A Narrative Inquiry into the Experiences of Point-of-Care HIV Testing Alongside People who were Tested while in a Correctional Facility or at a Bathhouse

Abstract

With a call to increase the accessibility of HIV testing in Canada, point-of-care testing for HIV is being readily adopted. The World Health Organization (WHO, 2012) outlines the importance of protecting the human rights of those being tested through ensuring: informed consent, confidentiality, access to counselling, correct test results, and a connection to care. Little attention has been paid to the experiences of people being tested through HIV point-of-care (POC). Some testing environments, such as bathhouses and correctional facilities, promote testing for HIV among higher-risk groups. In this narrative inquiry study I explored the experience of people testing positive for HIV through point-of-care while at a bathhouse. I engaged with two men, David and Chris, over a period of several months, in two to three conversations between one to almost five hours at a time. The conversations were transcribed verbatim and analyzed for narrative threads. Field notes and observations were also collected and reflections have been incorporated into this study. Three narrative threads for reconsidering practice were identified: a) seeing complexities and understanding testing decisions in relation to time, place, and social context; b) recognizing the impact and significance of secret and silent stories; and c) tentative and tension filled connections to care. It is important to understand testing experiences across time, place, and in diverse social contexts. These experiences are embedded within larger life histories of people that further raise questions about adequate support, follow up and counselling when POC tests are administered in bathhouses. Listening to the experiences of David and Chris has also revealed that health policy and public health practices are shaped by neoliberal discourses.