Scientific discourses: national HIV PrEP programmes for gbMSM
Year: 2026
Type: conference-paper
Abstract: Background: HIV pre-exposure prophylaxis (PrEP) pills are frequently taken by gay, bisexual, and other men who have sex with men (gbMSM) to prevent sexual acquisition of HIV. While well-intentioned, research on PrEP programmes often employs problematic discourses that influence how HIV prevention is understood and delivered. These problematic discourses extend into implementation, restricting conceptualisations of PrEP delivery and users. Aim: We explored research on national PrEP programmes to understand prevalent discourses in this research and explore how these impact implementation for gbMSM. Methods: We used Critical Discourse Analysis (CDA) to explore interpretive repertoires; subject positions; and the implications of these and other discourses for gbMSM engaging with PrEP programmes. Sources were identified through timebound searching (2012-2024) in six databases and Google Scholar. Thirtynine studies were analysed using critical discourse analysis rooted in the critical realist morphogenetic approach. Results: We identified discursive tendencies that described PrEP programme access as a risk reduction strategy and moralised the sexual and protective practices of gbMSM. PrEP programmes were frequently conceptualised solely as avenues for HIV risk reduction. Researchers conditionally supported autonomy among gbMSM only when it aligned with public health priorities. Conclusions: Problematic discourses restrict the capacity of research to ethically inform healthcare services for gbMSM. Researchers neglected broad benefits of PrEP in favour of individual and population-level HIV reductions. Equitable delivery of PrEP requires catering to the diversity of gbMSM; we encourage researchers to critically engage with language in dissemination to support holistic sexual health interventions and care.
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7202264589