Paper short abstract:

This paper analyzes pre-exposure prophylaxis for HIV as a form of “targeted biomanagement,” designed to recuperate "risky" populations as subjects of public health. The problematic US roll-out demonstrates the contingent nature of contemporary biopolitics as well as the unruly nature of the body.

Paper long abstract:

The 2012 FDA approval of the prophylactic use of antiretrovirals signaled a major shift in how US public health conceptualizes HIV prevention for "high risk" populations. While previous strategies to control the HIV epidemic aimed to prevent exposure to the virus, prophylaxis assumes that certain bodies will be exposed and aims to modify them at the molecular level to ward off infection. This paper analyzes pre-exposure prophylaxis for HIV (PrEP) as a form of "targeted biomanagement," designed to intervene upon the bodies of "risky" populations and recuperate them as ideal subjects of public health. PrEP is often positioned as yet another logical addition to the HIV prevention "toolkit," its faults to be rectified by future technological innovations. Via a discursive analysis of public health literature, promotional materials, public press, and regulatory documents, this paper offers a critical analysis of two aspects of this technology: (1) the difficulty of identifying and reaching those for whom PrEP is indicated, and (2) the potential that PrEP enables the proliferation of practices that previous HIV prevention strategies sought to eliminate. These outcomes demonstrate the contingent nature of contemporary biopolitical regimes as well as the unruly nature of the body, whose potential continuously exceeds attempts to categorize, quantify, and render it manageable.