Today was one of my least favorite days of the year. It was the day I had to have my annual smear test, to check my cervix is healthy and there are no signs of cancer. Women living with HIV have to do this every year in the UK. The GP surgery had called me a few weeks ago to remind me, and also to remind me of my flue jab. As usual I kept procrastinating. But as the cold increased in London I realized it was a good idea to be immunized, and checked ‘down there”.
Probably because I wasn’t exactly looking forward to it I kept pottering around the office and left late. I arrived at the surgery 15 minutes late. The nurse, maybe in an act of revenge, kept me waiting, and when after 10 minutes she let me in the visiting room she scolded me:
‘ I don” t do late”
‘ I am sorry” I said
” First let”s do the flue jab”
Before I could even think about it she had it out of the fridge and she stubbed my arm.
“It”s nothing” she said.
I put on a stoic expression . When I turned around to look at my painful shoulder I noticed she was not wearing gloves.I was stunned.I am used to be treated as a walking health hazard.
” Why are you not wearing gloves?’ I asked her
“Do you say this because of your status? ‘ She replied.
‘ Yes… But no… Well even if I wasn’t…So many people have it and they don”t even know it…’ I was thinking at WHO recommendations about Universal Precautions, but decided not to say anything.
” Oh come on! It”s only a flue jab…. If I was taking your blood I would wear gloves…but I have never had a needle stick injury doing a flue jab!”
Somehow I felt warm inside. I felt grateful to be treated like I wasn’t a dangerous threat. I was a person. When she finished with the jab. She looked at the computer screen and asked me ” Do you need any contraception?” “No thank you I said” and in my head I thought what a nice thing to ask a woman with HIV.
This felt especially good this week. On Tuesday I was at a meeting Positively UK had organized with the Women and Health Equality Consortium (WHEC). The meeting was attended by many other women who work in England supporting women living with HIV. We were looking at what were the needs of positive women today, and how we could have influence within the changed NHS structures .
Many participants reported that they had heard many women living with HIV in England, especially young women, being denied contraception, even when they directly asked for it. Many health workers just assumed that women with HIV must use condoms. However, we can only use condoms with the full support of our partners. And not all men, or women, like using them. Nowadays even the BHIVA treatment guidelines recognize that some people may not want to use condoms but choose to use treatment as prevention. The guidelines recognize that because of scientific evidence that effective treatment and an undetectable viral load can reduce the risk of person with HIV passing the virus to a sexual partner to very low level, comparable to condom use, people are entitled to start treatment to support them not passing HIV to their partner, just for prevention. However, some health care providers in the UK are still denying contraception to women living with HIV. Moreover dual protection has been recommended for HIV positive women for many years, and even acknowledged by UNAIDS. It was really sad to hear that this very bad practice is most diffused towards young women, who often lack the confidence to challenge it. Abusers of power target those who are most vulnerable and most unlikely to challenge them.
I wish every woman living with HIV coming out of a GP surgery could feel how I felt today when I walked out of my GP surgery. Head high, smiling. A woman that doesn’t” cause fear. A woman with the same desires, rights and access to choices as any other.