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HIV Testing

Blood tests to detect the presence of HIV (human immunodeficiency virus) first became available in 1985, after scientists and public health officials confirmed that the virus caused AIDS. Testing made it possible to diagnose HIV before symptoms surfaced and quickly became one of the most widely practiced responses to AIDS. While many public health officials and citizens considered testing a way to take control of one’s own health, this sentiment was not always widely held. Until 1987, when the medical establishment introduced AZT (azidothymidine), the first widely available, yet exorbitantly expensive, drug to slow HIV infection, many service providers, particularly ones who worked with communities of gay men, argued against testing. They feared that violations of privacy would outpace positive support and treatment options for people who tested positive. With testing, the prospect of a sudden, painful, seemingly random AIDS-related death was replaced with a similarly terrible future of stigma, isolation, and misdirected hatred resulting from a positive HIV test. These campaigns encouraged people to overcome their fear of the disease and the stigma it produced by stressing personal and social responsibility as well as the availability of information, support, and, later, treatment if infected with HIV.
AIDS Action Committee
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AIDS Action Committee

The AIDS Action Committee (AAC) began in 1983 in the basement of Boston’s Fenway Community Health Center, one of the first clinics in the country to treat people with AIDS. For more than thirty years, AAC has focused on AIDS advocacy, prevention, and support for those living with the disease, even as the kinds of images and words used in public health campaigns have changed over time. Early publicity focused on reaching various populations in Boston and New England to fight potential discrimination against people with AIDS at the same time that AAC worked to share specific strategies for keeping a diverse range of people healthy. By offering clear and concrete advice to people whose behaviors put them at risk of contracting HIV as well as the general public, AAC’s inclusive campaigns helped to prioritize AIDS in local and national conversations. To date, the organization has worked with more than half of the people diagnosed with AIDS in Massachusetts.

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America Responds to AIDS
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America Responds to AIDS

From 1987 to 1996, the Centers for Disease Control and Prevention sponsored America Responds to AIDS, a multipart public awareness campaign that focused on reaching a wide range of audiences variously defined by identity or behavior, from heterosexual single mothers, to teenagers of all races, to young adult African Americans, to people who lived in rural areas. The campaign reached millions, becoming a central prong in the “everyone is at risk” strategy of AIDS prevention. It suggested that the best way to respond to HIV/AIDS was to engage in honest conversations about risk behaviors, including the potential consequences of multiple partners, unprotected sex, intravenous drug use, or any activities that compromised the ability to make a sound, safe judgment. Not all applauded the effort. Some, particularly service providers working with groups with a high incidence of HIV/AIDS, most notably young men who had sex with men and intravenous drug users, saw the campaign as ignoring the particular needs of these communities in favor of supporting low-risk individuals. While these efforts claimed to reach all Americans, the efforts did not provide necessary outreach and education to those who also needed it.

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Condoms as Safer Sex
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Condoms as Safer Sex

In 1985, researchers at the University of California at San Francisco confirmed what many AIDS service providers and people with AIDS already assumed: condoms, when used consistently and correctly, could prevent the spread of HIV/AIDS. This was true with sex between men as well as sex between men and women. These findings, with support from the Office of the Surgeon General of the United States pushed public health departments across the country to create social marketing campaigns to encourage condom use. Some campaigns were graphically subdued, using large type and funny copy to entice a largely heterosexual audience without seeming illicit. Alternatively, the Safer Sex Comix published by the Gay Men’s Health Crisis in New York City used humorous, explicit imagery to reach gay audiences by suggesting that condom use could be pleasurable.

