Social Aspects of HIV Sarah Bernays · Adam Bourne Susan Kippax · Peter Aggleton Richard Parker  Editors Remaking HIV Prevention in the 21st Century The Promise of TasP, U=U and PrEP Social Aspects of HIV Volume 5 SeriesEditors PeterAggleton,CentreforSocialResearchinHealth,UNSWSydney,Kensington, Sydney,NSW,Australia SethKalichman,Psychology,UniversityofConnecticut,Storrs,CT,USA SusanKippax,SocialPolicyResearchCenter,UNSWSydney,Kensington,Sydney, NSW,Australia RichardParker,MailmanSchoolofPublicHealth,ColumbiaUniversity,NewYork, NY,USA John de Wit, Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands Sincethestartoftheepidemic,HIVandAIDShavefiredtheimaginationsofsocial aswellasmedicalandpublichealthscientists.Thisinnovativeseriesofbooksoffers asettinginwhichtopublishtheverybestofsocialscientificthinkingandresearch. The Social Aspects of HIV series offers readers authoritative introductions and overviews, together with summaries of enduring and cutting edge concerns. The series is international and multidisciplinary in focus, including contributions from psychology, sociology, anthropology, education, economic, political and social theory,andinternationaldevelopment.Individualvolumesofferscholarlyoverviews ofkeytopicsandconcernsbutalsoaddress‘bigissues’relevanttoHIVprevention, treatment and care. Sexual and drug-related practices; adherence; disclosure; and stigma and discrimination are among topics focused upon, alongside broader cul- tural, political and social responses to the epidemic, including globalisation and internationalisation. The political economy of AIDS, links to broader questions of sexualhealthandrights,andtheprogressivebiomedicalisationoftheresponse,will also be among key issues examined. The series will appeal to those working in public health, health psychology, medical sociology, medical anthropology, health promotion, social work and international development. Individual volumes are relevant to students, teachers, researchers and practitioners within each of these disciplines as well as program developers and managers working across a variety ofcontexts. Moreinformationaboutthisseriesathttp://www.springer.com/series/11922 (cid:129) (cid:129) (cid:129) Sarah Bernays Adam Bourne Susan Kippax (cid:129) Peter Aggleton Richard Parker Editors Remaking HIV Prevention in the 21st Century ¼ The Promise of TasP, U U and PrEP Editors SarahBernays AdamBourne SchoolofPublicHealth AustralianResearchCentreinSex,Healthand UniversityofSydney Society Sydney,NewSouthWales,Australia LaTrobeUniversity Melbourne,Victoria,Australia SusanKippax PeterAggleton SocialPolicyResearchCentre CentreforSocialResearchinHealth UNSWSydney UNSWSydney Kensington,NewSouthWales,Australia Kensington,NewSouthWales,Australia RichardParker DepartmentofSociomedicalSciences, MailmanSchoolofPublicHealth ColumbiaUniversity NewYork,USA ISSN2509-6559 ISSN2509-6567 (electronic) SocialAspectsofHIV ISBN978-3-030-69818-8 ISBN978-3-030-69819-5 (eBook) https://doi.org/10.1007/978-3-030-69819-5 ©SpringerNatureSwitzerlandAG2021 Chapters“AnticipatingPolicy,OrientingServices,CelebratingProvision:ReflectingonScotland’sPrEP Journey”,“HowtheScienceofHIVTreatment-as-PreventionRestructuredPEPFAR’sStrategy:TheCase for Scaling up ART in ‘Epidemic Control’ Countries”, “Stigma and Confidentiality Indiscretions: Intersecting Obstacles to the Delivery of Pre-Exposure Prophylaxis to Adolescent Girls and Young WomeninEastZimbabwe”and“TheDrivetoTakeanHIVTestinRuralUganda:ARisktoPrevention forYoungPeople?”arelicensedunderthetermsoftheCreativeCommonsAttribution4.0International License(http://creativecommons.org/licenses/by/4.0/).Forfurtherdetailsseelicenseinformationinthe chapters. 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Thepublisher,theauthors,andtheeditorsaresafetoassumethattheadviceandinformationinthisbook arebelievedtobetrueandaccurateatthedateofpublication.Neitherthepublishernortheauthorsorthe editorsgiveawarranty,expressedorimplied,withrespecttothematerialcontainedhereinorforany errorsoromissionsthatmayhavebeenmade.Thepublisherremainsneutralwithregardtojurisdictional claimsinpublishedmapsandinstitutionalaffiliations. ThisSpringerimprintispublishedbytheregisteredcompanySpringerNatureSwitzerlandAG. Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland Acknowledgements We thank Tom, June, Jacob, Kit, Preecha and Vagner for their understanding and supportwhilepreparingthisbook. ThanksalsogotoSarahHoileforhereditorialsupportthroughouttheprocessof preparingthemanuscriptforpublication. v Contents 1 RemakingHIVPrevention:ThePromiseofTasP,U=U andPrEP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 SarahBernays,AdamBourne,SusanKippax,PeterAggleton, andRichardParker PartI EfficacyandEffectiveness:ShapingPolicyandInforming Interventions 2 ‘PrEPIsaProgramme’:WhatDoesthisMeanforPolicy. . . . . . . . 21 HakanSeckinelgin 3 MakingtheIdealReal:BiomedicalHIVPreventionasSocial PublicHealth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 MarkDavis 4 PrEP,HIV,andtheImportanceofHealthCommunication. . . . . . . 