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Is Peer Pressuring Your Class To Get HIV Tested Brilliant? Or A Huge Mistake?

Next Friday at San Francisco’s private Urban School, where parents pay $32k a year to keep their kids out of public school, the entire senior class is getting an HIV test. Well the whole thing is, of course, voluntary, as no administrator nor student group can force kids to have their blood tested. The rationale, at first glance, makes sense: high school kids have sex, some more safely than others, and knowing your HIV status is a crucial step in staying healthy (and keeping your sexual partners safe). Except is creating an environment where kids feel peer pressured into getting tested a good idea?

“The goal is to educate on how easy it is to get tested and how important it is,” says Oliver Hamilton (pictured below), the 17-year-old senior who came up with the idea for the group test, who works in the office of an AIDS doctor. And while Hamilton stresses the test — which parents were notified about via letter — isn’t required, he’s very clear about the intent: make it “cool” to get tested, so that if you don’t, you feel left out. “[I]f 70 kids get tested and 10 don’t, people might wonder why those 10 are the ones who are scared. Critical mass is really important,” he tells the Wall Street Journal.

One the one hand, a group test de-stigmatizes the idea that being tested means you’re slutty. On the other hand, Hamilton’s very proposition — that the kids who don’t get tested will be wondered about by peers — isn’t a healthy environment for anyone. Do we really want to give kids another reason to be singled out?

What if one of the reasons students don’t want to get tested is because they already know they’re positive? Or what about students who have never used drugs, had sex, or engaged in other “high risk behavior,” and thus can be certain they are negative? The result of an entire class being tested with a handful of students refusing (for decent reasons) will have the reverse effect on those who don’t participate: they will be branded as weirdos. As outsiders. As — dare I say it — positive. Because otherwise why wouldn’t you get tested?

In the lead-up to the test, Mr. Hamilton and fellow student organizers are holding an information session required for all seniors. A voluntary lunchtime forum open to all students at the school is planned for next week to talk about the testing.

On testing day, Urban seniors will get tested in the gym by adult volunteers during study hall, lunch and other openings in their classes. Dr. Conant will oversee mouth-swab tests, with supplies donated by the maker of the tests, OraSure Technologies Inc. Mr. Hamilton also convinced a nearby Ben & Jerry’s to give free ice cream to all the students who participate.

Administrators at the 45-year-old high school in Haight Ashbury, which costs more than $32,000 each year to attend, were receptive to Mr. Hamilton’s plan when he presented it in the fall. “We understand that one of the best ways to alleviate the stigma that can be attached to testing is to let it become just part of the normal health practice of all teens,” says Charlotte Worsley, Urban’s assistant head for student life.

Students won’t get the results for a few days, and can receive them by phone, mail, or email (why not Twitter or Facebook?!) — an effort to put some distance between the social pressure of getting tested and the social pressure to tell everyone your results. But like the SAT, a test where there’s the same sort of social pressure to take it, very few students escape the inevitable question from classmates: So, how’d you do?

The HIV status of any person, let alone a teenager, is a very private matter. Creating a school environment where it’s expected to share sharing the results of your test might be enough to deter some kids from not getting tested; and those who do, and find out they are positive, may find themselves in a situation where they are lying to friends to escape the social stigma (and the endless questions about your sex life) that’s attached to being poz.

Nowhere in this post do I want to give the idea that I’m discouraging testing. I’m not. I love the idea. Get more young people tested right this minute! And I’m a big fan of any creative campaign that makes getting a HIV test seem “cool,” because “everyone else is doing it.” But I know HIV-positive high schoolers (my best friend is the father to one), and little gets this young man excited about having to discuss his status with anyone else. Making a school project out of something he struggles with every day? Not great fun.

And yet: Shouldn’t we be encouraging young people, in any way possible, to know their status? That’s exactly what this effort is doing. And based on that alone, it should be applauded.

