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Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis

New medicines can transform routines and priorities in clinical practice, but how do clinicians think and feel about these changes, and how does it affect their work? In Australia, the HIV prevention regimen pre‐exposure prophylaxis (PrEP) has been rapidly rolled out, transforming the sexual culture...

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Autores principales: Smith, Anthony K J, Newman, Christy E., Haire, Bridget, Holt, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9546439/
https://www.ncbi.nlm.nih.gov/pubmed/35635513
http://dx.doi.org/10.1111/1467-9566.13502
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author Smith, Anthony K J
Newman, Christy E.
Haire, Bridget
Holt, Martin
author_facet Smith, Anthony K J
Newman, Christy E.
Haire, Bridget
Holt, Martin
author_sort Smith, Anthony K J
collection PubMed
description New medicines can transform routines and priorities in clinical practice, but how do clinicians think and feel about these changes, and how does it affect their work? In Australia, the HIV prevention regimen pre‐exposure prophylaxis (PrEP) has been rapidly rolled out, transforming the sexual cultures and practices of users, but less attention has been given to the ways PrEP has reconfigured clinical practice. This paper draws on 28 qualitative semi‐structured interviews conducted between 2019 and 2020 with PrEP‐providing doctors and nurses in Australia to consider how they have affectively engaged with PrEP and put it into practice. Through a reflexive thematic analysis, we explore how clinicians adapted to PrEP, how the field of HIV prevention has been transformed, and how these developments have changed how clinicians approach patients. While the introduction of PrEP was initially received with uncertainty and shock, clinicians described PrEP as enjoyable to prescribe, and better aligned with the moral duties of sexual health consultations than existing HIV prevention strategies like condoms. Through approaching clinical work as an ‘affective practice’, we argue for attending not only to how new interventions change expectations and practices, but also how these changes are felt and valued by clinicians.
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spelling pubmed-95464392022-10-14 Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis Smith, Anthony K J Newman, Christy E. Haire, Bridget Holt, Martin Sociol Health Illn Original Articles New medicines can transform routines and priorities in clinical practice, but how do clinicians think and feel about these changes, and how does it affect their work? In Australia, the HIV prevention regimen pre‐exposure prophylaxis (PrEP) has been rapidly rolled out, transforming the sexual cultures and practices of users, but less attention has been given to the ways PrEP has reconfigured clinical practice. This paper draws on 28 qualitative semi‐structured interviews conducted between 2019 and 2020 with PrEP‐providing doctors and nurses in Australia to consider how they have affectively engaged with PrEP and put it into practice. Through a reflexive thematic analysis, we explore how clinicians adapted to PrEP, how the field of HIV prevention has been transformed, and how these developments have changed how clinicians approach patients. While the introduction of PrEP was initially received with uncertainty and shock, clinicians described PrEP as enjoyable to prescribe, and better aligned with the moral duties of sexual health consultations than existing HIV prevention strategies like condoms. Through approaching clinical work as an ‘affective practice’, we argue for attending not only to how new interventions change expectations and practices, but also how these changes are felt and valued by clinicians. John Wiley and Sons Inc. 2022-05-30 2022-07 /pmc/articles/PMC9546439/ /pubmed/35635513 http://dx.doi.org/10.1111/1467-9566.13502 Text en © 2022 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for the Sociology of Health & Illness. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Smith, Anthony K J
Newman, Christy E.
Haire, Bridget
Holt, Martin
Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis
title Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis
title_full Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis
title_fullStr Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis
title_full_unstemmed Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis
title_short Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis
title_sort prescribing as affective clinical practice: transformations in sexual health consultations through hiv pre‐exposure prophylaxis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9546439/
https://www.ncbi.nlm.nih.gov/pubmed/35635513
http://dx.doi.org/10.1111/1467-9566.13502
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