Chapter Twenty-Two
On the drive to Atlanta, Gwen asks Sarah what happened at the lab on Thursday when she went to take her viral load test.
“It was actually pretty funny,” Sarah laughs. “I filled out all the paperwork and handed it to the receptionist. But it didn’t take long for the head of the lab to come out to the waiting room to see me. He said that I had left the section blank about the dates of my previous positive HIV tests and that they needed that information before they could proceed.”
“What did you say?”
“I told him I had indeed taken a prior HIV test years ago – I couldn’t remember exactly when – but that it was negative.”
Gwen chuckles. “And he said?”
“He asked why I wanted to take a viral load test, then. I told him I was concerned that I may have gotten HIV from someone I recently slept with, and I didn’t want to wait weeks to find out if it was true or not, and I knew that the viral load test could tell me right away. And I flashed my wedding ring at him so he would understand.”
“You didn’t!” Gwen is shocked. This was a side of Sarah she had never seen – clever, cunning, and downright ballsy.
“I did. And he looked at me with some disdain, and then started apologizing that they would not be able to do a viral load test on me without a prior confirmed positive HIV result, and did I want to go ahead and take the new 20-minute Rapid Response test right then?”
“To which you said?”
“That I thought that if the Rapid Response test came back positive, I’d still have to wait a couple weeks to have it confirmed by a Western Blot. He looked around to make sure no one was listening, and then in a much quieter voice told me that if the Rapid Response was positive, he would do the viral load on me immediately.”
“Really?” Gwen finds herself whispering too.
“Yes, and then he said that the viral load test could be used as a substitute for the Western Blot as a confirmation test.”
“I didn’t know that.”
“That’s because it’s not true – at least not according to the protocol from the Centers for Disease Control and Prevention. The only alternative they allow is an immunofluorescence assay, which is not used much any more, at least in the U.S.” Sarah had done her research before going to the lab, and she knew what was permitted by the protocol and what wasn’t.
Gwen is finding this whole thing fascinating. “So he was suggesting you do something non-standard, which is why he was whispering.”
Sarah nods. “I assume so. Anyway, I agreed to do the Rapid Response, but I knew it would be negative, and it was.”
“So then what happened?”
Sarah notices a sign that reads, Welcome to Georgia. They had been traveling alongside a big river, or a lake, or something for a few minutes. “What’s that, Gwen?”
“That’s Lake Hartwell. Big lake. It’s supposed to have about a thousand miles of coastline.”
“And we’re in Georgia now?”
“Just crossed the line. But don’t keep me in suspense, Sarah. What happened?”
Sarah is getting a kick out of Gwen’s curiosity, and decides to string out the story as much as she can, just for laughs. “He came back out in about a half-hour and told me he was sorry that they wouldn’t be able to do a viral load test, since the Rapid Response was negative.” She pauses again.
“And that was it?”
“Well, no. He said my only option was to come back in about three months and do another Rapid Response, that sometimes it took a while for the body to make antibodies to HIV and show up on an HIV test.”
“Do mean to tell me that someone who tests negative on their first test will be told that it doesn’t matter – that they could still be HIV-Positive and the test just isn’t reacting yet?”
Leave it to Gwen to pick up on that right away. “Unbelievable, isn’t it?” Sarah agrees. “The test is supposedly always accurate if you’re positive, but not if you’re negative.”
“Man, have they got a racket going there. Tell everybody they have to retest in three months, and sell more test kits.”
Sarah shakes her head. “It’s worse than that, Gwen. If you still test negative in three months, they want you to come back again in three more months. Seems that someone once said HIV might take as long as six months to produce antibodies, probably without any scientific proof to back them up, as usual.”
Gwen is shocked. “I can’t believe it. So they never let anyone off the hook – they keep everyone scared to death that they might have HIV for up to six months. What assholes!”
“Exactly.” It’s clear to Sarah why she and Gwen were such fast friends; they think so much alike. “So I asked this guy, what do I do in the meantime? If I might still be HIV-Positive, but the test doesn’t show it yet, can I have sex with my husband?” Sarah pauses again.
“And what did he say?”
“He said if I really wanted to be 100% certain, the answer was No.”
“You’re kidding!” No answer. “Please tell me you’re kidding!” Still no answer. “You’ve got to be shitting me!” Gwen can’t get over it.
Finally Sarah says, “No, I’m not. And then I said, well, what do you suggest that I tell my husband is the reason I can’t have sex with him for six months?”
“This I gotta hear.”
Sarah laughs. “He didn’t answer me. He didn’t know what to say. So I asked him, what would your wife think if you told her you couldn’t have sex with her for six months.” Another pause.
“And?... C’mon Sarah. Don’t make me pull all of this out of you!”
Sarah finally relents. “He didn’t know what he’d say to his wife, but he admitted she’d probably be so suspicious, or at least curious, that he’d end up telling her the truth.”
“Which in your case would also mean, as far as he knew, telling Bill that you had slept with another man.” Gwen beeps the horn twice, just for emphasis.
“Of course! Anyway, I finally asked him why he wouldn’t allow me to take a viral load test even if I was negative on the Rapid Response, and he hemmed and hawed a little, mumbling something I couldn’t make any sense out of. So I asked him pointblank: Is it because you get too many high viral load results on HIV-Negative people, and that destroys the credibility of the test?”
Gwen is so proud of Sarah and now realizes why she’s such a good journalist. “What did he do?”
“He stepped back and looked at me, asked if I was a reporter for the paper or something, and then quickly turned and walked away.”
Are You Positive? Page 34