“At Risk impressively integrates scholarship in rhetoric of health and medicine, technical and professional communication, and queer rhetorics, extending ever-relevant conversations about rhetorical risk and resistance. Green demonstrates the need to account for sociopolitical systems and contexts in a richly contextualized and illustrative way. Our fields need more books like this.” —J. Blake Scott, author of Risky Rhetoric: AIDS and the Cultural Practices of HIV Testing
“A thoughtful, engaging, and meaningful contribution, At Risk disrupts the idea that healthy and risky behaviors are binary opposites and compellingly shows that we need a more precise and robust vocabulary of deviance in health and medicine. At the same time, it invites and challenges us to consider what ‘health’ means and who is allowed to define, access, or practice healthfulness.” —Molly Margaret Kessler, author of Stigma Stories: Rhetoric, Lived Experience, and Chronic Illness
At Risk explores how young people living with HIV have developed risk reduction practices that seem to contradict public health recommendations for HIV prevention. Putting forward a rhetoric of deviance to frame these instances, McKinley Green argues that they represent intentional healthcare decisions that help young people mitigate the health risks that are most pressing in their daily lives. While current HIV risk reduction priorities in the US are framed around a finite spectrum of sexual behaviors and medical technologies, those living with HIV often encounter a broader spectrum of risks shaped by structural inequities like racism, housing insecurity, queer and transphobia, HIV stigma, trauma in medical settings, and addiction, all of which create conditions that increase the risk of HIV transmission and present other threats to safety and autonomy.
Drawing from more than sixty hours of interviews with young people living with HIV, frontline healthcare workers, and HIV activists, Green highlights how those living with HIV have developed agency and expertise in navigating, mitigating, and communicating about risk. In doing so, he offers alternative epistemologies of sexual health risk that point toward more patient-centered HIV prevention frameworks.
McKinley Green is Assistant Professor of English at George Mason University. His research has appeared in Rhetoric of Health and Medicine, Reflections, Technical Communication Quarterly, The Journal of Technical Writing and Communication, and Computers and Composition.
Contents
List of Illustrations
Preface
Introduction
Chapter 1 “It’s Not Because of the Behaviors . . . It’s the Broken System”: Biomedicine’s Social Foundations
Chapter 2 “Did I Potentially Just Expose Myself?”: Surveillance and Stigma in mHealth Technologies for HIV Prevention
Chapter 3 “Thanks, My Asshole Is Very Clean”: Nondisclosure as Risk Reduction on Grindr
Chapter 4 “Prefer Not to Say”: Pleasure and Infectious Disease Surveillance
Conclusion
Acknowledgments
References
Index
