Imagining biosocial communities: HIV, risk and gay and bisexual men in the North East of England

Many critics have charted an increasing biomedical and individualised approach to HIV prevention among gay and bisexual men, citing a significant shift in HIV policy and practice away from the community-based approaches to HIV prevention which characterised early responses. However, this dichotomous approach to ‘the biomedical or the social’ fails to capture the complex ways in which community-based approaches and sexual practice are already inextricably linked with the biomedical. This article explores how biomedical constructions of risk are embedded in the community-based bodily management and sexual practice of gay and bisexual men in the North East of England. Drawing on Paul Rabinow’s concept of ‘biosociality’, the article proposes the notion of an imagined biosocial community: a community of gay and bisexual men who are affected by and at risk of HIV. Through this lens, the article explores how biomedical and sexual negotiations are situated in a broader history of illness, sexual politics and community. The article considers the importance of the biomedical in managing the body and the on-going significance of memory, community formation and identity in relation to ‘AIDS’. It then explores how the interplay of these elements is deployed or threatened within these imagined community norms of sexual practice, where responsibility to others is critical. In paying attention to an imagined biosocial community, this article demonstrates how perceptions of and adherence to imagined community sexual practice remain critical in addressing risk of HIV in an increasingly biomedicalised context

Can a pill prevent HIV? Negotiating the biomedicalisation of HIV prevention

This article examines how biomedicalisation is encountered, responded to and negotiated within and in relation to new biomedical forms of HIV prevention. We draw on exploratory focus group discussions on Pre-exposure Prophylaxis (PrEP) and treatment as prevention (TasP) to examine how the processes of biomedicalisation are affected by and affect the diverse experiences of communities who have been epidemiologically framed as ‘vulnerable’ to HIV and towards whom PrEP and TasP will most likely be targeted. We found that participants were largely critical of the perceived commodification of HIV prevention as seen through PrEP, although this was in tension with the construction of being medical consumers by potential PrEP candidates. We also found how deeply entrenched forms of HIV stigma and homophobia can shape and obfuscate the consumption and management of HIV-related knowledge. Finally, we found that rather than seeing TasP or PrEP as ‘liberating’ through reduced levels of infectiousness or risk of transmission, social and legal requirements of responsibility in relation to HIV risk reinforced unequal forms of biomedical self-governance. Overall, we found that the stratifying processes of biomedicalisation will have significant implications in how TasP, PrEP and HIV prevention more generally are negotiated

Barriers to uptake and use of pre-exposure prophylaxis (PrEP) among communities most affected by HIV in the UK: findings from a qualitative study in Scotland

Objectives: To explore the acceptability of pre-exposure prophylaxis (PrEP) among gay, bisexual and men who have sex with men (MSM) and migrant African communities in Scotland, UK. Design: Consecutive mixed qualitative methods consisting of focus groups (FGs) and in-depth interviews (IDIs) explored PrEP acceptability. Data were digitally recorded, transcribed and analysed thematically to identify anticipated and emerging themes. Setting: Participants were recruited through community sexual health and outreach support services, and from non-sexual health settings across Scotland. Participants: Inclusion criteria included identification as either MSM and/or from migrant African communities; 18 years and older; living in Scotland at the time of participation. 7 FGs were conducted (n=33): 5 with MSM (n=22) and 2 mixed-sex groups with African participants (n=11, women=8), aged 18–75 years. 34 IDIs were conducted with MSM (n=20) and African participants (n=14, women=10), aged 19–60 years. The sample included participants who were HIV-positive and HIV-negative or untested (HIV-positive FG participants, n=22; HIV-positive IDI participants, n=17). Results: Understandings of PrEP effectiveness and concerns about maintaining regular adherence were identified as barriers to potential PrEP uptake and use. Low perception of HIV risk due to existing risk management strategies meant few participants saw themselves as PrEP candidates. Participants identified risk of other sexually transmitted infections and pregnancy as a concern which PrEP did not address for either themselves or their sexual partners. PrEP emerged as a contentious issue because of the potentially negative implications it had for HIV prevention. Many participants viewed PrEP as problematic because they perceived that others would stop using condoms if PrEP was to become available. Conclusions: PrEP implementation needs to identify appropriate communication methods in the context of diverse HIV literacy; address risk-reduction concerns and; demonstrate how PrEP can be part of a safe and comprehensive risk management strategy

