“A good consultation is a consultation where you didn't speak”: HIV counselling as a denied and socially differentiated form of pedagogical authority

ABSTRACT

AIDS-related death rates have dropped considerably since antiretroviral therapies became available in 1996, just as David Silverman was finishing his study of pre- and post-HIV test counselling. Twenty years later, HIV counselling is ripe for a revisit, in the tradition of sociological re-examination of health-care practices after a major therapeutic development has altered the stakes. The article is based on observations of 214 consultations prior to or following HIV testing that took place in France between 2012 and 2014. It demonstrates that HIV screening workers deny the pedagogical authority underlying their work, and analyses the conditions under which they vary their advice according to the social properties of the person being counselled.

KEYWORDS:

• HIV
• medical screening
• counselling
• health inequalities
• medical work
• health education

Acknowledgements

The author would like to thank Dominique Memmi and Patrice Pinell for their guidance as dissertation advisors. This research was partly funded by Sidaction, a French non-profit organisation for the fight against HIV and the respect of HIV-positive people. Translation funding was provided by the CRESPPA-CSU, and the article was translated into English by Juliette Rogers.

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Funding

This research was partly funded by Sidaction, a French non-profit organisation for the fight against HIV and the respect of HIV-positive people. Translation funding was provided by the CRESPPA-CSU, and the article was translated into English by Juliette Rogers.