Abstract
IntroductionUnder austerity, governments shift responsibilities for social welfare to individuals. Such responsibilization can be intertwined with pre-existing social stigmas, with sexually stigmatized individuals blamed more for health problems due to “irresponsible” sexual behavior. To understand how sexual stigma affects attitudes on government healthcare expenditures, we examine public support for government-provisioned PrEP in England at a time when media narratives cast the drug as an expensive benefit for a small, irresponsible social group and the National Health Service’s long-term sustainability was in doubt.MethodsThis paper uses data from an original survey (N = 738) conducted in September 2016, when public opinion should be most sensitive to sexual stigma. A survey experiment tests how the way beneficiaries of PrEP were described affected support for NHS provision of it. Contrary to expectations, we found that support was high (mean = 3.86 on a scale of 1 to 5) irrespective of language used or beneficiary group mentioned. Differences between conditions were negligible.DiscussionSexual stigma does not diminish support for government-funded PrEP, which may be due to reverence for the NHS; resistance to responsibilization generally; or just to HIV, with the public influenced by sympathy and counter-messaging.Social policy implicationsHaving misjudged public attitudes, it may be difficult for the government to continue to justify not funding PrEP; the political rationale for contracting out its provision is unnecessary and flawed. With public opinion resilient to responsibilization narratives and sexual stigma even under austerity, welfare retrenchment may be more difficult than social policymakers presume.
Highlights
Under austerity, governments shift responsibilities for social welfare to individuals
This comparison shows essentially no difference, with almost identical means (3.860 for conditions mentioning gay people compared to 3.861 for those that do not, t(420) = 0.01, p = .99). This fails to support our first hypothesis (H1), which suggested that descriptions of pre-exposure prophylaxis (PrEP) studies that dealt with gay men would garner less support than those that did not
Using the case of the 2016 National Health Service England (NHSE) decision against funding PrEP, we show how—contrary to expectations—sexual stigma against perceived beneficiaries, even in times of austerity, do not necessarily move public support for the government provision of healthcare interventions seen to benefit these groups
Summary
Governments shift responsibilities for social welfare to individuals Such responsibilization can be intertwined with pre-existing social stigmas, with sexually stigmatized individuals blamed more for health problems due to “irresponsible” sexual behavior. To understand how sexual stigma affects attitudes on government healthcare expenditures, we examine public support for government-provisioned PrEP in England at a time when media narratives cast the drug as an expensive benefit for a small, irresponsible social group and the National Health Service’s long-term sustainability was in doubt. Elected officials are sensitive to public opinion on healthcare spending Under this backdrop, a key question emerges that is of great import for the health and wellbeing of sexual minorities: in times of austerity, does sexual stigma affect public support for new government spending seen to benefit “risky” and “irresponsible” individuals, such as gay men? A key question emerges that is of great import for the health and wellbeing of sexual minorities: in times of austerity, does sexual stigma affect public support for new government spending seen to benefit “risky” and “irresponsible” individuals, such as gay men? More generally, how does the framing of preventative drugs associated with risk taking and sexual minorities affect public attitudes on the government provision of them?
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