RESUMO
There is a rich tradition of research on the neuroanatomical correlates of spoken language production in aphasia using constrained tasks (e.g., picture naming), which offer controlled insights into the distinct processes that govern speech and language (i.e., lexical-semantic access, morphosyntactic construction, phonological encoding, speech motor programming/execution). Yet these tasks do not necessarily reflect everyday language use. In contrast, naturalistic language production (also referred to as connected speech or discourse) more closely approximates typical processing demands, requiring the dynamic integration of all aspects of speech and language. The brain bases of naturalistic language production remain relatively unknown, however, in part because of the difficulty in deriving features that are salient, quantifiable, and interpretable relative to both speech-language processes and the extant literature. The present cross-sectional observational study seeks to address these challenges by leveraging a validated and comprehensive auditory-perceptual measurement system that yields four explanatory dimensions of performance-Paraphasia (misselection of words and sounds), Logopenia (paucity of words), Agrammatism (grammatical omissions), and Motor speech (impaired speech motor programming/execution). We used this system to characterize naturalistic language production in a large and representative sample of individuals with acute post-stroke aphasia (n = 118). Scores on each of the four dimensions were correlated with lesion metrics, and multivariate associations among the dimensions and brain regions were then explored. Our findings revealed distinct yet overlapping neuroanatomical correlates throughout the left-hemisphere language network. Paraphasia and Logopenia were associated primarily with posterior regions, spanning both dorsal and ventral streams, which are critical for lexical-semantic access and phonological encoding. In contrast, Agrammatism and Motor speech were associated primarily with anterior regions of the dorsal stream that are involved in morphosyntactic construction and speech motor planning/execution respectively. Collectively, we view these results as constituting a brain-behavior model of naturalistic language production in aphasia, aligning with both historical and contemporary accounts of the neurobiology of spoken language production.
RESUMO
Neuroscience attracted increasing attention in mass media during the last decades. Indeed, neuroscience advances raise high expectations in society concerning major societal issues such as mental health and learning difficulties. Unfortunately, according to leading experts, neuroscience advances have not yet benefited patients, students and socially deprived families. Yet, neuroscience findings are widely overstated and misrepresented in the media. Academic studies, briefly described here, showed that most data misrepresentations were already present in the neuroscience literature before spreading in mass media. This triumphalist neuroscience discourse reinforces a neuro-essentialist conception of mental disorders and of learning difficulties. By emphasizing brain plasticity, this discourse fuels the neoliberal ethics that overvalue autonomy, rationality, flexibility and individual responsibility. According to this unrealistic rhetoric, neuroscience-based techniques will soon bring inexpensive private solutions to enduring social problems. When considering the social consequences of this rhetoric, neuroscientists should refrain from overstating the interpretation of their observations in their scientific publications and in their exchanges with journalists.
Assuntos
Deficiências da Aprendizagem , Transtornos Mentais , Neurociências , Humanos , Neurociências/métodos , Transtornos Mentais/fisiopatologia , Deficiências da Aprendizagem/fisiopatologia , Saúde Mental , Meios de Comunicação de MassaRESUMO
Conversational turn-taking is a complex communicative skill that requires both linguistic and executive functioning (EF) skills, including processing input while simultaneously forming and inhibiting responses until one's turn. Adult-child turn-taking predicts children's linguistic, cognitive, and socioemotional development. However, little is understood about how disruptions to temporal contingency in turn-taking, such as interruptions and overlapping speech, relate to cognitive outcomes, and how these relationships may vary across developmental contexts. In a longitudinal sample of 275 socioeconomically diverse mother-child dyads (children 50% male, 65% White), we conducted pre-registered examinations of whether the frequency of dyads' conversational disruption during free play when children were 3 years old related to children's executive functioning (EF; 9 months later), self-regulation skills (18 months later), and externalizing psychopathology in early adolescence (age 10-12 years). Contrary to hypotheses, more conversational disruptions significantly predicted higher inhibition skills, controlling for sex, age, income-to-needs (ITN), and language ability. Results were driven by maternal disruptions of the child's speech, and could not be explained by measures of overall talkativeness or interactiveness. Exploratory analyses revealed that ITN moderated these relationships, such that the positive effect of disruptions on inhibition was strongest for children from lower ITN backgrounds. We discuss how adult-driven "cooperative overlap" may serve as a form of engaged participation that supports cognition and behavior in certain cultural contexts.