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Fear Mongering
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Fear Mongering

As AIDS became a more widespread concern, public health officials and government agencies felt an increasingly urgent need to encourage people to protect themselves and their partners. Many state and local AIDS organizations tried to exert pressure on audiences using fear to prompt behavioral change, particularly among White heterosexuals who did not consider themselves at risk. Designed as an alternative to safer-sex campaigns, which highlighted pleasure and encouraged readers to rethink sexual practices in the age of AIDS, these advertisements shared a common visual and verbal language of gruesome death without providing information about how to prevent it. While a few emphasized the necessity of condom use or warned against sharing needles, most simply told readers to “get the facts” without providing substantive information. Often the fear came in an anti-sex form, such as, “Every time you sleep with someone, you’re risking your life.” In all cases, the campaigns harnessed fear to force people to acknowledge AIDS, but often omitted the helpful public health information about strategies citizens could use to protect themselves.

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Fight the Fear
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Fight the Fear

The fear of AIDS and resulting stigma for those facing the disease made getting accurate information to diverse audiences more difficult. Many people were afraid even to ask questions, lest they be marked with the societal shame then associated with AIDS. These posters and booklets, all designed for general audiences by various AIDS service organizations, reflected a variety of strategies to promote the spread of facts about the disease instead of rumors. They reminded people that everyone needed to have accurate information about AIDS and places where that information existed.

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Harm Reduction/Clean Needles
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Harm Reduction/Clean Needles

In the early 1980s, many believed that identity not behavior put people at risk for contracting AIDS. Known collectively as the 4 H’s: homosexuals, hemophiliacs, heroin users (representing all intravenous drug users), and Haitians, the four groups were considered vulnerable and blamed for spreading the disease. Intravenous drug users brought with them an all-too-familiar public health challenge. How do you inform, protect, and support a group that engages in behaviors deemed illegal and potentially considered wrong or sinful?

One answer, as illustrated in these public health campaigns, was harm reduction—the idea that if you could not stop people from using intravenous drugs, you could, at least, get them information about how to protect themselves while doing so. Using blunt, straightforward language, these campaigns spoke to needle users and the people who had sex with them. For general audiences, those who might see the materials in passing, harm-reduction campaigns underscored the idea that disliking or disapproving of a risky behavior was inconsequential: value judgments did nothing to prevent the spread of AIDS.

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HIV Testing
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HIV Testing

Blood tests to detect the presence of HIV (human immunodeficiency virus) first became available in 1985, after scientists and public health officials confirmed that the virus caused AIDS. Testing made it possible to diagnose HIV before symptoms surfaced and quickly became one of the most widely practiced responses to AIDS. While many public health officials and citizens considered testing a way to take control of one’s own health, this sentiment was not always widely held.

Until 1987, when the medical establishment introduced AZT (azidothymidine), the first widely available, yet exorbitantly expensive, drug to slow HIV infection, many service providers, particularly ones who worked with communities of gay men, argued against testing. They feared that violations of privacy would outpace positive support and treatment options for people who tested positive. With testing, the prospect of a sudden, painful, seemingly random AIDS-related death was replaced with a similarly terrible future of stigma, isolation, and misdirected hatred resulting from a positive HIV test.

These campaigns encouraged people to overcome their fear of the disease and the stigma it produced by stressing personal and social responsibility as well as the availability of information, support, and, later, treatment if infected with HIV.

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The Minority AIDS Project
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The Minority AIDS Project

In 1985, four years into the national health crisis, African Americans and Latinos accounted for three times as many cases of AIDS as whites. To address the growing disparate epidemic and counter the myth that AIDS was a “gay white disease,” Archbishop Carl Bean and members of the Unity Fellowship Church founded the Minority AIDS Project (MAP) to support communities in southern Los Angeles. Their bold, bilingual campaigns stressed AIDS as a very serious, rapidly growing problem in communities of color and provided information on prevention and care for those with AIDS. MAP, working along side two other community-based organizations—Blacks Educating Blacks About Sexual Health Issues (BEBASHI) and Black and White Men Together—became examples for future organizations focused on assisting African Americans and Latinos affected by HIV/AIDS.

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Native Peoples Respond to HIV/AIDS
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Native Peoples Respond to HIV/AIDS

Native peoples continue to be particularly vulnerable to the AIDS crisis due to several factors, including a lack of funding for culturally relevant information, myths and misperceptions about the disease and its causes, and community stigma. Native peoples represent a small percentage of both the United States population and the total number of reported cases of HIV/AIDS, but as a group, they have the third highest rate of diagnosis after African Americans and Latinos. The responses to this disparity have varied.