47 JoshGrimmandJosephSchwartz 5 AnticipatingPolicy,OrientingServices,CelebratingProvision: ReflectingonScotland’sPrEPJourney. . . . . . . . . . . . . . . . . . . . . . 59 IngridYoung 6 FightingforPrEP:ThePoliticsofRecognitionandRedistribution toAccessAIDSMedicinesinBrazil. . . . . . . . . . . . . . . . . . . . . . . . . 73 FelipedeCarvalhoBorgesdaFonseca,PedroVillardi, andVerianoTertoJr PartII Pleasure,AgencyandDesire 7 TheBeatificationoftheClinic:BiomedicalPrevention ‘FromBelow’. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 KaneRace vii viii Contents 8 NewPotentialsforOldPleasures:TheRoleofPrEPinFacilitating SexualWell-beingamongGayandBisexualMen. . . . . . . . . . . . . . 105 BryanA.Kutner,AdamBourne,andWillNutland 9 NewHierarchiesofDesirabilityandOldFormsofDeviance RelatedtoPrEP:InsightsfromtheCanadianExperience. . . . . . . . 117 AdrianGuta,PeterA.Newman,andAshleyLacombe-Duncan 10 Agency,PleasureandJustice:APublicHealthEthicsPerspective ontheUseofPrEPbyGayandOtherHomosexually-ActiveMen. . . 131 JulienBrisson,VarditRavitsky,andBrynWilliams-Jones PartIII ProvisionPoliticsandNewFormsofGovernmentality 11 ThePoliticalLifeofPrEPinEngland:AnEthnographic Account. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 SaraPaparini 12 ImplementationScienceor‘Show’Trial?England’sPrEPImpact Study. .. . . . . . .. . . . . .. . . . . .. . . . . .. . . . . . .. . . . . .. . . . . .. . 159 CatherineDodds 13 TheStigmaStrugglesofBiomedicalProgress:Understanding CommunityEngagementwithPrEPbyPeopleWhoUseDrugs. . . 173 AndyGuise 14 HowtheScienceofHIVTreatment-as-PreventionRestructured PEPFAR’sStrategy:TheCaseforScalingupARTin‘Epidemic Control’Countries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 RyanWhitacre 15 GettingRealonU=U:HumanRightsandGenderasCritical FrameworksforAction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 LauraFerguson,WilliamJardell,andSofiaGruskin 16 FallingShortof90-90-90:HowMissedTargetsGovernDisease Elimination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 KariLancasterandTimRhodes PartIV AnticipatingandUnderstandingtheConsequences ofBiomedicine 17 StigmaandConfidentialityIndiscretions:IntersectingObstacles totheDeliveryofPre-ExposureProphylaxistoAdolescentGirls andYoungWomeninEastZimbabwe. . . . . . . . . . . . . . . . . . . . . . 237 MortenSkovdal,PhyllisMagoge-Mandizvidza, RufurwokudaMaswera,MelindaMoyo,ConstanceNyamukapa, RanjeetaThomas,andSimonGregson Contents ix 18 ImaginedFuturesandUnintendedConsequencesintheMaking ofPrEP:AnEvidence-MakingInterventionPerspective. . . . . . . . . 249 MartinHolt 19 TheDrivetoTakeanHIVTestinRuralUganda:ARiskto PreventionforYoungPeople?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265 SarahBernays,AllenAsiimwe,EdwardTumwesige,andJanetSeeley 20 EntangledBodiesinaPrEPDemonstrationProject. . . . . . . . . . . . 277 LisaLazarus,RobertLorway,andSushenaReza-Paul 21 AnUnfinishedHistory:AStoryofOngoingEventsandMutating HIVProblems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 MarshaRosengarten Editors and Contributors About the Editors SarahBernays isaseniorlectureringlobalhealthattheUniversityofSydneyand anassociateprofessorattheLondonSchoolofHygieneandTropicalMedicine.An anthropologistbytraining,shespecialisesinco-designingandevaluatinginterven- tionstosupportcommunitiestoengageininfectiousdiseasecontrolandtreatment. She has developed long-term partnerships with national research institutions and leading sexual and mental health programmes working with young people in South Africa, Uganda and Zimbabwe as part of a collaborative effort to invest in capacitybuildingandtranslatingknowledgeintopolicyandpractice.Herworkalso extendstoSouthEastAsia,EuropeandAustralia.Shehasrecentlyworkedwiththe WHOtoinformtheirglobalguidelinesforadolescentslivingwithHIV. AdamBourne isanassociateprofessorofpublichealthandDeputyDirectorofthe Australian Research Centre in Sex, Health and Society at La Trobe University in Melbourne,aswellasaseniorvisitingfellowattheKirbyInstitute,UNSWSydney. A health psychologist by training, he has led numerous studies examining the perception and management of HIV-related risk among gay, bisexual men and other men who have sex with men in the context of new prevention technologies, aswellasthetreatmentandcareexperiencesofthoselivingwithdiagnosedHIV.His work extends across Europe, Eastern and Southern Africa, South East Asia and Australia and incorporates HIV-related research among people who use drugs (particularlyinsexualcontexts)aswellasfemalesexworkers.Adamisanassociate editor of the journal Sexually Transmitted Infections, is a member of the Victorian Whole of Government LGBTIQ Taskforce and, between 2016 and 2018, was a member Global Advocacy Platform to Fast-Track the HIV and Human Rights Response for Men who have Sex with Men, hosted by the MSM Global Forum andUNAIDS. xi