Queer(ing) EBM and DoxyPEP Policy and Practice in the UK

Description

In a 2017 joint statement by Public Health England and the British Association for Sexual Health and HIV (BASHH), British clinicians advised extreme caution in the use of doxycycline post-exposure prophylaxis (DoxyPEP) for preventing new STI transmissions. The statement suggests that DoxyPEP use should be restricted to research settings and requires further clinical trials (Kohli et al. 2022), partly due to concerns about antimicrobial resistance (AMR) (HPE 2022) and unknown impacts on the gut microbiome (Samuel 2023). Yet in 2024, UK DoxyPEP clinical science remains impoverished, with no current UK-based clinical trials underway (Weil & Nutland 2023). The slow rise of UK DoxyPEP science emerges from healthcare infrastructure instability, including funding shortages, laboratory and clinical capacity, and policy stratification across the devolved nations. The ‘problem’ of DoxyPEP, then, is a complex assemblage of social forces centralised within scientific evidence-making processes measuring the scalar risk of DoxyPEP on population health.

This paper examines the politics of UK DoxyPEP science and asks: How is knowledge about DoxyPEP science produced and contested? Who are the primary and secondary audiences? How do these knowledge pathways include and/or exclude the communities impacted by sustained STI transmission? Drawing on the sociology of knowledge, this paper examines the ‘evidencing process’ (Adams, Lancaster & Rhodes 20223) of DoxyPEP science across scientific papers, policy documents, health promotion materials, and interviews with health practitioners. In its first half, this paper explores how an evidence-based medicine (EBM) is constructed and rationalised to integrate DoxyPEP into UK national healthcare services. In its second half, this paper uses a ‘queer’ STS analysis to interrogate who this evidence-making process is for. My central claim is that a realistic DoxyPEP EBM requires queer systematic approaches to dealing with the problem of STI transmissions, focussed on specificity, adaptability, feasibility, and sustainability from and with(in) queer communities.

Period	20 Nov 2024 → 23 Nov 2024
Event title	American Anthropological Association Annual Meeting
Event type	Conference
Location	Tampa, United States, FloridaShow on map
Degree of Recognition	International