Part 2: The day at the clinic with all the questions

To schedule my undercover investigation, I went to Better2Know’s website and booked my tests. Although I was after the Chlamydia test, I thought “why not just do them all.” A comprehensive panel set the company back €430, yikes. The tests are given anonymously, so I wouldn’t have to wear my ape suit disguise. I simply gave a name of my choice, that I could give at the clinic, and was assigned a pin number as a reference for my results. Rather than having their own clinics, Better2KNow hires out clinics to conduct their tests. This was going to be an adventure.

I went into the Union Quay Medical Centre and there was no reference to Better2Know, but there was also no induction paperwork to fill in, thank god! I went into the exam room, had my blood drawn, my sites swabbed and urine collected. While we waited for my results to develop, I began my discovery. I asked the nurse about the tests, remarking on the novelty of a rapid Chlamydia test, how cool! She was open to talk, as she was with the clinic and not with Better2Know. She had travelled all over the world as a nurse and worked extensively in the emergency room. Surprisingly, she had only worked with rapid tests at this clinic. She told me that all of the tests were provided by Better2Know. Her relationship with Better2Know was comprised of two in person visits: one for the day of training for the tests and a second to follow-up to see how she was getting on. They left a fine laminated book as a reference for her as to how each test was to be conducted and evaluated.

The Chlamydia test was visually the same as the one marketed online by the Chinese manufacturer, the one where half of the patients with Chlamydia test negative (see part 1). With this rapid test, the patient is swabbed in the right places, the swab is put into one solution and the whole thing shook to release the bacteria. A second solution is added. Then a droplet of the mixed solutions is put on a strip and a color line then indicates a positive result. I also choose to get the standard urine test as well, as a control method…so the jury is still out for my results.

While Chlamydia is not a disease that requires reporting to the authorities in Ireland, all the others I was tested for are; however, it is the entity that orders the test, rather than the nurse or technician administering the test that has the responsibility for reporting and doing patient follow-up. Dear reader, I was negative for all of my rapid tests, but if I weren’t, no one would have to know except for those who I told out of the goodness of my heart. Under normal circumstances of a positive result, the clinic would report to the authorities certain bit of data about me. Then, of course they would prescribe me antibiotics for my bacterial infections and even give me prescription for my partner. In the case of HIV, HepB, or HepC, they would have referred me out to a specialized doctor and done the expected reporting. Better2Know was responsible for ordering the tests as a proxy for me, so they would be responsible for referring me or reporting me, or as their website stated, I could simply print out the results and show them to my doctor.

I had to move my appointment, as the nurse was to able to meet me at my preferred time. This was ok for me, but it could have delayed a needed diagnosis for someone else. My nurse was very friendly and informative. And at least for her, and for me, she has never has had to diagnose a positive result. Whew! #StayPositveTestNegative

The structures are in place that allow for people to be their own doctor through facilitators like Better2Know. A person orders their test/s and chooses how to follow-up and even can have the authority prescribe antibiotics to their partner, sort of. If they have follow-up questions, they can refer themselves out to a doctor or the hotline provided by Better2Know. Since patients can take on the capacity of doctors in so many steps in the STI diagnosis pathway, why not take the test at home? Keep an appointment for yourself?

That future is near, my dear reader. Follow the progress of the one-step wonder as we make at-home tests for sexually transmitted diseases. Do you like playing doctor?