Constructing victimhood in Canadian news coverage of HIV criminalisation: Claims-making activities and HIV non-disclosure.

A robust body of research has documented the representational politics of news coverage in their depiction of HIV-positive people charged for HIV non-disclosure. News media representations of HIV-negative sex partners in cases of HIV non-disclosure have received far less scholarly attention. Adopting a social constructionist perspective, this article identifies how "victims" of HIV non-disclosure are constructed in news media. It is based on a dataset consisting of 341 news articles on HIV non-disclosure from 14 English Canadian newspapers across the political spectrum. Victims of HIV non-disclosure were constructed as: (1) suffering horribly, (2) morally pure and virtuous, (3) vengeful and (4) agentic and responsible for their situation. We consider how such constructions are enmeshed within arguments that establish or reject HIV non-disclosure as a social problem. We then discuss the ways these constructions and the assumptions upon which they are based reflect broader discussions on the severity of HIV, the responsibility for HIV risk and exposure, and the contestations over the very nature of the social problem of HIV non-disclosure. Constructions of victims that uphold HIV criminalisation have relied on assumptions of HIV as a deadly disease but de-emphasise personal responsibility for HIV risk. By contrast, constructions of victims that, in effect, oppose HIV criminalisation have tended to minimise the harms of HIV and invoke personal responsibility for HIV risk. We suggest that both proponents and opponents of HIV criminalisation engage in the "ideology of victimhood" and thus participate in and reinforce what Best (1997) termed, the "victim industry."

De nombreux travaux de recherche ont mis en évidence les politiques de représentation de la couverture médiatique dans leur représentation des personnes séropositives accusées de ne pas avoir révélé leur séropositivité. Les représentations médiatiques des partenaires sexuels séronégatifs dans les cas de non-divulgation du VIH ont reçu beaucoup moins d'attention de la part des chercheurs. Adoptant une perspective constructionniste sociale, cet article identifie comment les « victimes ¼ de la non-divulgation du VIH sont construites dans les médias d'information. Elle est basée sur un ensemble de données comprenant 341 articles de presse sur la non-divulgation du VIH provenant de 14 journaux canadiens anglais de tous les horizons politiques. Les victimes de la non-divulgation du VIH ont été construites comme suit : (1) souffrant horriblement, (2) moralement pures et vertueuses, (3) vengeresses, et (4) agissantes et responsables de leur situation. Nous examinons la manière dont ces constructions sont imbriquées dans les arguments qui établissent ou rejettent la non-divulgation du VIH en tant que problème social. Les constructions de victimes qui soutiennent la criminalisation du VIH s'appuient sur des hypothèses selon lesquelles le VIH est une maladie mortelle, mais minimisent la responsabilité personnelle face au risque de VIH. En revanche, les conceptions des victimes qui s'opposent à la criminalisation du VIH ont tendance à minimiser les effets néfastes du VIH et à invoquer la responsabilité personnelle dans le risque d'infection. Nous suggérons que les partisans et les adversaires de la criminalisation du VIH s'engagent dans «l'idéologie de la victimisation¼ et participent ainsi à ce que Best (1997) a appelé «l'industrie de la victimisation et la renforcent.

Qualitative analysis in gay men's health research: comparing thematic, critical discourse, and conversation analysis.

Gay men's health typically relies on traditional forms of qualitative analysis, such as thematic analysis, and would benefit from a diversity of analytic approaches. Such diversity offers public health researchers a breadth of tools to address different kinds of research questions and, thus, substantiate different types of social phenomenon relevant to the health and wellbeing of gay men. In this article, I compare and contrast three qualitative analytic approaches: thematic, critical discourse, and conversation analysis. I demonstrate and distinguish their key analytic assumptions by applying each approach to a single data excerpt taken from a public health interview conducted for a broader study on gay men's health. I engage in a discussion of each approach in relation to three themes: its utility for gay men's health, its approach to dilemmas of voice, and its capacity for reflexivity. I advocate that qualitative researchers should capitalise on the full range of qualitative analytic approaches to achieve the goals of gay men's health. However, I specifically encourage qualitative researchers to engage with conversation analysis, not only because of its capacity to resolve dilemmas of voice and to achieve reflexivity, but also for its ability to capture forms of social life hitherto undocumented through thematic and critical discourse analysis.

"It's not rocket science, what I do": Self-directed harm reduction strategies among drug using ethno-racially diverse gay and bisexual men.

