When I am a graduate student, I go to my university’s health clinic for routine HIV screening. My personal history is very low risk, but I am a sexually active gay man, and the CDC recommends testing of all MSM — men who have sex with men — every three to six months.
The testing at this clinic involves making an appointment, filling out a questionnaire, talking with a counselor, getting blood drawn, and then talking with a counselor again a week later. All of the counselors are, themselves, graduate students in either physical or mental health programs; most of them are not really prepared for a patient who can quote health statistics from the most recent literature on population-level studies of HIV-positive individuals in high-income countries.
The first few times are fine, though the counselors clearly are a bit surprised to be dealing with someone who hasn’t had drunken unprotected sex and is now worried about it, but is just there for routine testing.
Then, I have the Awful Counselor.
Awful Counselor: “When were you last tested?”
Me: “Either four or five months ago. I know it was in [Month], but I don’t remember if it was at the beginning or end of the month.”
Awful Counselor: “How many sexual partners have you had since then?”
Me: “One partner in that time frame, oral sex only.”
Awful Counselor: “Is this a new partner?”
Me: “No. I’ve had sex with him before, too. He’s one of my four partners so far in my life.”
Awful Counselor: “So, why are you here?”
Me: “Because health authorities recommend regular testing for any sexually active MSM?
Awful Counselor: “But you were here less than six months ago. No one should be tested more often than once a year unless they’re doing something they shouldn’t be.”
Me: “Correct me if I’m wrong, but doesn’t the CDC specifically say that any sexually active MSM should be tested every three to six months?”
Awful Counselor: “Yes, but that’s wrong. It clearly shouldn’t be more often than once a year.”
She then rants about why people should get tested less often.
Me: “Well, okay, but I’m going to follow the CDC recommendations here. I trust them.”
Awful Counselor: “And you list yourself as low-anxiety?”
Me: “Yes. I know from my personal history that my odds of having contracted HIV are very low. But, there’s value from a public health standpoint if there’s more widespread compliance with recommended testing protocols.”
Awful Counselor: “Well, no one with the history you list would be here if they’re not anxious. So, either you are high-anxiety or this is not your accurate history. And that makes me wonder what else you’re lying about.”
Me: “Excuse me? You’re… accusing me of lying because I’m following CDC guidelines?”
Awful Counselor: “It’s possible that it’s not intentional on your part. But there’s no way everything you’ve said is true.”
Me: “You have literally no way to know that. And it’s also not even remotely your job to determine that. We’re done here.”
I left her office, told the secretary that the counselor hadn’t given me my paperwork for the blood draw, and went down to get the draw. I also grabbed a comment card and filled out how ludicrous and inappropriate the counselor was. For the rest of my time as a student there, I asked for a different counselor if I was assigned to the Awful Counselor. I don’t know how she kept that job.
