Abstract
Discourses of pre-exposure prophylaxis (PrEP) revel in its radical potential as a global HIV prevention technology, offering a promise of change for the broader landscape of HIV prevention. In 2018, the British Broadcasting Corporation (BBC) aired The People vs The NHS: Who Gets the Drugs?, a documentary focused on the ‘battle’ to make PrEP available in England. In this article we explore how the BBC documentary positions PrEP, PrEP biosexual citizen-activists, as well as the wider role of the NHS in HIV prevention and the wellbeing of communities affected by HIV in the UK. We consider how biosexual citizenship ( Epstein 2018 ) is configured through future imaginaries of hope, and the spectral histories of AIDS activism. We describe how The People crafts a story of PrEP activism in the context of an imagined gay community whose past, present, and hopeful future is entangled within the complexities and contractions of a state-funded health system. Here, PrEP functions as a ‘happiness pointer’ ( Ahmed 2011 ), to orient imagined gay communities towards a hopeful future by demanding and accessing essential medicines and ensuring the absence of needless HIV transmissions. This biomedical success emerges from a shared traumatic past and firmly establishes the salvatory trajectory of PrEP and an imagined gay community who have continued to be affected by HIV. However, campaigns about the individual's right to access PrEP construct the availability and consumption of PrEP as an end goal to their activism, where access to PrEP is understood as an individual's right as a pharmaceutical consumer.
Highlights
pre-exposure prophylaxis (PrEP) is a prevention strategy for people who are HIV-negative
We suggest PrEP imaginaries – and in particular how PrEP activism is positioned and/or curated as a cultural object of community storytelling within this well-established visual history of AIDS activism – are, at present, little explored within current social science and humanities PrEP scholarship
How does biosexual citizenship and PrEP activism sit within and speak to the wider history of HIV, and how is this portrayed? What role is played by the changing somatechnic assemblages of HIV in the development of PrEP imaginaries, the complex and undefined relationship between embodiment, technology, and bodily practice (Pugliese and Strkyer 2009)? In this article we focus on how the British Broadcasting Corporation (BBC) documentary positions PrEP, PrEP biosexual citizen-activists, as well as the wider role of the National Health Service (NHS) in HIV prevention and the wellbeing of communities affected by HIV in the UK
Summary
PrEP is a prevention strategy for people who are HIV-negative. This is the use of existing (tenofovir-based) HIV antiretrovirals which can either be taken daily or ‘on-demand’. Citizens’ own actions, or inactions, are understood as fundamental to their own (and others’) capacity for ‘risk’ or ‘vulnerability’ to disease This produces a personal responsibility – or obligation of sexual citizenship – and an ‘ongoing activity of self-actualisation’ (599) which places expectations upon – in this case – gay men to perform specific healthy and medicalised practices (Squire 2009), and to demonstrate particular identities; a duty to ‘become the right type of person’ (Keogh 2008: 600). We agree with Epstein that biosexual citizenship is about the interplay between, across, and at times in tension with the sexual (sexual meanings, practices, and/or identities) and biological (biomedicine and public health) To apply this to PrEP activism, it is important to consider if and how somatechnic assemblages of HIV are formed through PrEP activists’ interactions with health systems (Pugliese and Stryker 2009), and to consider who these activists are and how these collectives are socially situated. We are interested in how biosexual citizenship is configured through these future imaginaries of hope, a sense of what kind of lives count as a ‘good life’ (164), and the spectral histories of AIDS activism
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