But one thing that seems to be missing from Hamilton’s project is what happens when a student gets a positive test result back. All the negative kids will be waving around their results with pride. Are we going to make it cool for young people to be poz? Likely not. Which means poz kids, in an effort to avoid being bullied or pitied, will lie. Because

    that’s so healthy.

By:           Ryan Tedder
On:           Feb 4, 2011
Tagged: , , , , ,

  • 16 Comments
    • Tofer David
      Tofer David

      I don’t know how I feel about this…

      Feb 4, 2011 at 6:07 pm · @ReplyReply to this comment ·
    • Fitz
      Fitz

      Now that there are some treatments available, testing ought to be normal. We have rapid-oral testing. It should happen at every ER visit, every yearly physical, and as pre-req for schools, just like we make kids get PPDs. Maybe even at the front door for sex clubs. It’s too important, too easy to comply with, too stupid not to. The era of hiding your head in the sand is over… if you don’t have the balls to do it yourself, it should be done to you— as a public health issue.

      Feb 4, 2011 at 6:28 pm · @ReplyReply to this comment ·
    • Soupy
      Soupy

      I just got my test results. Negative. I’m always safe. But it’s nice to Know.

      Feb 4, 2011 at 6:57 pm · @ReplyReply to this comment ·
    • B
      B

      No. 1 · Tofer David wrote, “I don’t know how I feel about this…”

      Given the rate of progress, in not too many years we might have an oral test for STDs that is trivially administered, fast, and cheap, with a zero false-positive rate. If people started using such a test before becoming sexually active and used it consistently (e.g., both sex partners taking the test before doing anything), the chances of getting an infection would be nearly zero (zero if the test never misses an infection).

      The hard part may not be the technology so much as American puritanism – the “conservatives” would probably whine that providing the tests encourages premarital sex.

      Feb 4, 2011 at 7:12 pm · @ReplyReply to this comment ·
    • James Davis
      James Davis

      I’m very much in favor of testing, and education to help prevent the spread of HIV, but this is wrong.

      A serious invasion of privacy, which is a slippery slope.

      Feb 4, 2011 at 8:15 pm · @ReplyReply to this comment ·
    • jason
      jason

      I don’t see why we should surrender our blood to some social engineer who is part of the AIDS industry. These vile people can fuck off as far as I’m concerned. Stop playing politics with my blood.

      Moroever, since AIDS is largely a political illness, I refuse point blank to be a part of the circus. Go fuck yourselves if you think you can impose your politics onto me.

      Feb 4, 2011 at 8:49 pm · @ReplyReply to this comment ·
    • Michael
      Michael

      It’s voluntary, and what’s wrong with a little peer pressure to get kids motivated? Anti-smoking and other campaigns are designed around peer pressure. Some kids listen, others never will. Nobody gets to be old by being a fool.

      Feb 4, 2011 at 10:04 pm · @ReplyReply to this comment ·
    • Steve Paris
      Steve Paris

      This project is a pilot program for Teens For Testing and has been in the planning stages for nearly two years. To say that testing teenagers for HIV in a school environment is complicated would be a gross understatement. But we know it’s worth while.

      A lot of resources are directed toward educating kids about HIV/AIDS but less than 15% have been tested. We also know that many family physicians are reluctant to conduct the tests and kids aren’t comfortable talking about it with them. Our idea is to have the students educate each other about HIV/AIDS, talk about prevention and safe sex, and provide a way for them start taking control of their own sexual health. We think it’s a good idea and one we intend to roll out to more schools in the very near future.

      I can assure you we have had many long discussions with students, school administrators, parents and healthcare providers about the issues outlined here. And we will continue to have those discussions.

      There are a couple of clarifications I’d like to make about the program:

      - We are encouraging the students to keep their results private and not share the results with anyone. They’ve been quite receptive to this. Will some share their results? Quite likely. But I don’t expect we’ll see students waiving a flag about it.

