Attitudes toward HIV testing among impoverished inner-city African-American women.

During a study of the perceived benefits of unsafe (condomless) sex, some women's erroneous convictions that they have been tested for HIV seropositivity and most women's reluctance to identify their own sexual behaviors at high-risk when explaining why they had been tested were noted. Many participants assumed that clinicians drawing their blood would check it for HIV when they checked for other matter, and most of those reporting that they have had or would have HIV tests saw the test as part of a routine health check. Factors underlying the women's optimistically biased denial of their own HIV/AIDS risks and their related refiguring of the purposes and conditions of HIV testing are discussed, and the ways in which the women's attitudes critique current policies are described. Because of the culturally promoted strength and importance of women's denial, testing programs that seek to capitalize on an evoked sense of risk cannot succeed; such programs threaten women's faith in their relationships and question women's social and moral standings in a humiliating fashion. Those who promote testing would do better to present HIV screening as routine, because this is how women who accept testing generally portray it. Importantly, clinicians must explain that the test is not automatically administered. Cast as a standard health-related procedure for which permission must be granted, HIV testing will seem more rational, pro-active, and acceptable to the women targeted for testing.