Normalizing pre-exposure prophylaxis: a thematic synthesis of self-talk and communication work

Abstract This article investigates the communicative mechanisms underlying the normalization of HIV pre-exposure prophylaxis (PrEP) as it evolves from a contentious innovation to a more widely accepted sexual health approach. By synthesizing qualitative research on the lived experiences of early users of the first PrEP medication (Truvada) among gay, bisexual, and other men who have sex with men (MSM), we examine how these men communicatively negotiate the novelty, stigma, and normative tensions surrounding PrEP, and how these practices contribute to its normalization. A thematic synthesis of 28 studies identifies 2 key modes of communication: (a) intrapersonal self-talk to establish coherence, negotiate propriety, and deconstruct stigma and (b) interpersonal communication work to counter stigma and manage PrEP use disclosure. Our findings advance a communication-centered perspective on normalization, illustrating MSM PrEP users’ communicative practices in integrating PrEP into their lives, reshaping personal, relational, and cultural scripts about HIV prevention and sexual relations.