Couples HIV testing and counseling (CHTC) emerged as an early HIV prevention intervention for male couples in the US. Understanding how couples speak to a testing counselor may enhance CHTC training and delivery. Raters analyzed CHTC sessions involving 66 adult cisgender male couples and noted three distinct styles. When co-speaking, partners collaborated in the construction of a shared response, often using plural pronouns. Parallel speaking involved partners sharing individual perspectives in turn, often using singular pronouns. The spokesperson style was typified by one partner consistently speaking first and saying more. Most (65.1%) couples adopted a consistent style. The majority of these were co-speaking (72.1%). Fewer had a consistent spokesperson (18.6%) or parallel speaking style (9.3%). Where observed, style changes often accompanied shifts in topic or in the CHTC counselor's attention. A couple's communication style may provide CHTC counselors with information about partners' familiarity with each other's perspectives as well as relationship power. Implications for rapport building and engagement are discussed.