Managing risk, managing affects: The emerging biopolitics of HIV neutrality

Abstract

Discourses of HIV status neutrality have emerged in the wake of advances in biomedical technologies for HIV prevention and treatment of HIV. The combined effects of Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) give rise to the possibility of dramatically curbing new HIV infections and nurture fantasies about an HIV-free/risk-free futurity. In this article, we consider the possibilities of HIV neutrality as a social-material assemblage entangling different institutional investments and practices, discourses about HIV risk and prevention, historical memories, political rationalities, and as a generative point of contact between and across different actors, institutions and objects. We explore the different logics and sentiments that are being drawn together in three different sites where HIV neutrality is configured. Borrowing from cultural and social science approaches that grapple with emotions and feelings as ‘distributed phenomena’ that carry political and social significance, we interrogate the work of HIV neutrality in effecting new tensions in the affective economies underpinning gay sexual socialities’ relation to HIV/AIDS and HIV risk. Our analysis suggests that as these new social-material strategies emerge to manage HIV risk, they entangle historically sedimented effects of HIV/AIDS. We ask to what extent these assemblages are productive of new intimacies and alliances, and possibly renewed entrenchments of bio-social boundaries cutting across gay male socialities in North America.

Keywords:

• Risk
• HIV
• affective economies
• Gay men
• preexposure prophylaxis (PrEP)

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. In this article we focus specifically on men who have connections to gay men’s socialities. We use the term queer or queer men throughout the article to demarcate this connection, and to signal a set of social-sexual practices and embodiments that may include but can also be in excess of identity categories such as ‘gay’.

2. This interview together with associated in-person interviews with Damon Jacobs, founder of PrEP Facts (see Methods section are components of a New York Based study (2015–2017) We examined the ways in which queer men’s embodied understandings of intimacy and health risk were being reconfigured at the nexus of HIV prevention and social media technologies. We received consent from Jacobs to use his direct quote explaining the mission of PrEP Facts in the “about section of the Facebook home page. Ethics approval was granted through (UNIVERSITY) Institutional Review Board, March 2015.

3. We thank the editor of this Journal, Patrick Brown, for suggesting this connection

4. While the use of social marketing for promoting public health and addressing the socially embedded nature of health problematics has its origins in the United States – and indeed has become a significant actant in US health domains (Kotler & Lee, 2008) – its relative influence in other countries requires careful consideration.