Many of you have not had a recent HIV test. Although I do not have HIV, I know how scary getting tested can be.

Though very accurate at determining when HIV-reactive antibodies are not in the blood, HIV tests can turn up as many or more false positive results as real HIV infections.

Recently unemployed and about to lose my health insurance, in July of 2001 I visited a doctor at the California Pacific Medical Center, Davies Campus. I had a routine check up, and asked for an HIV test because it had been a few years since my last one.

Two weeks later, and no longer covered by insurance, I got a call from the doctor asking me to come back for a free appointment to get my test results. I returned the hospital and the doctor sat me down and shocked me with the news: my blood tested positive for HIV.

The doctor, who as a general practitioner working right on Castro street in San Francisco had a lot of experience with HIV, questioned me about my sexual activities and why I had taken the test, trying to determine if I had the usual risk factors for HIV.

The doctor brought up the four most common risks for heterosexual HIV transmission. These are needle drug use, anal sex, not using a condom, and infection from other STDs. None of these were part of my past. Although I knew I was not totally safe, how could I have HIV? Did I get it by kissing someone or through a cut on my finger? I was still shocked by the news and did not know what to think.

How many sexual partners I had been with since my last HIV test? While there were more then I wanted to think about, the number really was not that high. I told him and he responded by telling me that my experience was normal and by no means did I fit the profile for high risk of HIV infection.

The doctor said that the transmission rate was very low between men and women, even if they have unprotected sex. According to a ten year study conducted by researchers at the University of California San Francisco medical center, there is only a 9 in 10,000 chance of a HIV positive male infecting a female through unprotected sex. The study, published in 1997, said the chance of a male catching HIV from a female during unprotected sex is eight times smaller then that, more like 1 in 7000. But knowing the odds, that the chance I had been infected was small, did not really help. I had to know if the test results were right.

He told me the HIV test I had taken, the Enzyme-Linked Immunosorbent Assay (ELISA) could have been mistaken. This test, also known as enzyme immunoassay (EIA), is thought to be very accurate at detecting the absence of HIV antibodies, but the presence of other antibodies does generate false positives, which is why they needed to take more of my blood for the back up HIV test, the Western Blot. While ELISA tests for antibodies and antigens in the blood that react to HIV, the result only shows the quantity of HIV reactive cells. The Western Blot on the other hand measures to which of the known HIV proteins the antigens specifically react to, although as I was to learn, this test is also prone to mixed results.

The last thing he told me was that even if infected with HIV, with the new drug treatments I could expect to live around another 20 years.

They took more blood and sent me home, still stunned. Leaving the hospital I felt like a leper, like I had done something wrong and was a danger to others. I was able to talk about this with my friends that day, but could not bring my self to say anything to my family until I knew more. I spent the next few days hoping and praying that the test results were wrong.

Ten days later all they could tell me was the Western Blot results were indeterminate, and that I should wait a few months and come back. This wasn’t the best news but at this point I could deal with the stress of not knowing yet, I was relieved not having to face the worst. It wasn’t until October 2001 that I could find out the results of my retest, the ELISA came back negative.

A few of you may go through the same anxiety I went through, even the newer ELISA tests still generate a false positive one in a thousand times. Getting tested for HIV is still better then not knowing. Understanding the risks and problems helps overcome the fear that most people have of facing HIV.