Strategies to support HIV literacy in the roll-out of Pre-exposure Prophylaxis in Scotland::findings from qualitative research with clinical and community practitioners

Objectives: Limited understanding of pre-exposure prophylaxis (PrEP), coupled with negative public discourse, are significant barriers to its introduction. What works to support PrEP awareness and broader HIV literacy among diverse communities in the context of biomedical HIV prevention remains unclear. This article considers how PrEP can be translated across diverse communities and what the HIV literacy challenges might be in the current context of PrEP provision. Setting: We developed an HIV literacy informed community tool to support the roll-out of PrEP in Scotland. We undertook qualitative research with practitioners in urban and rural settings across nine Scottish health boards. Primary outcome measure: To examine HIV literacy challenges in the context of PrEP provision. Participants: Interviews and focus groups with community (n=19) and clinical (n=13) practitioners working with gay and bisexual men and African communities were undertaken between March and October 2017 concerning PrEP support, stigma and HIV literacy. Results: HIV literacy in the context of PrEP needs to consider more than the provision of individually targeted information. Practitioners identified and responded to stratified communities and social norms of knowledge, which influenced messaging, support and informed how practitioners enabled PrEP engagement and dialogue. Social barriers in HIV literacy, including structural stigmas relating to HIV and homophobia, shaped practitioner concerns and support for community members’ willingness to engage with PrEP. Conclusion: Critical HIV literacy in the age of PrEP is a complex social practice. Attention needs to be paid to how information is provided and facilitates engagement, rather than simply what information is given.By exploring practitioner use of the Know about PrEP tool, we have shown how consideration of the patterns of access to services and information, the delivery of and support for engagement with PrEP information and the wider strategies employed to negotiate ongoing structural social barriers can support more equitable and diverse PrEP community conversations

The People vs the NHS:Biosexual citizenship and hope in stories of PrEP activism

This is the final version. Available on open access from Edinburgh University Press via the DOI in this recordDiscourses of pre-exposure prophylaxis (PrEP) revel in its radical potential as a global HIV prevention technology, offering a promise of change for the broader landscape of HIV prevention. In 2018, the British Broadcasting Corporation (BBC) aired The People vs The NHS: Who Gets the Drugs?, a documentary focussed on the ‘battle’ to make PrEP available in England. In this article we explore how the BBC documentary positions PrEP, PrEP biosexual citizen-activists, as well as the wider role of the NHS in HIV prevention and the wellbeing of communities affected by HIV in the UK. We consider how biosexual citizenship (Epstein 2018) is configured through future imaginaries of hope, and the spectral histories of AIDS activism. We describe how The People crafts a story of PrEP activism in the context of an imagined gay community whose past, present and hopeful future is entangled within the complexities and contractions of a state-funded health system. Here, PrEP functions as a ‘happiness pointer’ (Ahmed 2011), to orient imagined gay communities towards a hopeful future by demanding and accessing essential medicines and ensuring the absence of needless HIV transmissions. This biomedical success emerges from a shared traumatic past and firmly establishes the salvatory trajectory of PrEP and an imagined gay community who continues to be affected by HIV. However, campaigns about the individual’s right to access PrEP construct the availability and consumption of PrEP as an end goal to their activism, where access to PrEP is understood as an individual’s right as a pharmaceutical consumer

"Da har jeg lært dem hvor dårlig de er, uten at de har lært seg noe i matematikk..." : En kvalitativ studie av erfaringer med god matematikkundervisning for matematikksvake elever.

