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Contextualizing Risk in the Ethics of PrEP as HIV Prevention: The Lived Experiences of MSM

Michael Montess

    Kennedy Institute of Ethics Journal
    |December 13, 2021
    PubMed

    Insights

    This article critiques the risk assessment for pre-exposure prophylaxis (PrEP) in HIV prevention for men who have sex with men (MSM). It argues for including social and political risks alongside medical ones for a comprehensive ethical evaluation.

    Area of Science:

    • Public Health
    • Medical Ethics
    • Sociology

    Background:

    • Pre-exposure prophylaxis (PrEP) is a key HIV prevention tool for men who have sex with men (MSM).
    • Current ethical assessments of PrEP primarily focus on medical risks and benefits.
    • This narrow focus may overlook significant social and political implications.

    Purpose of the Study:

    • To challenge the traditional risk assessment approach to PrEP ethics for MSM.
    • To broaden the ethical framework by incorporating social and political risks.
    • To provide a more nuanced analysis of PrEP's impact on MSM communities.

    Main Methods:

    • Critical analysis of existing risk assessment frameworks for PrEP.
    • Historical contextualization of HIV prevention and MSM experiences.
    • Incorporation of lived experiences of MSM regarding sex, HIV, and prevention.

    Main Results:

    • Medical risks of PrEP are often overemphasized in current assessments.
    • Social and political risks associated with PrEP use are frequently overlooked.
    • A broader framework is needed to encompass all relevant risks.

    Conclusions:

    • Rethinking risk assessment is crucial for a comprehensive ethical evaluation of PrEP.
    • Considering factors like trust and solidarity offers a more nuanced understanding.
    • This approach better addresses the social and political effects of PrEP on MSM relationships and communities.

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