September 10, 2007

Positive / Negative

Thursday is the day that the clinic offers free HIV tests to anyone who wants one. There are often aren’t too many takers and it seems a number of people don’t want a test because they don’t want to know the results. But we’re usually able to badger enough people who’ve been chronically ill or have STDs to come get a test.

I asked to learn how to do the tests as I imagined it was a matter of drawing blood, sending it off to a lab, and getting the results in a few days. The real reason I wanted to learn was that I wanted more experience drawing blood. The actual testing of the blood, I assumed, would be someone else’s job. But when I sat down to learn, I realized the reality was quite different.

Apparently, there are kits these days that can test blood for HIV within 15 minutes. All it takes is a few drops of blood dropped in a plastic tray, a reagent chemical, and an egg timer. So my job was to prick the patient’s finger, draw blood, drop it onto the test, and wait. It reminded me a lot of taking a patient’s blood sugar.

The patients receive pre-test counseling from our Xhosa nurse, Dorothy, so when they sit down in front of me they are totally clear on what the stakes are for them. It is literally a matter of life or death. As you might expect, there is a tremendous amount of emotion flowing through them and it is impossible to draw blood from them and not share in those emotions. After I draw the blood, we sit and wait and watch for the lines to appear on the test. One line means negative, two means positive. Each test feels so emotionally draining and it is not even my blood and life on the line. I don’t actually tell them the result – they go back to Dorothy for that – but I am the first to know and I am sure they can read my body language.

(Of course, I shouldn’t be quite so dramatic. We have a number of HIV-positive patients in Itipini who have been living with the virus for a number of years. Even in South Africa, where the virus is endemic and the government has been controversially slow to respond, HIV is not an automatic death sentence. There is reason for hope.)

I did three tests my first Thursday. They were, thankfully, all negative.


Stephen said...

Wow, that is incredible. I can't imagine how emotionally draining that must be. I didn't realize it was that quick. I wonder why it takes so long in the States?