Sexing the Archive

Despite being a widely consumed genre of visual culture, pornography remains a touchy subject in contemporary queer historiography. Queer archives overflow with it, but queer histories don’t. Historically associated with low culture and distrusted by value systems that have tended to privilege the “high” faculties of reason to the detriment of the “base” materiality of the body, its affects and appetites, porn is too rarely approached as a legitimate source with which to think cultural, affective, intellectual, and sexual histories. This article draws from porn studies and queer historiographies to draw some methodological considerations about the value, benefits, and challenges posed by porn archives to the writing of queer subcultural histories. Rather than trying to solve porn’s double ontological status as both documentary and fantasy, the authors locate in that defining feature of the genre porn’s value as a historical source. Simultaneously a document of sex cultures and of the edges of morality, and a historically and culturally situated speculation on what bodies and sex may become, porn offers both cultural critics and historians a rich archive for deepening their knowledge of the intersections of culture, morality, pleasure, community, embodiment, and the politics of belonging.

Fatal Adulteries: Sexual Politics in the English Revolution

This article argues for a reconsideration of the origins of Restoration sexual politics through a detailed examination of the effusive sexual polemic of the English Revolution (1642–1660). During the early 1640s, unprecedented political upheaval and a novel public culture of participatory print combined to transform explicit sexual libel from a muted element of prewar English political culture into one of its preeminent features. In the process, political leaders at the highest levels of government—including Queen Henrietta Maria, Oliver Cromwell, and King Charles I—were confronted with extensive and graphic debates about their sexual histories in widely disseminated print polemic for the first time in English history. By the early 1650s, monarchical sexuality was a routine topic of scurrilous political commentary. Charles II was thus well acquainted with this novel polemical milieu by the time he assumed the throne in 1660, and his adoption of the “Merry Monarch” persona early in his reign represented a strategic attempt to turn mid-century sexual politics to his advantage, despite unprecedented levels of contemporary criticism. Restoration sexual culture was therefore largely the product of civil war polemical debate rather than the singular invention of a naturally libertine young king.

Diffuse Gonococcal Infection (DGI) in a Patient with Treatment-Refractory Acetylcholine Receptor Antibody-Positive (AChR+) Generalized Myasthenia Gravis (gMG) Treated with Eculizumab

Patients receiving complement inhibitor, eculizumab, are at high risk for infections with encapsulated organisms such as Neisseria due to impaired opsonophagocytic activity. Impaired complement immunity may increase the risk for dissemination of asymptomatic Neisseria gonorrhoeae. Disseminated Gonococcal Infection (DGI) is a rare but potentially life-threatening complication associated with eculizumab. Physicians should obtain adequate sexual histories from the patients and educate them on safe sexual practices. Here, we describe a case of DGI in a 32-year-old African American female patient with acetylcholine receptor antibody-positive (AChR+) generalized myasthenia gravis (gMG), receiving eculizumab.

Acceptability and feasibility of screening pregnant women for sexually transmitted infections in Rawalpindi, Pakistan

Objectives: To understand the acceptability and feasibility of sexually transmitted infection (STI) testing during antenatal care, along with the prevalence of STIs, in Rawalpindi, Pakistan. Methods: We enrolled pregnant women seeking antenatal care and performed STI testing using Cepheid GeneXpert® CT/NG and TV kits and Alere Determine™ HIV and syphilis tests. We used interviewer-administered surveys to collect medical, social, and sexual histories. Participants testing positive for STIs and their partners were treated. Results: We enrolled 1001 women from September to December 2019. Nearly all women offered to participate in this study enrolled. Most women understood the effects an STI can have on their pregnancy (99.6%) and valued STI screening during pregnancy (98.1%). 11 women tested positive for any STI: ( Chlamydia trachomatis = 4, Neisseria gonorrhoeae = 1, and Trichomonas vaginalis = 6). Of those, six presented for a test-of-cure, and two were positive for Trichomonas vaginalis. None tested positive for HIV infection or syphilis ( n = 503). Conclusions: STI testing during antenatal care in Rawalpindi was acceptable, valued, understood, and feasible. The prevalence of STIs in pregnant women was low. Continued prevalence monitoring is warranted.

Uncertain Sexualities and the Unusual Woman: Depictions of Jane Addams and Emily Dickinson

How does contemporary society deal with uncertainty about sexualities in the past? We investigate how two museums manage uncertainty about the sexual histories of two female biographical subjects. Contributing to understandings of how cultural institutions handle such uncertainty, and, in particular, how museums depict gender and sexualities, our paper brings together current debates in literatures on queer histories, collective memory, and sexualities and gender. Our observations at the Jane Addams Hull House Museum and the Emily Dickinson Museum reveal that both museums handle uncertainty about their subject’s sexuality by conflating ambiguous sexuality with non-normative gender performance. This conflation results in the depiction of the character of the “unusual woman.” While one museum relies on the “unusual woman” to evade discussions of non-normativity, the other uses the same device to acknowledge and politicize uncertainty. Our research thus reveals institutional depictions of the “unusual woman” even in an era in which many cultural institutions work to frame sexual minorities as “normal” or the “same.” At the same time, our work intervenes in gender and sexualities scholarship by demonstrating that unusualness can be either obfuscatory or provocative; conflations of gender and sexuality are multifaceted and can either reproduce or disrupt normativity.

1286. Healthcare Provider Attitudes and Knowledge Around Pre-Exposure Prophylaxis (PrEP) for the Prevention of HIV-Infection in Tennessee

Background Daily pre-exposure prophylaxis (PrEP) is very effective at preventing HIV acquisition. PrEP use in the southern United States is low despite high regional HIV prevalence. Prior surveys of primary care providers (PCPs) regarding PrEP occurred before recent guideline updates, were not constructed using a theoretical behavioral framework and validated, or did not focus on the South. Methods We conducted a cross-sectional survey of Tennessee (TN) PCPs from March-April 2019 to assess PrEP knowledge, attitudes, and prescribing practices. Survey development was guided by the COM-B framework (capability, opportunity, motivation and behavior) and validated by pilot testing and cognitive interviews. Knowledge scores were calculated as +1 point for each correct option and 0 points for each incorrect option (maximum score=8). Wilcoxon rank-sum tests were used to compare scores, and Fisher’s exact tests were used to compare categorical variables, between PrEP prescribers and nonprescribers. Results Among 69 respondents, 39% (n = 27) had prescribed PrEP. There were no differences in beliefs about PrEP or sense of obligation to prescribe PrEP between prescribers and nonprescribers. Patient inquiry about PrEP was significantly associated with prescription (P < 0.001); 100% of prescribers had ≥1 patient ask about PrEP in the past year vs. 29% of nonprescribers. Prescribers’ median PrEP knowledge scores were higher than nonprescribers’ (Figure 1). Prescribers had higher self-reported ability to take sexual histories for MSM and heterosexual male patients than nonprescribers (P = 0.007, P = 0.007), and higher self-reported comfort with taking sexual histories for MSM, heterosexual male, and heterosexual female patients (P = 0.061, P = 0.005, P = 0.026, respectively). Nonprescribers frequently cited a need for training in PrEP contraindications and eligibility, cost of PrEP, and administrative burden as barriers to provision. Conclusion Less than half of TN PCPs we surveyed prescribed PrEP despite similar senses of obligation and PrEP-related beliefs between prescribers and nonprescribers. Future interventions to improve PrEP provision among PCPs in TN should target PrEP knowledge, ability and comfort with sexual history taking, and patient awareness of and ability to inquire about PrEP. Disclosures All authors: No reported disclosures.