What PrEP means for safe sex in Sydney: evolving norms - Bridget Haire


·      Bridget Haire discuses UNSW Qualitative study investigate how PrEP is affecting sex cultures amongst gay men on PrEP either privately sourced or on clinical trial, through interview and focus groups with gay men  and health providers.

·      Common themes discussed included: -

o   A new stigma evolving towards condom users that ppl not taking PrEP/ using only condoms are uninformed and condom-use lowers sexual capital.

o   Attitude towards STI’s includes a strong framework around testing and treating rather than condom use, accepting condoms not perfect and maintaining a strong community context.

(There remains a controversy amongst healthcare professionals as to whether there is a real increase in STI or just increased testing).

o   Attitude to Undetectable Viral Load  - polarised to ‘want to see it in writing’ to only asking if on medication or not.

o   Sex anxiety – PrEP has reduced sex related anxiety around HIV transmission.

·      In conclusion PrEP didn’t precipitate condom less sex as condom less sex predated PrEP but it does seem to be reinventing the idea of  ‘sexual citizenship’ (‘sexual citizenship’ first described by David T Evans in 1993 as the rights and responsibilities around ones sexual career). It seems a new stigma evolving with sexual rejection of condom users. This tension between PrEP and non-PrEP users needs to be addressed to develop the idea of that a combination of health promotions can reduce HIV.

·      The Implication is that health promotion needs to be embedded in the conversation that communities have in order to be relevant.  Future studies need to follow theses attitudes/ trends over time.