“Sexual Revolution” vs “Growing Up”: Racism Within Spaces and Communities Fosters PrEP Respectability

• In Event: 1476 - Biomedical Anxieties: AIDS Risk, Discrimination, and Healthcare Access

Abstract

HIV remains a significant health crisis for gay, bisexual, and queer (GBQ) men, especially GBQ men of color who comprise 45% of new infections. PrEP (Pre-exposure Prophylaxis) has the potential to radically transform the fight against HIV. While we are beginning to understand the racial disparities driving the racial divide in PrEP access, less is known about how the experience of being on PrEP differs for white GBQ men and GBQ men of color. Using interviews with 26 GBQ men on PrEP recruited using a respondent driven sampling strategy that sought diversity along race and class dimensions, this paper argues that the experience of PrEP for low-income Black men differs significantly from that of White men and middle-class men of color. While White men and middle-class men of color experience PrEP as a freedom from HIV fear and a chance to explore their sexuality in a kind of “sexual revolution,” low-income Black men see PrEP as a chance to “grow up” and control their sexuality in ways in line with dominant heterosexual sexual mores. I propose that two mechanisms interact to produce these different experiences: the places that these low-income Black men receive their access to PrEP, namely public health clinics and research studies, and the communities because of their class and their segregation away from mainstream, White gay neighborhood spaces due to racism. These mechanisms interact to limit their exposure to the ‘sexual revolution’ narrative of PrEP, reinforce HIV stigma and fear, and empower provider messages emphasizing hegemonic sexual norms. By understanding low-income Black men’s experience intersectionally, I suggest that racial disparities in GBQ’s HIV rates have a fundamental cause in the racism of gay communities and neighborhoods, requiring structural and cultural changes to these White spaces to reduce the burden of HIV in GBQ men of color.

Author

• Jason Orne, Drexel University