title: Phenomenologies of the akratic self: masculinity, regrets, and HIV among men on methadone.
abstract: This study explores the motivational bargaining processes that constitute an "act" of heterosexual HIV risk-taking by focusing on the narrative viewpoint of two men in methadone maintenance treatment programs in the Harlem section of New York City. These men reported sexual episodes with complex motivational "event grammars" that were analyzed using qualitative methods. Building on the concept of akrasia (failure to convert intentions into action), I argue that HIV risky heterosex results from temporal displacements of instrumental rationality by two other equally relevant orientations of sexual action, namely, affectual and normative. I conclude that sexual risk occurs in the context of emotions and normative presentations of the masculine self. Consequently, a man's risk of loosing footing or consistent face vis-à-vis his female sex partner, and not the risks of HIV, becomes a priority of the sexual interaction. Sexuality is at its core social and, hence, subject to more powerful forces than personal safety or behaviorist reward.
authors.affiliation: Trayectos Study (UCSF/CAPS), 4094 4th Avenue, Suite 202, San Diego, CA 92103, USA. jfontdevila@sdtrayectos.org
authors.forename: Jorge
authors.initials: J
authors.lastname: Fontdevila
mesh_terms: D000328:Adult; D004644:Emotions; D005783:Gender Identity; D006679:HIV Seropositivity; D020010:Heterosexuality; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009519:New York City; D019966:Substance-Related Disorders / Q000188:drug therapy; D047568:Unsafe Sex
chemical_list: D008691:Methadone