This chapter discusses the third paradox of the book, namely the notion that PrEP users are both responsible and irresponsible with regards to their sexual health. This paradox relates primarily to queer men in Denmark, who, on the one hand, recognise how PrEP supports them in their efforts to take responsibility for preventing HIV, yet, on the other hand, brings them to encounter ideas that associate PrEP with irresponsible sexual behaviour. The idea of being responsible appears to be rooted in an understanding of the difficulties in using condoms consistently, vulnerability to HIV, and the value of halting the spread of HIV. Meanwhile, associations between PrEP and irresponsible sexual behaviour stem from social representations of PrEP as being linked to risk compensation in the form of increased promiscuity and condomless anal sex, which in turn, despite evidence to the contrary (Murchu et al., 2022), are believed to contribute to a rise in other sexually transmitted infections. These opposing ideas are encountered in social interactions and inevitably draw on diverging socio-cultural views on queer sex and morality. For many of our participants, such opposing ideas were amplified and became particularly visible when hookups (that is, casual sexual encounters) and condom use were negotiated on mobile dating apps. What in general, and what particular ideas about (ir)responsible sexual behaviour, came to affect our participants was highly dependent on their social networks. It was through social networks that certain ideas and ways of thinking were challenged and reconstructed, and new and different ways of talking about PrEP were encountered. Noticeably, while young women in Zimbabwe felt ashamed to access PrEP, as discussed in the previous chapter, none of them talked about PrEP being associated with irresponsibility regarding sexual health. Although I will make a few references to young women in Zimbabwe, this chapter primarily draws on the accounts and experiences of queer men in Denmark.

The dialectics arising from PrEP’s association with both responsible and irresponsible sexual health behaviour necessitate numerous everyday PrEP negotiations. I capture and explore these through the following three headings:

  • Am I taking responsibility for my sexual health? Negotiating ‘PrEP responsibility’ in a relational context

  • Why do I feel irresponsible when taking responsibility? Shame associated with PrEP

  • Am I irresponsible? ‘Othering’ non-PrEP users

Am I taking responsibility for my sexual health? Negotiating ‘PrEP responsibility’ in a relational context

All participants across the two study settings subscribed to the idea that PrEP represents taking responsibility for one’s own sexual health and that of others. However, ideas about PrEP also being linked to irresponsible sexual behaviour were omnipresent among our queer male participants. Charles, who is interested in PrEP, talked about the social representation of PrEP being linked to promiscuity:

Taking PrEP is seen a little bit like a licence to be – if not promiscuous – to be sexually active [little laugh]. There are some in the gay community, who because of internalised homophobia, consider people on PrEP as ‘too gay’. Too ready to have gay sex. Promiscuous. (Charles, age 65, eligible for PrEP)

What Charles is also alluding to is divisions within the queer community, and how PrEP spurs new ideas of (ir)responsibility and queerness. These ideas appear to be encountered and amplified by certain relational practices, such as negotiating condom use and using dating apps for hookups, which will be the focus on this section.

I would like to begin with our participants’ relationship to condoms. There was a broad and shared understanding that using condoms consistently is impossible, and it is in the context of this representation that taking PrEP becomes a responsible thing to do. The queer men in Denmark often referred to the belief that using condoms in ‘the heat of the moment’ is challenging. Jens, a 40-year-old man who was not on PrEP at the time of the study but awaiting a referral, explains that he only uses condoms half the time: ‘I think it’s impractical. I think it’s a turn-off in that act.’ Young women in Zimbabwe also occasionally referred to the challenge of using condoms in the ‘heat of the moment’ but did so in relation to how much access there is to condoms. Maidei, in her account of the role of PrEP in HIV prevention, took a photograph of a condom (see Figure 5.1) and described the common idea that young people do not have access to condoms as and when they need them, and that young women do not always have the power to negotiate condom use with men:

This is a picture of a pack of condoms. Condoms are the traditional and old way of protecting against HIV that almost everyone in our communities know about, even the young children – they grow up knowing that there is something called condoms. The importance of PrEP comes out for me when looking at this condom because I feel that one of the reasons young people end up getting HIV is the fact that they sometimes do not have access to condoms at the very moment they want to have sexual intercourse. I can imagine a situation whereby two young people meet up and they are now in the heat of the moment wanting sex, but they have no condoms with them. If one is already on PrEP it means they are protected, even if they have sex without condoms, they will maintain their negative status. The other thing with this condom is that it is worn by men and they have the power to protect. If a man decides he does not want to use condoms it means the female counterpart is at risk of having HIV. If she is already on PrEP she would have protected herself from getting HIV. (Maidei, age 26, eligible for PrEP)

Many young women also referred to the point that married women face challenges in negotiating condom use with husbands. This is exemplified by Precious, who says that PrEP allows you to ‘safeguard your health and life knowing that your husband is unfaithful’. It is against this background of ideas and beliefs about the practical limits of condoms that PrEP becomes synonymous with taking responsibility for one’s own health and life.

