1 December 2018
Richard Carson is CEO of ACET Ireland who have launched a new project offering HIV Testing to churches in Ireland. Here Richard brings ACET’s annual GUEST Blog post written specially for VOX magazine on World AIDS DAY,
Recently some of our staff, including myself, received training on how to carry out a rapid HIV test. While I had observed the test on numerous occasions there is something very different about carrying out the test yourself. As a former Science teacher, I was drawn to the sight of the relevant disciplines. The hand held, finger prick and breaking of skin reminded me of Biology. The blood pressure, capillary action and use of gravity point to Physics. The three humble tubes deliver a Chemical reaction with an immediate result. The whole thing is over in about 60 seconds. It is clinical and decisive.
There is a crude public health reality at play. There are estimated to be well over 1,000 people living with HIV in Ireland who are not aware of their status. Each year a person is undiagnosed will lessen ten-fold the likelihood that treatment will lead to a normal longevity. This treatment is so effective that if a person is adhering to their medicine and has what is called an ‘undetectable viral load’ (as is the case for almost all who adhere) then sexual transmission to another person is impossible. This is called U=U, Undetectable = Untransmittable, and it is changing the story of HIV.
The UK has seen a 28% decrease in HIV diagnoses over the past two years in part as a result of this impact of treatment as prevention. Ireland is yet to turn this corner. We have one of the highest rates of late diagnoses (where the virus is already negatively impacting the immune system) in Western Europe and testing must come to where people are at.
With these startling realities there is a temptation to reduce the HIV testing encounter to a measurable event, a box ticked on a surveillance report and a funder satisfied. It is the temptation to remain relevant, to turn single blue dots (a negative test result) into double blue dots (a reactive test result), like stones into bread. It is the temptation with which we begin Advent, that we are waiting for God to do big loud measurable things to make our world a better place. But there is more at play here than the presence of a test result.
In these moments the wisdom I hear is ancient and profound. It does not come from myself or from a strategic plan or a well delivered workshop. The word is Zakhar! (זכר) Remember! The voice of Moses in Deuteronomy 8 rings through the centuries. This call to worship is a call to resistance; resistance to reducing the human and divine encounter to a test result. But there is much to remember.
Remember there is culture
Our work is largely in minority ethnic and multi-ethnic contexts and it also brings us in contact with a range of state and community agencies. One observation we have made is that integration in Ireland, at least when it comes to health or community development, is regularly understood in uni-directional terms - How can we better integrate them (the migrant) into us (the White-Irish culture)? This approach looks well intentioned, can demonstrate some positive outcomes but those exist to hide its own inadequacies.
Real integration is mutual and marked by profound listening and transformation of host and guest. When a White Jesus lies at the centre of my faith, my actions to include the other and draw them closer to this centre may appear virtuous but they are ultimately destructive. When is the last time you made yourself vulnerable to the hospitality, theology, wisdom, mentoring, leadership of someone from a minority ethnic group in Ireland? Regularly the person being tested has spent years at the receiving end of White-Irish peoples’ refusal to be vulnerable with themselves and learn from the other. I have to remember this as I reveal the number of blue dots at the bottom of the well.
Remember there is memory
Whether it is the late 20th century celebrity or the experience on the African continent of what we call a generalised pandemic, the person being tested often holds a set of memories of what HIV may mean for them. Strong here is the simple equation that HIV = death. As already highlighted this is no longer true but the memory can be so powerful that it takes numerous reminders to deconstruct the false assumptions.
For many in Ireland these memories are linked to siblings, children, partners and friends, villages, towns, colleges, churches, tribes and cities. Some are long gone. Some are bravely living with HIV, knowing that the virus need not define their story as they thrive as parents, friends, leaders and more. All these people’s lives are in the space between the tester and the tested. I have to remember I am privileged to encounter these memories. I must hold them tenderly as a I pour the final chemical that contrasts the result to the blank background.
Remember there are economics
Tests often take place in churches who struggle to pay the rent that allows them worship in humble industrial estate units at the edge of the Irish city. Some have been driven away from cultural and historically ecclesial centres by high rents and are led by pastors who regularly and vulnerably express their anxiety that the church with the better car park/worship experience/children’s ministry will draw away the faithful.
The eviction to the ring road is a reflection of the normalised racism that is experienced on a weekly basis. Every congregation we encounter is in some way impacted by the now evidenced racial discrimination in employment in this country. Mammon still holds sway in Irish churches and society. I am not the only one tempted to count numbers and measure souls. I have to remember this as we complete the surveillance report and sign consent forms.
I have to remember that there is faith, hope and above all, love. We must remind ourselves that the disciples, and even John the Baptist, expected a Messiah who would conquer with the same force that had placed them in bondage. Whether it is empires or economies, populations or pandemics, we still long for the violent Saviour, delivering a solid foundation out of our problems that keeps us in control.
But Advent teaches us that yes the Cornerstone will come but He will be both remarkable and unremarkable. A disenthrallment must take place over the coming weeks as we leave behind our hope in a strategic, effective, measurable solution reigning at the centre of power so that we might encounter a vulnerable baby in the margins and just kneel in awe and wonder.