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| David and me, 1988 - just about the time we had our HIV tests. |
Cloistered nuns and injection drug users. Farmers growing organic soybeans and young men who like to go clubbing. Married couples celebrating golden anniversaries. Sixteen year-olds getting their drivers licenses. Crossing guards, missionaries, and metrosexuals. Everyone. When an entire town or county or state gets tested, the stigma associated with the test is rendered obsolete.
The first time I met with him, Brad Ogilvie gave me a present, a present he would like to give to everyone who’s never received one. It sat between us on the table at the coffee shop all morning as we chatted and got to know each other. And then, on returning to my desk, I dropped it, unopened, into a file folder marked “Mosaic Initiative” with my notes from the morning.
Later I’d write a story about the Mosaic Initiative and its passionate mission that everyone know their HIV status. The day I sat down to write the piece, I pulled that little gift from the folder and opened it up. It was a rapid-response home HIV test; it’s Brad’s hope and life’s mission that these become as commonly accessible as home pregnancy tests. For a few dollars at the drugstore, anyone could pick one up, dropping it into the shopping basket with a Diet Coke, a bag of Skittles, some Tylenol, or a magazine. He wants them to be that commonplace.
I’d been tested for HIV before. When I was engaged to be married, it was Illinois state law that everyone applying for marriage licenses take the test and that the results of the tests be released to prospective spouses.
So, 23 years ago, my husband and I went to the student health center on our college campus, sat in procedure rooms next door to each other and had blood taken. After several minutes, a nurse came into the room where I waited (no doubt thinking through my to-do list – Was everything ready for the bridesmaid luncheon? Was I crazy to have ordered a pink wedding cake?) and informed me that neither my fiancé nor I was infected with HIV, the virus which causes AIDS.
I hadn’t been tested since then, until the day I opened Brad’s gift.
The bag’s contents were neatly packaged. There was a sheet of white paper, folded into quarters. A single sterile alcohol wipe. A finger-pricking device which at first glance looks like a stray cap from a green marker. Lastly, sealed in a heat-resistant Mylar packet, were two flexible droppers and a white plastic wand that resembles a miniature pregnancy test.
I opened the wipe and swept it across my index finger. I twisted off the pricking device’s safety cap and pierced my skin quickly. The jab was less painful than a paper cut. A tiny drop of blood appeared and I drew it into an empty dropper and then released it into a well at the end of the wand. I added the re-agenting fluid to the blood and, moments later, pink dye moved across the test window, staining it.
If only one vertical line comes into focus, antibodies indicating infection have not been detected. Two lines mean that the test-taker is infected with HIV, the virus that attacks blood cells crucial to the immune system and causes causing AIDS. One line appeared in the window and I sat staring at it for a long time, thinking of how it would feel had there been two.
David Allen is co-director of Canticle Ministries in Wheaton, an organization that provides transitional housing to people living with HIV. Allen, a certified HIV tester and counselor, is a volunteer at the Dupage County Health Department.
“There are a lot of worried people out there who avoid being tested,” Allen said. It’s not the pin-prick that intimidates them—in fact, some HIV tests are performed by gently passing a swab along the gums inside of a person’s mouth. Instead it’s social stigma which keeps too many people from being tested.
“Even people who have engaged in risky behaviors don’t want to ask their primary caregivers for a test,” said Dr. David Tewes, president of Serenity House Counseling Services, Inc., an addictions treatment facility in Addison .
“HIV testing is an integral part of what we do,” Tewes said. “People come into recovery, often after doing really risky things like sharing needles and having unprotected sex. If they test positive, it’s a very good incentive not to relapse because we can keep them connected to treatment. We educate them about HIV. It’s a treatable, livable illness.”
The availability of antiretroviral therapies mean that a positive HIV test result is no longer a death sentence. Early entry into treatment, however, is vital. Antiretroviral drugs significantly reduce viral load, not only protecting the immune system from attack but reducing the likelihood of infecting someone else. HIV is passed from one person to another only through blood, semen, vaginal fluids, and breast milk.
Shortly after being infected with HIV, some people experience flu-like symptoms as their bodies develop antibodies to fight the virus. Others have no symptoms at all. According to the Centers for Disease Control (CDC), 97% of infected persons develop detectable antibodies within the first three months of exposure. For some, it takes longer.
“There is less fear and less press about HIV, but it is still very much with us,” Allen said.
A recent article in The New England Journal of Medicine reported that the number of adults living with HIV in Washington , D.C. , for example, is higher than that in Ethiopia , Nigeria , or Rwanda
Of the more than one million people living with HIV in the U.S.
This, too, relates to fear. There is fear on the part of experts who appropriately could point out that an HIV test isn’t as benign as a tube of toothpaste. They worry that some people, on discovering that they are positive, might be overwhelmed with grief or fear and commit suicide. Or, worse yet, would they keep secret their status, fail to seek medical treatment, and transmit the HIV to others through behaviors such as unsafe sex? What about false positive or false negative test results?
“The problem with that line of thinking is that it suggests that the current system is working. Everyone needs to know their HIV status and the bottom line is that it’s just not getting done,” Brad Ogilvie says.
The Mosaic Initiative is a grassroots organization Brad established in 2005. Brad is a clinician and counselor who is HIV positive himself. He continues to petition the FDA to approve the sale of inexpensive, rapid, over-the-counter home testing kits. Mosaic’s “Know Your Status” campaign not only educates people about HIV, but encourages all people to be tested.
“Only when every member of a community knows his or her own HIV status can the virus be contained,” Brad has said. “Home-based testing is an option, and people are empowered when they have more options.”
As a voice advocating for community-wide testing, Brad is in good company. In 2006, the CDC announced new guidelines encouraging doctors to offer routine HIV tests to all patients between the ages of 13 and 64.
“It’s not become routine,” David Allen said. “Doctors are reluctant to talk about social risk factors with their patients. And patients might refuse, fearing that their insurance companies might deny them coverage if they tested positive.”
Brad remains committed to spreading the message that everyone should be tested. And when he says everyone, he means everyone who is of age to be sexually active.
Everyone.
Wait? Even monogamous, church-going, at-home moms in the suburbs, like me?
Yes. Everyone. Cloistered nuns and injection drug users. Farmers growing organic soybeans and young men who like to go clubbing. Married couples celebrating golden anniversaries. Sixteen year-olds getting their drivers licenses. Crossing guards, missionaries, and metrosexuals. Everyone. When an entire town or county or state gets tested, the stigma associated with the test is rendered obsolete.
“When people are tested, they are leading by example. They become educated about HIV and can share information with others,” Brad has said. “Everyone should know their status.”
Learn more about Brad and his work at www.mosaicinitiative.org.
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