HIV pre-exposure prophylaxis and the 'problems' of reduced condom use and sexually transmitted infections in Australia: a critical analysis from an evidence-making intervention perspective.
Condom use
HIV pre-exposure prophylaxis
HIV prevention
Poststructural policy analysis
Problematisation
Sexually transmitted infections
Journal
Sociology of health & illness
ISSN: 1467-9566
Titre abrégé: Sociol Health Illn
Pays: England
ID NLM: 8205036
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
pubmed:
20
6
2019
medline:
13
5
2020
entrez:
20
6
2019
Statut:
ppublish
Résumé
HIV pre-exposure prophylaxis (PrEP) has been embraced in Australia, making PrEP available with public funding to people at risk of HIV. Here, we consider the associated 'problems' of reduced condom use and sexually transmissible infections (STIs), as seen by HIV professionals. Twenty-one interviews were conducted during May-August 2017. All agreed that PrEP was a valuable addition to HIV prevention, but their views about reduced condom use and STIs were variable. Using poststructural policy analysis, three main stances were identified: (1) Concerned/alarmed. PrEP was seen as causing reduced condom use, STIs and antibiotic resistance, posing threats to the general population; (2) Neutral/normalising. Stakeholders emphasised that condom use was declining and STIs increasing independently of PrEP, and that PrEP was simply a new tool to be accommodated; (3) Optimistic/critical. PrEP was seen as diminishing fear of HIV and engaging users in more frequent testing and treatment that could lead to declining STI rates. What linked all three stances was the selective performance of evidence, deploying a mixture of personal experience, clinical observations, behavioural data and epidemiology. Anticipating possible futures through evidence-making suggested practical, political and moral consequences for what PrEP could become. We encourage others to consider these consequences with care.
Identifiants
pubmed: 31215066
doi: 10.1111/1467-9566.12967
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1535-1548Informations de copyright
© 2019 Foundation for the Sociology of Health & Illness.
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