Since 1987, the National Native American AIDS Prevention Center (NNAAPC) has offered programs and outreach to Native communities. The NNAAPC’s Social Marketing Clearinghouse includes a variety of educational resources, including posters, which have been tailored to individual Native nations in many parts of the country. Many of the posters displayed here reflect the work of tribal governments and local community organizations as they strive to educate their citizens and non-Native neighbors about AIDS. Although not originally focused on HIV/AIDS prevention or awareness, staff at health clinics and support organizations frequently counseled individuals on pursuing safer, healthier behaviors and, in the process, became key participants in fighting the epidemic in Indian Country. The images here reflect an array of culturally— and oftentimes tribally-specific messages aimed at a broad, new audience that required help and information.

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Please Be Safe” by the Northwest AIDS Foundation
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Please Be Safe” by the Northwest AIDS Foundation

In 1987, with funding from the U.S. Conference of Mayors, the Seattle-based Northwest AIDS Foundation launched the “Please Be Safe” campaign to help gay and bisexual men reimagine their sexual behaviors. Using a different creative visual strategy than the sexually charged imagery of some contemporaneous public health efforts, this campaign used road signs—a straightforward, familiar set of symbols—to discuss and advertise sexual safety. The “Please be Safe” or “Rules of the Road” campaign used road signs and compelling, straightforward, community-specific language to help gay men engage in safer sex. The campaign sought to establish these practices as the new norm for all. The “Sexual Safety Card” featured on many of the posters provided quick and accessible information on activities at every level of safety.

The Northwest AIDS Foundation, in addition to producing public health posters, hosted open discussions of risk, testing processes, sexual health, and provided support for people with AIDS and their loved ones. In 2001, the organization merged with the Chicken Soup Brigade to form the Lifelong AIDS Alliance.

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Postcard Politics
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Postcard Politics

By the mid-1980s, as the AIDS epidemic became a full-on crisis, AIDS activists turned to art and graphic design to illustrate and punctuate their responses to the disease and the resulting social crises. Emerging out of ACT UP’s (AIDS Coalition to Unleash Power) Gran Fury, a collective of artists who used their talents to fight AIDS, artistic activism insisted that visual culture had tremendous power to affect behavioral and political change. Gran Fury plastered urban neighborhoods with posters featuring arresting and provocative images that forced some to confront their homophobia and others to reimagine what they could do to fight AIDS.

In addition to creating posters, artists reproduced those images as postcards. These small, portable, inexpensive items were visual reminders of how big the AIDS crisis had become. Displayed for the taking at bars, restaurants, neighborhood shops, and community centers, these postcards allowed activists, including those who never joined Gran Fury, to reach an even wider audience.

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South Carolina AIDS Education Network (SCAEN)
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South Carolina AIDS Education Network (SCAEN)

In 1986, DiAna DiAna, an African American hairdresser with a small salon in Columbia, South Carolina, felt compelled to take action when a local newspaper refused to run an advertisement for condoms. DiAna, who had no formal training in public health, began to use her shop as a space to engage customers, mostly African American women, in conversations about why they should care about and practice safer sex. She designed a distribution system to provide free protection—a basket full of gift-wrapped condoms available free to any of the shop’s customers who wanted them. While the artist who drew the posters displayed is unknown, the style typified DiAna's approach to AIDS prevention. DiAna firmly believed in the empowerment of community members so that they saw the epidemic as a problem they could take action.

