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The Storm |
Chapter 2: Test Anxiety
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The Storm |
Chapter 2: Test Anxiety
During the next week there were several crisis calls from Sarah as she danced toward, then, away from the idea of HIV testing. In the meantime, her gynecologist, Dr. Marten, had called, leaving several messages at Sarah's home and work to call her. Sarah was irate, focusing many of her feelings on Dr. Marten, rather than on her own fear.
On Tuesday Sarah came to the session. She reported a very stressful week with difficulty sleeping, increased irritability, shortness with her co-workers and snapping at Rebecca. She had several more bad dreams, but did not remember the content.
Finally, she heaved a sigh. "I am just going to do it, to call the test place and get a test. I can't stand the not knowing. I am just going to drive myself crazy if I don't do it!" We discussed the logistics of the test (where she would go; when; etc.) and Sarah left the session committed to being tested for HIV.
On Friday she called to arrange an emergency session. When we met she said she had gone to the testing site on Thursday and had a panic attack. She was in the waiting room, having decided on a number for her anonymous test, when she realized she had chosen Rebecca's birthday. She had gone to the door to flee when the counselor at the test site appeared. Sarah was ushered in and given information on HIV, and then her blood was taken for the test. Sarah would have to wait two weeks and then return. She was confused, as people often are when they are given information when they are in shock. She said the counselor talked about 'ELISA' and 'some kind of blot test' and 'false-positives'.
At our crisis session she was truly scared. She was having a hard time breathing, and reported that all she could think about was how stupid she had been, that she was an idiot, and that if she knew beforehand all the things about HIV that the counselor had told her, that she would never have had sex, ever! She would have had Rebecca by artificial insemination from semen that had been screened for HIV.
She
said every time she looked into her daughter's eyes, all that she could
imagine was that her daughter would have no mother.
| I
was going through my own parallel process with Sarah, as we so often do
with our clients. I was recalling my own HIV test and all the anxieties
and fears which were elicited. Surprisingly, Sarah never once asked my
HIV status during the course of treatment. I think, initially, she
was afraid of what the answer would be. If I was HIV+, that would
be too overwhelming for her. If I wasn't, how could I understand
what she was going through? You might want to stop and consider for
a moment how you would respond if a client asked you about your HIV status.
I also was remembering an earlier time, before HIV was discovered, when the only decision was to take an AIDS test or not. There was no treatment. If the AIDS test was positive, it was a death sentence. The good news is that if you or your client is HIV positive, there is now treatment available. |
For more details on testing for
HIV, go now to the 
HIV
Antibody Testing Link. Sarah learned two extremely important thing
about HIV.
When a virus infects your body, certain cells make proteins called antibodies, which attack the virus and try to keep it from spreading. The HIV test detects these antibodies to the HIV virus. It can take the body up to six months from the time you become infected by HIV to develop antibodies to the virus. During this "window period," you should realize that, even if your HIV test is negative, you could still be infected with the virus.
Knowing this fact can
save lives! People unclear on the window period can have HIV, test
negatively, and expose others. Please make sure that you understand
it; so you can educate your clients who have a negative test prior to the
time period for the antibodies to appear before they go on to expose other
partners.
Sarah
was increasingly anxious as the time came closer for her HIV test results.
She reported "making several deals with God, such as 'I will never
lose my temper again with Rebecca if I am OK'" and looking for signs everywhere.
"If I saw a hummingbird, that was a good sign. If the light turned
red before I got to the intersection, that was a bad sign."
| My job was to help Sarah manage her anxiety and to face the unknown. I knew that the uncertainty she was facing around the HIV test results would pale in the face of the uncertainty of a positive HIV diagnosis. Yet, each of us, every day, faces the unknown. Is today the day we die? It is exhausting to live on this edge; so mostly we forget. We go unconscious about the uncertainty of life. It is a great mystery when we die. Sometimes it takes a jolt, a lightning bolt such as an HIV test, to wake us up, to ponder the great mysteries of existence. |
Sarah went back two weeks after her test and was told that her first test was positive, but that routinely a second, more accurate test was given to rule out false positives. Sarah again was seen for an emergency session, and began again the dance of denial and dissociation, coupled with great fear.
The first test given is usually
the ELISA, or enzyme-linked immunosorbent assay. If this is positive,
the Western Blot test is administered. Generally, a person is considered
HIV positive only if both tests are positive. This is considered
accurate 98% of the time.
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