Assuntos
Comunicação , Função Executiva , Adulto , Humanos , Masculino , Pré-Escolar , Criança , Feminino , Estudos Longitudinais , Função Executiva/fisiologia , Fala , CogniçãoRESUMO
Research on online pornography abstinence movements has predominantly focused on men's perspectives, often within the context of the broader manosphere. This focus has overshadowed the unique experiences and viewpoints of women in these movements. Our study aimed to fill this gap by exploring women-centric perspectives in pornography abstinence forums, particularly Porn Free Women (r/pornfreewomen). Using a mixed methods approach, this study examined the sexual scripts presented in women-dominated pornography abstinence communities. Our structural topic modeling analysis delineated the interplay of therapeutic, heteronormative, and empowerment themes that were evident in women's narratives and expressions. Further, our discourse analysis elucidated three specific scripts: the addiction script, the heterosexual script, and the liberation script. These interweaving narratives show that discussions of women's pornography abstinence are multifaceted and include a variety of perspectives to negotiate. These results contribute to a nuanced understanding of the values of health and well-being, sexual liberation, and feminism within women's pornography abstinence communities.
Assuntos
Literatura Erótica , Feminismo , Humanos , Literatura Erótica/psicologia , Feminino , Adulto , Comportamento Sexual/psicologia , Abstinência Sexual/psicologia , InternetRESUMO
Sexual violence is a public health threat in the USA and past research has found that survivors who seek support and disclose their experiences tend to have greater positive outcomes, such as positive life changes, reduced post-traumatic stress disorder, and fewer depressive symptoms. While social media have become an important site of disclosure, over-moderation of sex and sexuality on social media platforms due to the passing of the Fight Online Sex Trafficking Act and the Stop Enabling Sex Traffickers Act may inadvertently lead to the removal of survivors' posts and hinder their ability to build communities of support. In line with critical discourse analysis, this study examined the discursive strategies utilized in online disclosures made by sexual violence survivors on the social media platform TikTok to determine if they make use of algospeak, a neologism referring to the strategy of misspelling words or using coded language to avoid detection and deletion by site moderators. Analysis of the data indicated that sexual violence survivors do make use of algospeak, as well as direct and indirect language, to share their disclosures, and that, while TikTok claims to provide space for survivors' stories, its guidelines and approach to language about sex and sexuality may create barriers to building supportive communities.
RESUMO
BACKGROUND: The proliferation of social media platforms has provided a unique space for discourse on mental health, originally intended to destigmatize mental illness. However, recent discourses on these platforms have shown a concerning shift towards the romanticization of mental health issues. This research focuses on Twitter (now called X) users' authentic discussions on the phenomenon of romanticizing mental health, aiming to uncover unique perspectives, themes, and language used by users when engaging with this complex topic. METHODS: A comprehensive content analysis was conducted on 600 relevant tweets, with the application of topic modeling techniques. This methodology allowed for the identification and exploration of six primary themes that emerged from Twitter users' discussions. Statistical tests were not applied in this qualitative analysis. RESULTS: The study identified six primary themes resulting from Twitter users' discussions on the romanticization of mental health. These themes include rejecting/critiquing the glamorization of mental health, monetization of mental health by corporate organizations, societal misconceptions of mental health, the role of traditional media and social media, unfiltered realities of depression, and the emphasis on not romanticizing mental health. CONCLUSIONS: This study provides valuable insights into the multifaceted discourses surrounding the romanticization of mental health on Twitter. It highlights users' critiques, concerns, and calls for change, emphasizing the potential harm caused by romanticizing mental illness. The findings underscore the importance of fostering responsible and empathetic discussions about mental health on social media platforms. By examining how Twitter users interact with and respond to the romanticization of mental health, this research advances our understanding of emerging perspectives on mental health issues among social media users, particularly young adolescents. The study also underscores the effects of this phenomenon on individuals, society, and the mental health community. Overall, this research emphasizes the need for more responsible and knowledgeable discussions around mental health in the digital age.
