title: Diagnostic technologies in practice: gay men's narratives of acute or recent HIV infection diagnosis.
abstract: Diagnosing HIV-positive gay men through enhanced testing technologies that detect acute HIV infection (AHI) or recent HIV infection provides opportunities for individual and population health benefits. We recruited 25 men in British Columbia who received an acute (n = 13) or recent (n = 12) HIV diagnosis to engage in a longitudinal multiple-methods study over one year or longer. Our thematic analysis of baseline qualitative interviews revealed insights within men's accounts of technologically mediated processes of HIV discovery and diagnosis. Our analysis illuminated the dialectic of new HIV technologies in practice by considering the relationship between advances in diagnostics (e.g., nucleic acid amplification tests) and the users of these medical technologies in clinical settings (e.g., clients and practitioners). Technological innovations and testing protocols have shifted experiences of learning of one's HIV-positive status; these innovations have created new diagnostic categories that require successful interpretation and translation to be rendered meaningful, to alleviate uncertainty, and to support public health objectives.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom Daniel.Grace@lshtm.ac.uk.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grace
authors.affiliation: Simon Fraser University, Vancouver, British Columbia, Canada.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Steinberg
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Kwag
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Chown
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Glenn
authors.initials: G
authors.lastname: Doupe
authors.affiliation: Community Based Research Centre for Gay Men's Health, Vancouver, British Columbia, Canada.
authors.forename: Terry
authors.initials: T
authors.lastname: Trussler
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Rekart
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Gilbert
mesh_terms: D000328:Adult; D001955:British Columbia; D002985:Clinical Protocols; D019937:Diagnostic Techniques and Procedures / Q000523:psychology*; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D033262:Narration; D036301:Qualitative Research; D012309:Risk-Taking
keywords: HIV/AIDS; experiences; health care, users’; illness and disease, experiences; knowledge construction; technology, medical