HIV Testing and Wishful Thinking
Condomless sex supports the Monogamy Narratives women tell about themselves and their relationships. A positive HIV test leads a woman to replace this narrative with another: as Martha Ward ( 1993b) shows, many HIV-positive women tell of broken trust and partners that must not have really loved them. I call this narrative the "Betrayal Narrative."1
Even prior to and without positive diagnoses, women fear betrayal. A woman may believe in her own wisdom and skill in choosing safe partners, and she may trust her man when he says that he is faithfully monogamous. But, for reasons connected to risk perception (see Chapter 3), probing questions asked in the context of actual HIV testing will probably reveal that she also believes that if anything will lead to a positive test it will be her partner's misbehavior and his lack of concern for her wellbeing -- not her own high-risk action. The frequency of male betrayal (abandonment, abuse, etc.) helps explain the prominence of the theme and the assumption. Importantly, the extrapunitive thinking underlying this assumption releases women from responsibility for the possible consequences of what are actually their own unsafe practices (e.g., having condomless sex with a non-monogamous partner). Positive tests lead to Betrayal Narratives, which are hindsighted depositions of a partner's disloyalty and deceit. But what leads to testing in the first place if women do not see themselves at risk? What do women think and feel about HIV tests and the testing process? These are the questions that this chapter addresses.
Because of the increasing frequency of HIV infection among impoverished urban Blacks and because HIV can be passed on in pregnancy, inner-city public health care workers often urge pregnant clients and