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Faire le jeu des « irresponsables » pour endiguer l’épidémie de VIH ? Responsabilités et idéaux dans les consultations PrEP en France Volume 41, issue 1, Mars 2023

Author
* Sociologue, Laboratoire Interdisciplinaire d’Études sur les Réflexivités – Fonds Yan Thomas (LIER-FYT) de l’École des Hautes Études en Sciences Sociales (EHESS); valentinrio96@gmail.com

Playing into the “irresponsable” hands to curb the HIV epidemic? Responsabilities and ideals in PrEP consultations in France

For HIV-negative people, pre-exposure prophylaxis (PrEP) consists of taking a combination of antiretroviral drugs before and after sexual intercourse to drastically reduce the risk of infection in the event of exposure. In France, since its institutionalisation in 2016, this prevention strategy has been criticised for, on the one hand, taking away the responsibility of its users, who would no longer use condoms enough, and, on the other hand, the medical institution, which could thus aggravate the resurgence of other sexually transmitted infections. Based on the observation of around fifty PrEP consultations during 2018, this article proposes to understand the way in which risks are managed and benefits defined in a clinical situation - without seeking to evaluate the effectiveness of such a device. In terms of risk reduction, we note the reciprocal transfers of responsibility attributing the burden of primary HIV prevention to the patient and secondary STI prevention to the medical follow-up. Finally, we show that the definition of benefits results from the joint realisation of a public health ideal and a liberal-pluralistic sexuality ideal.