‘If your results are positive, we’ll call you within one to two weeks. If not, you won’t be contacted,” the doctor told me before she took a sample of my blood. I wondered how on earth I could go the next couple of weeks not knowing whether I was sexually healthy.
But I’d never known. I was aware that if you’re sexually active you’re supposed to get regular Sexually Transmitted Infection tests, and like many I’d been meaning to get one for a long time. I’m a gay man, so I’m at high risk for STIs such as gonorrhoea, syphilis and the big one – Human Immunodeficiency Virus. But I’d kept making excuses.
“It hurts,” someone told me once although how exactly it would, I wasn’t sure.
“If you’re HIV-positive, they have to tell your employer,” I remembered somebody else saying. A simple Google search would have taught me not to listen to these claims, but I think part of me wanted to listen. It meant I didn’t have to face up to the possibility that I might have HIV.
I saw the advertisement on my Facebook newsfeed that morning. “Free STI test”, it said. Walk-in. No appointment necessary. I’m a journalism student and I wanted to do the test as research for my thesis on the gay blood ban, a closely related issue. But now that I was contemplating actually going, it suddenly became personal. I’d had very few sexual partners, but working on my thesis had made me begin to question my own sexual health.
Then there were the figures. The Health Protection Surveillance Centre (HPSC) routinely releases reports on the number of new cases of HIV and other STIs in Ireland. The most recent quarterly report showed that between July and September 2012, 50.5 per cent of the 91 diagnoses of HIV were found in men who have sex with men; 47 per cent of those were diagnosed at a late stage. If you become infected with HIV, the earlier you start treatment could be the difference between living a normal life and living a short one. So even if I had HIV, I realised I was better off knowing it.
I arrived at the private clinic to find a group of people waiting at a bus stop directly outside, and wondered if they were watching me as I approached the entrance. As I buzzed the intercom I averted my gaze from the engraved metal sign on the wall. Maybe if I pretended I wasn’t going for an STI test, my onlookers would play along.
I stepped into a modest reception hall and told the woman behind the small pane of Plexiglas that I was here for “one of those” while awkwardly gesturing at an advertisement I recognised from my newsfeed. She asked for my first name and phone number, gave me a piece of laminated paper with the number “10” on it and directed me downstairs to a dated canteen.
As I sat down at one of the mismatched tables I sensed a definite self-consciousness from the eight or nine people in here. Most avoided eye contact as they stared into their magazines and mobiles; a few others exchanged guilty glances with anyone who would return them, perhaps looking for some solidarity as they prepared themselves for an experience they had to be dreading as much as I was.
I waited more than two hours. Dr Fiona Lyons, consultant genitourinary physician at the Guide clinic at St James's Hospital, says waiting times can vary depending on a number of factors, including the number of staff able to serve at the clinic on a particular day and whether or not walk-ins are allowed.
She points out that the Guide clinic, which is Ireland’s largest free public STI clinic, also offers a fast-track test where people who don’t think they are at immediate risk can shorten their waiting time by administering the test themselves. So why do people still choose the private option?
It might have been my small-town upbringing, but something told me to avoid getting tested at a hospital. Dr Lyons admits that “you could bump into any of your mates,” at St James’s, but says that a chlamydia screening in Ireland pilot study conducted last year found people living in urban areas aren’t so easily embarrassed, often preferring accessibility over anonymity. So it’s just a matter of preference.
My time came. I’d been waiting so long I’d didn’t feel much as the smiling woman escorted me upstairs to the surgery, which was really just an arbitrary room in this dilapidated inner-city building.
The doctor didn’t ask about my sexual history, but did ask if I was in a relationship, and whether they were male or female. Dr Lyons explains that this is so they can administer the right type of test; because I sleep with men, along with the blood test (for syphilis, hepatitis B and HIV) and urine test (for chlamydia and gonorrhoea), I gave throat and rectal swabs, also used to test for chlamydia and gonorrhoea.
Afterwards I realised I needn’t have worried. Not only was it painless, but my results, negative or positive, would be kept confidential.
The only information blood clinics are obliged to share is data on new diagnoses of STIs; your personal information is kept safe. But I was still worried about my sexual health, and that worry stuck with me for the following fortnight.
When I ask Dr Lyons why the clinic only phones people whose results are positive, she says it’s a volume issue.
The Guide clinic alone tests more than 25,000 people every year, and it would take too long trying to contact every person who gets tested. She does say the clinic is working to solve this issue, perhaps by introducing a text messaging or online follow-up service.
I seemed to get an extraordinary number of calls from unknown numbers in the days following the test. Something dreadful landed in the pit of my stomach every time I picked up. The first time it was my bank. Phew. Another time it was my phone company. On one occasion I even got a call from a doctor, but it concerned a completely unrelated issue.
Eventually two weeks went by. I never did get a call from the clinic, but I was more aware of my sexual health than ever.