Some queer male PrEP users who engaged in condomless anal sex expressed ambivalence in relation to how PrEP use affected their sexual behaviour. Poul, a 46-year-old PrEP user, describes how PrEP has allowed him to have casual sex responsibly because he does not have to worry about HIV. At the same time, he is acutely aware that having casual and condomless anal sex with different men increases his chances of contracting and spreading sexually transmitted infections, which he refers to as ‘careless’ behaviour:

It [PrEP] allows me to have casual sex with random men in random places. Without having to think about HIV. But what about all the other sexually transmitted infections I can acquire? Why take PrEP at all if I have to put on a condom anyway to avoid everything else? After all, I don’t put on both rainwear and an umbrella when it rains. PrEP has made me careless in some ways. I do just like everyone else – forget that there is also something other than HIV in circulation. (Poul, age 46, PrEP user)

Paul highlights an inherent paradox of the PrEP pill, namely that it protects (against HIV), yet it does not (against other sexually transmitted infections). For Poul, ‘careless’ or ‘irresponsible’ condomless anal sex is built into using PrEP. Combining PrEP and condom use is, to him, illogical. Why be on PrEP if you are using condoms anyway? While the impracticality of consistent condom use, as discussed earlier, justifies PrEP use, Poul’s deliberations over how PrEP affects his sexual behaviour and condom use illustrate how such opposing ideas affect self-understandings (for example, being ‘careless’), thoughts, and actions. Many queer male PrEP users in Denmark encountered these ideas on Grindr, a dating app, which cemented different types of (ir)responsibility. For Klaus, a 42-year-old queer man in an open polyamorous relationship, PrEP simply represents taking responsibility for sexual health: one’s own and others’. He says, ‘If I can see on the app that he is on PrEP, I feel safer.’ He goes on to argue that if he is contacted by someone on Grindr who is not on PrEP, he will approach a possible sexual relationship with caution. In contrast, for Sigurd, a 35-year-old queer man also on PrEP, declaring one’s PrEP status on Grindr signals an interest in condomless anal sex, which he does not associate with taking responsibility for one’s own sexual health. He explains:

If you meet someone on Grindr, they may write on their profile that they are on PrEP. It is good thing because it suggests that PrEP is not so stigmatised within this group of queer men. It is rare I speak to someone on Grindr who is on PrEP but does not declare it on their profile. When I do, I wonder why they do not declare it. There have been periods where I removed my PrEP status from Grindr, because I did not want people to assume that I was OK with condomless anal sex. (Sigurd, age 35, PrEP user)

For Sigurd, PrEP signals not only an interest in condomless anal sex, but also a vulnerability to sexually transmitted infection. Sigurd also indicates that it can be difficult to negotiate condom use if his Grindr profile shows that he is on PrEP. Similarly, Christian, a 26-year-old queer man on PrEP, details his experiences of unsuccessfully negotiating condom use with another PrEP user (see Figure 5.2):

A ‘No Stopping’ road sign, looked at from the pavement, with a wall to the left and a road to the right.
Figure 5.2:

Rejected by people on PrEP

I want to share this photo to explain some of the experiences I have had with people on Grindr. One evening I was chatting with a guy, and we were planning to meet for sex. During the chat we started discussing protection. We were both on PrEP, but for him it was a deal-breaker if I was to insist on using condoms. He explained why he did not want to use condoms. I occasionally have sex without condoms, but if condomless sex is a must for the other guy, I tend to say ‘no thanks’ myself. I feel I put myself at too high a risk of catching a sexually transmitted infection. I feel I have these discussions more and more often. (Christian, age 26, PrEP user)

