HIV Testing Among “MSM”: Prevention Technologies, Sexual Moralities and Serologic Self-surveillance

Abstract

Global AIDS guidelines have prioritized the expansion of HIV testing among the groups most exposed to the virus, such as those referred to as men who have sex with men (MSM). This paper analyses the relationships between the production of prevention strategies and sexual moralities based on the results of a systematic review of academic literature about testing with gays and MSM (2005-2015, using the PubMed, Sociological Abstract and Lilacs databases). The analysis of 65 articles reveals the recruitment strategies for identifying target-subjects and how they are held responsible for their serological self-surveillance, including routine tests. The findings also point to a diversification of testing locations. Implicit assumptions about sexuality and gay affection are conveyed through the interventions’ emphasis on sociability spaces and occasional sex, especially when facilitated by the use of apps. Attentive to the symbolic dimensions of the new prevention technologies and strategies, we argue that the expansion of testing with a focus on “MSM” signals a displacement of health interventions. If before actions to control the epidemic sought to intervene in sexual practices, the current efforts are concentrated on promoting self-surveillance of one’s serological status.

Aids em cartazes: representações sobre sexualidade e prevenção da Aids nas campanhas de 1º de dezembro no Brasil (2013-2017)

“…If pre-CP campaigns appealed for condoms and the management of affects and erotic interactions -particularly in those relationships regarded as stable 8 -now the motto for accountability is directed to 'self-awareness'. This would be one of the effects of the growing incentive to incorporate testing into the subjects' daily lives, as illustrated by an analysis of the international literature on test uptake strategies among the so-called MSM 32 .…”

Testagem para o HIV e profilaxia pós-exposição entre homens que fazem/ não fazem sexo com homens

“…Men who do not have sex with men can also practice anal intercourse sex, and have historical, cultural, social and behavioral conditions of vulnerability to HIV and other STIs, but are left on the sidelines in prevention policies or are covered in general educational materials. 24,25 In Botswana, men were the least aware of their HIV status. After intervention with the local community, the level of knowledge of HIV status increased 37% among males and 77% among youth.…”

“…The individual has the right to exercise his/her sexuality with freedom and autonomy, and the access to information, education and knowledge in relation to STI/HIV/AIDS prevention is inherent to sexual and reproductive rights. 25…”

Dificuldades no acesso aos serviços de saúde por lésbicas, gays, bissexuais e transgêneros

“…33 It is understood that the involvement of STIs by LGBT individuals may occur due to non-use of condoms, injecting drug use and, above all, lack of knowledge of their serology, factors related to non-access to health services and contribute to the non-treatment, adherence and follow-up of these individuals. 27,34 It is noted that the LGBT population, for a long time, was the group that was predominantly associated with the involvement and spread of HIV/AIDS. 35 It is understood that this association, in the early 80's, was mainly linked to homosexual individuals and transvestites, expanding the stigma, prejudice and homotransphobia contexts already existing in society.…”