Your test results are protected by state and federal privacy laws. They can only be released with your permission. Whether anyone can know about your test results or your HIV status depends on what kind of test you take: confidential or anonymous. Some states only offer confidential testing.
Confidential testing means that your name and other identifying information will be attached to your test results. The results will go in your medical record and may be shared with your health care providers and your health insurance company. Otherwise, the results are protected by state and federal privacy laws.
Anonymous testing means that nothing ties your test results to you. When you take an anonymous HIV test, you get a unique identifier that allows you to get your test results.
With confidential testing, if you test positive for HIV or another STI, the test result and your name will be reported to the state or local health department to help public health officials get better estimates of the rates of HIV in the state. The state health department will then remove all personal information about you (name, address, etc.) and share the remaining non-identifying information with CDC. CDC does not share this information with anyone else, including insurance companies.
For more information, see AIDS.gov’s questions about Civil Rights, Legal Disclosure, Insurance, and the Workplace