Recently, I finished an HIV (human immunodeficiency virus, a.k.a. the virus causing AIDS) self-test at home.
As it was over a year ago when I was taking an HIV test at an NGO (Non-Governmental Organization) in Beijing, the idea of scheduling another HIV test has been shaped in my mind for a long time. Usually, I will plan an HIV test every time I end up a relationship with someone, but I kept single and experienced some oral sex with several persons in the last year.
As oral sex without a condom can also spread HIV by chance (although at a very low possibility), personally I usually judge that as unsafe sex activity too, so I believe a test is necessary. But it becomes a big problem that how should I take the HIV test.
Ordinarily, in China, you can take a formal HIV test at China CDC (Centers for Disease Control and Prevention) or any 3A-level hospital (refer to Classification of Chinese Hospitals):
Tests are free in China CDC, but you need to provide and register your ID card to avoid abusing. They promise all personal information will be secrets.
If that register still makes you feel uncomfortable, go to a nearest 3A-level hospital. There's no need to record any personal information to take tests in hospital, but you need to pay by yourself.
Also, some NGO can offer HIV screening test for free with equipment provided by China CDC.
I used to go to local CDC (Nanjing Jiangning CDC) for HIV tests. They asked me many privacy details in the pre-test counseling like:
- Are you at school or work?
- What college are you at?
- When is your last time unsafe sex?
- Who did you do with?
- Did you play the male character or the female one?
What makes me uncomfortable is not only how they collect my privacy details, but also their attitude towards me after knowing I am an MSM (Men who have sex with men).
They told me the percentage of gay people infection is much higher than that of straight people who hire prostitutes. They even suggested me to change my sexual orientation.
So I prefer not to go to China CDC for an HIV test. Although I can also make an appointment with local NGO for an HIV screening test, I'm still too lazy to make an appointment. So I decided to take a test at home.
I ordered some HIV test kits (cassettes) from Taobao, the most famous shopping site in China. There are two main kinds of packages on the market, one is for blood, and one is for saliva (oral fluid), and I choose the blood type.
After I received the package, I opened it and got a one-time-use Safety Lancet, an Alcohol Prep Pad and a pack of a Test Kit. Open the Test Kit pack, and there are a cassette, a pipette, and a small bottle of a buffer. So as for how I saw the volunteer from NGO did, I used the Alcohol Prep Pad cleaning my finger and then pressed the Safety Lancet on it to get blood.
I have to say, the Safety Lancet is designed so smart that it's built for one-time-use. And you don't have to see how the trigger punctures your finger, which makes people like me can also finish this step comfortably at home.
Then use the pipette to move your blood from finger to the cassette. Add a drop of buffer and wait for 10 to 15 minutes, the result will be shown on it.
(I'm still the lucky guy!)
Yes, that's all the steps you need to do. Different from the formal test, this kind of tests can only be used for screening, but that's much easier than going to a China CDC or 3A hospital.
Notice: Check the dependability of product if you want to act a test at home, check this page from US CDC if you live in the US. Also, you should note that there is a window period in the HIV infected period, patients in this period cannot be detected but can also infect another person.
最近，我在家完成了一次 HIV（人类免疫缺陷病毒，也就是引起艾滋病的那位）自检。
鉴于我上次在北京的 NGO 接受 HIV 检查已经是一年多前的事情，所以我已经打算再检查一次有一段时间。一般来说，我会在每次和前一任分手后安排一次检查，不过鉴于在过去的一年里我一直处于单身状态，又和几位基友有过口交行为，所以决定保险起见还是再查一次。
毕竟没有安全套的口交也有几率传染 HIV（尽管几率极低），我个人一般会把口交也算作不安全性行为，这样看来检查一次还是有必要的。然而问题是该如何检查。
在中国，你通常可以在疾控（疾病控制与预防中心）或者任何一家三甲医院接受较为正式的 HIV 检查：
在疾控检查是免费的。不过为了防止资源被滥用，你需要提供并登记身份证件。官方同时也保证所有个人信息将会被保密。
如果登记身份证使你感到不适，也可以就近前往附近的三甲医院寻求检测。在医院检测不需要提供个人信息，但是你需要自行付费。
此外，一些 NGO 也通过由疾控配发的器材来向公众提供 HIV 初筛检测。
我也曾经在疾控进行过 HIV 检测，令人记忆深刻的是他们会在检测前的咨询环节向你询问很多较为敏感的隐私问题：
- 你目前在上学还是在工作？
- 你在哪所大学就读？
- 你上一次高危性行为是什么时候？
- 你是和谁进行的？
- 你在性行为中扮演的是男性角色还是女性角色？
嗯，作为一个同性恋者，疾控的阿姨们会毫不忌讳地询问你是「男性角色」还是「女性角色」（当然，也有一次是描述为插入方和接受方就是）。不过最令我感到不适的还不只是他们如何收集我的隐私，更有他们在得知我同性性取向后的态度。
与同志 NGO 团体的志愿者们为你减轻压力的做法相反，疾控的咨询人员更经常在精神上给你施加压力。他们告诉我：同性性行为者的 HIV 感染率比异性恋直男嫖娼更高。让你思考如果感染后要怎么面对家人和同学。甚至会强烈地建议你「改变」自己的性取向。
我本只是检查一次以防万一，硬是被吓出了一万种感染的可能性。
所以在那之后，我十分不情愿前往疾控检查。同时，尽管我还可以和本地的 NGO 预约进行一次检测，不过懒惰如我实在是懒得预约（更多的是不想添加以后不会有来往的人的微信），于是决定干脆在家做个检测。
作出决定后我就从淘宝购买了两套 HIV 检测试纸。目前市面上存在两种检测包，一种是血液检测、一种是唾液检测，为了结果的准确性我选择了血液检测。
收到包裹后，打开包裹是盒装的检测试纸以及配套的一次性安全采血针和酒精消毒擦。打开检测试纸的盒子，里面有一个本体、一个移液管和一小片缓冲剂。于是按照此前在 NGO 接受检测的步骤，我用酒精纸擦擦手指，然后用一次性采血针在手指上轻压进行采血。
不得不说，一次性采血针真是非常好的发明了。首先这玩意儿是一次性使用，安全、不担心交叉感染。然后通过采血针采血完全不需要看见用针戳手指这样的画面，即使胆小如我也能轻松在家完成。
接着用移液管吸起从手指挤出的血液，滴在试纸盒的采样区。再滴上一滴稀释液坐等 10 到 15 分钟就可以在试纸上看到检测结果了。
（让苍天知道我不认输！）
是的，这些过程并不复杂，对于我这样的笨手笨脚也不算很难操作。不过与正式检测不同，这种在家完成的试纸检测只能用于初筛，而且存在假阳性的情况。不过相比前往疾控（受歧视）和医院（排队挂号），这样在家检测实在算是轻松许多。
说到这里我有个大胆的想法：能不能屯一些试纸，然后带着试纸出门就敞开了约。
（虽然估计并不会这么做。）
注意：建议在购买前确认产品可靠性，同时也需要注意正确的操作过程（可以看看南方都市报的这则试纸测评）。此外需要知道在 HIV 感染中存在「窗口期」的概念，处于窗口期的感染者无法被检测到，但同样存在传染性。
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