title: Responsibility and risk: accounts of reasons for seeking an HIV test.
abstract: Using data from recordings of HIV test counselling sessions in publicly funded sites in Northern California, US, this paper examines the discussion of clients' reasons for testing as a site for self-presentation. While counsellors attempt to use the reason for testing discussion as a lead-in to a discussion of risk behaviour, clients often describe their testing as part of a routine, not in response to a specific risk. Clients use three practices to present themselves as reasonable and responsible people who are in control of their HIV status. First, clients present the normal and routine nature of testing, thereby portraying their reasonableness in seeking an HIV test. Secondly, clients deny or downgrade their risk when counsellors seek to identify a specific risk. Thirdly, when introducing a particular risk, clients package it within mitigating contexts that emphasise their knowledge about and control over the risk. These practices can make it difficult for counsellors to focus the counselling session on a specific risk incident. One of the counsellors in our dataset provides an alternative approach that manages to elicit risk and legitimates routine testing as a reason for testing.
authors.affiliation: Seung-Hee Lee, Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94105, USA. seung-hee.lee@ucsf.edu
authors.forename: Seung-Hee
authors.initials: SH
authors.lastname: Lee
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sheon
mesh_terms: D002140:California; D003376:Counseling; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D018570:Risk Assessment; D013637:Tape Recording