Knowing Your HIV Status: Why Not Get Tested?

Cropped view of gloved tech's hands about to draw blood from forearm of patientIn the state of New York, where my private psychotherapy practice is located, the law requires the offer of an HIV test to patients between the ages of 13 and 64 in primary care settings, emergency departments, and inpatient settings. The law does not require anyone to accept the offer, of course; that would be tantamount to mandatory HIV testing. The law has numerous intentions, not the least of which is to get individuals thinking about their HIV status and to begin conversations between patients and their medical providers about HIV/AIDS.

As a psychotherapist in practice in New York City, I am often asked, “Should I take an HIV test?” and “Why should I take an HIV test?” These are both excellent questions. Since a good therapist is not in the business of giving advice, I typically respond with a question of my own: “What reasons can you think of for not taking an HIV test?” I’ve heard many answers over my nearly 20 years asking this question. Some of the most common responses are variations of:

  • “I’m afraid to get a positive test result.”
  • “Why bother when there is no cure?”
  • “I can’t afford to get tested.”
  • “I don’t know where to get tested.”
  • “I don’t want my doctor or insurance company to know the results.”
  • “I’m worried about confidentiality and stigma.”
  • “I’m afraid of needles.”

For some people, these are very real concerns. However, much has changed—for the better—in the last 20 years. While there is still no cure or recognized vaccine for HIV, treatment has advanced significantly. Many HIV-positive people are living longer and healthier lives on treatment with medication consisting of only one pill taken once a day. Assuming you test regularly, learning you are HIV-positive can enable you to begin treatment with these medications as soon as possible.

Access to HIV testing has never been greater. Here in New York City, the Department of Health and Mental Hygiene offers free and confidential testing for HIV and other sexually transmitted infections. Many cities and towns across the country offer similar services. This allows even those individuals without access to affordable health care to be tested.

Access to HIV testing has never been greater. Here in New York City, the Department of Health and Mental Hygiene offers free and confidential testing for HIV and other sexually transmitted infections. Many cities and towns across the country offer similar services.

HIV tests can also be self-administered in the privacy of your home. These tests involve swabbing the lining of your mouth and waiting about 15 to 20 minutes for a result. They aren’t free, but they can be purchased at many pharmacies and they don’t involve needles and blood. Assuming your result is HIV-negative, no one else ever need know you took the test.

This leaves the issues of stigma and confidentiality. Although the stigma attached to HIV and AIDS, particularly in the 1980s and ’90s, has lessened dramatically, some remains. In certain ethnic and religious communities, HIV/AIDS remains a symbol of sin, mostly because of its early ties to drug use and sexual transmission. However, even in these communities, education and better treatment is eroding the fear and shame attached to HIV/AIDS.

Fear of stigma often leads to concerns over confidentiality (although there are other reasons our medical information should always remain confidential). In the early years of HIV testing, the tests could be anonymous. Anonymous testing meant no identifying information was connected to the blood sample or the ensuing result. Under confidential testing, identifying information is collected but protected by laws of confidentiality that cover your test facilitator, your doctor, and any other provider to whom you disclose your HIV status, including your therapist. Today, HIV testing done in the state of New York is confidential and not anonymous.

If you are contemplating taking an HIV test, talking about these issues with a knowledgeable, caring, and nonjudgmental therapist can help you make a decision you are comfortable with.

© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Joseph Robert Scrivani, MSW, LCSW, therapist in Astoria, New York

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Jaden

    Jaden

    July 7th, 2017 at 10:37 AM

    When you know that you have engaged in unsafe sexual or drug use behavior at some point it can be frightening to go for that test. But to be a good and honest human being you have to.

    I mean I wouldn’t want someone to have no idea if they were spreading the virus but they are just afraid of what news they would receive. There is a time to be blissfully ignorant. With your HIV status though, this is not the time.

  • billie

    billie

    July 10th, 2017 at 7:33 AM

    The access is there for so many and yet they are not taking advantage. If you want to be educated then you have to first know your status. There are no longer any excuses.

  • Avril

    Avril

    July 15th, 2017 at 8:37 AM

    NOT getting tested
    NOT knowing your status
    IS selfish and criminal

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