Care, and the less of it: Haunted gestures and the affective economy of pharmaceutical HIV prevention

Abstract

Pre-exposure prophylaxis (PrEP) is an antiretroviral drug that effectively prevents an HIV infection, which German statutory health insurance has covered since 2019. The drug's use in Germany has (re)surfaced ambivalent emotions: hopes for an HIV/AIDS-free future and sexual liberation rub against enduring worries and moralizations of promiscuity. Drawing on ethnographic fieldwork in Berlin's sexual cultures and prevention landscape, this article engages the affective economy that has emerged concerning PrEP and the hopes, worries, and accusations the drug has incited. To illustrate how the conflicting affects surrounding PrEP use haunt this economy, the article builds from the German notion of Sorglosigkeit/carelessness—a term intentionally straddling the ambivalence between being careless and carefree. Sustained by healthcare infrastructures and PrEP users’ practices of self-care, carelessness is not taken to be antithetical to, but operating on the affective terrain of, Sorge (worry, anxiety, concern, care). Ethnographically grounding carelessness in intergenerational hauntings of HIV/AIDS, the article examines gestures as they situate embodied emotions and personal experiences in the course of collective history. Three specific gestures—a sigh, finger-pointing, and palpation—mediate between biographies, bodies, and publics, and trace how carelessness circulates around PrEP.