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Professional Conferences

JUNE 2021

“Understanding the Effects of PrEP on Political Solidarity among MSM: Differences in Sexual Moralities and Intergenerational Views” at the Canadian Philosophical Association Virtual Conference

In this paper, I focus on the concept of solidarity in the ethics of pre-exposure prophylaxis (PrEP) as HIV prevention among men who have sex with men (MSM). Solidarity is a concept that is increasingly being used in bioethics, especially feminist bioethics, in order to understand the broader effects of emerging medical technologies on individuals as well as communities (Sherwin, 2008; Sherwin & Stockdale, 2017). I use the recent academic work on solidarity to analyze and contextualize the ethics of PrEP in terms of solidarity within gay communities in North America. Although the AIDS epidemic and early AIDS activism necessitated solidarity among MSM, including the formation of groups like Gay Men’s Health Crisis and ACT UP, this solidarity is being threatened today by new devleopments in HIV treatment and prevention and new developments in society more broadly, including the successes of the gay rights movement, which are eroding the foundations of this solidarity. Therefore, I highlight two challenges that PrEP presents to solidarity among MSM and the normative implications of these challenges. First, PrEP exposes differences in sexual moralities among MSM by reinforcing widespread social and political objections to its use based on its effects on safe sex, promiscuity, and the stereotyping of gay, bisexual, and queer men in society. These objections to PrEP centre on the risks associated with condomless sex, the recent changes in sexual and romantic relationship structures, and the strategy of the gay rights movement respectively.


Second, PrEP highlights differences in intergenerational views by exposing how the legacy of the AIDS epidemic affects the views of HIV among MSM from different generations. The deep divisions exposed by PrEP within gay communities along generational lines and lines of sexual morality demonstrate a clear threat to solidarity. These challenges raise important questions about the use of PrEP as HIV prevention among MSM today because of the specific critical and historical context of its use in North America. First, there are epistemological questions about how to weigh the testimony of survivors of the AIDS epidemic against MSM who feel marginalized and alienated by established gay culture. Second, there are ethical questions about whether to take community damage into account in thinking about how to advocate, advertise, and promote PrEP. Finally, I explain how responding to these challenges can actually build, or rebuild, solidarity within gay communities. I consider the kinds of opportunities that PrEP provides for building, or rebuilding, solidarity among MSM and within gay commmunities around new understandings of non-traditional sexual behaviour, non-traditional sexual and romantic relationships, and intergenerational differences. For example, if MSM discuss their views on sexual morality and their experiences of HIV with each other more openly, then they can begin to understand how to better relate to each other. Understanding how PrEP challenges solidarity among MSM helps us account for the social and political dimensions of this emerging medical technology as well as the specific social and political effects of PrEP on communities of MSM and gay, bisexual, and queer men in North America.

OCTOBER 2020

“Understanding the Effects of PrEP on Political Solidarity among MSM: Differences in Sexual Moralities and Intergenerational Views” at the American Society for Bioethics and Humanities Virtual Conference

In this paper, I focus on the concept of solidarity in the ethics of pre-exposure prophylaxis (PrEP) as HIV prevention among men who have sex with men (MSM). Solidarity is a concept that is increasingly being used in bioethics, especially feminist bioethics, in order to understand the broader effects of emerging medical technologies on individuals as well as communities. Although the AIDS epidemic and early AIDS activism necessitated solidarity among MSM, this solidarity is being threatened today by new developments in HIV treatment and prevention and new developments in society more broadly. Therefore, I highlight two challenges that PrEP presents to solidarity among MSM and the normative implications of these challenges. First, PrEP exposes differences in sexual moralities among MSM by reinforcing widespread social and political objections to its use based on its effects on safe sex, promiscuity, and the stereotyping of gay, bisexual, and queer men in society. Second, PrEP highlights differences in intergenerational views by exposing how the legacy of the AIDS epidemic affects the views of HIV among MSM from different generations. Finally, I explain how responding to these challenges can actually build solidarity within gay communities. I consider the kinds of opportunities that PrEP provides for building solidarity among MSM and within gay commmunities around new understandings of non-traditional sexual behaviour, non-traditional sexual and romantic relationships, and intergenerational differences. Understanding how PrEP challenges solidarity among MSM helps us account for the social and political dimensions of this emerging medical technology.

