Parts of this transcript are analysed in Interrogation
and Confession in Risk Assessment
(Short Article published in June 97 Focus Supplement on HIV Test Counseling)
and Draft of Thesis Chapter 5 (long version
of above article)
C: So you've read the information on the study.
Do you consent to be recorded?
P: Yeah.
C: Great. And what brings you in to be tested tonight?
P: Someone I slept with in high school might have it.
C: It being HIV?
P: Yeah.
C: Oka:y. And have you ever been tested before?
P: No I haven't.
C: Okay. Let me explain what's going to happen tonight and um, then we'll
get on with it. The test is free, what that means is that you don't pay
any money. What the state wants me to do is to fill out a demographic form
based upon some questions I'm going to ask you...regardng your sexual or
substance using behavior. And then we're going to go over it, and if there's
anything that jumps off the page that appears to be a risk for infection,
then uhh, we'll talk about ways of minimizing the risk of infection. Then,
what'll happen is you'll go back out and have a seat in the waiting room
and then the blood drawer will call yellow __. And you'll go in and they'll
draw one vial of blood out of your arm. They'll label it. It goes to the
Alameda county testing site, and the result will be back here two weeks
from tonight. Okay, now the test that's going to be conducted on your ..the
blood sample is a test for HIV antibodies. Okay, a lot of people talk about
HIV as being a virus. It's actually a retrovirus. With a virus, when we're
told that we have antibodies, we've learned that that protects us. With
a retrovirus, which works just in reverse, if you have antibodies, it means
you're infected and contagious. Okay?. Umm, whether your test results come
back negative or non- reactive or whether they come back positive or reactive,
it's important that you come back two weeks from now for the results. Number
one, if you're negative, then you don't have to worry about the friend in
high school. If it comes back positive, it's been found that longevity of
life is determined upon immediate ahh, treatment. And longevity of life
can be anywhere from ten to sixteen years. And there's a very good indication
that the people who find out that they're positive at this time, if they
get into treatment and take care of themselves, very likely will be around
for the cure. Okay? So there was this sexual, unsafe sexual encounter with
a partner in high school, but you heard a rumor that he was HIV positive,
or do you know for a fact?
P: I, it was a rumor.
C: Okay, All right. Have you had a chance to talk to..
P: I haven't seen him in like two years.
C: Okay. All right. Let's go over the form, quickly and then we'll go from
there. So you said you were how old?
P: Twenty four.
C: Okay. And you're female. And your race or ethnicity?
P: Umm, I guess I'm White? HH
C: And what county do you live in?
P: I live here in ___________.
C: Okay so would be ____________ . And your home zip code?
P: ________.
C: Okay. Are you pregnant?
P: No.
C: Okay. I want you to take a look at the next two questions. The first
one is "Client was refered by?" and your choices were one through
twelve and then "Client's reason for testing" and your choices
are one through nine. If you'd just tell me which ones.
P: (15)Uhh, 11, because I already knew about the testing here already.
C: Okay, but how did you know about it? Are you a student at the University?
P: No, but I've been living here.
C: You live here. Okay. Okay. And what about the second question?
P: (15)Well, I don't know if he's postive or not. I guess nine or other.
It was just a rumor....I hope.
C: Who did you hear the rumor from?
P: My sister, she still goes to the same school. And you know how things
go around.
C: Has she asked him? Or has anybody [ asked him
P: [ He doesn't live there anymore.
C: Ahh, Okay. (8) What did you hear about the rumor?
P: Just that he had been kicked out of the Navy and that's why.
C: Mmmh.
P: I mean, I don't ...I don't think it's true but, I mean
C: It sounds like your concerned enough to [ want to
P: [ Yeah, and then, there's been other people too, I mean I might as well
get tested.
C: Okay. Do you inject drugs or other substances?
P: No. I never have.
C: Have you ever been diagnosed with a sexually transmited disease?
P: No.
C: Okay. Have you ever had sex with a prostitute or sex worker?
P: No.
C: What's your definition of sex?
P: (7) Anytime you exchange fluids I guess, I mean, (2) or intercourse.
I wou.. but it doesn't have to be.
C: Like vaginal intercourse?
P: A little, it's sex, but, between two women or something, it's not like
that.
C: Okay. All right. Let me ask this. Have you ever had sex with a male partner?
P: Yes
C: In the last year?
P: Yes.
C: Have you ever had sex with a female partner?
P: No.
C: Okay. Have you ever knowlingly had sex with an HIV infected partner?
P: No.
C: Have you ever sex with a partner who injected drugs or other substances?
P: Once. Yes.
