Last Updated on July 29, 2021 by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT
This guest post was written by M. Juliana Golden of TransmitInfo.org.
Just Another STI/STD Testing Day
Work that day began just as it had every other day; little did I know, it would be one of the most impactful days of my career – giving my first HIV positive result.
Fulfilling my duty as a medical assistant for a community health clinic, I ran the beginning of the day HIV testing controls. “Controls” are scientific tests used to ensure the clinic’s STI/STD testing devices are functioning correctly. Two tests are started using heat inactivated human plasma positive for HIV antibodies, wherein one test is always a control (during that time, our clinic was still using the now defunct Clearview Rapid HIV testing cassette system). After 15 minutes, the controls showed the tests were working properly, and I recorded the results in a daily log.
I began seeing patients, collecting urine samples, and performing STI/STD testing for everything from chlamydia, gonorrhea, syphilis, and HIV, to urinary tract infections and pregnancy. Much of my job involved prepping and educating patients, testing them and sometimes administering results. After me, patients saw the clinician where they were given contraception and prescribed medication if needed.
Around noon, I called back a patient scheduled for a Sexually Transmitted Infection Check (STI/STD testing) and, with a few questions, determined the patient would benefit from an HIV test. I informed the patient this test would be accurate up to three months prior, because it can take up to three months from exposure to HIV for antibodies to form in the blood. I also informed the patient that if the test came back positive, they would need to have blood drawn to send to a lab for further positive confirmation. The patient acknowledged understanding, and I began the test. Testing requires a small finger prick, after which one drop of blood is mixed with a few drops of buffer solution. The test takes 15 minutes to process, so I took a timer into the interview room and began asking the patient medical history questions.
We were half-way done with the interview when the timer went off. I excused myself from the patient and went into the lab to check the HIV test result. The result was positive.
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Giving an HIV Positive Result
The room spun as I worked toward reining in the terror pulsing through my body.
After two years administering STI/STD testing at the clinic, and approximately 6,000 tests personally conducted, I had not yet seen an HIV positive result. I knew what awful, miserable task lay before me: I would have to deliver life-altering news to that unfortunate person.
My clinic manager sat in as I informed the patient, “I’m sorry. Your preliminary HIV test has come back positive.”
We collected resources for the patient, had a trained HIV counselor on speaker phone, and drew blood for a confirmatory test which later also came back positive. There were tears, hugs, and a deep sense of sorrow in the room.
No amount of training could have prepared me for that day. I was profoundly affected for weeks afterward.
If anything positive came of the experience, it was my renewed sense of purpose in our clinic’s mission, and how important it was to our community.
So far, this was one of my most difficult, harrowing, and inspiring days working in the field of sexual health and reproductive care.
This guest post was written by M. Juliana Golden. M. Juliana Golden is co-founder of Transmit Information, Inc., a nonprofit organization with a mission to provide education and advocate for the prevention of STDs, to normalize sexual health, and to get families talking. They believe that sex is not shameful but a part of the natural human progression. M. Juliana Golden has previous experience working as a Medical Assistant at a community clinic for several years. You can also find Transmit Information, Inc. on Facebook and Twitter!
Wow, this post really gave me a lump in my throat. Keep up your awesome work and hopefully a day like this will become rare for clinicians and patients around the country.
Thanks so much! Yes, I have the same hope for clinicians globally! While I believe we will always have STDs, the difficulty in giving a positive diagnosis and receiving those results will certainly diminish as we work to eradicate the fear, misunderstandings, and stigma surrounding sexually transmitted infections and diseases! 🙂
Thank you for the positive feedback! I believe clinicians need more continuing education when speaking with patients newly diagnosed with an STD. Sometimes health professionals just get into a routine: this is your diagnosis, this is your treatment, here are your take home instructions. They don’t always take the time to delve into the emotional aspects of STDs or to tell patients ” you are not alone, this is common, we are going to treat this and you will be okay”.
Excellent point….Truly, it’s the clinicians who take the time to address the emotional quotient who are going the distance by not treating their patients as just another number or step in their day. I think things are moving in that direction – when my boyfriend and I went to get tested a couple months back, I asked how they responded to individuals with positive results and the nurse showed me the pamphlets about stigma they had to distribute and told me about the on-site counseling process they have in place. I’d just like to see this approach used more often and especially when patients see their regular practitioners. In time, I suppose, and with the proper education – the continuing education could go a long way toward implementing a more holistic health-care approach! 🙂