To go Friendly, or how anonymously get tested for HIV

For the first time, I tested for HIV ten years ago. Incidentally, in the mobile laboratory during the rally in Kyiv Day. I remember those fifteen minutes was particularly stressful. Waiting for the results of any tests always gives me uncomfortable emotions. Like a visit to a doctor. It turned out it can be differently ...

"HIV is no longer a health problem"

I found out about the Friendly Doctor by accident. But I’ve decided to test the medical service for myself. The Friendly Doctor is focused on the LGBT community, including men who have sex with men (MSM), but heterosexual clients also can benefit from the office.

Here you can not only take the test for HIV, but also to consult a dermatologist, a psychologist, a urologist, a sexologist, and a family doctor.

I enter the site to make an appointment. In a few minutes I already have a reminder in my mailbox about the place and time convenient for me. So the Friendly Doctor is friendly so far.

The visit’s day. I am coming to the given address. I’m met by the doctor Roman Ivasiy (doctors also can be chosen on your own). First and foremost, I draw attention to ... absence of other patients. Later I was told that was one of the servicing principles of the Friendly Doctor to keep anonymity of the patient by all means.

"Do you first get your HIV test? What is the purpose of testing? Do you know the status of your partner? .. ". Asking me, the HIV doctor-consultant, the intern of the cardio-rheumatologic department of Kyiv City Clinical Hospital № 6 Roman Ivasiy is preparing the test device.

Honestly, to prick the finger is always a little painful ... And while we are waiting for the result, Roman tells about the questions that his visitors often concern.

- We must ask about the kind of a sexual intercourse: anal, oral, or vaginal. Depending on it, the risk of infection increases. HIV is transmitted through blood and semen. Thus, the mucous membrane of the rectum is very thin, moreover, it quickly absorbs a biological matter. So if one partner is HIV-positive and do not care about the safety of the other partner, the risk is very high ( for both active and passive partner). The risk of infection also increases during the menstrual cycle of women. If you may choose, oral sex is the safest one.

- There is a fear that the latex cell is much bigger than the HIV infection, I ask the doctor.
- It's true, but you should know that high-quality condoms have several layers of latex, they are tested for water and airproofness. So condoms are a guaranteed protection. Doctors often state about 90% of the security. The remaining 10% depends on the quality and shelf life of the condom, unfortunately, not all people read the production date on the package. And the level of protection depends on the conditions in which the product is maintained. Carrying a condom in the back pocket of jeans for a long time just does not improve its quality ...

- As far as I know, the rapid test doesn’t detect the infection overnight after a short period of being infected ...
- In the three month period after the unprotected exposure, the concentration of the virus is quite large. Moreover, the HIV virus actively multiplies. Therefore, the level of the infection in this time period is high. Although the rapid system can not detect it, because antibodies are not produced. We use the clinic test of the fourth generation, which can detect HIV in 3 weeks rather than in three months, as usual. Typically, these tests are used if there are specific reasons for that after a short survey of the client. If there is doubt about the status of the partner, and you've had unprotected sex, even oral, it is advisable to undergo the rapid HIV test again after 3-month period. Discordant couples often turn to us for verification of another partner when only one partner has the HIV-status.

- Can we live with HIV?
- According to the statistics, one in ten who come to us are HIV-positive. In Ukraine, officially there are almost 276 thousand people living with HIV. However, many do not realize that HIV is no longer such a medical problem because there is an effective treatment. With timely detection of the positive status and correct diagnosis, lifetime treatment is appointed. There are no restrictions in the quality and lifetime. People can plan a family, women give birth to healthy children.

My 15 minutes is coming to an end. The doctor explains how the test system functions:
- The test strip is needed to ensure that the test is valid. We wait for 15 minutes to be on a safe side though the result on the test strip can be seen in five minutes ...
- Mr. Roman why haven’t you said earlier?

REFERENCE. From the date of the project’s launch in 2014, the Friendly Doctor services have been used by 17, 000 people including about a thousand detected HIV positive ones. The platform operates in 9 regions (Kyiv, Poltava, Chernihiv, Kharkiv, Odesa, Dnipropetrovsk, Kherson, Vinnytsia, and Lviv) involving 20 doctors.
The idea of the Friendly Doctor belongs to All-Ukrainian Charitable Organization FULCRUM, in particular, its Executive Director Bogdan Globa. The first office was opened in 2014 within the framework of the project Jump Up! in cooperation with Elton John AIDS Foundation (EJAF) and the French charity Sidaction.

"To take people out of their hideaways"

In Ukraine, HIV testing is conducted in the state AIDS centers, private medical services, community centers, and various social organizations that usually work with vulnerable populations. This is mainly injecting drug users, sex workers, street children, people released from prison and LGB representatives of the community, including men who have sex with men.

"Deficiencies of the testing in community centers include that various people go there with various needs: to visit clubs, to socialize, to receive legal assistance ... and someone comes to get HIV test ... And all of them are in one space where you meet with friends, strangers, social workers who know you or your partner. But it isn’t often the question of only preventive nature ... There are people who normally would react to such an atmosphere. And there are those who do not come to the state hospital because they have prejudices about the system or doctors, or stigma towards people with HIV",  says the project manager of AUCO FULCRUM Anton Levdik.

So Friendly Doctor proposed the model for LGBT people without a middlemen appearing during testing.

"And this has allowed people who do not come for fear of being outed to be taken out of their hidden places. You know, not every man who has sex with a man identifies himself with the LGBT community. A man can have a heterosexual family, a wife, children, and a man-partner. Gay? This is not about me. Sexuality? This is not about me. I have a normal family, but ... here are relations ... "  says Levdik.

The Friendly Doctor has the database of experts. Each doctor was trained on tolerance towards the LGBT community.

"The most interesting thing was to observe during the training how stereotypes and fears about LGBT representatives including how they look and what their behavior should be were destroyed. So to say, ‘define at first sight’. It turned out our first impressions be often wrong", smiles my companion.

By the way, to find professionals, we sometimes had to reask again, so to say, unfamiliar acquaintances involving lots of people.

"To get a contact of a doctor really reliable and trustworthy occured to be very difficult. But we were looking for. We have doctors who phoned themselves because they wanted to work with LGBT", says Anton Levdik.

If the client becomes aware of a positive result, then his doctor directs him where to go and how to act. Testing is mainly carried out by those doctors who work at AIDS centers. So, basically, a person who made an appointment anonymously is under the care of the doctor in the future.

"This is extremely important. Thus, we reduce the percentage of people who after having learned of their HIV status ‘got lost’. At this stage our main goal is that the person would start treatment at the beginning rather than at the stage when it is difficult and expensive to treat", says Levdik.

My source adds that you can visit the doctor with a partner, "And this is probably about the confidence ... In the case of sexually transmitted disease, the treatment is usually needed for both partners. And if it is not a problem to visit a doctor together for heterosexual couples, two girls or two guys find it, mainly, impossible The Friendly Doctor provides this service. If the disease is suspected, with the support of your partner it’s easier to accept information about your health. These15 minutes for the test system works may seem like an eternity for someone... ".

Iryna Vyrtosu, journalist of the Human Rights Information Center