Responsibilization and Sexual Stigma Under Austerity: Surveying Public Support for Government-Funded PrEP in England

Abstract

Introduction Under austerity, governments shift responsibilities for social welfare to individuals. Such responsibilization can be intertwined with pre-existing social stigmas, with sexually stigmatized individuals blamed more for health problems due to "irresponsible" sexual behavior. To understand how sexual stigma affects attitudes on government healthcare expenditures, we examine public support for government-provisioned PrEP in England at a time when media narratives cast the drug as an expensive benefit for a small, irresponsible social group and the National Health Service's long-term sustainability was in doubt. Methods This paper uses data from an original survey (N = 738) conducted in September 2016, when public opinion should be most sensitive to sexual stigma. A survey experiment tests how the way beneficiaries of PrEP were described affected support for NHS provision of it. Contrary to expectations, we found that support was high (mean = 3.86 on a scale of 1 to 5) irrespective of language used or beneficiary group mentioned. Differences between conditions were negligible. Discussion Sexual stigma does not diminish support for government-funded PrEP, which may be due to reverence for the NHS; resistance to responsibilization generally; or just to HIV, with the public influenced by sympathy and counter-messaging. Social policy implications Having misjudged public attitudes, it may be difficult for the government to continue to justify not funding PrEP; the political rationale for contracting out its provision is unnecessary and flawed. With public opinion resilient to responsibilization narratives and sexual stigma even under austerity, welfare retrenchment may be more difficult than social policymakers presume.

Past-futures in experimental care: breast cancer and HIV medicine

“…Initial HIV treatment today is adapted to individual and host genotyping but subsequent regimens are highly standardised. With simpler regimens, patients are increasingly encouraged to monitor their own health (see Beckmann 2013;Hildebrandt, Bode, and Ng 2019). 5 HIV has become a chronic condition for the majority; services have been streamlined, andin a UK climate of economic austerityreduced.…”

Uncertainty in cyber de-responsibilisation

“…Some researchers have carried out studies to determine how well citizens can accept the responsibilities assigned to them in different domains. For example, Hildebrandt et al assess public support for less responsibilization and more support for those who engage in risky sexual behaviours 19 . Hart argues that the responsibilization of criminals who have served their time is inappropriate because a this approach does not provide the level of support they need 18 .…”

A New Era of Queer Politics? PrEP, Foucauldian Sexual Liberation, and the Overcoming of Homonormativity

“…A recent study, on the other hand, shows strong public support in the U.K. for governmentprovisioned PrEP, cf. Hildebrandt et al (2020), while another study shows increasingly homophobic and stigmatizing PrEP discourse in the U.K. media between 2012 to 2016, cf. Mowlabocus (2020).…”