MAY 2020

“Understanding the Effects of PrEP on Political Solidarity among MSM: Differences in Sexual Moralities and Intergenerational Views” at the Canadian Bioethics Society Conference in Toronto, Ontario (Cancelled due to COVID-19)

JANUARY 2020

“Demedicalizing PrEP for HIV Prevention: The Social and Political Effects on MSM” at the American Philosophical Association (APA) Eastern Division Conference in Philadelphia, Pennsylvania

In this paper, I will explore the ethics of using pre-exposure prophylaxis (PrEP) as HIV prevention for men who have sex with men (MSM). The Centre for Disease Control and Prevention (CDC) considers MSM to be the highest risk group for contracting HIV in North America. The ethics of using PrEP as HIV prevention among MSM, however, has both a medical dimension and a social dimension. Whereas the medical dimension of the ethics of PrEP includes concerns about side effects, drug resistance, and distribution, the social dimension of the ethics of PrEP includes concerns about stigmatization, sexual and romantic relationships, and sexual freedom. The medical concerns of the ethics of PrEP may take precedence over the social concerns, but there is a growing body of literature that already addresses the medical concerns. Much less attention has been given to the social concerns of the ethics of PrEP and in this paper I will fill this gap in the literature. Therefore, I will focus on the often overlooked social dimension of the ethics of PrEP in order to help understand the connection between the risks, relationships, and responsibility of MSM using PrEP as HIV prevention.

MAY 2019

“Assessing the Risk of PrEP as HIV Prevention for MSM: Values and Value Assumptions” at the Canadian Bioethics Society (CBS) Conference in Banff, Alberta

In this paper, I argue that men who have sex with men (MSM) should embrace pre-exposure prophylaxis (PrEP) as an HIV prevention strategy despite the risks involved in its use. The most important ethical question about PrEP seems to be whether or not it is too risky to be officially approved as HIV prevention and whether or not it is too risky to be used by individuals who are at high risk for HIV. The debate about the ethical implications of PrEP always involves risk of some kind to some degree, starting the with the risk assessment of PrEP by regulatory agencies like Health Canada.


However, the ongoing risk debate about PrEP usually focuses on certain medical risks, including the risk of HIV, the risk of other STIs and the risk of promiscuity, and ignores other social and political risks, including the risk of acquiring the stigma around PrEP, the risk of reinforcing stereotypes about MSM and the risk of exacerbating divisions within the MSM community. The philosophical literature on risk demonstrates that the present risk assessment of PrEP is inadequate because it seems to rely on the classical model of risk assessment, which endorses a neutral or value-free risk assessment. This obscures the social and political risks involved in PrEP use and the values that are involved in PrEP risk assessment.


Furthermore, the present risk assessment influences the decisions of healthcare professionals, policy makers and individuals by structuring their decisions about PrEP around medical conceptions of risk. However, if we apply an alternative model of risk assessment to PrEP and we investigate the risk assessment in the personal decisions of MSM in particular, then we can expose the many different kinds of risks and benefits involved in PrEP use and the kinds of problematic value assumptions involved in PrEP risk assessment. Brunk et al. (1991) provide an especially helpful model that identifies several of the relevant kinds of value assumptions usually involved in risk assessment. Unfortunately, the values of MSM are often ignored in medical issues because these values are often different than those of the rest of society. For example, MSM often value non-traditional sexual behaviour and non-traditional sexual and romantic relationships. As an oppressed social group, MSM have unique experiences in society and these experiences lead to unique values that disrupt the status quo. The fact that the controversy around PrEP is framed as a debate about risk actually contributes to the reinforcement of what we think of as the risks associated with PrEP, the reinforcement of what we think of as risky sexual behaviour and the reinforcement of harmful narratives about male homosexuality and bisexuality. If the values of MSM are considered in PrEP risk assessment, then the social and political benefits of PrEP become especially clear. Acknowledging the role of value assumptions in the risk assessment of PrEP would improve the quality of its risk assessment and it would improve the utility of PrEP as an HIV prevention strategy for MSM.

OCTOBER 2018

"The Problem of Anthropocentrism in the Ethics of Climate Change" at the Canadian Society for Environmental Philosophy (CSEP) Conference in Calgary, Alberta

JUNE 2018

“Challenging the Anthropocentrism in the Ethics of Climate Change” at the Canadian Philosophical Association (CPA) Conference in Montreal, Quebec

In this paper, I challenge the latent anthropocentrism in the ethics of climate change. Anthropocentrism is an epistemic bias towards humans that limits our understanding of the ethics of climate change and the effects of climate change on non-human nature. I focus on Stephen Gardiner’s analysis as an example of good contemporary academic work on the ethics of climate change that nevertheless struggles with anthropocentrism.


Anthropocentrism in the ethics of climate change today has to be challenged if we are to understand the moral dimension of climate change more accurately and take the necessary steps to fight it properly.

MAY 2018

“Comparing PrEP for HIV Prevention Among MSM and the Birth Control Pill: Sex, Power & Social Justice” at the Canadian Bioethics Society (CBS) Conference in Halifax, Nova Scotia

In this paper, I explore the ethics of using pre-exposure prophylaxis (PrEP) as HIV prevention for men who have sex with men (MSM) by comparing it to the use of the birth control pill among women. The history of the birth control pill demonstrates how new medical technologies can really affect the social lives of people who use them. Although the medical concerns about the ethics of new medical technologies like PrEP may take precedence over the social concerns, there is a strong focus in literature on these medical concerns. I focus on the often overlooked social dimension of the ethics of PrEP and I investigate how PrEP affects the social lives of MSM, especially as it becomes more widely available in Canada. I argue that PrEP increases access to the social goods of sexual relationships, romantic relationships and sexual freedom for MSM in general.


