Let me put it this way: there was no reason for me to think I had anything.
But I was still antsy sitting in the waiting room (maybe it’s something about being in a clinic) and I only got more nervous when they started asking me questions (maybe it’s something about being asked questions).
What if — ?
Well, there was —
I wasn’t a fan of the SATs, but I can’t say taking an STD test was any better. When my editors pitched this article to me and told me about their idea for the first-person portion of it, I must admit, I was less than thrilled. But the more I thought about it, the more I realized that it was a good idea. At 20, I had never been tested, and, well, even at Yale, you never know.
Whether you’ve been hearing it since middle school, or your freshman “Connections” workshop was your first time with sex ed, you probably know it’s important for sexually active people to get tested for sexually transmitted diseases. But getting tested, as I discovered, can be inconvenient or scary, even if you’re reasonably sure going in that you’re disease-free. And according to Peer Health Educators, a place in one of the 12 colleges is by no means a guarantee of safety.
“If you talk to the clinicians [at UHS], they’ll say that the percentages of STDs at Yale are fairly comparable to the general college population,” said Jacqueline Farber ’03, a PHE co-coordinator.
Nationally, 10 to 15 percent of college students are infected with chlamydia each year, Farber said. And according to the American Social Health Association’s Web site, the great majority of cases have no symptoms. Ten to 15 percent is one or two people in your seminar, six or seven people in your entryway, and two or three Yale Daily News editors. And that’s not counting gonorrhea, herpes, syphilis, HIV or any number of other infections.
But PHE co-coordinator Amal Bass ’03 said she knows people who do not use condoms during sexual activity because “they don’t believe another Yalie could give them a disease.”
Peer Health Educators cite two common misconceptions: that Yalies are largely disease-free and that oral sex and genital-genital touching are in some way “safe” — in reality, STDs can be transmitted without vaginal or anal penetration.
“Just because we think that we are so smart doesn’t mean we’re necessarily safe from these things, doesn’t mean we’re invincible,” Bass said. “I often encounter this [attitude] in people who are upset because they just found out they do have an STD. The statistic is, by age 21, one in four people will seek treatment for an STD. That’s entirely our demographic.”
And yet, according to ASHA less than half of adults ages 18 to 44 have ever been tested for an STD other than HIV/AIDS.
“I was really taken aback by the fact that, in our population, a really small portion of people get tested for STDs,” said Monica*, who has been tested “a number of times” since she first had sex.
Monica attended a large public high school that had a health center that provided, among other services, free and confidential STD tests, birth control, and “all kinds of contraception.”
“It was free, and the fact that it was there on campus made it very easy. So I just decided to do it to be on the safe side,” Monica said.
University Health Services offers all Yale College students — regardless of whether or not they are members of the Yale Health Plan — a number of services, including free, confidential STD testing. But Farber said she thinks many students do not realize what is available to them.
“I know seniors who have never set foot in UHS,” Farber said. “They’re confused because they waived major medical care. [The PHEs] really encourage people to get checkups, to take advantage of the clinicians we have here. At least from my perspective, prevention is best. But beyond prevention, regular testing.”
Students can make appointments for STD tests through Student Medicine at UHS, the same department that treats students with the flu or pink eye. So in addition to the fact that the test is confidential — everything discussed stays between the patient and clinician — not even the other patients in the waiting room will know the student is being tested.
Brenda* said she was tested in part because she could do so during a routine visit to the gynecologist’s office. In addition to convenience, she said she thought friends’ behavior and their openness about sex can impact whether or not one gets tested.
“I think it depends on who you hang out with,” Brenda said. “All my friends at home get tested and it seemed like a normal thing.”
Monica theorized that fear can keep some who might be at a high risk for STDs out of the clinic.
“I think that if you’re afraid you have something, you really don’t want to know about it,” Monica said. “It’s easier just to say, ‘I’m fine.'”
Eileen*, who has never been tested, said a variety of factors — including the fact that she is gay — have kept her from doing so. She said she knows getting tested is important and the idea that one can’t contract an STD through lesbian sex is a misconception. But in her case, she said, minor reasons add up.
“It’s a combination of not thinking that there’s a serious chance of me contracting anything, laziness, and just sort of not feeling comfortable about it,” said Eileen. “It’s a little this and a little that.”
It was a little this and a little that for me, too, until I had to meet a deadline.
Unable to get an appointment at UHS in time, I went to a clinic run through Yale-New Haven Hospital. It’s in a nondescript series of rooms on the first floor of the Gateway Center, located on Meadow Street near Union Station — more of a walk than UHS, but still not far. Pink and purple cardboard Easter eggs, as well as a few bunnies and chicks, decorate the windows of the waiting room; when I first walked in I was afraid I had gone to a pediatric clinic.
