I was waiting at a new clinic in a new city. The clinic, which filled the first floor of a small house just east of downtown Denver, still bore vestiges of a home; a wrought iron fence, a little yard and a mailbox. The receptionist walked over from her desk and handed me a clipboard with some flapping paperwork and a pen. As I read the forms, that breed of anxiety that waits in waiting room began to creep into my consciousness.
The first page listed the reasons why someone would or would not want to get tested for HIV. PRO: If you have HIV you can get medicine to help you stay healthy. PRO: You can learn how to avoid giving HIV to your partners. PRO: You can help your friends and your community by keeping HIV from spreading. CON: If you have HIV, it can cause worry about getting sick or dying. CON: Getting tested may be embarrassing or frightening.
A technician walked by and saw what I was reading. “We considered changing the first section,” he said. “The pros and cons came off a bit sarcastic and mean.” But the list struck me as more direct than sarcastic, more honest than mean.
Forty-five minutes later, the doctor called me into his office. After asking me the inevitable set of questions, he handed me a swab, which I wiped around the inside of my cheek.
“How are you going to be if your test comes back positive?” he asked. Noticing that I was taken aback, he added: “I ask everyone that.”
I told him the truth: “Probably surprised and upset. Scared.”
In an attempt to calm myself down, I went through all the reasons and pseudo-reasons I didn’t, couldn’t have HIV. I almost always use protection. Everyone I hook up with says they’re clean. I’m not “at risk” (the euphemism du jour for ‘a poor minority’). I’ve never shot up. I’m safe and smart. I go to Yale. As I waited, my pocket buzzed. It was a GroupMe message about a cappella tap night. Yale felt far away.
Part of me—despite constant warnings from doctors, professionals, peers and parents—still subscribes to the comforting American misconception that HIV is a remote affliction, contracted exclusively by people far away, fictional or decades-long dead. RENT characters and sub-Saharans get HIV. Not me. The notion of invulnerability is reassuring, if duplicitous. Six months ago, when I was at Yale Health for my six-month screening, I asked the nurse drawing my blood if she had ever treated a Yale student for HIV. She laughed without smiling, as if to say ‘One of them looked just like you.’ For Yale’s many virtues, it is not an HIV-less citadel. There are people here with multiple sex partners and there are people here with access to intravenous drugs. Yes, there are forces that keep us safer (free condoms, free testing, those workshops) but no amount of protection and education can eliminate the danger altogether.
So why don’t we test ourselves? We take advantage of the workshops and the free condoms. Testing is free and Yale Health is close. The procedure is fast (in my experience), and the results are confidential. It keeps our community a healthier, safer place.
The challenge lies not in convincing ourselves that it’s the right thing to do, but in confronting the subject in the first place. Due to the stigma surrounding HIV — and other prevalent STIs — testing is not a topic we like to talk about. One of the most frightening aspects of an HIV test is the process of transforming the virus from an abstraction into a reality. For an hour and a half, HIV has our attention and forces us to reckon with the prospect of stigma and mortality. What would my mom do if I have HIV? What would my friends think? How much would medication cost? Would anyone still sleep with me? Would Yale kick me out? How many years would I lose from my life? Facing these questions requires courage.
It was a short bike ride home, but by the time I climbed the stairs to my room I was exhausted. Lying down on my bed, I reached into my backpack and pulled out the now dog-eared copy of the pro-con list from the clinic. Before tossing it in the trash, I looked at it one more time.
There are other pros to HIV testing. They go unlisted but we feel them right away. Intimations of mortality make us appreciate our lives. Intimations of stigma make us appreciate our communities. As with any other test, we emerge on the other side; maybe smarter, maybe stronger, certainly with a clearer sense of our limitations and our capacities.
Nathan Kohrman is a junior in Saybrook College. Contact him at firstname.lastname@example.org.