Centre for Biomedicine, Self and Society, Usher Institute, University of Edinburgh, Edinburgh, UK.
Sociol Health Illn. 2023 Jun;45(5):1046-1062. doi: 10.1111/1467-9566.13632. Epub 2023 Mar 15.
The introduction of HIV pre-exposure prophylaxis (PrEP) raises important questions around how new biotechnologies are negotiated within contemporary settings and how they can shape the moral governance of biocitizens, or as we explore, biosexual citizens. This article draws on qualitative interviews and focus groups to consider how the normative biosexual citizen was cast at the start of provision in Scotland by clinical and community practitioners. Our findings show how practitioners navigated ideas around who was deserving of support and access to PrEP in the context of limited resources, interpreted what legitimate risk narratives might look like for different groups and translated particular gendered, sexualised and racialised risk profiles in the context of PrEP provision. This draws attention to how normative biosexual citizenship was not determined through meeting a set of clinical criteria and adhering to a prophylaxis regime but cast through ongoing negotiations with clinical and community practitioners in relation to normative ideas of essential care, constrained resources, risk narratives and gendered and racialised bodies. Our research indicates how access to PrEP will continue to demand particular enactments of normative biosexual citizenship that may well be at odds with the experiences and needs of communities affected by HIV.
HIV 暴露前预防 (PrEP) 的引入引发了一些重要问题,即新的生物技术在当代环境下是如何被协商的,以及它们如何塑造生物公民的道德治理,或者如我们所探讨的,生物性行为公民的道德治理。本文通过定性访谈和焦点小组,考虑了临床和社区从业者在苏格兰开始提供 PrEP 时,如何塑造规范的生物性行为公民形象。我们的研究结果表明,从业者在资源有限的情况下,如何围绕谁应该得到支持和获得 PrEP 的问题进行了探讨,解释了对于不同群体而言,合法的风险叙述可能是什么样子,并在 PrEP 提供的背景下,对特定的性别化、性化和种族化风险特征进行了翻译。这引起了人们对规范的生物性行为公民身份不是通过满足一系列临床标准和遵守预防方案来确定的,而是通过与临床和社区从业者就基本护理、资源受限、风险叙述以及性别化和种族化的身体的规范性观念进行持续协商来确定的。我们的研究表明,获得 PrEP 将继续要求特定的规范生物性行为公民身份的表现,这可能与受 HIV 影响的社区的经验和需求不一致。