For Christian and Klaus, PrEP represents two different things, both of which become visible and necessitate negotiation when chatting to other queer guys on dating apps like Grindr. According to Christian, these everyday negotiations are happening more and more often. For Klaus, PrEP simply signals taking responsibility for preventing HIV, whereas for Sigurd and Christian, PrEP signals both responsibility for HIV prevention and irresponsibility by being associated with condomless anal sex and an increased likelihood of contracting a sexually transmitted infection. For queer men among whom taking PrEP is unambiguously considered a responsible thing to do, catching a sexually transmitted infection is not a major concern. It is ‘just like catching a cold’, as described by one participant; something that is quickly dealt with as part of their PrEP hospital controls. Still, for queer men in this ‘camp’, there is such a thing as catching too many sexually transmitted infections, as explained by Feng, and this is where ideas about ‘irresponsible behaviour’ and ambiguity can begin to sneak in:

Within a period of eight months from September 2020 to April 2021, I contracted a sexually transmitted infection four times, plus corona [COVID-19]. Therefore, frequent check-ups were necessary. I was in Bispebjerg hospital multiple times. And I regretted my irresponsible behaviour on my own health. (Feng, age 35, PrEP user)

On the other hand, Sigurd, Christian, and others take PrEP more ambivalently, seeing it as being linked to both responsible and irresponsible sexual behaviour. Condom use, or lack thereof, and the potential for increases in other sexually transmitted infections play central roles in this fluctuation between linking PrEP to responsible or irresponsible sexual behaviour. This is clearly described by Mike, another PrEP user:

People on PrEP take responsibility for themselves. And I think that’s cool when people do. But it’s clear that if I just fool around without a condom and don’t think about whether I have chlamydia for example, then I wouldn’t think it was very responsible, right? (Mike, age 32, PrEP user)

Another PrEP user, Stefan, takes the consideration of sexually transmitted infections to a whole other level, reflecting with guilt and uncertainty on the implications of condomless anal sex. Through questions, Stefan highlights some of the contentions, uncertainties, dilemmas, and ambiguities that he and his friends are dialectically considering:

My friends [on PrEP] and I have the same considerations. How do we avoid transmission of sexually transmitted infections? Do we risk creating more resistant types of gonorrhea? Will we see new sexually transmitted infections? Are we selfish? I mean, are we a risk, a societal risk? Uh, come on out and spread some resistant bacteria through condomless sex. (Stefan, age 35, PrEP user)

What Stefan importantly highlights – by referring to his friends – is that different ideas and beliefs about condom use and the chances of contracting sexually transmitted infections are discussed differently across various social networks. This leads to varying norms and attitudes that may influence how these men interpret and prioritise the advice given by PrEP providers. Some men, like Sigurd and Mike, try to follow advice from healthcare workers to continue using condoms as much as possible, whereas other men place greater emphasis on the monitoring of sexually transmitted infections and accept that contracting gonorrhoea, syphilis, or chlamydia is part of the game. These different ideas often meet and collide during chats on dating apps like Grindr, necessitating negotiation and consideration. Worryingly, these different ideas may give rise to social divisions within the queer community, paradoxically alluding to an entirely different dimension of irresponsibility, with Klaus ‘othering’ non-PrEP users as being ‘unsafe’, and Sigurd expressing a slight frustration about his PrEP-peers’ carelessness about other sexually transmitted infections and insistence on condomless anal sex.

I will return to the processes of ‘othering’ non-PrEP users later in this chapter. Meanwhile, I wish to end this section with questions raised by Jens, which not only capture his deliberations, but highlight how queer men are increasingly forced to consider and navigate their status as either PrEP users or non-users during interactions with other queer men: a navigation that inevitably involves negotiating ideas about PrEP’s association with responsible and irresponsible sexual health behaviour. Jens, who is not yet on PrEP but awaiting access, is wondering if his PrEP non-use diminishes his sexual capital:

If I was on PrEP, would I send a signal to my sexual partner that I take myself more seriously, and that I take responsibility for my sexuality? I would feel more liberated. Does he think less of me because I’m not on PrEP? Do men who are on PrEP have a greater ‘value’ than those who are not? Has PrEP become a form of capital, a status symbol? (Jens, age 40, PrEP interested)

Equally, queer men on PrEP may ask themselves the opposite questions if on a date with a non-PrEP user. Several PrEP users have told me that disclosing PrEP use to a date can be anxiety-inducing, especially if recognising PrEP’s associations with ‘irresponsibility’. How will he react? Does he think I sleep around a lot? Does he think I only want condomless anal sex? This questioning, and having to tailor one’s responses to both perceived and observed reactions of peers, illustrate how deeply entrenched PrEP and ideas of responsibility and irresponsibility have become within queer communities, and how they need to be negotiated in day-to-day interactions. The subsequent sections will provide further evidence of this dynamic.

