HIV Testing

Friday was National HIV Testing Day. I got a jump start on the occasion actually…I took the test the week before last and got the results back on Wednesday.

The testing process is unpleasant enough that I can understand why many people don’t take it. I don’t mean that the process is physically unpleasant…the test itself is a simple oral swab usually. But before taking the test, one usually completes a questionnaire and then has an interview with a test center worker about one’s sexual history since last testing. I understand that the need for the information, both for epidemiological analysis and to provide good counseling, but the process is a lot what I imagine confession is like for Catholics. I always end up reliving the guilt from the times I’ve strayed from strict adherence to the condom code since I last tested.

That’s not the hard part though (and to be truthful, the test center counselors do their best to be as matter of fact as possible). The hard part is waiting for the results. Let me say first that I’ve not had a particular reason to be worried over the results: I generally play safe and am not particularly promiscuous. Even so, I find things to worry about over the week between taking the test and getting the results. I find that I dwell on the encounters that were not 100% safe, wonder about the risk of oral transmission, and so on. I begin to interpret minor illnesses as signs of impending doom. None of this is rational, but I do it anyway.

By Tuesday then, the day I was to get the results, I was pretty much frazzled, and was relieved when it was time to get the results. So I go to the testing center and…

No results. The lab somehow had not processed the samples from the previous week. Can I come back tomorrow to get the results?

I was pretty much a wreck then all evening Tuesday and all day Wednesday, even getting downright paranoid. But I also had some time to think more carefully about what it was that I feared from the results. Suprisingly for me, as I analyzed my thinking more carefully, it wasn’t the virus itself that I was worried about, or about getting sick. What I feared was becoming a social outcast.

Most gay men have the experience of being social outcasts, to at least some degree. It goes with the territory. But gay men who are positive experience that sort of social rejection again, this time from among other gay men. Once one is positive, one’s range of dating, sexual and social opportunities becomes much more limited. My inner economist would put it this way: one’s “value” in the gay male sexual community drops significantly when finding out one is poz. (Incidentally, I suspect from what I have observed that this same sort of sexual devaluation happens on the basis of race within the gay community).

I don’t really have a solution to this problem, but it does point to an important reason why many gay men don’t get tested for HIV: plausible deniability. If one does not get tested for HIV, then one can go on belieiving (and telling others) they are HIV negative. In my boudoir, some men will ask my HIV status (or if I am “clean”), but no one has ever asked when I was last tested, or if I’ve had unsafe sex since last testing. Thus, so long as one never tests, one never has to face the possibility of telling a partner that they are (or may be) positive.

There’s bound to be an academic paper somewhere in here…I just haven’t found it yet!