral sex with the penis. You can also cut the latex condom lengthwise, if you do not have a dental dam, which you can use against the vagina and the anus. All condoms and dental dams should be one-time use only.

Tracey: Does having other STIs like gonorrhea or herpes, increase risk for HIV?

Melinda: Sexually transmitted infections (STIs) which cause open sores, like syphilis and herpes, increase your risk for HIV infection, if you have sex with an HIV-infected partner. I recommend that you talk to your health care provider and get treatment for your STI. This may help reduce your risk of getting HIV infection.

Tracey: How can a young woman protect herself from HIV infection?

Melinda: The only surefire way is to avoid any behavior that might result in contact with blood, semen, or vaginal secretions, which means to ABSTAIN. But if that's not your decision, then know your status and know your partner's status, and use barrier forms of protection, such as latex condoms and dental dams. Also, do not use oil-based lubricants, such as petroleum jelly or vegetable shortening, because they will break down the latex of the condom and increase your risk of exposure to HIV and other STIs.

Tracey: If I had unprotected sex last week, how long should I wait before being tested?

Melinda: The Centers for Disease Control and Prevention currently recommends getting tested six months after the last possible exposure to the virus. (It is possible to be exposed during unprotected vaginal, anal, or oral sex; as well as when sharing needles). It is important, during the six months between exposure and the test, to protect yourself and others from further possible exposures to HIV.

Tracey: What if a young woman decides during counseling that she does not want to take the test?

Melinda: That's her decision, though I'd encourage her to go home, think about the reasons TO get tested, and come back. I'd probably give her some literature to take with her/some resources to look up while she thinks about it.

Tracey: What if a young woman changes her mind and does not want to know her test results?

Melinda: That's her decision, though I'd encourage her to take a few minutes, think about the reasons TO know her status, and come back. A person should feel comfortable to some extent, and be willing and able to deal with knowing her/his status.

Many people say they would prefer not to know if they were HIV+. However, even if someone's HIV test comes back positive, it is an opportunity to get into early treatment. While there is no cure for HIV, there are drug regimens and other treatment options that can prolong and improve the quality of life. The earlier infection is detected, the more time and options a person will be afforded for exploring these different avenues of opportunity.

:: Testing Locations and Information Resources ::

Tracey: Where can I go to get tested and get information on HIV and AIDS?

Melinda: You can go to the local health departments, private doctors' offices, hospitals, and sites specifically set up to provide HIV testing. It is important to get tested at a place that also provides counseling about HIV and AIDS, so that you can receive information as well. The CDC National STD and AIDS Hotlines can answer questions about testing and can refer you to testing sites in your area. You can also go to the HIV Testing Sites database for a list of sites in your area, if you want to go where no one knows who you are. You may call the CDC National STD and AIDS Hotlines 24 hours a day, 365 days a year at:

• 1-800-342-AIDS (1-800-342-2437)
• 1-800-AIDS-TTY (1-800-243-7889) TTY
• 1-800-344-SIDA (1-800-344-7432) Spanish

Getting tested is a big decision and if you have already done it, congratulations!! If you haven't or still have more questions, there are a variety of resources you can check. NAPWA sponsors National HIV Testing Day and lists local sites you can get tested. You can also go here http://www.mtv.com/onair/ffyr/protect/testing.jhtml If you are nervous, call beforehand and ask questions. Take a friend (or a partner!) with you. And remember that none of us is perfect. No one at the clinic is judging you or your behavior. We all just want you to have all the information and resources you deserve to live the healthiest and happiest life you can.

:: Partner Communication ::

Tracey: How can I convince or suggest to my partner that we get tested together?

Melinda: No one wants to cause pain or anguish to someone they care about, and while we should always be thinking about protecting ourselves from infection by another, it is also a way to prevent passing along any infections we may not know that we have. Saying something like, “I am concerned about my health, and your health and that, in order for both of us to stay healthy, it's important to us, as a couple and as individuals, to get tested.”

Tracey: What do you say to people who say that condoms cause them to "lose the feeling?"

Melinda: In discussing condoms, we cannot simply pretend that it is easy or that using them won't make a difference and won't affect how intimacy feels. Instead, we talk about why it might be difficult, and sometimes role-play discussing condoms with a partner. To those who complain about condoms changing the way 'it feels', we talk about having the partner put on the condom, using lubricants, non-penetrative options, and considering experimenting with using a female condom. Sometimes, using condoms can delay orgasm for men, which can increase the pleasure for both. Finally, the peace of mind both partners can have, knowing that they are greatly decreasing the likelihood of either causing or having an unintended pregnancy or a sexually transmitted infection, can increase intimacy and the comfort level of both partners. I encourage men who masturbate to use condoms, and for both young women and men to realize that there are pleasure levels when you are sexually active, and that, should you develop genital warts, for example, you will definitely "loose the feeling."

:: Personal Counselor Perspective ::

Tracey: What do you enjoy most about being an HIV testing counselor?

Melinda: Telling people that the test came back negative, and feeling/seeing their joy and relief. Then, using that moment to emphasize this opportunity for behavior change (I talk specifics here) and to communicate that they have a new lease on STAYING healthy. Volunteering as an HIV counselor at a local clinic for over a year has been a great way to meet amazing people. I am always very humbled by the fact that people would share their very private, sometimes painful stories with me. And it really emphasizes that you cannot tell, from simply looking, who might be at greater risk of becoming infected with HIV, or may already have other sexually transmitted infections.

Tracey: How did you decide to become an HIV counselor?

Melinda: Oh, for so many reasons. I think to help friends and peers understand the importance of HIV testing and to help young women and all youth to improve their ability to care for their own health.

Tracey: Thanks, Melinda, for all your time and answering so many questions for us!

Melinda: Anytime! This is an opportunity to help other young women like myself, understand the importance of having an HIV test. To all mysistahs out there, know your status in order to stay healthy!

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