Why do I feel irresponsible when taking responsibility? Shame associated with PrEP

This section goes a little deeper into the paradox of feeling both responsible and irresponsible when on PrEP, linked to the sexuality of queer men. Bo, a queer man, captures the paradox in a single sentence: ‘PrEP provides me with a feeling of taking responsibility for the life that I live.’ Reading between the lines, Bo compares his sexual behaviour with conventional sexual norms and highlights the need to take responsibility for his ‘irresponsible’ sex life. For many of our queer male participants, PrEP was not only associated with taking responsibility, but also served as an unwelcome reminder of ‘irresponsible’ and ‘deviant’ sexual behaviour, rooted in the internalised stigma and shame of their sexuality. While both queer men and young women expressed feelings of shame in relation to PrEP, the ‘good’ sexual behaviours they compared themselves to, as well as the different minority positions, were different from those they occupy within their respective socio-cultural environments.

When comparing themselves to others, the queer PrEP users recognised that they have active and colourful sex lives with multiple partners. While some celebrated this unashamedly, many also felt a deep sense of shame. Their shame was often linked to ideas of irresponsibility: for previously having had multiple partners without using protection, putting themselves and others at risk of HIV; for needing a costly drug, which is surrounded by controversy in the public sphere (see Chapter 3); and for continuing to have condomless anal sex (as discussed earlier). In our interviews, ideas of shame were often described by the queer men in relation to their encounters with PrEP services. Here they were, as part of the eligibility screening process I described in the previous chapter, required to participate in an honest and open discussion about their sex life, detailing past occurrences of condomless anal sex and sexually transmitted infections. Twenty-five-year-old Sigurd describes how the screening process made him feel: ‘When I came to the hospital, I had to explain why I felt I needed PrEP. I had to talk about my sex life, and it gave me a feeling of being a promiscuous, uhh yeah, slut.’ Queer men like Sigurd enter hospitals as responsible citizens, intending to prevent the spread of HIV, but in the screening process end up feeling ashamed and irresponsible for having had unprotected sex with multiple sexual partners and for qualifying for PrEP. The queer men spoke highly about the healthcare staff who deliver PrEP, calling them non-judgemental. The shame thus came from comparing their sexual behaviour with ideas about ‘good’ or ‘normal’ sexual behaviour. Mike clarified the link between shame and ‘deviance’ from norms and ideas about ‘good’ sexual behaviour, and in the process highlighted how such feelings of shame may deter some people from accessing PrEP:

To be considered eligible requires me to account for my sex life. Occurrences of condomless sex, sexually transmitted infections, et cetera. This makes PrEP inaccessible. To share the most intimate details of your life is scary. It takes a certain person to do that. I have worked hard not to be ashamed. We live in a culture where people get stigmatised for being sexually adventurous. It is called ‘slut-shaming’ and I fear this prevents people from accessing PrEP. People don’t have the strength to disclose such details. They don’t want to feel shame or be shamed for their desires or the choices they make. (Mike, age 32, PrEP user)

Unlike Sigurd, Mike did not talk about his own feelings of shame. He recognised the presence of shame in other people and explained that he has been on a journey of mental work to not be ashamed. He said that ‘it takes a certain person’ to unashamedly talk about one’s sex life in a culture that judges and ‘slut-shames’ PrEP users. Later in our interview with Mike, he began to unpack what has helped him overcome the shame associated with PrEP use (and become this ‘certain person’). When asked about how PrEP features in his friendship group, he explained:

Not everyone is on PrEP, but relatively many are, and it’s something we talk about. So, I know which of my friends are on PrEP. It’s normal in that sense, and nobody feels they are being shamed for being on PrEP. Or any longer, that is. There was a time, in the beginning, when people started using PrEP, where PrEP users were considered promiscuous. Now the tone is much, much nicer. Now taking PrEP is more about health and protecting yourself. And this has been normalised. There used to be an ugly tone, and some conversations were uncomfortable, but now we’re more open, and it’s nicer to talk about it. (Mike, age 32, PrEP user)

Mike navigates within a social network where PrEP is increasingly used and talked about, and where the members of his social network, through everyday PrEP negotiations, have shifted the narrative about PrEP from being related to irresponsible and promiscuous behaviour, to one characterised by taking responsibility for their health. His account of the change he has observed highlights the important role of informal networks in formulating opportunities for dialogue and creating new norms that help queer men ‘get ahead’ in relation to PrEP uptake. Sigurd also acknowledges the comfort he finds from having friends with whom he can talk about PrEP, captured through a photograph he took (see Figure 5.3):

