The United Nations has set a goal that 90% of people with HIV should know their status by 2030. As a result, increasing numbers of people are expected to undertake self-tests to see if they may have HIV.
HIV testing can be done in a number of ways. Some clinics offer a simple blood test, with results provided in a few days. Others use saliva or a finger-prick sample of blood and offer results immediately. Home sampling kits, designed to be sent back to the clinic for results, are available in the UK through this link. Then there are home testing kits that provide results straight away, known as self-test.
For self-test, the person swabs their gums with a testing strip. The testing strip is then placed in a tube that analyses the strip for the presence of HIV antibodies. It looks similar to a pregnancy test – a window in the testing kit shows lines to show a result of positive or negative.
Knowing an HIV status is essential for two reasons. One, HIV-positive people can take measures, such as practising safe sex, to avoid transmitting the virus to others. And two, HIV treatment increases a person’s T-cell count (important immune cells for fighting infection) and reduces levels of HIV in the body. Without treatment, HIV can turn into AIDS, which is a life-threatening condition.
Although the test is physically easy – just a quick mouth swab – it can be emotionally difficult. Nurses who dispense these tests are often asked to support, guide and counsel the people taking the test – but their practice must be based on the most up-to-date information available. Consequently, nurse educators must find ways to promote learning in the most effective way possible.
Learning by doing or through experience is called “experiential learning”. It offers a great way to understand how people experience a situation. Our research presents an overview of nurses’ experiences when we asked them to test themselves for HIV.
Our students revealed that they worried about their past sexual encounters and the test made them recall all of these encounters. And, despite their knowledge of health, some questioned non-risky behaviour – such as sharing cups with roommates. They then considered how their patients may feel when taking the tests. If they were concerned about “sharing cups”, then their patients might have similar worries. This suggested a need to consider what questions their patients may have.
All 30 participants of the study said they had experienced emotional fluctuations, worrying about the possibility of a positive test result. A few wanted to be alone when they were viewing the results of the test, they were nervous about waiting and some worried that they hadn’t done the test properly. All participants said they underestimated the significance of asking their patients to take such an “easy” test.
It motivated the nurses to learn more about HIV and HIV testing. Taking the test gave them insights into their patients’ experiences – they felt they understood why people may be reluctant to take the test. Taking part in the study meant they felt better able to give advice to their patients. This is important because, as patients, we trust those who have insight into our experiences. People who have experienced similar feelings will be more compassionate and understanding.
Nowadays, self-test kits are available in pharmacies and online, but the test is not all that is needed. People must be prepared for the result and, if they are HIV positive, they must be able to access treatment and support. This could be improved if it was guided by people who have been taken the test themselves. Nurses and other healthcare workers play an important role in process, and experiential learning is key to offering a more informed and humane test.