Anthony K J Smith

New and re-emerging political, economic, and legal issues threaten global sexual and reproductive rights and HIV responses. This session aimed to understand how social contexts evolve with and affect sexual cultures amidst social unrest and biomedical HIV prevention, and how to alleviate structural violence and centre pleasure-based HIV responses.

Associate Professor Laura Ferguson (University of Southern California) argued that the toughest contemporary challenges are social and political, highlighting disruptions to sexual rights and cultures resulting from COVID-19, conservative laws and political environments, mass migration, and ongoing issues of stigma and discrimination. Creative solutions and interventions to ameliorate negative effects were explored, including digital health solutions, political advocacy, and structural interventions aimed at reducing stigma. Professor Adam Bourne (La Trobe University, Australia) asked if we are fully capitalising on the benefits of biomedical HIV prevention. While PrEP and U=U have enabled pleasure and well-being for gay and bisexual men, people living with HIV face sustained sexual rejection based on HIV status, and access to pleasure is globally inequitable. Professor Bourne observed that while there are often commitments to a holistic definition of sexual health in HIV policy and clinical guidelines, these documents primarily focus on the avoidance of infection and disease rather than on integrating pleasure. Dr Ryan Whitacre (GENDRO, United States) presented data from a multi-country study of refugees in Europe, highlighting the legal liminality that reduces the health and well-being of queer refugees. Compounding structural factors result in queer refugees being exposed to violence, including through transactional sex.

Audience questions focused on the relationships between bodily autonomy, pleasure, and women (and the quashing of Roe v Wade in the United States), the reimagination of how safe sex is conceptualised, and identifying how conservative legislation (such as recent anti-homosexuality laws in Uganda) were exported from the United States. This session emphasised that a commitment to pleasure in HIV responses, the protection of sexual and reproductive rights, and understanding the political and economic forces shaping harmful conservative legislation is needed more than ever. Not addressing these risks increasing stigma, suffering, and diminished progress in HIV and sexual health.