Two cocktails, two empty water glasses, and a glass jug on a wooden table. At the top of picture is an arm resting on the table.
Figure 5.3:

Talking to friends

I’m sharing this picture to illustrate that it’s nice to have friends to talk about PrEP with (over a pink rim job cocktail!). We both started on PrEP at the same time, and it makes it easier when you can exchange experiences. Some people think ‘you should just use a condom’, so it’s nice to have friends who are on the same page as yourself. (Sigurd, age 35, PrEP user)

PrEP is, for many queer men, an unwelcome reminder of so-called irresponsibilities, leading to feelings of shame. Queer friends and social networks were described as playing a pivotal role in finding comfort and reshaping this narrative. However, for a number of our queer participants, PrEP did not add to or remind them of shame. On the contrary: PrEP was said to remove shame altogether. It did so by eliminating the ‘irresponsibility’ of HIV risk arising from condomless queer sex. For this small group of queer men, HIV risk and related stigma were intrinsically linked to their sexuality and identity as queer men. By removing the risk of HIV from their sexuality, PrEP also removed shame from having sex with other men, as described by Toke:

When I got onto PrEP I began to realise how ashamed I had been of my sexual behaviour. I realised that the shame I felt was connected to the risk of HIV. I struggled to come out as a gay man, I think because of this risk. With time, and when I got onto PrEP, I began to be at ease with my sexuality. Before I felt ashamed when having sex with another man. When I got onto PrEP, and the risk of HIV was eliminated, I began to feel much less shame. (Toke, age 27, PrEP user)

Although Toke had a different interpretation and experience from many of our other queer participants, he further underlines the deep-rooted hang-ups and shame associated with HIV, queer sex, and deviance from sexual norms in the context within which PrEP is used.

Am I irresponsible? ‘Othering’ non-PrEP users

Perhaps as a way of coping with negative stereotypes and notions of ‘irresponsibility’, and to develop more positive social identities, a number of our participants talked about themselves in an ‘us’ vs ‘them’ manner. Oftentimes, sentences that began with ‘we, PrEP users’ were followed by favourable statements about PrEP users and less flattering statements about non-PrEP users. For instance, Stefan, a 35-year-old PrEP user, said that in his social network of PrEP users, ‘There is the prejudice that people who are not on PrEP are a little boring’, with ‘boring’ referring to the notion of non-PrEP users as sexually less adventurous. This is supported by Mikkel, a 26-year-old PrEP user, who also demarcated clear boundaries between PrEP users and non-PrEP users, recognising that ‘It’s probably just a prejudice.’ Mikkel describes how there are two types of gays: those who use apps like Grindr and those who do not; those who cruise and use saunas and those who do not. According to Mikkel, it is the former group that is on PrEP, and the group he favourably sees himself as being part of. For Mikkel, being on PrEP is a statement, signalling a rejection of the ‘traditional’ life. He explains: ‘To have several sexual partners can be a type of statement. I don’t aspire to a traditional life, or go out to look for a stable partner, someone to marry.’

Oral PrEP is not merely about taking a pill for HIV prevention. PrEP plays an integral role in forming social identities around PrEP use and in some social networks comes with the status of being adventurous and sexually liberated, as opposed to traditional and boring. Forming social identities around their adventurous and liberated sexualities not only helps PrEP users cope with ‘slut-shaming’, but also recasts the idea of ‘being slutty’ as something positive. Furthermore, and as alluded to earlier, many queer men were able to reconcile being sexually adventurous with being responsible. However, in the process of representing themselves as ‘responsible’ citizens preventing the spread of HIV, some inadvertently further reinforced the ‘othering’ of non-PrEP users, representing them as irresponsible. For instance, Bo, when discussing the need for PrEP to be made more easily accessible, explained that ‘PrEP should be made more easily accessible for those who are not so good at taking responsibility for themselves.’ As discussed earlier, this ‘othering’ occurs against the backdrop of recognising the limits of condom use. This ‘othering’ is thus conditional on practising safe sex. Mike explains: ‘It is not that I think that people who are not on PrEP are irresponsible, as long as they use protection and go and get tested.’ Similarly, Toke, without using the word ‘irresponsible’, describes how he would negatively view a non-PrEP user engaging in condomless anal sex:

If he was very sexually active, and aware of PrEP, then I think it would, one way or the other, leave a negative impression [on me]. I would be thinking: Why on earth are you not protecting yourself, when you know that you have condomless sex, and know that this drug can eliminate the risk of HIV? (Toke, age 27, PrEP user)

Both Toke and Mike do not seek to ‘other’ queer men who are in monogamous relationships or able to consistently use condoms. They do, however, ‘other’ those men who are eligible for oral PrEP yet not enrolled.