Assuntos
Transtornos Mentais , Mídias Sociais , Humanos , Adolescente , Ansiedade , Transtornos de Ansiedade , IdiomaRESUMO
BACKGROUND: Empirical studies suggest that gratitude positively influence the quality of life of palliative patients and relatives. However, the literature is marked by a lack of conceptual clarity about what gratitude is and whether it can bring about individual and social benefits. AIM: This paper explores how palliative care patients and relatives understand gratitude, how discursive representations of gratitude may affect their positions, perceptions and relations, and how to conceptualise gratitude in the palliative context. DESIGN: We examine 33 gratitude letters written by patients and relatives and 25 semi-structured interviews conducted as part of a pilot gratitude intervention study. We use a qualitative approach, thematic analysis, within a conceptual framework of discourse analysis. SETTINGS/PARTICIPANTS: Data were collected from 23 patients and 13 relatives recruited through three hospital palliative care services in French-speaking Switzerland. RESULTS: Participants articulate gratitude in five ways: (1) appreciating others; (2) love; (3) need to reciprocate; (4) appreciating the little things; (5) solace amid serious illness. While some of these representations are sources of positive emotions and outlook, wellbeing and hope, others may confirm self-perceptions of powerlessness and burden. These results support a tridimensional conceptualisation of gratitude in palliative care as source of individual benefits, valuing closest relationships and moral obligation. CONCLUSION: Our study suggests that gratitude is a key to a good (end of) life, whilst highlighting potential negative effects. It could help healthcare professionals to better understand what gratitude means to patients and relatives, which may facilitate awareness and fostering of gratitude in palliative care.
Assuntos
Cuidados Paliativos , Qualidade de Vida , Humanos , Cuidados Paliativos/psicologia , Qualidade de Vida/psicologia , Pesquisa Qualitativa , Pacientes , Pessoal de SaúdeRESUMO
Intrinsic inequity in assessment refers to sources of harmful discrimination inherent in the design of assessment tools and systems. This study seeks to understand intrinsic inequity in assessment systems by studying assessment policies and associated procedures in residency training, using general pediatrics as a discourse case study. Foucauldian discourse analysis (FDA) was conducted on assessment policy and procedure documents. Two authors independently prepared structured analytic notes using guiding questions. Documents and respective analytic notes were subsequently reviewed independently by all authors. Each author prepared further unstructured analytic notes on the documents' discourse. The authors then compared notes and constructed truth statements (i.e., interpretations of what the discourse establishes as true about the construct under study) and sub-strands (i.e., themes) that were repeated and legitimized across the documents via iterative discussion. Based on analysis, the authors constructed two truth statements. These truth statements, "good assessment is equitable assessment," and "everyone is responsible for inequity," conceptualized inequity in assessment as an isolated or individual-level aberration in an otherwise effective or neutral system. Closer examination of the truth statements and sub-strands in the discourse presented an alternative view, suggesting that inequity may in fact not be an aberration but rather an inherent feature of assessment systems.
Assuntos
Internato e Residência , Humanos , Criança , PolíticasRESUMO
Administrative staff in higher and health professions education have been described as invisible and been characterized by what they are not: non-academics, non-teachers, non-faculty and non-professionals. Staff appear as passive objects in literature and minimized in institutional reports. These characterizations contribute to the undervaluing of staff and can lead to inefficiencies or tensions in the working environment within health professions education. This study sought to identify discourses connected to the undervaluing of staff work.This study used a Foucauldian-inspired critical discourse analysis approach within the context of a single Canadian Faculty of Medicine. Data collection involved compiling an archive of published literature and institutional archival documents extending approximately 150 years, interviews with twelve staff members and nine faculty members, and the author's lived experience as staff.Three primary discourses of staff were identified: staff as caregiver, matriarch, and professional. These discourses regulate staff (and their relations with faculty) differently, creating differences in what staff and faculty can do, be, or say (or not do, be, or say). While in the first two discourses of caregiver and matriarch, staff power is largely absent or obscured, in the third discourse, differing constructs of the concept of "professional" used by faculty and staff demonstrate a rise in power of staff and the declining authority of faculty.Writing administrative staff back in and centring staff voices can help provide agency to staff and reduce or help navigate possible tensions in the workplace.
RESUMO
Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures.
