At first I thought it was a fluke. But then I heard the same story told again. Different friend. Different doctor. Same problem.
I have been telling students, peers, and friends to get tested for HIV since I was fifteen years old. At the University of Pennsylvania, I volunteered at our anonymous HIV testing site. Aside from me, only two other individuals were tested at my site during my six month tenure. Clearly, the stigma surrounding HIV testing was a major obstacle.
But now, as my friends are older and not necessarily having monogamous relationships (not that they were back then, either), the people in my life are far more responsible about knowing their sexual health status. Though it still causes them great anxiety, they know that an HIV test is part of what it takes to be a sexually healthy person. I was ecstatic when my friend Jane (names have been changed to protect the responsible parties) told me that she was going to request an HIV test at her next check up.
And then last night, Jane called me. "So, I did it. Got the test, and it's negative. But I do need to tell you something." (I waited nervously.)
"So I asked the doctor for an HIV test. His response? 'Why? I don't think that you need to be tested. You're fine.' I said, But I am a single woman who is sexually active. I would like the test. Don't you test other patients? He replied, 'Yes, but only if they ask.'"
Holy crap. That doctor should have responded. "That's great, Jane. Very responsible. Sure, I'll test you.Is there anything that you would like me to know? Any other tests you feel like you want to have?"
But no. Instead Jane hears, "I don't think that you to be tested. You're fine."
WTF is going on???
The scary thing is that this is the second time I have heard this story this month. Haven't we learned (albeit the hard way) that you can't tell who has HIV just by looking at him/her? Haven't we learned that you cannot make assumptions about a patient based on what you perceive their lifestyle/orientation/gender to be?
So this is my call to action: Patients speak up! Ask to be tested. And doctors - stop making it so damn difficult for people to be responsible. Give patients the test when they ask for it. Don't try to talk them out of it. And most importantly, offer the test when you are doing a general physical examination. Spend the extra thirty seconds that it takes to ask the question and send the nurse in to draw that blood. Otherwise, you are not part of the solution; you are part of the problem.