User Resistance in HIV Technology Design: Toward a Critical Participatory Rhetoric for Technical and Professional Communication

Abstract

This dissertation investigates the digital risk communication practices of 14 young people living with HIV, part of a community-driven initiative to involve youth as participants in developing a digital tool to support HIV risk reduction. While many health practitioners and technical communication scholars involve end-users as participants in design settings, and researchers have pointed to digital health technologies as opportunities to reach vulnerable populations and mitigate health disparities, this study found that youth often resisted digital infrastructures to encourage risk reduction. Participants rarely listed their serostatus on dating applications, interacted with HIV-focused social media pages, or incorporated digital platforms into their healthcare management. This study extends on participatory theories in technical communication and technology design by focusing on these moments of resistance, when individuals refuse technology-based initiatives or subvert systems designed to include them. Drawing from histories of resistance in queer theory and HIV activism, this study argues that these unruly and resistant user experiences complicate dominant narratives about sexual health and envision alternative epistemologies of HIV risk. Developing participatory infrastructures that center on these ulterior health practices can enable more equitable healthcare arrangements that reflect the situated risk communication expertise of people living with HIV.