Anticipations of ending the HIV epidemic using Pre-exposure prophylaxis (PrEP): affective states and uncertainties among PrEP users in Dar es Salaam

At a study site in Dar es Salaam, 'risk subjects' (Rose, 2007), in this case, transgender women and men who have sex with men, come to gain access to Pre-exposure prophylaxis (PrEP) – a novel HIV prevention pill. The pill holds the promise to 'end HIV by 2030' according to the WHO. This paper draws on ten months of ethnographic fieldwork between 2021/2022 at a PrEP study site in Tanzania. The paper explores how some PrEP users anticipated an HIV-negative future with PrEP as a temporal possibility (Adams et al., 2009) and hope for the best possible future for themselves, their partners and their community. The paper found that using PrEP not only introduced hope for the future but PrEP also introduced novel uncertainties and affective states into their users' lives, such as rumours about the spread of PrEP as an ineffective drug and uncertainty about PrEP's effectiveness caused by stress related to HIV status. Furthermore, PrEP users were concerned about the potential stigma they could experience as PrEP users, as PrEP was associated with promiscuity, sex work and HIV positivity. Lastly, the projectivization (Prince, 2014) of PrEP and the unstable provision at the beginning of the PrEP scale-up in Tanzania caused anxiety and uncertainty to its daily users. Finally, I speculate on whether biomedical interventions, such as PrEP, can hold their promise of ending an epidemic in solitude. I anticipate a need to include social and structural perspectives in present public health interventions to 'end AIDS' sometime in the future.