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For thirty years, researchers in bioethics have been interested in the boundaries separating therapeutic research from standard clinical management. An important concept in international literature on this subject is that of “therapeutic misconception.” This covers the possibility of confusion, on the part of participants in clinical trials, between research and the practice of routine clinical care. This article examines the relevance of the concept through the ethnography of three therapeutic trials on HIV carried out in Senegal, as well as the analysis of the experience of the participants in these trials. If there is confusion, the anthropological approach shows that it mostly stems from structural factors differing from those the theorists of the concept draw upon; hence, their normative propositions should consider the specific contexts in which clinical research is conducted.