Cultural discourses and HIV/AIDS activists’ meanings about PrEP

Abstract

Since the approval of pre-exposure prophylaxis (PrEP) for HIV prevention in 2012, research has increasingly considered how communities of men who have sex with men make sense of this prevention technology, often highlighting individual-level attitudes about PrEP. Drawing on interviews with 16 HIV activists, this study aimed to determine how activists make sense of advances in HIV prevention technology. Participants’ sense-making about PrEP took the form of not merely the expression of individual attitudes, but rather reflections connected to their personal biographies and activist experience. Activists sustain seemingly contradictory discourses about PrEP, at once drawing on personal biographies and a discourse central to activist history to express scepticism about PrEP, but also other discourses to justify pharmaceutical intervention for prevention. Study findings provide evidence of the importance of attending to past and present cultural discourses when examining health advocacy groups’ constructions of advances in science.

Keywords:

• PrEP
• HIV/AIDS
• activists
• discourses
• sexual health

Acknowledgements

I thank Miranda Waggoner, Douglas Schrock, Koji Ueno and Monique Santiago for their thoughtful comments and support on this manuscript. I acknowledge and thank the journal editor, administrators and anonymous peer reviewers for their consideration and productive comments. Lastly, I am grateful to the activists who took the time to participate in this study and who made this manuscript possible.

Disclosure statement

I report no potential conflict of interest.

Funding

There is no funding to report for this study.

Notes

1 In clinical trials, Descovy for PrEP, developed by Gilead Sciences, was shown to be less toxic to the kidneys and bones compared to Truvada (Beasley 2019).

2 An Op-ed posted to The Advocate by ACT UP New York charged Gilead Sciences with delaying the release of Descovy for PrEP to extend profits on Truvada for PrEP (ACT UP NY 2019).

3 In a 2015 interview in The Advocate, Larry Kramer expressed disdain for Truvada, asserting that sexual liberation was the ‘wrong thing’ to fight for. James Krellenstein shared in a 2020 Slate Op-ed that such sentiments were ‘successful in shaming young queer people about their sex lives’ and thus are indicative of a normative and responsibilised gay subjectivity.