Skip to main content


EGENIS seminar: "MSM face barriers? The politics of biomedical non-use in English discourse", Mr Adam Christianson (Wellcome Doctoral Candidate, Goldsmiths, University of London)

Egenis seminar series. Supported by the Social Sciences and Humanities Research Council of Canada.

What is accomplished by the claim “patients face barriers”? Though the term implies an excluded patient, I argue barriers play an important role in constructing the users and non-users of an evidence-based interventions. This paper examines ‘barriers’ as a strategy in the problematization of HIV pre-exposure prophylaxis (PrEP) non-use in England between 2015 and its commissioning in 2020.

Event details

I discuss how litigation over the provision of PrEP in the English health system inadvertently opened the drug and its user to two competing styles of thought about the governance of HIV. I argue this gave way to two competing alliances of healthcare actors who concurrently struggled against each other over the user whilst collaborating for PrEP provision. Examining textual claims made about PrEP non-use between 2015-2020, I discuss how “barriers” became a key vector by which highly credentialled health activists from two camps struggled for authority over the governance of HIV-prevention. I describe how barriers are at the heart of an array of personal, experiential, and evidence-based claims occurring across public facing and credentialled discourse. Rather than resolve the problem of exclusion barriers ostensibly index, I suggest barriers played a more expansive role in transforming individuals into subjects of increasingly molecular HIV-prevention. I argue attending to the role of barriers in problematizing non-users extends our understandings of compliance in healthcare governance and contributes to a sociology of non-doing.

Register here