The popular and scientific media often describe people who are at risk for human immunodeficiency virus (HIV) infection but fail to use condoms as being "in denial." Unfortunately, most authors, clinicians, and health officials -- indeed, most people -- take the specifics of the denial process for granted. Denial has become a blanket term in the most literal sense, tossed about freely, covering up or hiding away the broad range of complex factors that contribute to Acquired Immunodeficiency Syndrome (AIDS) risk misperceptions and unprotected (e.g., condomless penetrative-receptive) sex. Until we examine these factors and arrive at an understanding of the mechanisms of AIDS-risk denial, we will be unable to suggest effective ways to lessen the denial, and we will continue to be limited in our ability to decrease the high rates of unsafe sex it entails.
The research described in this book takes a critical approach to AIDS- risk denial, providing insight into how and why it occurs. Findings suggest that women who hold certain expectations for heterosexual unions actually need to practice unsafe sex in order to support their beliefs that their own unions meet these expectations. Women seem to have a related tendency to assume that they have themselves been tested for HIV seropositivity (antibodies to the human immunodeficiency virus) when they have not. Both unsafe sexual practice and the tendency to assume testing stem from wishful thinking engendered by women's hopes for their relationships and their desires to preserve status and self-esteem.
AIDS is on the rise among women -- especially among poor Black and Latina inner-city women. Regular condom use can help stop the spread of HIV, but public response to warnings about the consequences of unprotected or unsafe (condomless) penetrative-receptive sex has not been enthusiastic. Most of us do not see ourselves as people at risk for AIDS. Few of us use condoms on a regular basis even though having condomless penetrative-receptive sex with an HIV-positive partner could lead to HIV infection. In the following chapters, I ask how and why we fail to acknowl-