Social scientists have much to contribute to the analysis of the real and potential contribution of pre-exposure prophylaxis (PrEP) to HIV prevention around the world. Beyond just a matter of clinical efficacy and getting pills into people's mouths, PrEP raises a number of important social-psychological questions that must be attended to in order to translate biomedical and clinical findings into uptake of PrEP among enough people at risk of HIV infection to produce population-level effectiveness. PrEP is a dynamic phenomenon with “dialectical” attributes that invite both optimism and cynicism as a desirable and effective HIV prevention strategy. PrEP disrupts traditional notions of “safe” and “unsafe” sex; it confers on its users a level of agency and control not generally achieved with condoms; and it affects sexual practices and sexual cultures in meaningful ways. As these dynamics play out in different contexts, and as new modes of PrEP administration emerge, it will be important for social scientists to be engaged in assessing their impact on PrEP implementation and effectiveness.
This article explores the meanings 18 HIV-negative gay male participants in San Francisco attributed to their positional identity as 'bottoms'. In particular, I analyze two dominant, mutually constitutive sets of sexual scripts participants invoked in their bottom narratives: first, that bottoms are men who desire to produce pleasure for their partners; and second, that bottoms are men who desire to submit sexually to their partners. I argue that these scripted conceptions both give possibility to and constrain the ways in which participants interpret and experience their sexual practices and desires. I conclude by examining how these scripts operate as structurated social phenomena that shape the ways in which participants are able to navigate scenarios in which these scripts conflict directly with 'safer sex' scripts, potentially resulting in what I term 'pleasure/risk dilemmas'.
Despite not originating in Spain, the 1918 influenza pandemic is commonly known as the “Spanish flu”—a name that reflects a tendency in public health history to associate new infectious diseases with foreign nationals and foreign countries. Intentional or not, an effect of this naming convention is to communicate a causal relationship between foreign populations and the spread of infectious disease, potentially promoting irrational fear and stigma. I address two relevant issues to help contextualize these naming practices. First is whether, in an age of global hyperinterconnectedness, fear of the other is truly irrational or has a rational basis. The empirical literature assessing whether restricting global airline travel can mitigate the global spread of modern epidemics suggests that the role of travel may be overemphasized. Second is the persistence of xenophobic responses to infectious disease in the face of contrary evidence. To help explain this, I turn to the health communication literature. Scholars argue that promoting an association between foreigners and a particular epidemic can be a rhetorical strategy for either promoting fear or, alternatively, imparting a sense of safety to the public.
At precisely the same time that gay and lesbian activists were securing marriage rights for same-sex couples nationwide, courts and "tough on crime" state legislatures were devising new ways to regulate sex. Despite recent estimates that over 750,000 Americans are registered sex offenders, few sexuality scholars have examined the growth of punitive policies regulating sex offenders. In this article, I draw on a unique set of data on the population of sex offenders in the United States to analyze: (1) whether recent trends in sex offender registration mirror those of corrections more generally, and (2) whether these policies disproportionally impact racial minorities. Findings reveal that sex offender registries grew dramatically between 2005 and 2013; that this growth is out of step with concurrent trends in corrections; and that black communities are disproportionately impacted. I conclude by considering whether these data reveal a new mode of "governing through crime" specifically targeting sex.It might as well be admitted that sex is a disgrace.Michael Warner (1999) There is a big secret about sex: most people don't like it.
A 2014 U.S. Department of Justice Best Practices Report advocates that states eliminate HIV-specific criminal penalties except under 2 conditions: when a human immunodeficiency virus (HIV)-positive person intentionally commits a sex crime or transmits the virus by engaging in behavior that poses a significant risk of transmission, regardless of actual transmission. We assess the premise of these exceptions to understand whether these best practices are based on scientific evidence about the population at risk of infection and the risk of sexual violence by HIV-positive individuals.We employ nationally representative, cross-sectional survey data from the Current Population Survey (CPS), the Survey of Inmates in State, Federal, and Local Jails (SISFLJ), and the National Health and Nutrition Survey (NHANES).Data from the CPS, SISFLJ, and NHANES are weighted and combined to analyze bias in the population at risk of HIV. Linear probability models are employed to estimate the likelihood that HIV-positive inmates are incarcerated for violent or sexual offenses, net of socioeconomic factors.We find significant measurement bias in HIV prevalence rates. The selection of national surveys for population denominators distorts contemporary estimates of HIV prevalence by 7% to 20%. Our findings also illustrate that HIV-positive inmates are 10 percentage-points less likely to be incarcerated for violent offenses than HIV-negative inmates.National best practice guidelines may undermine effective social policy that aims to curtail stigma within HIV-positive communities because scientific evidence neither include inmates into prevalence denominators (as a measure of the population at risk) nor assess the likelihood that HIV-positive inmates commit violent or sexual crimes.
Introduction
The U=U (i.e., undetectable equals untransmittable) campaign is founded upon biomedical advancements that have positioned HIV as a manageable condition with effectively zero risk of transmission. In spite of these developments, attitudes of sexual and gender minority populations regarding the necessity of seropositive status disclosure remain unexamined.
Methods
The current study analyzed qualitative data regarding the necessity of seropositive status disclosure from 62 sexual minority men as well as transgender and gender non-conforming individuals who have sex with men from 2020 to 2021.
Results
The majority of participants believed disclosure to be necessary and invoked several social and structural factors that informed their attitudes. Participants cited HIV criminalization laws, the ethics of non-disclosure, and disclosure as a means of educating sex partners when appraising the necessity of disclosure. Participants also presented concerns regarding U=U efficacy and HIV stigma.
Conclusions
Findings indicate that the disclosure of seropositive status to sex partners is still important to U=U-aware sexual and gender minority individuals. The majority of the study sample, irrespective of HIV status, believed seropositive status disclosure was necessary in advance of sex.
Policy Implications
Findings suggest opportunities for public health messaging to remediate concerns about U=U efficacy, combat misinformation, and clarify out-of-date information on HIV criminalization.
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