In this thesis, I examine an ASO in Pittsburgh, Pennsylvania, in order to explore how case managers interpret the complex needs that HIV-positive clients present while trying to encourage them to become responsible citizens. The data are drawn from participant observation, structured interviews with case managers, and a content analysis of case managers' notes in clients' files. I find that clients do not regularly ask for services related to health maintenance, case managers negotiate surveillance and empowerment strategies in four ways, and external factors complicate case managers' ability to carry out their jobs in a climate of surveillance and empowerment. I conclude that responsible citizenship, in the sense of describing how case managers encourage clients to become more self-sufficient, is present in the language that case managers use to depict their approach to case management with clients