C: How long ago?
P: About six months?
C: Okay. Can you tell me a little bit about that?
P: Well, it was once and it was protected.
C: It was.
P: Yes.
C: Okay. Have you ever had sex with a partner who's had multiple sex partners?
P: Yes.
C: In the last year?
P: Yes.
C: Okay. And have you ever had sex with a male partner who's had sex with
another male?
P: No.
C: Okay. And how many sexual partners have you had in the last year?
P: (6) Four.
C: Four?
P: I'm pretty sure.
C: And that would be vaginal intercourse, or anal intercourse or oral sex?
P: Uh, yeah.
C: Okay (3) Okay (8). I want you to take a look at the top four questions.
I'm interested in your intercourse history, specifically condom or latex
barrier use. For instance, when I engage in vaginal intercourse, my partner
wears a condom never, sometimes or always?
P: (4) Uhh, sometimes.
C: And that's within the last year?
P: Yes.
C: Okay. Do you and your partners engage in anal receptive...sex? That's
where he would put his penis in your anus.
P: Uh, I've done that a couple times, like three times and I don't think
we ever used anything.
C: Okay. In the last year?
P: Yeah.
C: Okay. Are you okay.=
P: Mm hm.
C: 'Cause you grabbed your stomach.
P: (HHHH) I'm just thinking.
C: What about?
P: Well, you go back over all the things that you've done, and..I don't
really feel ashamed, I just feel kind of stupid.
C: Why stupid?
P: Because, (4) I mean, all those people are gone now, and they're not really
part of my life anymore, and I've really care that much for them, and and
to get something like that from somebody (2) or to give it to someone, is
kind of heavy.
C: What would that mean to you?
P: (5) I'm more concerned about whether or not I could have ever given it
to anyone.
C: Mm hm. hhhhhh
P: (6)And it's like murder.
C: What (Why)?
P: Your not pulling a trigger, but it... y you've given what's going to
kill them.
C: Or may kill them. It's a potentially fatal disease. But there
are many people that live with it for many years, and research continues
(4) How about oral sex?
P: Hhhh. mmh.
C: When my partner and I engage in oral sex, does my partner wear a condom
never...?
P: Never.
C: Okay. (8) Does he ever ejaculate in your mouth?
P: Yes.
C: Do you swallow or spit it out?
P: (5) With different people different things.
C: Okay. All right. Now. You've told me that you don't inject drugs,
but are there any recreational drugs that you use in conjunction with sex?
Like alcohol?
P: I drink some.
C: How about a little grass?
P: Yeah.
C: Cocaine?
P: Nnno.
C: Crack?
P: No.
C: Crank?
P: When I was a teenager.
C: Okay. Any other drug use?
P: Hallucinogenics, like LSD or mushrooms.
C: Okay. (10) How you feeling right now?
P: All right.
C: Okay
P: (3) Just keeping my fingers crossed. HHHH
C: You're real concerned, huh?
P: I'm not, I I don't think I should be concerned. Because I know it might
sound foolish, but I came from a really small town, and most of the people
I've been with have...been...young and virgins. But you know it hasn't always
been like that.
C: Mm hmm
P: So I just. I always thought I was pretty safe.
C: (5) Okay. Let me ask you just a couple more questions. Just so we can
complete this form. Have you ever received money for sex?
P: No.
C: Have you ever received drugs for sex?
P: No.
C: Umm, do you share objects fingers, sex toys with your partners?
P: Sure.
C: Okay. Umm, do you work at a job where you run the risk of blood to blood
exposure to HIV?
P: I don't...no.
C: Okay. All right. Other behavior or behavior resulting in blood to blood
contact, or which allows blood contact with the mouth, vagina or anus? Here
we'd be looking at anything like S/M, tatooing, piercing, any sort of rough
sex, where, oh for instance you give your partner a love bite and it breaks
the skin and you have his blood in your mouth or...
P: Ahh, well I'd say yes then.
C: To which part?
P: (2) hmm,
C: To the little love bites that...
P: hhhhhhh.Umm: well I've had sex when I've menstruated
C: Mm hm
P: I don't think I ever put a costume on (1) or anything like that (3) So,
I don't know I'm not sure how to answer that.
C: Okay. Do you have any tatoos?
P: Yeah, a couple.
C: Were they done in..?
P: They were both done in stores
C: sterile conditions? And piercings?
P: All but one my friend did at home.
C: How do you feel about, the questions that you answered? If I turned this
form around and we changed roles and I was the client you were the counselor,
how would you evaluate me?
P: Hmmm. Well?
C: What recommendations would you make to me?