Tittel:«Da har jeg lært dem hvor dårlige de er, uten at de har lært seg noe i matematikk…». En kvalitativ studie av erfaringer med god matematikkundervisning for matematikksvake elever. Bakgrunn, formål og problemstilling: Begrepet matematikkvansker betegner elever som av en eller annen grunn har spesielle vansker med å tilegne seg de kunnskaper i matematikk som er forventet ut fra deres alder, klassetrinn og læreforutsetninger (Holm, 2012, s.5). Forskning viser at rundt 10 % av elevene i grunnskolen har matematikkvansker (Ostad, 2010). Med bakgrunn som matematikklærer og med utgangspunkt i opplæringslova § 1-3 (1998), hvor det slås fast at opplæringen skal tilpasses den enkelte elev, har formålet med forskningsprosjektet vært å få innsikt i og kunnskap om erfarne og reflekterte matematikklæreres praksis. Hvilken erfaring og forståelse lærerne har utfordringene elever med matematikkvansker møter i matematikkfaget og hvilke didaktiske valg de tar for å tilrettelegge undervisningen på best mulig måte for elevgruppen. Med dette som bakgrunn har jeg valgt hovedproblemstillingen: Hvordan underviser matematikklærere elever med matematikkvansker? Metode:På bakgrunn i forskningsprosjektets formål og problemstilling, anså jeg det som hensiktsmessig å benytte kvalitativ forskningsmetode. Jeg vurderte forskningsintervju som godt egnet til å få beskrivelser av og innsikt i informantenes erfaringer og refleksjoner. Forskningsintervjuene ble gjennomført med utgangspunkt i en semistrukturert intervjuguide, hvor tema og forslag til spørsmål ble utarbeidet på bakgrunn av forskningsspørsmålene og oppgavens teoretiske referanseramme. Utvalget består av fem matematikklærere fra Østlandsområdet og er kriteriebasert på bakgrunn av engasjement for tema, minst fem års undervisningspraksis i matematikk og erfaring med matematikksvake elever. Bearbeiding, analyse og tolkningen av materialet er foretatt gjennom fenomenologisk og hermeneutisk tilnærming. Analyse og tolkning, samt presentasjon og drøfting av materialet tar utgangspunkt i Kvale og Brinkmanns (2009) tre fortolkningskontekster: selvforståelse, kritisk forståelse basert på sunn fornuft og teoretisk forståelse. Resultat: Restatene viser et variasjonsspekter i praksiserfaringer fra undervisning av elever med matematikkvansker og hvilke utslag vanskene kan gi i undervisningen. Det fremkommer både likheter og ulikheter i hvordan lærerne kartlegger, planlegger, organiserer og gjennomfører undervisningen på bakgrunn av hva de opplever som særlig gunstig for elevgruppen. Matematikklærernes forståelse av matematikkvansker er hovedsakelig knyttet opp mot de konkrete utslagene vanskene gir i matematikkundervisningen. Forståelsen av fenomenet fremstår som relativt lik, hvor beskrivelser av at matematikksvake elever har grunnleggende vansker med å forstå og behandle tall og gå fra konkret til abstrakt kunnskap er et fellestrekk. I tillegg uttrykker alle en opplevelse av at elevene har dårlig selvtillit i faget og at hjemmemiljø og deres rolle som lærere har betydning for elevenes matematiske utvikling. Mitt hovedinntrykk er at lærerne opplever at variasjon i arbeidsmetoder og prinsipper er grunnlaget for god matematikkundervisning. Utvalget gir varierte beskrivelser av hvordan de bruker tavleundervisning, oppgaveløsning, konkretiseringsmateriell, praktisk erfaring, begrepsopplæring, veiledning, elevsamtaler og diskusjoner for å tilrettelegge for læring. To faktorer utpeker seg som særlig viktige. Det ene at elevene må oppleve mestring og det andre at eleven må føle tilhørighet og trygghet i undervisningssituasjonen. Ved å organisere undervisningen i liten gruppe eller ved ordinær undervisning forteller lærerne hvordan de tilrettelegger for mestring, gjennom tilpassede oppgaver, konkretiseringsmateriell og veiledning individuelt eller i gruppe. De forteller på ulike måter hvordan de bygger opp klassemiljø og relasjon til elevene slik at elevene skal føle seg trygge i undervisningen

