Welcome to Passing the Test: The Challenges and Opportunities of HIV Testing in Black America. We are pleased to partner with the Global Business Coalition on HIV/AIDS, Tuberculosis & Malaria (GBC) and the National Association of People with AIDS (NAPWA) on this edition of the state of AIDS in Black America series by the Black AIDS Institute.

Knowing your HIV status is a right and a responsibility. Knowing the HIV status of your partner can save your life, and finding out your HIV status has never been easier. HIV tests are affordable. There are agencies offering free HIV tests in nearly every city in America. HIV tests are painless. The most common form of HIV testing today uses an oral swab—no more blood or needles. The days of waiting a week to get your results are over. With the rapid tests, you can get your results back in less than an hour.

People who are diagnosed late in the course of HIV infection have a much poorer prognosis than individuals whose HIV diagnosis is timelier. In New York City, individuals whose HIV and AIDS diagnoses occur within 31 days of one another are twice as likely to die within four months of diagnosis as people with a non-concurrent AIDS diagnosis. Early knowledge of HIV infection plays a key role in reducing HIV-related morbidity and mortality.

So, let’s think about it. HIV tests are free, easy, painless, quick, and you get information that just might save your life. What’s not to love about that? You would think everyone in America would get tested for HIV.

Yet, 1 in 2 of Black people in the U.S. infected with HIV don’t know their HIV status. Many people living with HIV are diagnosed only in response to symptoms, usually several years after initial exposure to the virus. In Washington, D.C., 69% of AIDS cases were diagnosed with HIV less than a year earlier. Among HIV-positive Black gay and bisexual men who participated in a CDC-sponsored multi-city study, 67% were previously unaware of their infection.

Clearly, when it comes to the challenges and opportuities of HIV testing in Black America, we have not yet passed the test. This report looks at the reasons Black Americans get tested for HIV or not; describes the evolution of HIV testing technology; and looks at the impact of stigma on our willingness to get tested.

The energy around testing is important, but it can also be dangerous—if the work stops there. This report explores the range of challenges that go hand-in-hand with testing—most importantly, the connection between testing, prevention and treatment—and the ways in which individuals, community leaders and policymakers can help take on those challenges. Most importantly, the report proposes solutions. In addition to government initiatives to close the testing gap, the report specifically examines the under-utilized potential of social marketing and other testing-promotion efforts to increase knowledge of HIV status in Black America like the new CDC initiative, Act Against AIDS and the Black AIDS Media Partnership, the National Medical Association’s Physicians Testing Initiative, NAPWA’s Mayor’s Testing Initiative and the Test 1 Million campaign.

As always, we are ever mindful that “nobody can save us from us, but us.” At the end of the day, it all boils down to what you do. If we come together, we can meet this challenge and pass the test. Enjoy the report.