Martinez-Lacabe Alvaro
University of Sussex, UK.
Health (London). 2025 Mar;29(2):220-235. doi: 10.1177/13634593241238862. Epub 2024 Mar 18.
Framed across three distinct periods of the history of neoliberalism and the HIV epidemic in England, this article conducts a detailed examination of the concept of personal responsibility and its contested uses within HIV prevention. The article questions the theoretical potential of neoliberal subjectivities to comprehend behaviours related to the pharmaceuticalised governance (or lack thereof) of gay men's sexual health, exploring the gap between theories emphasising individual responsibility and the practical experiences of gay men. The analysis draws on testimonials from gay men in oral history interviews and archival sources. The article illustrates how the pervasive notion of personal responsibility in England has been co-opted by neoliberal ideologies, leading to the stigmatisation of gay men whose sexual behaviours diverge from public health mandates. The widespread stigmatisation resulting from this ideology underscores a significant limitation in the theoretical framework of neoliberal subjectivities. This constraint extends beyond merely failing to grasp the complexity of sexual behaviours; it also reflects a lack of understanding of any other behaviour related to public health. Therefore, the article concludes by advocating the necessity of employing and constructing alternative theoretical frameworks to comprehend the pharmaceutical governance or lack thereof of gay men's sexual health. Through a concise autoethnography of the authors' pharmaceutical sexual health governance, the article introduces the concept of biocommesuration as an illustrative analysis that transcends the limitations of neoliberal subjectivities.
本文跨越英国新自由主义历史和艾滋病流行的三个不同时期,详细考察了个人责任的概念及其在艾滋病预防中的争议性应用。文章质疑新自由主义主体性在理解与男同性恋者性健康的药物治理(或缺乏药物治理)相关行为方面的理论潜力,探讨强调个人责任的理论与男同性恋者实际经历之间的差距。分析借鉴了口述历史访谈中男同性恋者的证词和档案资料。文章说明了英国普遍存在的个人责任观念是如何被新自由主义意识形态所利用的,导致那些性行为偏离公共卫生要求的男同性恋者受到污名化。这种意识形态导致的广泛污名化凸显了新自由主义主体性理论框架的重大局限性。这种限制不仅在于未能把握性行为的复杂性;它还反映出对任何其他与公共卫生相关行为的理解不足。因此,文章最后主张有必要采用和构建替代理论框架,以理解男同性恋者性健康的药物治理或缺乏药物治理的情况。通过对作者药物性健康治理的简要自我民族志研究,文章引入了生物计量的概念,作为超越新自由主义主体性局限性的一种说明性分析。