The young women on PrEP in Zimbabwe did not explicitly ‘other’ women not using PrEP. They were generally understanding of the different challenges women face in accessing and using PrEP. However, when asked how they differed from non-PrEP-using women who are vulnerable to HIV, they often pointed to individual qualities. This included their ability to take control of and responsibility for their own sexual health and life, not caring about social norms or what other people might say about their PrEP use. In the process, they implicitly juxtapose these qualities with those of non-PrEP users, casting non-PrEP users as opposites: unable to take control and responsibility for sexual health and caring too much about what others think. One young woman, Stella, said:

What makes me different is that I realised I should take responsibility for myself. My life matters. My life is important. I will not let anyone try and control my life especially regarding HIV. So, prevention is better than cure. (Stella, age 26, PrEP user)

The relative absence of young women’s perspectives on the paradox of (ir)responsibility is noteworthy, and Stella’s account may point to an explanation. Her motivation to access PrEP is driven by a need to take control of her life, meaning protecting herself from her partner’s sexual risk practices, not her own. I also alluded to this in the previous chapter; it suggests that young women do not talk about PrEP use in the context of their own behaviour, but from the perspective of HIV vulnerabilities arising from their partner’s so-called irresponsible behaviour. It is perhaps for this reason we do not find that the young women moralise, contest, and challenge their own sexual practices to the same degree as do the queer men. This may explain why the paradox ‘responsible, yet irresponsible’ did not feature strongly among our young women participants.

Conclusion

Am I taking responsibility for my sexual health? Why do I feel irresponsible when taking responsibility? Am I irresponsible? These questions are revealing of some of the many everyday PrEP negotiations that queer men in particular, either interested in or already taking PrEP, are likely to engage in as they encounter differing and opposing ideas about PrEP (ir)responsibilities. While all participants in the study recognised that PrEP represents taking responsibility for HIV prevention and one’s own sexual health, this was not without its contradictions and nuances. This chapter has detailed some of the many opposing ideas and ways of thinking that circulate around PrEP, with ideas of increasing promiscuity, condomless anal sex, and chances of contracting sexually transmitted infections being critical to PrEP’s association with irresponsibility. Interestingly, many of these ideas were reproduced by the queer community itself. The dating app Grindr played a significant role in solidifying various ideas around PrEP’s (ir)responsibility, both through the app’s signposting of PrEP status, and through the sometimes uncomfortable and contentious condom use negotiations taking place on the app before a hookup. PrEP services were also noted to accentuate ‘irresponsibilities’, both through the PrEP eligibility criteria requiring disclosure of past ‘irresponsibilities’, and through regular controls for sexually transmitted infections, which for some queer men was a source of shame.

The ideas and ways of thinking that queer men are exposed to differ significantly between them, which inevitably affects how they view and understand themselves and others as (ir)responsible. Many of our queer participants formed part of social groupings in which PrEP was increasingly talked about favourably, facilitating positive social identities around PrEP use. Some social networks have reframed negative expressions such as ‘slut-shaming’ into something positive. While signalling PrEP use may increasingly constitute a form of sexual capital within many of the social networks of our study participants, this was not the case in others’ social networks. As queer men date and hook up with men across different social networks, they inevitably have to consider and navigate diverging representations of PrEP as being linked to responsible or irresponsible sexual behaviours. In an analysis of testimonial blog posts from the US-based ‘My PrEP Experience’ website, Hedrick and Carpentier (2021) also found that current and potential PrEP users had to negotiate and manage stigma online, and that some managed to deal with blame and shame through a creative reappropriation of negative labels.

How queer men negotiate PrEP in everyday life is thus, to a large degree, influenced by how PrEP is talked about within their social networks. Consequently, social networks play a key role in determining how queer men navigate different understandings of what responsibility means in the context of PrEP, deal with feelings of shame, or demarcate differences between PrEP users and non-PrEP users. According to our research, such everyday PrEP negotiations play a defining role in queer men’s experiences and continued engagement with PrEP in Denmark.