‘HIV Both Starts and Stops with Me’: Configuring the Neoliberal Sexual Actor in HIV Prevention
This article argues that newer HIV prevention campaigns and health promotions that focus on reaching the public with information on how to prevent HIV infections or treat them once a person becomes HIV positive are mainly built upon the rationale of what has been called ‘a neoliberal sexual actor’. The sexual actor being represented is predicated upon the tenets of a neoliberal subject wherein market choice, rational risk analysis, personal responsibility, and personal entrepreneurship are in focus. Whereas many of the newer health promotions are built upon the tenets of neoliberalism, these health promotions while being both inclusive in terms of sexualities and racialized identities nevertheless play on neoliberal ideals that may or may not be available for the people who are most vulnerable in terms of HIV risk. The article ends up by arguing that while many of these health promotions are both ‘sex-positive’ and avoid the specter of ‘risk’ and ‘infection’ and rather play on neoliberal concepts, they nevertheless also leave behind those that for whatever reasons cannot comply with or access these tenets. In an era when the HIV effort strongly plays on a rhetoric of ‘leaving no one behind’ such an overt focus on the neoliberal concepts of free choice, market freedom, personal responsibility, and ‘rational’ risk calculation, might end up leaving behind the most vulnerable people within the HIV epidemic.
KeywordsHIV/AIDS Neoliberalism PrEP Prevention Health promotions
I would like to thank the journal editor as well as the anonymous reviewer who gave invaluable advice and whose comments really lifted the article as a whole.
This study was done in connection to post-doctoral research work at the place of employment of the author, but no specific funding grant was funding this study.
Compliance with Ethical Standards
Conflict of interest
This article does not contain any studies with human participants or animals performed by any of the authors.
- Brown, W. (2009). Edgework: Critical essays on knowledge and politics. Princeton: Princeton University Press.Google Scholar
- Chakrapani, V., Newman, P. A., Shunmugam, M., Logie, C. H., & Samuel, M. (2017). Syndemics of depression, alcohol use, and victimization, and their association with HIV-related sexual risk among men who have sex with men and transgender women in India. Global Public Health, 12(2), 250–265.CrossRefGoogle Scholar
- Foucault, M. (2007). Security, territory, population: Lectures at the Collège de France, 1977–78. New York: Springer.Google Scholar
- Foucault, M. (2008). The birth of biopolitics: Lectures at the Collège de France, 1978–1979. New York: Springer.Google Scholar
- Grant, R. M., Anderson, P. L., McMahan, V., Liu, A., Amico, K. R., Mehrotra, M., et al. (2014). Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. The Lancet Infectious Diseases, 14(9), 820–829.CrossRefGoogle Scholar
- Hardt, M., & Negri, A. (2001). Empire. Cambridge: Harvard University Press.Google Scholar
- McCormack, S., Dunn, D. T., Desai, M., Dolling, D. I., Gafos, M., Gilson, R., et al. (2016). Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomized trial. The Lancet, 387(10013), 53–60. https://doi.org/10.1016/s0140-6736(15)00056-2.CrossRefGoogle Scholar
- Mimiaga, M. J., Cleirigh, C., Biello, K. B., Robertson, A. M., Safren, S. A., Coates, T. J., et al. (2015). The effect of psychosocial syndemic production on 4-year HIV incidence and risk behavior in a large cohort of sexually active men who have sex with men. Journal of Acquired Immune Deficiency Syndromes (1999), 68(3), 329.CrossRefGoogle Scholar
- Mitchell, W. T. (2013). Iconology: Image, text, ideology. Chicago: University of Chicago Press.Google Scholar
- Nealon, J. (2007). Foucault beyond Foucault: Power and its intensifications since 1984. Palo Alto: Stanford University Press.Google Scholar
- Smart, B. (2003). Economy, culture, and society: A sociological critique of neo-liberalism. Buckingham: Open University Press.Google Scholar
- UNAIDS. (2018). Miles to go—Closing gaps, breaking barriers, righting injustices, 268.Google Scholar
- WHO. (2016). Action plan for sexual and reproductive health. Towards achieving the 2030 agenda for sustainable development in Europe—Leaving no one behind.Google Scholar