'On December 1, 2015, sex changes. Forever': Pre-exposure prophylaxis and the pharmaceuticalisation of the neoliberal sexual subject. Issue 8 (3rd August 2018)

• Record Type: Journal Article
• Authors: Thomann, Matthew
• Is Part Of: Global public health. Volume 13:Issue 8(2018)
• Page Start: 997
• Page End: 1006
• Publication Date: 2018-08-03
• Subjects: Pre-exposure prophylaxis -- biomedical interventions -- HIV prevention and treatment -- men who have sex with men -- neoliberalism; Public health -- Periodicals; 362.105
• DOI: 10.1080/17441692.2018.1427275
• Languages: English
• ISSNs: 1744-1692

Abstract

ABSTRACT: The global scale-up of AIDS treatment initiatives during the first decade of the twenty-first century has been referred to as a kind of 'pharmaceuticalisation' of public health, a trend that is now building in the area of HIV prevention. This paper traces the emergence and increased uptake of pre-exposure prophylaxis (PrEP), antiretroviral medications that can keep HIV negative individuals from becoming infected, placing it within the broader (re)casting of HIV prevention as a medical and technological problem that has been central to the recent 'end of AIDS' discourse. While HIV prevention discourses have been grounded in a neoliberal calculus of individual responsibility since the late 1990s, PrEP constitutes a pharmaceutical extension of the responsibilised sexual subject. Central to this extension are the acknowledgment of one's risk and a willingness to take pre-emptive medical action to secure a future without HIV. For men who have sex with men, a population heavily targeted for biomedical interventions in the United States, PrEP marks a shift in moral discourses of what it means to be a responsible sexual subject. Characteristics of the pharmaceutical extension of the neoliberal sexual subject are explored through an examination of a New York City-based PrEP promotional campaign.