Unsurprisingly, I don't have AIDS

December 1st was World AIDS Day.

In an effort to ensure we had a related story in the Kalleone paper that morning, I appropriated the suggestion of one of my JHR predecessors, Kevin, to visit one of the country's voluntary testing sites with a Kalleone colleague, to get an inside look at how the HIV testing machine in SL was working.

And so, on the Friday preceding the first of the month, I arrive at Connaught Hospital in downtown Freetown and await Sheik's arrival. He's late. The coordinator of the testing centre is later. I am unsurprised.

Sitting outside the testing centre as we await the coordinator's arrival, Sheik and I compile a list of questions to pose to the man in charge of a fairly extensive, country-wide Voluntary Confidential Counseling and Testing campaign. Once we've put pen to paper for a reasonable list of queries, I stare at the floor, waiting. I'm getting really good at waiting.

"What do you think about AIDS?" asks Sheik.

I launch into a meandering answer, noting that I think it's an absolutely terrible disease, but emphasize that I retain optimism that its reach can be brought largely under control with improved antiretroviral (ARV) drug distribution and well-run information campaigns.

"So you think it exists, then?" Sheik astutely gleans.

Oh. I see. Turns out that the very reporter I'm writing an informative article about HIV/AIDS with needs reassurance that a disease which has killed more than 25 million people since 1981, approximately the same length of time he's been on the planet, exists.

"I think poverty is a big part of the problem," he offers.

There we go. That I can work with. I agree that poverty plays a role to some extent; it can often be an obstacle to quality education, leaving poor people more ignorant of the causes of HIV and therefore more likely to engage in activities that leave them at risk for contracting the virus.

"Yeah," he agrees. "And because poor people can't afford to treat other diseases with medicine, they get HIV."

Hm. Not so much how it works, turns out. Unfazed, I explain how HIV is actually contracted, but Sheik doesn't seem especially convinced, laughing as I suggest that having unprotected sex with an infected partner is not worth the risk.

He says he never wears condoms. He was late today because he spent the night at his latest girlfriend's place, one of his four current "girlfriends". On the plus side, I know this article will be informative for at least one person, even if it is the man who writes it.

The coordinator has arrived. We conduct our interview and at the end I ask if we can talk to one of the nurse-counselors that administer the tests. He disappears for a minute, and then tells us there's one that will speak with us right away. Uncharacteristically easy, but I'm not one to question good fortune.

Sheik and I join the nurse, Mariama, in one of the confidential rooms and Sheik explains that we're journalists working on a story for World AIDS Day. I ask if it's possible for me to get tested. I was planning to do that anyway, so that we could really understand the process, but it seems especially necessary now that I know how badly my colleague needs to see this. My attempts to convince him to get tested as well are ineffective.

Admittedly, having the test administered is a substantially less courageous act when you know it'll come up negative, but I still hope my actions - answering all the nurse's deeply personal questions, without hesitation, in the company of a man I met a little over a month ago - will have some sort of impact on him, will somehow stir him to consent to a test of his own.

I can understand why getting tested would be a scary prospect, especially if you've just learned a lot about the disease and your lifestyle seems to indicate that you would be at risk. And especially given the stigma associated with HIV and the widespread perception that a positive test is a death sentence. Blissful ignorance may seem preferable to the misery of knowing.

There is international controversy over the move to criminalize the knowing transmission of HIV. Last year, Sierra Leone passed an act that did just that, meaning those who have tested positive but willfully continue to spread the virus are subject to up to seven years in prison. Some argue that by not getting tested, you avoid opening yourself up to the possibility of jail time.

Certainly, the issue is not an easy one to resolve. But these things only highlight for me the need to spread the message that ARV drugs can keep the virus largely at bay. And someone in this country is obviously trying. Large billboards throughout the city espouse the message of young people "living positively" with HIV.

Back at Connaught, Mariama has completed the questions. She takes a small pinprick of blood from my right ring finger, reminding me of the drop they use to test you for an iron deficiency before you're cleared to donate blood back home. In 15 minutes, I'm staring at my negative result and Mariama's throwing boxes of condoms at both Sheik and I as we proceed to our next interview.

The whole process serves as a strange juxtaposition with my colleague's lack of HIV knowledge. The nurse-counselor said all the right things and it's encouraging to think there are 348 more of these testing centres scattered throughout the Salone landscape.

But then I remember that only six years ago, there were no such testing centres or counselling available, and it will take time to see the results of this labour. The repercussions of today's work will be the success stories that my successors get to write about.

Still, Sierra Leone does not have an AIDS epidemic on the scale of southern African countries like Zimbabwe (20.1% adult prevalence rate), Botswana (24.1), South Africa (18.8), Namibia (19.6), and Swaziland (33.4). Not even close. Compared to those harrowing numbers (from 2005), Sierra Leone sat at 1.5% for the same reporting period - which, of course, is still high enough to be very disconcerting.

Sheik and I return to the office and put together this story. As we part ways at the end of the day, Sheik says he'll get tested on Monday.

He does not.