Posted by Dave on February 5, 2010 | 4 Comments
When I came up with the idea of live-blogging an HIV test, I thought the day I actually drew blood would be the most interesting. After that, you just call an 800-number to get your results — where’s the drama in that?
For me, of course, there isn’t much. I’m quite certain I’m negative. Even if I do come out positive, there’s a good chance that result would turn out to be a false positive. But the instructions for the Home Access HIV test make it clear that counseling is available for anyone who buys the test. While $64.94 might seem like a lot for a drug-store item, for professional counseling it’s a bargain.
I wondered if any of Home Access’s counselors would be willing to go on the record talking with me, so I gave them a call and spoke with the company’s director of operations, Barb Godsey. She told me Home Access is a small company that’s been in business since the 1990s. Their first two products were the HIV Express Test and Standard Test, which gained FDA approval as a class 3 medical device in 1996. At this time, there was no other company that did this sort of home medical testing.
My blood sample was sent to Home Access via FedEx, and arrived there this morning. Once there, blood samples are logged into their computer system, and then put through a laboratory test. If the result is negative, the result is logged. If it’s positive, the test is repeated, then confirmed with a separate test. At 6:30 p.m. Central time, the results are released, and I’ll be able to call into their automated system and get my results. I’ll report them here as soon as I find out.
Home Access has six counselors available to take calls. Every positive test result is given by a live counselor, as are all indeterminate results. If your result is negative, then 90 percent of the time it’s given by computer, but 10 percent of negative results are also automatically forwarded to counselors for quality control.
Godsey assured me that all their counselors have degrees in counseling or social work, and are trained according to a rigorous protocol. They handle about 10,000 calls per month.
Godsey then handed me off to Kathleen Colby, a counselor who proudly proclaims she’s been with Home Access “since the beginning.” She was a case manager prior to joining the company. I asked her how they break the news of an HIV-positive result. “We sit with them,” she says.
One thing I forgot to mention yesterday is that when I called in to pre-register, I was asked if I believed my result would be positive or negative. Colby says this is a critical bit of information in how they handle the session. If someone believes they are positive, they might be ordering the test simply to confirm a doctor’s diagnosis. They might already have some symptoms of HIV disease. If the caller believes they will be negative, then counselors can be prepared for the worst.
Colby says the calls can take no time, but might last “15, 30 minutes, an hour and a half.” She stays on the line for as long as she’s needed. Then she tries to find out what other sources of support the caller has. Do they know someone who has HIV or AIDS? Does a friend or family member know they are taking the test? Often these people can help them handle their test results. She tries to direct callers to HIV support groups and counseling services in their area, but “many people don’t want us to know where they are,” so that’s not always an option. She lets callers know they can call back for additional counseling if they need it.
Colby’s clearly proud of the work she does, and it shows in her voice. The counseling services are available at any point in the testing process. “I’ve spoken with one woman several times over the course of the last two days. She hasn’t even sent her sample in yet.” Some people are afraid to prick their finger. Some people call for their results and hang up before they get the answer. Some receive the news at work, and the counselors suggest they call back at another time for additional help.
If a result is negative and the caller expected a positive result, the counselors will also step in, explaining the CDC’s “window period” of six months: It can take up to six months after an exposure to HIV for your test results to be positive. That said, Colby says a positive result shows up within three months of exposure 90 percent of the time. The counselors explain all this, and suggest that people inside the window period wait a few months before trying again.
Godsey says their HIV test results are close to the national average of 1.8 percent positive: They range between 1.7 and 2.1 percent positive. While that might seem low, remember that a lot of people take these tests routinely as a precaution: they might engage in safe sex with an HIV-positive partner, for example.
Godsey says that her company won’t be a part a new technology that may soon gain FDA approval: Rapid testing. Like a pregnancy test, this new test will offer results at home in 20 minutes. Colby believes that counseling is an integral part of the service they provide, and offering a service that didn’t require a counselor to deliver a positive test result would “compromise our standards.”
When I told Colby that I had taken the test, and that I expected to get my results today, I could hear the excitement in her voice: “You should call in and track your test,” she said. She explained that many clients are anxious to get their results, so they will let them know their sample has arrived and when the results will be ready. “Otherwise, they might be calling back every hour.”
So after I got off the phone with her, I hung up and called their toll-free number. The pre-recorded message, oddly, said it might be 3 days before I get my results. That’s the one hitch in their systemâ€”I’m thinking it might be that their message-playing computer doesn’t distinguish between “express” and “standard” clients. But once I was through to a human operator, she could locate my order and tell me it had arrived at 8 a.m. and I’d get my test results by 6:30 tonight (7:30 Eastern time). I’ll be back with an update as soon as I get my results.
7:58 p.m.: I received my results and, as expected, I am HIV-negative. It’s a very nice system, though, carefully thought-out. If I ever thought I was in danger of a real infection, I wouldn’t hesitate to use it again.