Thoughts on my first rapid AIDS test

30 minutes to understand that a lot has changed on the AIDS prevention field

Bonjour, do you want to make a rapid AIDS test?” a young man in white coat asked me when I was leaving the subway on my way to visit a friend, in a suburban district East Paris. It’s very quick, totally free and anonymous, he added.

My first reaction was to refuse it. Being a committed monogamous married male I felt no real reason to have myself tested — but I was early to the visit and curiosity took the best of me, so I accepted the invitation of the always smiling volunteer to join him in the kiosk they had installed on the sidewalk outside the station. Better than some Bible talk, I pondered. And off I went.

A white van with big red ribbons and prevention posters was parked alongside the tent, making some sort of extension with people who looked like social workers gathering around, while others tried to attract passersby on a hurry to get home in the cold January evening.

Other people were being tested so I had to wait. I took the time to start chatting with the volunteer who brought me there.

Aides is a well-known organization in France, so I sure had heard of their work but never really seen any of their actions. Jean (as I will call him) explained in a well-rehearsed speech that today the number of people living with HIV remains very high in some communities, so not only homosexual males, drug users, transsexuals but people from sub-Saharan, Western Africa, and French Caribbean (Antilles, French Guiana) male and females are particularly exposed to HIV nowadays. Of the 150,000 people living with HIV in France today, an estimated 30,000 people (20%) are unaware of their HIV status. As a consequence: there is between 7,000 to 8,000 new infections each year.

Now that explained why I — a tall, black male — was targeted for the action and why they were in this particularly mainly African neighborhood. Fair enough, help must come where its needed.

My turn finally came to enter the testing van. Inside, a dim light, a table and a makeshift lab organized as tidy as possible. Curtains in the windows gave a minimal privacy. Barry White old hits were playing on the radio. How proper, I thought.

Before going testing Jean fished out a long form and explaining how everything would be set for “statistic purposes” started asking a long chain of blunt, uncomfortable, way too personal questions: “Do you have sex with males? With transsexuals? If so, are you top or bottom? Have you been incarcerated in the last 6 months? Do you have, or have you been tested for Hepatitis B or C? How many sexual partners of either gender you have been with in the last 6 months?” Then, he added to the form my name and cellphone number. Anonymity and confidentiality took a huge blow here.

After cleaning my hands, I was asked if I was still willing to make the test. He explained he can’t test someone that is not fully aware of every aspect of the testing and the facts he explained. I couldn’t help but agree. Then with a quick gesture he got a blood sample from my index finger and placed it in the testing kit he had organized on the table.

While awaiting for the results, we continued to talk and I took the opportunity to ask about treatment solutions for seropositive persons.

“Nobody dies of AIDS in France anymore”, Jean said. “Medicine has evolved a lot these last years, so it’s now treated more as a chronic disease than anything else” he continued. I asked about the profile of the seropositive he encounters. “Mostly Africans. And female.”

“No French blond women get infected. Well, it still happens, but it’s very rare”, he added.

Uneasiness started to win me. I grew up in the 80's and my generation was the first to receive the AIDS prevention propaganda bombing of the time, all while seeing famous people die. David Kirby’s deathbed photo is still a vivid memory of the media portrayal of AIDS in my teen years. The “it’s only a disease” talk just didn’t match with my prevention education. Watching someone half my age advocate some medication to be able to get exposed with reduced risk sounded to me a reckless shortcut. “Yes, it’s true. But these risk behaviors happen, so it’s better if there’s a protection”.

Another thought struck me. This was way too informal. I was here exchanging brutally honest thoughts with a total stranger inside a lab/van in suburban Paris, soft music in the background, awaiting for a chemically induced sign that could fundamentally change my whole life. 30 minutes is way too long and makes you ponder a lot of things. First of all, what I was doing there? This was not the best place to do such thing. The guy in front of me is not a health professional. And… how someone reacts having being told positive in such informal circumstances? I asked Jean. He had never experienced it, so he couldn’t say. Lucky guy.

Results time came for me. Jean announced matter-of-factly that I was negative. He fished another form stating that for the time being I was declared HIV-negative, signed it upon, and handed it to me. And that was it, I was free to go to my rendez-vous.

In the end I came out (no pun intended) of this experience with more questions than answers. A negative result is only good for past exposures. Not a real assurance for those in doubt, I’d say; but already a good help. Targeting people by race and origin is a good strategy? What’s the legal validity of the results I had in hand? Why white females are less deemed to be infected than the others?

That was not an altruistic action either: Jean is a regular employee of Aides. People are invited to get tested as often as they see fit, and the organization is paid 24 euros each test by the French Social Security. All in all I don’t know if this is a really good approach, but surely mentalities have changed on the AIDS prevention field from my schoolboy years…

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