Social Representation, Identity and HIV Prevention: The Case of PrEP among Gay Men

Abstract

HIV remains a major public health challenges four decades after its first clinical observations. In the last few years, pre-exposure prophylaxis (PrEP) has emerged as a significant biomedical tool for preventing HIV. Despite its clinical effectiveness, PrEP has not obtained with consensual approval from all sections of society. Uptake of the prevention tool has not been sufficiently high in the groups at highest risk of HIV – not least gay men who are disproportionately affected by HIV in the UK and in other Western countries. Both public and patient acceptability of PrEP are important factors in determining the effectiveness of the prevention tool. This chapter focuses principally on PrEP awareness, acceptability and uptake among gay men in the UK. In this chapter, it is argued that social representations of PrEP and the identities of potential users play an important role in responses to PrEP. First, a social and political overview of the HIV prevention tool is provided. Second, social representations theory and identity process theory from social psychology are described and their utility in existing PrEP research is outlined. Third, empirical research into public and patient understanding and acceptability of PrEP is reviewed. Fourth, a broad set of principles for raising awareness among gay men at risk of HIV is presented. It is argued that a culturally sensitive approach to HIV prevention is required and that social psychology has an important role to play in future campaigns for preventing HIV in global settings.