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Accepted Contribution:
Contribution short abstract:
PrEP prevents HIV but is unequally accessible. This paper contrasts a pharmacist’s localized strategy with activists’ transnational solidarity efforts, examining who is granted or excluded from PrEP access and its promise of ‘careless sex,’ revealing tensions in sexual health as a ‘un/common good.’
Contribution long abstract:
Pre-Exposure Prophylaxis (PrEP) is an antiretroviral drug that effectively prevents HIV when taken as prescribed. Since 2019, PrEP and accompanying tests have been covered by statutory health insurance in Germany for so-called ‘risk groups,’ primarily but not exclusively gay men. While this coverage expanded access to sexual health, it also sparked debates about responsibility and ‘careless sex.’ Based on multi-sited fieldwork in Germany and Colombia, this paper examines two contrasting approaches to achieving access to PrEP: a pharmacist’s circumvention of German pharmaceutical law to offer PrEP at reduced prices before insurance coverage and the transnational activism of a Berlin-based group of migrants from Europe and Latin America advocating for solidarity with queer people in the Global South.
Both efforts are rooted in critiques of historical and systemic inequities affecting queer communities. The pharmacist’s approach focused on navigating the German system, achieving his goal with the inclusion of PrEP in public insurance. In contrast, the activists frame health as a global common good, viewing insurance coverage in Germany as only a partial victory. By juxtaposing these approaches, this paper interrogates the tensions between localized and transnational efforts to common sexual health and examines who remains excluded from access to PrEP and its promise of sexual liberation. Ultimately, it reflects on how these disparities challenge the notion of sexual health as a ‘un/common good’ in a deeply unequal world.
Health as a Common Good? Reimagining Health Care in an Unequal World
Session 1