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

Datos Bibliográficos

ID2249603
AutoresMartin Holt (0000-0002-2586-8274, Centre for Social Research in Health UNSW Sydney Sydney Australia, autor de correspondencia), Christy E Newman (0000-0002-5482-2822, Centre for Social Research in Health UNSW Sydney Sydney Australia), K Lancaster (0000-0002-2411-7970, Centre for Social Research in Health UNSW Sydney Sydney Australia), A K Smith (0000-0002-0005-9542, UNSW Sydney), Shana D Hughes (0000-0002-1388-4103, University of California, San Francisco), Shana Hughes (Center for AIDS Prevention Studies University of California San Francisco San Francisco CA USA), Hong‐ha M Truong (0009-0001-0310-8872, Center for AIDS Prevention Studies University of California San Francisco San Francisco CA USA)
Año2019
Volumen41
Número8
Páginas1535-1548
Fecha de publicación2019-11-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSociology of Health & Illness (JOURNAL)
Identificadores de la revistaISSN: 0141-9889 • E-ISSN: 1467-9566
EditorialWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12967
PMID31215066
OpenAlexW2949962460
IdiomaEN
Citas recibidas12
Referencias citadas39

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

Condom · Environmental health · Family medicine · Gynecology · Human immunodeficiency virus (HIV) · Intervention (counseling) · Men who have sex with men · Population · Pre-exposure prophylaxis · Psychiatry · Public health · Syphilis · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing · Sex work and related issues