Caring infrastructures for sexual health and the implications of antibiotic-resistant STIs

Infrastructures fundamentally shape sexual health, but their gaps and failings often only come into view during moments of crisis. Antimicrobial resistance (AMR) is a looming microbiological and global societal crisis, and one that is posing increasing challenges and risks for medical practice and public health alike. In sexual health, concerns have been raised about growing resistance in Neisseria gonorrhoeae and the less well-known Mycoplasma genitalium. In this article, we examine contemporary sexual health infrastructures and their adequacy in the context of rising antibiotic-resistant STIs. To do this, we draw on 49 semi-structured interviews with cisgender gay and bisexual men, and trans and gender diverse people (GBTQ+) in Australia. Findings reveal that growing costs, a lack of access to sexual healthcare services, complexities in navigating these services and lengthy wait times all present challenges to optimal care, and that growing resistance may further strain these socio-material-temporal arrangements. We argue that greater investment in sexual health infrastructures will increase capacity to accommodate complex lives, multiple subjectivities and ensure easier access to services. In the context of resistance, this frames sexual health infrastructures beyond ideas of simply 'coping with crisis' to being able to care well for people within a shifting environment.