- Sarah Arnoff
- Utah AIDS Foundation's Jared Hafen says around 3,000 Utahns are living with HIV.
Half a dozen men sit along the perimeter of a small room, shifting their eyes this way and that while buoyant dance music plays through twin speakers.
I sheepishly bumble in and find a seat. We are, in effect, facing the same brown table, cluttered with magazines and clipboards—the very essence of a waiting room, the same scene from a thousand doctors' offices across the land. Except on this table, the centerpiece is a purple container filled with condoms.
A couple more men slip in and find unoccupied chairs. Arriving two minutes after 5 p.m., I am the seventh client. To maintain confidentiality, my name for the next 90 minutes becomes "No. 7."
One guy smirks and says quietly to another man on his left, "Maybe we've all been messing around with the same girl."
The joke fell flat, likely in light of the import of the test we are about to take, or because several of the assumed heterosexual men in the room actually aren't. Or maybe because, simply enough, it felt worn and not particularly funny. Maybe it was for all those reasons. Maybe something else.
I catch myself wondering who writes Rihanna's lyrics; one of her songs pulses through the otherwise still air.
As is the case with infectious diseases, detection is paramount.
The Centers for Disease control estimates about 13 percent of people infected with HIV are not aware they have contracted the disease. In Utah, almost 3,000 people are HIV-positive, Utah AIDS Foundation Program Director Jared Hafen says. That means if national statistics bear out, between 200 and 400 Utahns could be carrying the virus and not know it.
Consequently, it's unlikely those people likely are not receiving treatment.
A Utah Department of Health report from 2015 indicates that 93 percent of newly diagnosed persons with HIV are finding care within a year. Almost 67 percent are linked to care within the first month of testing positive.
HIV treatment has made enormous strides in the last few decades. And partners of people with HIV can also take medication to reduce their risk of infection. Pre-Exposure Prophylaxis, shortened to PrEP, is a daily pill, for instance, that if taken as prescribed can drastically cut down the risk of contracting HIV.
"It's fairly new here, but becoming more and more popular," Hafen says.
It's Hafen who suggests, during a recent interview, that I go through the testing procedure for a first-hand account of the process. The AIDS Foundation provides the only free test in the state for people who might be at risk of contracting HIV or potentially passing it along to another.
The clinic is funded through federal dollars that are obtained through grants to the state health department, as well as private donations. The total operating cost is about $100,000 per year, according to Executive Director Stan Penfold. Due to an uptick in clientele, money is stretched thin, and often funds run out before the fiscal year's end. Penfold says, however, that the foundation can supplement the clinic budget from other programs to cover the costs.
About $45,000 of the operating costs comes from a grant for HIV testing. Penfold says if the federal government were to cut that amount, the foundation would need to scramble to make up the difference. "That would be concerning," he says.
On this Monday evening, though, a local waiting room is open and filling up.
After about half an hour of rigorous eye shifting, a volunteer calls out, "No. 7." I go into a screening room and sit opposite Celestia O., a shy volunteer who is reluctant to share her last name. She wears a wide smile and speaks in soft tones.
It's Celestia's job this night to determine which tests for sexually transmitted infections I should take. I'm here for HIV testing, so I stick to the plan. But those who might be concerned can get a more thorough exam. The center can check for hepatitis C, chlamydia, gonorrhea and syphilis through a blood draw.
"It's just a recommendation," she says. "Final judgment is yours."
From a slow cooker, Celestia pulls a warmed rice bag and hands it to me. It's meant to keep the blood flowing in my fingers, and she passes my file to another volunteer wearing a gray sweatshirt. We go upstairs where I wait in another communal room to be called back by a technician, who will prick my finger, draw my blood into a thin straw and test it.
When I spoke with Hafen, he explained that the testing window for HIV is best two to four weeks after engaging in risky sex. Results might not be accurate for a person who tested on the same day he or she contracted HIV.
"We use the fourth-generation test and it's testing for antibodies and antigens," Hafen had informed me. "It is accurate, about 99 percent accurate, after two weeks."
I massage the rice bag nervously, like it's a piece of molding clay I'm working to soften.
Moments like this—ones that requires a blood sample and intervals of waiting—can inherently induce anxiety. But the AIDS Foundation tries its best to create an atmosphere that minimizes those feelings. After my blood is sucked into a tube, I am ushered into another waiting room with leather couches. Pirates of the Caribbean is on TV.
Test results take about 25 minutes to process, they say. Shortly thereafter, I'm called into a small room for counseling. Before asking about my sex habits, Camrin Rivera, my volunteer counselor, acknowledges his line of questioning can come off as invasive. That's not his intention, of course. But the counselor with the most relevant information is the one who can best collaborate on the development of a healthy plan.
Rivera pauses from inquiries about my sexual history in the past year to drive this point home.
"To be fair, I'm not judging," he says. The counseling session promotes open, honest conversations between sexual partners. This includes frank discussions beforehand about when you and your partner were last tested.
Testing isn't the only service provided by the AIDS Foundation. Inside the center, there are rooms for group counseling, a library, a hotline center and, in the basement, a food bank, which looks like a miniature convenience store.
"It can be for anybody but it's designed specifically for people with HIV," Hafen had said. It is stocked by small donations, holiday drives and private pledges. "Even Stevens [Sandwiches] has been pretty amazing," he added.
In a one-on-one counseling room, Rivera offers some advice, then I head back to my spot on the sofa and Pirates until I am called by another volunteer holding a chart, which I assume has my blood results. This volunteer, an elderly divorcée, sits me down in an office room and looks me in the eye as he tells me the verdict.
As to how much longer the clinic will be able to sustain free testing, give peace of mind to those who test HIV-negative and offer treatment options for those who test positive, Penfold says the foundation is committed to continue to provide the screenings. If the Affordable Care Act is repealed, it wouldn't impact testing directly, but it could present challenges to the way the foundation provides treatment.
"That could have really significant impacts on people living with HIV," he says.