testing before sexing: responsible = relief

I met a really cool girl in Namibia, and when it became apparent that we were heading down the road leading to my bed, we both had some reservations, and were thankfully able to talk about it openly.

For her, she had read numerous stories about me in my sex blog, and though I talk about the importance of using protection, you can never be too sure of a new partner when you know they’ve been active in different parts of the world. For me, I’m freaked out by the high prevalence of HIV/AIDS in Namibia (and Africa in general), with the (not so accurate) stats saying roughly one in every six adults here is HIV positive.

So rather than live with the anxiety, we decided to do the responsible thing, and go together for HIV testing.

We arrived in a downtown clinic, where I was a noticeable standout with my white skin. After registering at reception, we sat in a room with park-style benches around the edges, and a television to keep people’s minds elsewhere. It wasn’t exactly a place full of energy and happy faces, but we talked away in Spanish, both of us really nervous, wondering what we’d do if the results weren’t negative.

We were eventually called into an office for pre-test counseling, done by a psychology student. The room had chairs with ripped seats, a sink with a bar of soap, a doctor’s examination bed, and a desk where we sat in front of the young counselor.

After taking down our names (I thought the tests would be anonymous, but not at this clinic), she asked whether or not we were a couple: if yes, we continue the consultation together; if no, one of us could wait outside. We let her know that we recently met, and wanted to do the test together.

She let us know that she would be asking a series of personal questions, and she’d be watching us, looking into our minds, and if we had trouble answering the questions honestly, then we wouldn’t be permitted to do the tests. I thought that was a bit extreme; are you going to send away someone who has come to find out their status because they don’t understand what HIV/AIDS is, and encourage them to leave uninformed to potentially spread the disease further?

One of the first questions was why we wanted to be tested, ladies to answer first. She said she just met me, and wanted to know her status. She was tested last year, but had another partner in between. For me, I had not been tested in about four years, and I was genuinely feeling the fears that people talk about all the time: not wanting to get tested, because I’m afraid to know if I’m HIV positive; re-living every sexual encounter since my last test, thinking about the few situations that could have put me at risk; wondering what it would be like to live with the stigma, and to know that my life would be cut short and be full of speeches every time I thought about getting involved with another woman; wondering what I would do if I was negative, and my potential partner, who I barely know, is positive, and I suddenly need to carry her secret and support her in ways that are much heavier than if we had just decided to trust the 99% effectiveness rate of condoms without asking questions; but what if that small percentage of ineffectiveness has already infected me; then the internal conversation starts all over again in the mind.

Next we were asked what we know about HIV/AIDS. My partner explained how HIV is a virus that leads to AIDS. I expanded, based on the info I’ve accumulated as a development worker: the virus attacks the immune system, weakening it, and making the body more vulnerable to other illnesses that it in turn has difficulty fighting off (those illnesses could be something as simple as the common cold, to something as serious as Tuberculosis, which is curable but requires daily, uninterrupted treatment, and is very common in Namibia, with roughly 75% of the patients in the program I work with in Katutura co-infected with HIV). And as the HIV virus breaks down the cells that help fight off illness, the count of these cells eventually gets so low that the infected person’s immune system cannot function, and they are diagnosed with AIDS. There is no vaccine or cure for the disease, however anti-retroviral drugs (ARVs) do help patients live longer.

We were then asked what could be done to prevent the spread of HIV, and what we were doing. Abstaining was the first answer, and the counselor asked why we were there if we weren’t having sex. We explained that we wanted to be responsible and check our status before being sexually active and possibly spreading the disease. The counselor added that HIV can be transmitted from one person to another through their blood (through a cut, open sore, sharing dirty needles, etc), through vaginal fluids and semen (she forgot to mention breast milk and through giving birth), but not through sharing toilet seats, shaking hands, or other myths that many people still believe and fear in this part of the world. But she didn’t really recognize the value of testing before instead of after getting involved.

The next line of questioning had to deal with multiple partners, and the ‘Break the Chain’ campaign that is currently running in Southern Africa. The counselor asked what country I was from, and then used me as an example to illustrate an idea: she said that I may be here in Namibia for a short period of time, telling this girl that I have only one partner, meanwhile back in Canada, I have another girl waiting for me, and another in another country I visited, or another part of town; if one of those partners is HIV positive, it creates a chain of disease that comes back to this girl, and the chain needs to be broken by using protection, and reducing the number of partners we sleep with (she didn’t speak of monogamy, which I thought was more realistic culturally).

I pointed out to the counselor that the same scenario applies to women sleeping with multiple partners, not just men, and everyone agreed that it is not only a male model that she was illustrating.

I don’t know if she left the lecture on protecting ourselves rather short because she sensed that we were not people who were sleeping around, but for the average person coming into counseling, I thought that much more could have been said (we were pretty much saying ‘Yes, yes’ to everything), as it was not very educational or convincing if they’re really trying to change behaviour.

My personal feeling is that multiple partners is very common in sub-Saharan Africa, and rather than campaign for people to ‘break the chain’ by being monogamous or having less partners, they could modify the idea to ‘protect yourself from the chain’, showing how a condom protects us from whatever diseases we are sexually connected to, and if we really want to enjoy ourselves and think about our own health, the best way to do it is to use condoms every time we’re with somebody.

The counselor eventually allowed us to move onto the second office, where we were greeted by a man and an enthusiastic woman, who said she was very happy to see a young couple coming to do testing together (it doesn’t seem very common here, and 95% of the people in the waiting room were women, not men).

As they prepared to give us a ‘rapid test’, which takes only about 15 minutes, I noticed that the man was working away without any latex gloves on. This reminded me of a poster I saw in the VSO office, asking people to donate latex gloves to NGOs to be shipped overseas.

First, my finger was pricked with some type of needle, then the blood sucked into a little glass tube, and finally dropped on two different types of tests. After we both did it, we were sent back out to the waiting room, for what seemed like much longer than fifteen minutes.

When we were called back into the room, there was an immediate sense of relief, as the woman referred to us in a playful voice as the beautiful young couple, before asking if we were ready for our results. She gave each of us the other’s result, ensuring that we shared the correct information: both said ‘non-reactive post test’, which wasn’t exactly clear. She explained that at this point, both of our blood samples showed no trace of HIV/AIDS, but that there is a three-month window from the time we had sex with our last partner, and during those three months, an HIV-positive person could still test negative, as the virus grows in the body. Her suggestion during this time was to ‘condomize’, and then come back for a follow-up test after three months. She said that we should feel happy, and asked us to hug and kiss for her before leaving. We exited the room with big smiles on our faces, looking forward to what comes next without a heavy stress from the unknown.

We both thanked each other (before and after the test) for doing this together, and it made me feel very responsible, as we walked around the city in each other’s arms (receiving a lot of stares from the crowds who still aren’t so accustomed to seeing mixed-race couples here, but that’s another story!). It’s definitely worth holding off the next time you find yourself hot and ready with someone you don’t know, especially in a high-risk situation, so that you can first remove any fears and hesitation (and knowing your partner’s status will do that), before enjoying the pleasures that come with a peaceful mind.