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U.S Conference of Mayors and Municipal AIDS Projects
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U.S Conference of Mayors and Municipal AIDS Projects

The U.S. Conference of Mayors established an AIDS project in 1984 at the urging of then mayor of San Francisco Dianne Feinstein, the municipal leader of one of the cities most seriously affected by AIDS. From her position at the helm of the city where gays, lesbians, and people with AIDS developed models of care, treatment, and prevention, Feinstein persuaded her fellow mayors to extend San Francisco—style efforts to cities nationwide. This brought much-needed information and support to areas not thought of as gay centers, but nonetheless had growing local AIDS epidemics. Local AIDS projects, including those in Milwaukee and Denver, used the San Francisco model of combining calls for prevention and care to focus on the needs of different populations within their cities and present explicit information about safer sex and intravenous drug use. This was particularly essential after 1987, when the United States government ceased providing federal funding to campaigns deemed supportive of homosexuality and drug use.

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The Whitman Walker Clinic
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The Whitman Walker Clinic

Working in gay communities almost a decade before AIDS appeared in the United States, the Whitman-Walker Clinic was at the frontline of AIDS service prevention in the nation’s capital. Established as part of the Washington Free Clinic and originally named the Gay Men’s VD Clinic, it opened in a church basement in 1973 to provide gay men with unbiased sexual health care. The founders renamed it in 1978 in honor of two people who defied gender and sexual norms of the nineteenth century: Walt Whitman, the famous American poet, who made his life with men, and Dr. Mary Edwards Walker, a feminist activist and medical doctor, who dressed exclusively in men’s clothes and was the only woman to receive the Medal of Honor for her service as a surgeon during the Civil War.

As early as 1983, the clinic staffed the first AIDS hotline in the city, and within two years, it opened multiple homes for people with AIDS who sought refuge and care from the larger gay and lesbian community. In addition to providing much-needed care for people with AIDS and access to treatment, Whitman-Walker was at the forefront of designing and distributing safer-sex materials that targeted a range of audiences. Even as the clinic created campaigns to help all kinds of people, it never forgot to attend specifically to the needs of men who had sex with men.

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You Can’t Get AIDS From…
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You Can’t Get AIDS From…

Since the first announcements about AIDS appeared in the early 1980s, myths have persisted alongside the epidemic, and rumors have accompanied emerging scientific ideas about the disease. First was the powerful stigma attached to the 4 H’s—homosexuals, Haitians, hemophiliacs, and heroin-IV drug users—those initially believed to be at risk for contracting AIDS. Then came unfounded concerns about catching AIDS from drinking fountains, toilet seats, handshakes, and hugs. The campaigns collected here were designed by AIDS service organizations to dispel major myths about who could contract the disease and raise awareness about how it spread. By directly confronting AIDS myths and rumors, these efforts ensured that more people understood that AIDS was not a punishment or a disease that only affected “at-risk” populations: it was something that required everyone to think and respond to in healthful ways.

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16 Images

Red tinted color photograph of a smiling white woman and man sitting on a couch.

Everyone has a reason to get an HIV test, Westchester County (NY) Department of Health, 1980s-1990s

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Red tinted color photograph of a smiling white woman and man sitting on a couch.
The White heterosexual couple pictured here reminded readers that HIV/AIDS affected all types of partners. Some public health campaigns attempted to appeal to the reader’s sense of love, responsibility, or consideration for others by stressing the benefits of diagnosis for romantic and sexual partners. Targeting heterosexual couples, this campaign, from Westchester County in New York, emphasized that HIV could be spread and contracted by both genders and HIV/AIDS was a concern for all couples, regardless of race.
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African American man and woman smiling at each other.

Everyone has a reason to get an HIV test, Westchester County (NY) Department of Health, 2001?

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African American man and woman smiling at each other.
This campaign broadened its audience to reach White and African American heterosexual couples and reminding them of their equal risk. Some public health campaigns attempted to appeal to the reader’s sense of love, responsibility, or consideration for others by stressing the benefits of diagnosis for romantic and sexual partners. Targeting heterosexual couples, this campaign, from Westchester County in New York, emphasized that HIV could be spread and contracted by both genders and HIV/AIDS was a concern for all couples, regardless of race.
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African American man sitting at the end of a long park bench, underneath is a small inset of an African American man on a bicycle smiling.