Reimagining risk :exploring understandings of risk in sexual health amongst gay and bisexual men in the North East of England

This ESRC funded qualitative research was initiated in response to a re-emergence of syphilis and continuing increases in HIV rates amongst gay, bisexual and/or men who have sex with men (MSM) in the North East of England. The research was conducted in partnership with local sexual health services from three NHS Primary Care Trusts and a gay and bisexual men’s sexual health organisation, with findings intended to inform sexual health services and policy. The aim of this research was to situate understandings and meanings of risk in sexual practice within the everyday lives and experiences of MSM within this particular epidemiological and geographic context. The research asked what MSM understood as a risk in their sexual practice; how they responded to perceived risk in their sexual practice; and what influenced these understandings and responses to risk. In-depth interviews were conducted between March and August 2009 with twenty-three gay and bisexual men, aged 18 – 63, who lived, worked, socialised or accessed sexual health services in the North East of England. In contrast to public health concerns that MSM are not longer practising ‘safer sex’ in a ‘post-crisis’ era of HIV, participants described the ways in which they were engaged in a creative and reflexive sexual practice which considered and responded to risk of infection. Findings indicate how respondents drew directly on biomedical knowledge and technologies to inform their understandings and responses to risk. However, these responses were embedded in perceived community norms of sexual practice, which drew on memories of HIV and were based on a harm reduction strategy. Findings from this research are discussed in three chapters in this thesis. The thesis first explores how participants negotiated biomedical and embodied understandings of risk within a community practice that prioritised HIV prevention. The following chapter considers how particular sexual actors were constructed as risky and the implications this had for participants’ own understandings of risk and responsibility. The final analysis chapter details the ways in which place and space played an important role in understandings of risk and responsibility, and points to the ways in which regional and national boundaries, as well as changing community sexual practices, impact on the location and management of risk.Economic and Social Research Council (ESRC

Psychology: Physiological effects of negative international news on

News depicting conflict in foreign countries is often perceived differently by those living in America, and these differences may also have implications for gender-related news. Foreign and national news is often categorized as ours versus theirs when reporting on or perceiving news (Nossek, 2016). This suggests that if a person classifies news as theirs versus as ours , there could be a discrepancy in the emotional response to the news received based on how an individual decides to subconsciously categorize it. A person may have an emotional response upon seeing negative news, resulting in a physiological state change (Soroka, et al, 2019). There are various physiological changes in response to emotional arousal, such as an increased heart rate. (Sassenrath, et al, 2021). Another physiological measure is skin conductance response, which is an indirect measurement of the autonomic nervous system (Hein, et al, 2010). Previous literature has revealed that physiological differences occurred between male and female participants when exposed to news related to gender discrimination (Quasney, 2009). This study thus focuses on news related to gender inequality and the ways it may elicit a change in physiological markers in female participants. Specifically, the study examines the changes in skin conduction and heart rate of American female college students when viewing news clips from various global regions. The participants watched four news clips reporting about women’s rights issues from four different global regions (Europe, Latin America, West Africa, and the Middle East). The heart rate and skin conductance responses of the participants were taken with BIOPAC monitors (EDAs and pulse plethysmograph) while the participants watched the news clips. Two multifactorial ANOVA tests were utilized to analyze the relationship between the news clips and the ethnicity of each participant with the changes in skin conductance and heart rate. Data collection is ongoing, and results will be presented at the conference