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New Data on HIV MSM Prevention

New Data on HIV MSM Prevention. Phil C. Langer, Angela Kühner & Jochen Drewes. HIV Risks Reduction Strategies among Gay and Bisexual Men and the Psychosocial Dynamics of Risk Behaviour. 9 th Conference of the European Sociological Association Lisbon, Sept 5 th , 2009.

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New Data on HIV MSM Prevention

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  1. New Data on HIV MSM Prevention Phil C. Langer, Angela Kühner & Jochen Drewes HIV Risks Reduction Strategies among Gay and Bisexual Men and the Psychosocial Dynamics of Risk Behaviour 9th Conference of the European Sociological AssociationLisbon, Sept 5th, 2009

  2. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies ESA 2009 What can you expect? Background: epidemiological situation & reflections in research and prevention Methods: participatory qualitative research design Results: use of risk reduction strategies among MSM & psychosocial dynamics Discussion: implications of the sexual “entrepreneurial self”

  3. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies 1. Background The epidemiological context: new HIV diagnoses in Germany “men having sex with men” year of diagnosis Source: Robert-Koch-Institute (2009)

  4. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies 1. Background The research discourse • normalization of AIDS as a consequence of antiretroviral treatment success (“therapy optimism”) • use of harm reduction strategies instead of coherent protective behaviour (“safer sex”): e.g. serosorting

  5. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies 1. Background The reaction of HIV prevention These men tell about love, sex, desire, and risk. “I know what I’m doing”  addressing the need for rational decision-making in coping with sexual risks. Source: http://www.iwwit.de (Screenshot 25.8.09)

  6. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies 2. Methods The study “Positive Desire” 58 in-depth interviews with MSM who tested HIV positive since 2001 and MSM who were untested but reported sexual risk behaviour (Nov. 06-Aug. 07) qualitative design, research process according to Grounded Theory addressed as experts via community media, internet, HIV medical centers, AIDS NGOs… community-based participatory research highly diverse sample with regard to age (range 19-72), social status, migration background (17,2%) psychodynamic team coaching, scientific advisory board constructivist paradigm led the analysis of interaction, narration, and discourse

  7. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies 3. Results “How did I get infected?” “Pozzing” “Virgin” Narrations “Barebacking” “Accident” “Risk Managament” “Ignorance”

  8. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies 3. Results Case vignette: a risk management narration combination of risk reduction strategies community knowledge about transmission “risks” “It didn’t work out with condoms. So we tried it without, and it was great. But I was active in 90 percent, and my friend took his pills and his virus was undetectable.” HIV risk behaviour “Dan” “I was in a very depressive phase and I didn’t care for anything. I took drugs. And I thought: Why should I live at all? I didn’t attempt suicide, but these thoughts were quite present.” mental health burdens drug use biographical crisis 30 y.o. gymHIV diagnosisin 2006 vulnerability dynamics

  9. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies 3. Results “Cross-road“ to risk behaviour determination of transmission probabilities in biomedical discourse serosorting, strategic positioning, PEP, PrEP, therapy sorting… construction of “risk” in prevention discourse community knowledge mental health burden protective behaviour biographical crisis sexual risk behaviour drug use lack of community support “spoiled identity”: coming out, stigma, discrimination, violence… heteronormative discourses and practices vulnerability dynamics

  10. P.C. Langer, A. Kühner & J. Drewes: HIV Risk Reducation Strategies 4. Discussion “viral sex” as resistance practice Some implications Other psychosocial dynamics leading to HIV infections in gay and bisexual men Different psychosocial dynamics leading to HIV infections in other groups Importance of dispositive analysis and analysis of psychosocial background for understanding of risk behaviour rationalization of sexuality structural dimension of behaviour? “Entre- preneurial self” resources of the subject? neoliberal public discourse “risky subjects”

  11. New Data on HIV MSM Prevention Dr. Dr. Phil C. LangerDepartment of Psychology, Munich University & Bundeswehr Institute of Social Sciences, Strausberg & Center of Transdisciplinary Gender Studies, Berlin University e-Mail: langer@lmu.de Dr. Angela Kühner Social Sciences Department, Goethe-University Frankfurt & Department of Psychology, Munich University e-Mail: kuehner@soz.uni-frankfurt.de Dipl.-Psych. Jochen Drewes Institute of Public Health, Free University Berlin e-Mail: jochen.drewes@fu-berlin.de

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