Friday, February 29, 2008

what do you do when you hold someone's fate in your hands?

I've decided that my job might be easier if I get certified as an HIV counselor. Not that I interact much with our clients because of my managerial role, but I'm the type of manager who likes to get her hands dirty every once in a while. So if we've got a line of people waiting to get tested, I'd love to jump in and help out.

The certification requires two types of training, one is testing and the other is the counseling/mental health aspect of testing. This week, I completed the testing part of the requirement.

The test is really simple. It's the Oraquick test, which examines an oral sample with results in 20 minutes. Besides maintaining universal precautions, the testing part is simple. And the testing training was only a couple of hours, with lots of hands on practice.

Part of the training was quality assurance. In order to make sure the box of tests you received is effective, you must conduct three tests to see if all the tests are good. So, we were handed a box of vials to conduct tests with. One contained HIV, subtype 1 antibodies. Another contained HIV, subtype 2 antibodies. And finally the last one was negative. Don't worry. The HIV vials contained irradiated matter for our protection. Also, antibodies are not the virus, but rather come from the immune response your body generates when infected with HIV.

We all tested each vial with an Oraquick stick (which looks exactly like a pregnancy test) and waited for the results. At the 15 minute mark, my lines were visible. The HIV sticks had two lines. The negative stick only had one.

image courtesy of

While someone was in the front of the room talking about DC's HIV/AIDS administration, I looked at my tests and let my mind drift. In my head, I pictured myself actually giving someone this test. I stared at the HIV positive sticks until I lost focus. How could I possibly tell someone that they are HIV positive? (Ok, for those of you who know, I know that the test provides a preliminary positive result that then needs to be verified by Western blot. However, the Oraquick test is more than 99% accurate, so I think it's safe to assume for now that a positive test result means the person is HIV positive.)

Where will I find the strength to tell someone that his/her life is about to change? How could I possibly help them deal with the news? Am I capable of helping someone get through that ordeal?

I'm sure that the counseling training will provide some answers. But it's one thing to take a class on a subject and a whole other thing to actually apply that in real life. And considering the population I'm testing (DC has the highest rate of HIV infection in the country), something tells me that I'll be giving out quite a few positive results.

And I'm not sure how to wrap my head around that.

P.S. If you are interested in being certified as an HIV counselor, please email me at and I would be happy to let you know how to do it.


intellileg said...

I guess the question I'd ask is in what other situations might someone test positive?

Rather you are there to talk a person through the issues than have her/him find out from a (usually unsympathetic, harried and often ill-informed) nurse or doctor at the hospital, on reporting with a AIDS-defining illness. You are in a space where you can provide positive support about a usually frightening issue. The atmosphere in which someone is diagnosed is one of the most important determinants in how they then go on to address the issues that surround HIV infection -- particularly where stigma is rampant, as in DC.

In other words: do it because people like you are needed in the field :D

Capitol Hill 20210 said...

Yes I agree with the intellileg - that is a very difficult job and it sounds like you are the right person. When I worked at the vet, they used to have me do the euthanisias with the clients, because I had some calming and sincere effect. I cried with the families everytime we put an animal down -- it really gets to you.

I would possibly be interested in this.

lizzie said...

intellileg: you are so right. actually a blog peep wrote me to tell me about someone who had been refused an HIV test at a local DC hospital. so this kind of treatment is common. i know it's all about the patient, but i'm afraid i may not have enough strength for both of us. and i certainly don't want to give off that air of 'i'm not sure if i can do this.' i want to be confident and reassuring.

but i know that i can do this!

capitol hill 20210: i'm amazed at what you do! those families needed someone like you and you really pulled through for them. did you ever feel like you didn't do enough?

also please feel free to email me if you want some info on how to train to be an HIV testing counselor. i'd be happy to share that information with you (it's really hard to find on the Web)