      – We will be following the same protocols and procedures that other testing organizations follow. And if a student tests positive, we will arrange for confirmatory tests, provide counseling and direct them to the extensive HIV/AIDS network of care available in the Bay Area.

      The students involved in this project have worked hard to create a program to educate their peers about healthy sex lives and starting a routine of regular testing.

      All the best,
      Steve Paris
      Teens For Testing/Conant Foundation

      Feb 5, 2011 at 3:25 am · @ReplyReply to this comment ·
    • Hyhybt
      Hyhybt

      @jason: I’m not sure what you mean by that. Do you mean it doesn’t exist as a genuine medical condition, or that it does, but people shouldn’t find out whether they have it or not?

      Feb 5, 2011 at 10:51 am · @ReplyReply to this comment ·
    • David
      David

      It’s a huge mistake. HIV tests can be false positive, in which case you may end up suffering intense anxiety and depression, social stigma and discrimination, and even treatment with toxic antiretrovirals that destroy the bone marrow, the digestive tract and the liver.

      A false positive HIV test can ruin your life.

      It is therefore irrational for people who have no reason to believe that they could be HIV positive to get tested.

      To peer-pressure those types of people into getting tested anyway is unethical.

      Feb 6, 2011 at 12:44 am · @ReplyReply to this comment ·
    • thematics
      thematics

      @David: You’re flat out wrong. A ‘false negative’ test is much more likely to occur than a false positivr, due to the ‘latency’ period — the time between exposure to the virus and the time when such infection can be detected.

      Get a clue.

      Feb 6, 2011 at 3:00 am · @ReplyReply to this comment ·
    • ewe
      ewe

      works in the office of an “AIDS DOCTOR?” That is the first time i ever heard that terminology.

      Feb 6, 2011 at 3:06 am · @ReplyReply to this comment ·
    • thematics
      thematics

      @EWE: Good call!
      ‘AIDS Doctor’ covers at least 5 recognised medical specialties. Each specialty has a role to fufill, but primary care docs are the people most likely to educate the general public on how to ‘keep safe’.

      There are two key aspects to attend to here: a) keeping HIV neg folks negative, and b) helping HIV poz folk from spreading the virus.

      It may shock or annoy some people, but the earlier the better when it comes to educating sexually active people on how to prevent the spread of HIV.

      Despite ads depicting HIV+ individuals as capable of climbing mountains or fording streams, even the best m/e/d/s only delay the onset of symptoms.

      We shall, we must, and we can do better.

      Feb 6, 2011 at 3:58 am · @ReplyReply to this comment ·
    • Fitz
      Fitz

      @thematics: There is a third aspect: getting Poz people into treatment so that they can stay healthy, productive, and happy for as long as possible. And you are right, false positives are almost unheard of… for a lot of reasons, one of which is that a poz result is automatically retested before being diagnosed. (by law).

      Feb 6, 2011 at 8:52 am · @ReplyReply to this comment ·
    • thematics
      thematics

      @Fitz: Yes, you’re absolutely right! Getting people into treatment early helps improve longevity and health status, plus decreases the spread of HIV.

      No matter how many times you’ve done it, informing someone they’re HIV+ doesn’t get any easier.

      The debate over “seniors” getting tested is outright silly. Any individual who is sexually active should get tested, whether 17 or 71. My great aunt got tested at 77 because, well, she’s still out there getting some action … and she has a nifty little card in her purse to show potential boyfriends!

      Feb 6, 2011 at 12:31 pm · @ReplyReply to this comment ·
    • Nathan
      Nathan

      @jason: You’re an idiot, AIDS is much more than a political illness. Tell someone who has unknowingly transmitted it to a partner because they didn’t get tested it isn’t a real disease. With your carefree attitude on AIDS you might as well be a bugchaser. I pity anyone unfortunate enough to sleep with your untested self; if you’re as lackadaisical about STD testing as your post indicates who knows what’s shacked up in you.

      Feb 10, 2011 at 6:38 pm · @ReplyReply to this comment ·

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