Accounting for HIV Risk Among Men on Methadone

This study explores accounts and reasons for engaging in HIV risk-taking behaviors reported by heterosexual men in methadone treatment programs in the Harlem section of New York City. A convenience sample of 62 men who reported having abused their female partners in the past 12 months participated in 10 focus groups. Data analysis revealed four types of HIV risky accounts, which we labeled nihilistic, hedonistic, fatalistic, and normative. The accounts were rarely found in isolation, but were delivered in rich “performative” constellations. We conclude that normative accounts in particular have important implications for HIV prevention. They show that the (hetero)sexual act is interactive “hard work” to say the least, and condoms have no role interrupting it. In the end, the risks of losing masculine face before a female partner are very much prioritized over long-run HIV risks.