Chapter 2

Chapter 2


Difficult times

   At the end, Brian lived with her grandmother and he became 15 years old. Brian was very active, was loving to make new friends. But friends of him were not very smart good guys. Some of them were using drugs. Some of them were sent to jail due to robbery, rape. Brian could not stop himself and finally he started on drugs too. That interest ended up using IV (Intravenous) drugs. Poor Brian, he was in a trouble. One day he lost his mind, needing drug IV. It was a crisis. He used a friend’s needle to inject drug. And he got calm down. After a while, he realized that he used someone else’ needle. And the owner of needle had been sick for a while before that crisis. Brian started to think if he got infected by any virus. He tried to talk his friend and his friend told him that he didn't know if he had any infection. So, they decided to go to a doctor, but they didn’t have enough money to pay 250 US dollars doctor visit and also no health insurance. So, they found a way to get tests. They applied for blood donation. Because they do hepatitis, HIV tests for free for donors. They went to a hospital but before that, they tried to look good, bought new clothes. Before donation, they were asked to fill a form if they were suitable to donate blood. There was a question: “Are you an intravenous drug user?” They decided to choose “No”. Otherwise, that would be a risk for them about being refused without test. They needed test, so they chose “no”.

First HIV Test

 They use 4th generation ELISA test at that hospital to diagnose Anti-HIV. Anti HIV test detects antibodies against HIV. HIV is Human İmmunodeficiency Virus. So, when a  person got infected with HIV, the body starts to produce anti HIV molecules. But, that takes a while like 3-4 weeks to 3-4 months according to immune system of host. Meanwhile, Anti HIV test gets usually negative at early stage even though the person carries virus. That’s the handicap of fast, reliable ELISA tests. But new combined tests started to check an antigen, a molecule of the virus called p 24 with anti HIV anti core at the same time. Even though the body has not produced anti HIV, tests find the antigene, the virus. But sometimes, they have false negatives results too. So, the form being filled by the donor is very important. Because if they declare that they use IV drugs or having unprotected sex etc., they should do extra tests like molecular HIV RNA test which detects the virus’ small particles. But those tests are very expensive, that’s why, they don't use molecular tests for scanning for donors. Because, a lot of people apply for donation and that would cost too much. So, they trust donor candidates but if they have a suspicious, they don’t take blood.

 Let’s go back to Brian. Brian and his friend Alex, gave form, and they got interview. In this interview, doctor didn’t like their attitudes, had a suspicion but said ok to do test. So, blood samples were taken and they were waiting for results excitingly.

  Doctor showed up with a report on his hand. He talked to Alex first, Doctor said, “Alex, we need to repeat your test. We have to be sure about anti HIV test of you.”  And then he turned to Brian, “Brian, we also need to repeat your anti HIV test, there could be a mistake, so we need new samples.” They accepted but they were very worried. The result of Alex was 787.18 S/co which means  very high positive. But the result of Brian was 1.2 S/co which means borderline positive. They repeated test with new blood samples and results were nearly same. Doctor Ahmad (Who is an Egyptian physician works there) had a suspicious if they were a gay couple or IV drug users. But Dr. Ahmad had to be very carefully because they filled the form as they were not gays and not drug users. So, Dr. Ahmad told them, “We are sorry, we can’t accept blood donation from you guys, we need extra confirmation tests and you guys should see infectious disease department.” Dr. Ahmad made a report, informed Infectious Disease (ID) department of the hospital. And they were accepted to ID polyclinics.