BACKGROUND: Research on harm reduction has typically focused on broad-based or organisational strategies such as needle exchange and opiate substitute programmes. Less attention has been paid to the self-directed harm reduction practices of substance users themselves. Few studies have focused on sexual minority populations such as gay and bisexual men and fewer still on the marginalised groups that constitute these populations. This paper identifies self-directed harm reduction strategies among substance using ethno-racially diverse gay and bisexual men. METHODS: This article presents findings from the Party Drugs Study in Toronto's gay dance club scene, a community-based qualitative study in Toronto, Canada. We present a thematic analysis of interviews with 43 gay and bisexual men from diverse ethno-racial backgrounds about their substance use in the gay dance club scene. FINDINGS: We identify five self-directed harm reduction strategies: rationing, controlling or avoiding mixing, controlling quality, maintaining a healthy lifestyle, and following guidelines during substance use. CONCLUSIONS: We discuss our findings in relation to prior research and to critical theory. We suggest that drug users' awareness of possible harm, and their personal investment in harm reduction, constitute a viable platform from which community-based and public health organisations may promote and strengthen harm reduction among gay and bisexual men from ethno-racially diverse backgrounds.

'I've heard wonderful things about you': how patients compliment surgeons.

This investigation was motivated by physician reports that patient compliments often raise 'red flags' for them, raising questions about whether compliments are being used in the service of achieving some kind of advantage. Our goal was to understand physician discomfort with patient compliments through analyses of audiotaped surgeon-patient encounters. Using conversation analysis, we demonstrate that both the placement and design of compliments are consequential for how surgeons hear and respond to them. The compliments offered after treatment recommendations are neither designed nor positioned to pursue institutional agendas and are responded to in ways that are largely consistent with compliment responses in everyday interaction, but include modifications that preserve surgeons' expertise. In contrast, some compliments offered before treatment recommendations pursue specific treatments and engender surgeons' resistance. Other compliments offered before treatment recommendations do not overtly pursue institutionally-relevant agendas-for example, compliments offered in the opening phase of the visit. We show how these compliments may but need not foreshadow a patient's upcoming agenda. This work extends our understanding of the interactional functions of compliments, and of the resources patients use to pursue desired outcomes in encounters with healthcare professionals.

Accounts of HIV seroconversion among substance-using gay and bisexual men.

Statistical associations between substance use and seroconversion among gay and bisexual men abound. However, these associations often ignore men's own interpretations of their seroconversion. Using in-depth interviews with gay and bisexual men who reported using drugs or alcohol at the time of their seroconversion, we identify how these men explain the events that led to HIV transmission. Whereas a small minority of respondents reported substance use to explain their seroconversion, the majority reported three competing explanations. These participants claimed that they lacked sufficient knowledge about the behavioral risks that led to their seroconversion; that their decision to engage in unsafe sex was because of negative personal affect; and that they "trusted the wrong person." We link these findings to prevention and suggest that gay and bisexual men who use substances for recreational purposes will benefit from prevention efforts designed to address issues of gay and bisexual men rather than substance-using men.

A discursive approach to disinhibition theory: the normalization of unsafe sex among gay men.

HIV research and prevention commonly cite disinhibition theory as an explanation for HIV infection among gay men. Analyzing qualitative interview data in which men talk about recreational substance use and their safer sex practices, we interrogate the concept of disinhibition theory from a discursive perspective. From this perspective, we treat talk not as a route or resource to something presumed to lie beyond the talk, but as a form of action designed for its interactional context. We demonstrate how the men normalize unsafe sex through constructions of disinhibition as common and widespread. In doing so, the men manage accountability for their own experiences with foregoing condom use while using substances. Our analysis demonstrates the men's displayed concerns to avoid individualized explanations for having engaged in unprotected sex. This may explain why some gay men may resist HIV prevention campaigns, based on these very individualized explanations.

Impact on HIV test providers of giving a positive test result.

The provision of a positive HIV antibody test result and the direction and support given to the test recipient are critical components of care and prevention. There has been little research that describes what happens in such interactions between recipient and provider. The impact on the test provider of delivering the HIV test result is an important issue to consider. The discomfort experienced by some health providers in giving a positive test result may have adverse effects on the client interaction or may carry over into subsequent client interactions. Utilizing a thematic analysis on interview data from 24 HIV test providers, we describe the impact of delivering a positive test result on HIV test providers, identify the factors that influence this impact, and describe strategies used to manage the impact. As with other health care professionals communicating "bad news,"HIV test providers experience a variety of impacts. While a small number of providers indicated little or no impact of delivering the HIV positive test result because the diagnosis is ''not the end of the world,'' most indicated it was difficult as it was anticipated that the test recipient would (or did) find the news distressing. Several coping strategies were identified.