Despite the clinical success of Truvada-as-PrEP in preventing HIV transmission for several years, it has still not yet been widely adopted by the MSM community. Clinicians insist that the drug is safe, and there are avenues to pay for the drug even for the uninsured—and yet, there is hesitation. Since the 1980s, HIV/AIDS narratives have been linked to what Susan Sontag (1989) calls an “imputation of guilt,” and more broadly, the creation of a connection between queer sexuality and social stigma whose inertia is difficult to escape. How is the way people talk about PrEP framed by this discursive history? Can the community’s reluctance be understood in those terms, and addressed by deeper understandings of how the disease and its treatment are conceived?
This article takes a discourse analysis approach to examine the narratives surrounding PrEP, in particular those that have circulated in online and print media in the USA. These are contextualized by the evolution of conversations surrounding the disease and its treatment, from “death sentence” to chronic illness to medical condition. Following Kover (1998), HIV/AIDS is positioned here as an object of the terrifying sublime, that can only be dealt with indirectly, while PrEP represents a (possible) shift in strategies for coping with the disease, from avoidance to confrontation, with all that that entails.
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