Los Angeles, California
It was one of those Pittsburgh days where we had snow, rain and sunshine all before 2 p.m. It was reflective of my own indecisiveness. This was my second attempt at walking nonchalantly by the front door of the health department and I still couldn’t muster the courage to enter the building. I peeked inside the door, but inside was a blur. I hid behind a corner, pulled out my phone and read, “STD/HIV testing: weekdays from 8:30 to 3:30, first floor.”
After standing suspiciously on the sidewalk for five minutes, fearful I might run into someone I know, I finally walked into the building. I shyly made eye contact with the lady at the counter. “HIV testing?” she asked, and I nodded almost imperceptibly. She handed me some forms and pointed me to the room on the right. I looked up and there was a big yellow sign above the door that read “STD Clinic.”
I walked in and immediately spotted HIV- and STD-related brochures and posters on the wall. Educational videos were playing on the TV. There were six people in the waiting room and no one spoke. I took an empty seat in the corner, exchanged a brief greeting with a man dressed in a suit seated across from me and looked down at my phone. An overwhelming sense of panic overcame me.
After watching video after video, I was ready to throw my phone at the TV if I had to listen to another cheesy conversation about HIV testing between two gay men in a bar. When the nurse finally called my name, I rose and followed her sheepishly into the exam room.
I sat down nervously while the nurse looked over the forms. “You are far from home,” she commented. I was a bit shocked she knew that until I remembered I used my California license as a form of identification. She smiled and told me to relax. She asked me about school and we chatted about the city and life.
Before I realized it, I was telling her about my sexual behavior and history. The testing procedure went by rather quickly and painlessly (finger stick and blood draw). I was told that my rapid test results would be ready in 20 minutes. It was the most nerve-racking 20 minutes of my life.
Once again seated in the waiting room, I aimlessly stared at the girl across from me. I was consumed by the fear of a positive test result. I looked around but found no consolation in the faces of the strangers in the waiting room. The posters, brochures and videos that once irritated me seemed somewhat calming now. I could hear the clock ticking. Those 20 minutes seemed to pass by so slowly.
Finally, the nurse walked back in and called my name. I solemnly walked toward her into the same exam room, where she informed me that I was negative. I felt a sense of relief.
That is the story of the first time I got tested for HIV a couple of years ago. As someone who later decided to work in the HIV prevention field, it was an invaluable lesson in the barriers to HIV testing. When I look back now, I can jokingly tell you that it was a somewhat awkward yet comical incident. But at the time, the fear of my privacy being compromised, the stigma of HIV and the anxiety I felt waiting for the results were as real as they get. And even today, those feelings still haunt me vividly.
I was fortunate to have been tested by a gentle staff member who helped ease some of the tension during the procedure, but not everyone will run into an understanding nurse. While there are numerous benefits to HIV testing and knowing one’s status (e.g. risk reduction, early treatment and improved prognosis, just to name a few), if public health practitioners cannot help alleviate some of the stress associated with the current practice of HIV testing, how do we expect individuals to engage in HIV testing?
This is an important issue because many national and local agencies have recognized the role of HIV testing in the framework of HIV prevention. The UCLA Center for Digital Behavior fosters a group of interdisciplinary researchers who focus on using technologies to address health disparities.
The Harnessing Online Peer Education (HOPE) project was a 2011 Facebook-based intervention that educated at-risk men who have sex with men (MSM) about HIV and provided them with access to HIV home testing kits. There are several advantages to home testing kits: 1) you no longer have to show up at traditional testing sites or be seen in their vicinity, so they offer an alternative for those who fear stigma; and 2) you test yourself anywhere, like the comfort of your home, and you can be with people to support you through the anxiety of HIV testing.
One of the key findings of the HOPE project was that participants who requested a home testing kit were more likely to be unsure about their HIV status and have let more time elapse since their last HIV test. This is encouraging because it tells us that by providing home testing kits through Facebook (along with prevention education), we were able to reach people who were unaware of their HIV status and had not been tested as regularly as they should have been.
Because of the recent explosion in social media use, Facebook and other social media technologies have emerged as a platform to not only reach a large number of individuals at risk for HIV, but also provide HIV education and access to home testing kits. At the time of the HOPE project study, the only FDA-approved HIV testing kit was the Home Access kit, which uses blood drawn from a finger stick to detect HIV antibodies and returns the results within seven business days.
In 2012, the FDA approved OraQuick, an oral fluid HIV home testing kit. OraQuick is now being sold at select drug stores. Amazingly, these tests provide results in 30 to 45 minutes. Innovative technologies such as social media and home testing are revolutionizing HIV prevention by decreasing stigma and subsequently increasing the rates of HIV testing.
What three adjectives best describe you?
Friendly, genuine and honest
What is your greatest achievement?
Simply being alive
What is your greatest regret?
I didn’t practice enough piano when I was young.
What keeps you up at night?
If you could change one thing about living with HIV, what would it be?
Stigma and any sort of prejudice against people living with HIV/AIDS or homosexuality
What is the best advice you ever received?
“If you don’t have a dream, how you gonna make your dreams come true?”
What person in the HIV/AIDS community do you most admire?
Everyone in this community—their courage inspires me every day
What drives you to do what you do?
I enjoy learning about human sexuality.
What is your motto?
First you dream
If you had to evacuate your house immediately, what is the one thing you would grab on the way out?
Sadly, my laptop
If you could be any animal, what would you be? And why?
A dolphin. I would get to be in the water all the time.
Los Angeles, California