PrEP, Pharmakon, and Ambivalence in the Era of Nordic HIV Prevention

Abstract

Using Derrida's notion of pharmakon (again from Plato), I want to bring attention to how we can utilize the notion of pharmakon as an analytical device for thinking about the entanglements between pharmaceuticals, and historical HIV narratives, and the contemporary landscape of HIV in the Nordic region. Pharmakon can denote both cure and poison. However, it can also refer to a meaning associated with scapegoating. This article will argue that the introduction of PrEP in Norway (and elsewhere) has set in motion discourses wherein PrEP can be perceived as a form of pharmakon based on the different actors framing the discourse. On the one hand, some have come to see PrEP as a pharmaceutical, which can usher in a new form of freedom that alleviates fears of HIV as well as opens up new intimacies. This is the curative side of PrEP. On the other hand, others have raised fears of the possible rise in other STIs due to PrEP usage, as well as the alleged 'abandonment of condom culture. This can be perceived as the poison side of PrEP. Finally, others have pointed to the moral and fiscal responsibilities associated with PrEP usage and the perceived loss of 'responsible gay sexuality. With the rise of the phrase 'Truvada whore', this can be seen as the scapegoating side of PrEP as pharmakon wherein PrEP users are scapegoated for their use of PrEP, and thus blamed for increases in STIs and lack of funds for other medical services provided by the welfare state such as migraine medicines in the Norwegian discourse. The article will utilize Norwegian material from public debates around PrEP as well as supplement these with discourses from Sweden and Denmark to make a disciplinary conjecture regarding the status of PrEP when seen through the concept of pharmakon.

Examining provincial PrEP coverage and characterizing PrEP awareness and use among gay, bisexual and other men who have sex with men in Vancouver, Toronto and Montreal, 2017–2020

“…Data from 2019 found 1150 people using PrEP in Norway; of these, 821 are on a daily dosing regimen (71.3%), while 330 are on an intermittent or event-based dosing regimen (28.7%). Of interest is that approximately 98% of all PrEP users in Norway are GBM[37].…”