Nobody likes to be the bearer of bad news. And the news Paula Ellis gives out is very bad indeed.
About five times a month, the counselor at the Central Maryland Red Cross must tell a blood donor that he or she is infected with the HIV virus, which causes AIDS.
"It kind of pulls at your heart a little bit," said Ms. Ellis. "It's not something you want to tell someone, but if you are giving that information, you want to do it in the best way you can."
Notifying donors they are HIV positive has become an unfortunate duty for blood centers in recent years. About 2,500 of them around the country have created departments specifically for this purpose -- and to provide counseling to those who learn in this roundabout way that they have the deadly infection.
At the Red Cross, which includes Maryland, Washington, northern Virginia and some of southern Pennsylvania, a counselor has been assigned since 1985 to deal with the HIV-positive donors.
Ms. Ellis describes her job as stressful, but one she feels obliged and committed to do.
"I think that good counseling services should be given," she said. That's the primary reason I stay in the job."
Donors whose blood is HIV contaminated get a letter from the Red Cross headquarters on Mount Hope Drive in Baltimore; no details are given in the letter, but donors are asked to come in to talk to a staff member.
When they arrive, Ms. Ellis will explain that one of the tests came out reactive, or positive, for the HIV virus. "Usually at that point I slow up, see if they have something to say, see how they respond," said Ms. Ellis, who has previous experience in counseling people with infectious diseases and went through a Red Cross training program.
Reactions vary from person to person. Sometimes, she said, it's denial: They can't believe it's happened to them and often can't explain how they are at risk.
For the clearly distraught, counseling is provided not only about the disease, but also to help prevent suicide, if counselors suspect the person may resort to that. It doesn't happen often, Ms. Ellis said, but there have been instances.
Other people react calmly, she said, perhaps unsurprised at the news or more aware of situations that put them at risk.
After the test results are disclosed, donors are told how the virus is transmitted, its effects on health and the symptoms that may appear. They also are referred to support services in the area.
"We give them a brochure on living with HIV," said Ms. Ellis.
Although she clearly is aware that a brochure won't help someone live with a disease for which there is no known cure, "I want to give good information . . . that is crucial to them."
Ms. Ellis advises against donating blood as a means of finding out if you have AIDS. People may have done this when the AIDS epidemic began, but the Red Cross discouraged it and now there are physicians and clinics offering free testing.
Currently, there are 1,398 known cases of AIDS in the state, Maryland health officials say. Last year, 47,000 people underwent voluntary AIDS testing and counseling at one of the ** state's 127 sites. Of those, 1,100 turned up positive for the virus.
That's a far greater percentage than the five out of 28,000 HIV-infected blood donors per month in this region. But although the numbers are fewer at the Red Cross, that doesn't ease the shock felt by the donor or the burden on those who must give the bad news.
"There is a lot of stress to it," said Ms. Ellis. "So you play a lot of
tennis, a lot of basketball, and you go for a lot of long walks."