However, there are many social objections to the use of PrEP by MSM that argue that PrEP actually increases risky sexual behaviour. I find that it is helpful to compare PrEP to the birth control pill in order to respond to such objections because similar arguments were levelled against the birth control pill in the past. Both PrEP and the birth control pill help prevent unwanted outcomes of sex; PrEP helps prevent HIV infection and the birth control pill helps prevent pregnancy. Empirical evidence demonstrates that the use of the birth control pill by women does not reliably increase their risky sexual behaviour. Therefore, I argue that PrEP does not increase risky sexual behaviour either. The birth control pill has increased sexual activity, the number of sexual partners and the risk of STIs, pregnancy and abortions for women. Nevertheless, increased sexual behaviour is not regarded as a reason to prohibit women’s access to the birth control pill. In fact, the birth control pill actually helps empower women by allowing them to take control of their sexuality and their sexual health. PrEP similarly empowers gay men, bisexual men and other MSM because it increases their control over their sexuality and their sexual health, which increases their sexual freedom in general.


Although the birth control pill and PrEP are usually studied in different populations, the success of the birth control pill for women suggests that reducing the risk of unwanted outcomes of sex does not necessarily lead to increased risky sexual behaviour. This comparison is important for issues of social justice in the health care of MSM. MSM, as a social group, have specific health care challenges and opportunities because of the approval of PrEP for HIV prevention in Canada in 2016. The comparison between PrEP and the birth control pill also raises difficult questions about access to health care, responsibility, power, relationship dynamics, social acceptance and mental health. Although the birth control pill is not perfect, it is important to learn lessons from the experience of women using the birth control pill in order to optimize the use of PrEP for HIV prevention among MSM.

NOV 2017

“Increasing Sexual Freedom for MSM through PrEP” at the Community Based Research Centre (CBRC) Conference in Vancouver, British Columbia

In this presentation, I explore the ethics of using pre-exposure prophylaxis (PrEP) as HIV prevention for men who have sex with men (MSM). I focus on the Canadian social, legal and medical context where PrEP was approved in 2016, but I also draw on information from the American context where PrEP was approved in 2012.


Although the medical concerns about the ethics of PrEP often take precedence over the social concerns, there is a growing body of literature in bioethics that addresses the medical concerns. Therefore, I focus on the sometimes overlooked social dimension of the ethics of PrEP. Whereas the medical dimensions of the ethics of PrEP include issues of safety, drug resistance and access among others, the social dimensions of the ethics of PrEP include issues of serodiscordance, stigmatization and sexual freedom. I argue that PrEP increases access to the goods of sex and romantic relationships for MSM and reduces the stigmatization of both HIV positive people and people who are at high risk of contracting HIV, such as MSM. I conclude that PrEP increases the sexual freedom of MSM, including those who are HIV positive and those who are HIV negative.


Furthermore, I explain how the analogy between PrEP and the birth control pill is helpful for understanding this sexual freedom; the ways in which the birth control pill empowers women is similar to the the ways in which PrEP empowers MSM. However, this analogy is also helpful for understanding some of the complexities and limitations on this sexual freedom. I address these complexities and limitations in order to further analyze the extent of the sexual freedom that PrEP affords MSM.

MAY 2017

“Using PrEP for HIV Prevention for MSM: Risks, Relationships & Responsibility” at the Canadian Bioethics Society (CBS) Conference in Montreal, Quebec

MAY 2016

“The Ethics of PrEP for HIV Prevention: Serostatus, Stigmatization & Sexual Freedom” at the Canadian Philosophical Association (CPA) Conference in Calgary, Alberta

In this paper, I explore the ethics of using pre-exposure prophylaxis (PrEP) as HIV prevention for men who have sex with men (MSM). Although the medical concerns about the ethics of PrEP may take precedence over the social concerns, there is a growing body of literature that addresses the medical concerns. Therefore, I focus on the often overlooked social dimension of the ethics of PrEP. I argue that PrEP increases access to the goods of sex and romantic relationships for MSM and reduces the stigmatization of HIV positive people and people who are at high risk of contracting HIV.

Posters

APR 2018

“Comparing PrEP & the Birth Control Pill: Sexual Freedom, Empowerment & MSM” at the Canadian Association for HIV Research (CAHR) Conference in Vancouver, British Columbia

APR 2018

“A Blended Learning Curriculum for Training Peer Researchers to Conduct Community-Based Participatory Research” at the Canadian Association for HIV Research (CAHR) Conference in Vancouver, British Columbia

Graduate Conferences

APR 2016

“Non-Human Rights and Mind-Reading: Empathy, Moral Agency & Personhood” at the York University Graduate Philosophy Conference in Toronto, Ontario