I asked the receptionist if I was in the right place, leaning through the window separating her desk from the waiting room in an attempt to keep our conversation private. Having first gone to the wrong building at the hospital, I had been asking old women that question all morning and getting pity-filled responses that seemed to assume I must have an STD if I was getting tested.
This reaction is not uncommon. Mark* said he thinks people tend to support STD testing “in principle” but wonder about individuals’ reasons for getting tested, sometimes suspecting them of “slutting around.”
“I don’t really feel like people would look down on it, but they might, of course, if it’s a person who might have a reputation,” Monica said. “But even if somebody is promiscuous — then it’s even more important to get tested.”
The receptionist at the clinic was matter-of-fact. Yep, this was the place. She had me come into her office to fill out forms and pay the $5 cash fee, then asked me to wait outside. About a minute later, she popped her head back out the door to ask me if I was interested in an HIV test, which she could get me set up for right away. Because there was no additional charge and I was already getting antsy sitting there with nothing to do, I said OK.
It was a decision I regretted as soon as Ray*, who introduced himself as my HIV counselor, pulled out a sterile plastic tube containing a needle he said he was going to use to draw my blood. While he explained that the test would be confidential, I looked from the needle to a long questionnaire about my sexual and health history back to the needle.
I decided to back out when he handed me the consent form. I told him I’d changed my mind — I was squeamish about having blood drawn.
This was not entirely true. What got to me more was the prospect of having to answer all those questions. It didn’t matter who knew the answers, it was having to ta
ke the time to come up with honest responses that seemed unappealing, and maybe the prospect of what those responses would be. I didn’t think I’d done anything particularly unsafe, but —
Brenda said she had similar experiences when she was tested.
“You feel like you’ve been really safe but then, once they start asking questions, it makes you nervous,” Brenda said. “They get to the last questions, like ‘Have you ever had unprotected sex,’ and you want to justify it — ‘Yes, but only with my really serious boyfriend’ — but they don’t care about the reason behind it, they just want to know whether you have or not.”
Ray gave me a look that was somewhere between blank — not to be cruel, I think, but more to give me time to reconsider backing out — and sympathetic. It was a you-know-better look I would get several more times from the nurse as she read me another questionnaire. Ray offered to test me with something called “Oral Sure,” which would scrape cells from inside my cheek to send to the lab. I realized that I had no real reason not to go through with it, and agreed.
Then he began with the questionnaire, a similar version to that I would have to answer again later for the nurse who tested me for other STDs. The questions were supposed to assess my risk factor, and ranged from “How many sexual partners have you had in the last three years?” to “Have you ever had sex for drugs or money?” The HIV test questionnaire had an additional section full of questions such as, “If your test comes back positive, would you feel depressed? Would you want to hurt yourself?”
After I finished with Ray I moved on to the nurse, who ended up having to draw my blood anyway — it’s the only way, she explained, to test for syphilis. A doctor followed her, took more samples, and then told me to wait while she “ran off to check the results under the microscope.” The results of my blood and HIV tests would be available April 3; they gave me a number to call and codes to give the operator.
And so I was left again to wait nervously, though I wasn’t nervous for any particular reason.
Each successive person I saw in the clinic — from the receptionist to the doctor — had asked me why I was getting tested. I told them all one of my friends had just gotten tested, and had suggested I do the same. But the clinicians’ responses to this were vaguely skeptical — perhaps because of my obvious anxiety, they didn’t quite believe me. But anxiety over the test is common.
“It’s a little nerve-wracking,” Mark said. “It happens to anyone. Until you get the results back, it’s a little bit of paranoia.”
Perhaps it was the fact that at this point, in the waiting room, the situation could go either way — before, I had never been tested, but I was fairly certain I didn’t have any diseases. But I wasn’t sure until the doctor returned and told me everything was fine.
A first test can be nervewracking no matter what the test is for. Some say STD tests do not get easier.
“I’ve gotten HIV tests a number of times, and even though I’m pretty sure I don’t have HIV, every time I get the results back I’m scared about even that one time I had unprotected sex,” Monica said.
Every time you answer the questionnaire, you have more history to account for. But that very fact, PHEs say, is what makes getting tested again and again so important. Bass and Farber caution, however, that the group does not want to intimidate people or tell them what to do. They provide information, not advice, they say.
“Yale students are very bright and very independent, and they’re going to decide what they want to do on their own,” Farber said. “Obviously, we’re adults and we encourage students to make their own decisions about what risks they’re going to take.”
*Some names have been changed upon request.