P: Well I'd, I'd think you were at risk.
C: You would think I was at risk?
P: Well anyone who has multiple partners is. ( ) I don't think it's that
bad though. () I think anyone should get tested. I'm surprised I've waited
so long.
C: How long have you been sexually active?
P: About six years.
C: ( ) Let me tell you what I see. Any concerns I would have would run around
here, vaginal intercourse with a condom sometimes, for your age, for your
number of sexual partners, for your lifestyle..What could we do to..
P: The thing is I'm in a monogamous relationship now.
C: You are?
P: I don't know, it's very tender HHH and it doesn't look like there could
be anyone else.
C: You're in a monogamous relationship. How about your partner?
P: Oh yes.
C: He's in a monogamous relationship too?
P: He's with me here today.
C: How long have you been in this relationship?
P: About four months.
C: Okay, now since you only use condoms then, sometimes, are you (3) taking
precautions or using other birth control measures?
P: Well, I'm taking the pill...
C: Okay.
P: (8) protects me from that.
C: Okay
P: (HHHHH)
C: I fyou get out of a monogamous relationship where you're not sure that
it's a mutually monogamous relationship
P: Yeah
C: you want to try to bring this up to always.
P: Yeah...definitely
C: Okay. One of the reasons we ask questions about non-injection or recreatioal
drug use is that when people are high, they're less likely to think about
this.
P: Yeah. mmm.
C: Now is your partner being tested tonight?
P: Why?
C: No, is your partner [ being tested tonight.
P: [ Is he? Yeah
C: So yeah, So you're both coming in. I think it would be a good idea for
you to be tested, if for no other reason than you haven't been tested before.
Also because you don't know whether your friend in high school is HIV positive
or not. Plus I detect a certain (5) undercurrent in you of concern
P: .hhhhh
C: and I think it would be good for you to, to know for sure.
P: Well that's why I came.
C: Okay. Good. All right. Why don't you take a look at this lab slip. I
want you to see that this number up here at the top
P: Mm.
C: is the same as the number on the peel off labels. And I also want you
to see that this is a carbon form and that the number on the last page is
the number on the first page. Okay, when you leave the clinic tonight you'll
leave with the last page. Says absolutely nothing about HIV or AIDS. It
has date of specimen up here. It has your your return appointment, date
and time. You results will be here on ___________ between 5 and 7 pm. Now
if you're out there around four o'clock on, you knock on the door and we'll
give you your results early.
P: Okay.
C: You must, please note, you must bring this slip with you. Okay I might
remember your face but I would never be able to associate it with this number.
P: No.
C: And this is how we get our results back. I want you to see also on this
lab slip. We will be using the ELISA test and your results come back either
reactive or non-reactive. If they come back reactive that means you're HIV
positive, means you're infected and contagious. If you come back non-reactive,
that means you're HIV negative. Now you're HIV negative up until 90 days
before [today's date]. The date that we're going to draw the blood specimen.
Now you're in a monogamous relationship now, you've told me it's been a
monogamous relationship for four months. So these test results should be
98-99% accurate. That we shouldn't have to be concerned with the window
period. Now if you're watching the TV out there, what's the window period?
P: Uhh, did they say six months.
C: Uhh, they've brought it down to 90 days. It's it's the time it takes
from the date of possible exposure to HIV to where antibodies are found
in your blood. They've found that 96-98% of the population should seroconvert
within 90 days. Okay, now you've been with your partner for four months
so that should take care of that for you. I want to explain that what were
testing for here is HIV antobodies
P: Mm
C: not HIV. Both, if you've got HIV antibodies you're positive, infected,
and ahh contagious. What's going to happen is that you're going to go back
out into the waiting room and have a seat and they're going to call Yellow
____ and you're going to another room and they'll ask you to roll up your
sleeve and they will draw one vial of your blood. They will take one of
these peel off numbers and attach it to the vial. Now these are relatively
easy to peel from here 'cause it's treated but they're much more difficult
to take off of the vial. I'm taking the top peel off number and putting
it to the top of the demographic form. Also I'm noting certain things about
about you: that you're female, that you're twenty years of age, that you
reside in ________ county , and your zip code. If the person turning in
this receipt, does not somehow resemble you, we will not give them the results.
This is to protect you. Now the state of California has a law that says
that you may not be tested against you will for HIV antibodies. So I need
to ask you if youre in here of your own free will. You're not here under
threat, force, coercion, or anything else, it's your [ desire to
P: [ Yes...HHH.
C: Now do you have any questions for me?
P: No.
C: Okay...
[tape machine turned off]
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