At Risk: Rhetoric, Deviance, and the Politics of HIV Prevention

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.