‘Don’t lose it on the bus!’: casting the normative biosexual citizen in early Scottish pre-exposure prophylaxis provision

Young, I. and Boydell, N. (2023) ‘Don’t lose it on the bus!’: casting the normative biosexual citizen in early Scottish pre-exposure prophylaxis provision. Sociology of Health and Illness, 45(5), pp. 1046-1062. (doi: 10.1111/1467-9566.13632) (PMID:36920962)

Abstract

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.

• Item Type: Articles
• Additional Information: This research was funded by Scottish Chief Scientist Office Postdoctoral Fellowship (PDF/14/02; CF/CSO/02). Nicola Boydell is supported by the Health Foundation’s grant to the University of Cambridge for The Healthcare Improvement Studies Institute. Ingrid Young & Nicola Boydell are currently members of the Wellcome supported Centre for Biomedicine, Self and Society (209519/Z/17/Z).
• Keywords: HIV/AIDS, inequalities, pre‐exposure prophylaxis (PrEP), sexual health.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Boydell, Dr Nicola and Young, Dr Ingrid
• Authors: Young, I., and Boydell, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU; College of Social Sciences > School of Social and Political Sciences
• Journal Name: Sociology of Health and Illness
• Publisher: Wiley
• ISSN: 0141-9889
• ISSN (Online): 1467-9566
• Published Online: 15 March 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Sociology of Health and Illness 45(5):1046-1062
• Publisher Policy: Reproduced under a Creative Commons license

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
170578		Addressing HIV literacy and inequalities in an era of biomedical HIV prevention: supporting the wellbeing of communities most affected by HIV in Scotland	Ingrid Young	Office of the Chief Scientific Adviser (CSO)	PDF/14/02	HW - MRC/CSO Social and Public Health Sciences Unit