HIV testing scared the hell out of me, I found out knowing is better than not knowing, Burroughs Wellcome, 1990s

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African American man sitting at the end of a long park bench, underneath is a small inset of an African American man on a bicycle smiling.
How do you motivate someone to take a test that might reveal that they have a terminal illness? This campaign addressed the fear directly, stressing the benefits of early diagnosis and support resources available, including the opportunity to receive information anonymously. Testing campaigns gained traction as medical research proved and continues to prove that knowing one’s HIV status early means more successful treatment options that potentially prolong a patient’s life.
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Black and white photograph of an African American woman and young girl looking at the viewer.

I can’t afford to be sick, can you?, AIDS Health Project, 1980s-1990s

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Black and white photograph of an African American woman and young girl looking at the viewer.
While this poster might speak specifically to black mothers, the image reminded all parents of the importance of being tested for the sake of one’s family.
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Black and white photograph of an Asian American man in a leather jacket looking at the viewer.

I can’t afford to be sick, can you?, AIDS Health Project, 1980s-1990s

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Black and white photograph of an Asian American man in a leather jacket looking at the viewer.
In 1998, the Supreme Court ruled that HIV/AIDS fell under the Americans with Disabilities Act (ADA). The decision protected people with AIDS in their workplaces; until then, testing positive for HIV might mean losing one’s job and health insurance. A group of concerned mental health and medical professionals in San Francisco formed the AIDS Health Project (AHP) to support a growing community of people who needed emotional and psychological support as well as medical treatment. The AHP provided crucial, groundbreaking support in getting people tested: the organization offered the first large-scale testing programs along with resources to help people manage either a positive or negative result. This campaign used frank, simply put descriptions of the multiple costs of not knowing one’s HIV status, stressing the financial, personal, and family consequences of remaining ignorant.
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Black and white photograph of an African American man looking at the viewer.

Most men don’t cheat, do you?, AIDS Health Project, 1980s-1990s

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Black and white photograph of an African American man looking at the viewer.
An HIV-positive diagnosis sometimes forced difficult discussions about sexual behaviors, including the new potential consequences of cheating on a partner. Instead of shaming its audience, campaigns like this encouraged people to take precautions to protect themselves, their partners, and their families. A group of concerned mental health and medical professionals in San Francisco formed the AIDS Health Project (AHP) to support a growing community of people who needed emotional and psychological support as well as medical treatment. The AHP provided crucial, groundbreaking support in getting people tested: the organization offered the first large-scale testing programs along with resources to help people manage either a positive or negative result. This campaign used frank, simply put descriptions of the multiple costs of not knowing one’s HIV status, stressing the financial, personal, and family consequences of remaining ignorant.
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Black text on a green background. Two boxes underneath title.

Take this simple AIDS test, New York State and City Departments of Health, 1980s-1990s

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Black text on a green background. Two boxes underneath title.
Testing for HIV became more essential as new treatments became available. Released to the public in 1987, AZT (azidothymidine) was a powerful, new drug that slowed the progression of HIV to AIDS—but it only worked with the benefit of early detection and treatment. Posters, like this one, stressed the importance of getting tested, specifically so that treatments like AZT could be an option.
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Color photograph of a yellow sunflower, with half the petals missing, “I’m positive” and “I’m negative” alternate by each of the remaining petals.

The David Geffen testing center offering a more human approach to HIV testing, David Geffen Center, Undated

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Color photograph of a yellow sunflower, with half the petals missing, “I’m positive” and “I’m negative” alternate by each of the remaining petals.
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Color photograph of a multiracial group of five woman looking at the viewer.  Red ribbon in the top left corner.

To love is to protect, New York State Department of Health, 1980s-1990s

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Color photograph of a multiracial group of five woman looking at the viewer.  Red ribbon in the top left corner.
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Color photograph of a yellow sunflower, with half the petals missing, “I’m positive” and “I’m negative” alternate by each of the remaining petals.

We offer a much more effective method to reduce HIV test anxiety, David Geffen Center, Undated

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Color photograph of a yellow sunflower, with half the petals missing, “I’m positive” and “I’m negative” alternate by each of the remaining petals.
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Black and white photograph of a multiracial group of woman variously dressed and two holding babies, all looking at the viewer.

