ABSTRACT
Drawing on two distinct ethnographies in Latin America, this chapter considers the social consequences of the biomedicalisation of HIV and HPV prevention strategies in re-defining sexual health. The first case study assesses how access to pre-exposure prophylaxis (PrEP) for HIV prevention in Peru shifted meanings and understandings of sexuality and the importance given to sexual risk in the political economy of global health. The second examines how the introduction of Gardasil’s HPV preventive vaccine and associated public policies impacted gender, sex and sexuality in Mexico. While approved for use with all adolescents, the vaccine’s promotion to cisgender girls reified dominant narratives about heteronormative cisgender female sexuality and risk. By understanding PrEP research and HPV vaccination as deeply connected to the workings of health systems from the North, we show how biomedical prevention fails to engage with social and political realities concerning sex, sexuality and gender in Latin America. These realities must be understood as both barriers and facilitators to the successful deployment of biomedical prevention but must be understood in the context of history, the local environment, culture and social relations – and how these too have been influenced by the broader political economy of health.
