From the beginning of the HIV/AIDS epidemic, the meaning of HIV testing from a public health perspective was a mode of disease prevention or risk reduction. The perspective assumed that knowledge of infection would reduce risk-taking behavior and increase disclosure of HIV status to others, thereby reducing further infections. However, the meanings of HIV testing among the lay public, from the 1980s and continuing today, go well beyond medical diagnosis and disease prevention and have important implications for testing decisions and risk-taking behaviors. Specifically, HIV testing often invokes symbolic meanings of risk—as opposed to risk reduction—especially identity and relational risks.

In spring 1985, the U.S. Food and Drug Administration approved the first AIDS antibody test, developed to protect the blood supply. Soon the test began to ...