Which woman should get an HIV test?, Medical Arts and Photography Branch - National Institutes of Health, 1980s-1990s

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Black and white photograph of a multiracial group of woman variously dressed and two holding babies, all looking at the viewer.
Many women did not consider themselves at risk for infection, despite hundreds of posters that aimed specifically to reach the female audience. This was, in part, because most public health initiatives focused on types of people (gay men, hemophiliacs, intravenous drug users) and not behaviors (having unprotected sex, sharing needles). This campaign, designed by the American College of Obstetrics and Gynecology and the American Academy of Pediatrics, targeted pregnant women and women with children in hopes of appealing to them as mothers to get tested.
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Black and white photograph of a toddler looking at the viewer holding a toy.

Who will take care of him?, AIDS Health Project, 1980s-1990s

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Black and white photograph of a toddler looking at the viewer holding a toy.
An early diagnosis often meant a more successful course of treatment, an especially relevant argument for the parents of young children, like this one. A group of concerned mental health and medical professionals in San Francisco formed the AIDS Health Project (AHP) to support a growing community of people who needed emotional and psychological support as well as medical treatment. The AHP provided crucial, groundbreaking support in getting people tested: the organization offered the first large-scale testing programs along with resources to help people manage either a positive or negative result. This campaign used frank, simply put descriptions of the multiple costs of not knowing one’s HIV status, stressing the financial, personal, and family consequences of remaining ignorant.
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Blue tinted photographs showing four people’s faces above a line of people talking on phones.

You are not alone, fight the fear, Gay Men’s Health Crisis, 1995

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Blue tinted photographs showing four people’s faces above a line of people talking on phones.
In 1982, the Gay Men’s Health Crisis formed in a New York City apartment to advocate for AIDS research as well as provide outreach and education. By stressing community, solidarity, and support, this poster reminded people that everyone was frightened of this new disease and taking action meant being informed.
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Three photographs surrounded by text. One is African American man, another is of people playing basketball, last one is white man and woman kissing.

Take the HIV Test. You can live with the results., Michigan Department of Public Health AIDS Prevention, 1980s-1990s

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Three photographs surrounded by text. One is African American man, another is of people playing basketball, last one is white man and woman kissing.
Public health officials faced a serious challenge in prompting people to get tested for HIV: potential social stigma and isolation along with limited medical treatment made facing a terminal diagnosis all the more terrifying. This campaign, from the Michigan Department of Public Health, laid out the benefits of testing by stressing the resources available to help individuals cope with either a positive or negative diagnosis.
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Black and white photograph of a white woman holding a toddler, the toddler is looking at the viewer.

You don’t have to look sick to have AIDS, AIDS Health Project, 1980s-1990s

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Black and white photograph of a white woman holding a toddler, the toddler is looking at the viewer.
Posters like this focused on the benefits of HIV testing for future mothers, who could pass the virus to their newborn babies at birth. Early testing and prenatal care made a difference: when HIV-positive mothers took advantage of the resources available to them, their children were less likely to contract the disease. A group of concerned mental health and medical professionals in San Francisco formed the AIDS Health Project (AHP) to support a growing community of people who needed emotional and psychological support as well as medical treatment. The AHP provided crucial, groundbreaking support in getting people tested: the organization offered the first large-scale testing programs along with resources to help people manage either a positive or negative result. This campaign used frank, simply put descriptions of the multiple costs of not knowing one’s HIV status, stressing the financial, personal, and family consequences of remaining ignorant.
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Black and white photograph of an African American

You don’t have to look sick to have AIDS, AIDS Health Project, 1980s-1990s

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Black and white photograph of an African American
Before a test was available, people with AIDS usually had to manifest symptoms of another infection, such as Kaposi Sarcoma or pneumonia, to learn their status and often died shortly after. HIV tests made it possible to begin treatment far earlier and with better success, but only if people sought testing before symptoms arose.
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