Assuntos
Planejamento Estratégico , Humanos , Canadá , Centros Médicos Acadêmicos/organização & administração , Análise DocumentalRESUMO
It has been claimed that various discourses related to competence influence higher education, but there is limited understanding of the discourses underlying competence development. The specific aim of this study was to explore epistemic discourses concerning the development of competence of health professionals with a master's degree in health science. Accordingly, the study was qualitative and adopted discourse analysis. Twelve participants, all of whom were Norwegian health professionals aged between 29 and 49 years, participated in this study. Four participants were in the final stage of study for their master's degree with three months left before completion, four had completed their degree two weeks before their participation, and four had been working for one year after the completion of their degree. Data were collected in three group interviews. Three epistemic discourses were revealed: (1) a critical thinking competencies discourse, (2) a scientific thinking competencies discourse, and (3) a competence-in-use discourse. The former two discourses were considered the dominant discourses and indicated that a knowing "that" discourse connected the specialized competence of different health professionals with a wider field of competence. This wider field transcended the boundaries of various health disciplines and represented a novel competence developed through a synergizing process between critical and scientific thinking competencies, which seems to drive continued competence development. A competence-in-use discourse was formed in the process. This discourse can be viewed as a unique outcome that contributes to health professionals' specialized competence and suggests that a knowing "how" discourse was also an underlying background discourse.
Assuntos
Educação de Pós-Graduação em Enfermagem , Humanos , Adulto , Pessoa de Meia-Idade , Pensamento , Pessoal de Saúde , Atitude do Pessoal de SaúdeRESUMO
BACKGROUND: The WHO advocates patient and public involvement as an ethical imperative, due to the value of the lived experience of patients. A deeper understanding of the shared meanings and underlying beliefs of healthcare professionals and managers for and against including patients in care pathway development. OBJECTIVE: To explore the considerations of healthcare professionals and managers on the involvement of patients and public in care pathway development. METHODS: In a medical rehabilitation centre we conducted a single case study that was part of a 2-year action research programme on blended care pathway development. Following 14 semistructured interviews with healthcare professionals and managers, we analysed their discourses on the value of patient involvement as well as the potential threats and opportunities. RESULTS: We identified four discourses. Patient as expert frames involvement as relevant, as adding new perspectives and as required to fully understand the patient's needs. Skills and representation is based on the construct that obtaining valuable insights from patients requires certain skills and competences. Self-protection focusses on personal, interprofessional objections to patient involvement. Professional knows best reveals expertise-related reasons for avoiding or postponing involvement. CONCLUSION: These discourses explain why patient and public involvement in care pathway development is sometimes postponed, limited in scope and level of participation, and/or avoided. The following strategies might minimise the paralysing effect of these discourses: strengthen the capabilities of all stakeholders involved; use a mix of complementary techniques to gain involvement in distinct phases of care pathway development; and create/facilitate a safe environment. Put together, these strategies would foster ongoing, reciprocal learning that could enhance patient involvement. PATIENT OR PUBLIC CONTRIBUTION: This study belonged to an action research programme on blended care pathway development (developing an integrated, coordinated patient care plan that combines remote, digital telehealth applications, self-management tools and face-to-face care). Multidisciplinary teams took a quality collaborative approach to quality improvement (considering patients as stakeholders) to develop 11 blended care pathways. Although professionals and managers were instructed to invite patients onto their teams and to attend care pathway design workshops, few teams (3/11) actually did. Unravelling why this happened will help improve patient and public involvement in care pathway development.
Assuntos
Procedimentos Clínicos , Pessoal de Saúde , Participação do Paciente , Humanos , Pessoal de Saúde/psicologia , Entrevistas como Assunto , Atitude do Pessoal de Saúde , Pesquisa QualitativaRESUMO
The family meal has been extensively investigated as a site for children's acquisition of eating-related behaviors and attitudes, as well as culture-specific rules and assumptions. However, little is known about children's socialization to a constitutive dimension of commensality and even social life: good manners concerning bodily conduct. Drawing on 20th century scholarship on body governmentality and good manners, and building on recent studies on family meal as a socialization site, the article sheds light on this overlooked dimension of family commensality. Based on a corpus of more than 20 h of videorecorded family dinner interactions collected in Italy, and using discourse analysis, the article shows that family mealtime constitutes a relevant arena where parents control their children's conduct through the micro-politics of good manners. By participating in mealtime interactions, children witness and have the chance to acquire the specific cultural principles governing bodily conduct at the table, such as "sitting properly", "eating with cutlery", and "chewing with mouth closed". Yet, they are also socialized to a foundational principle of human sociality: one's own behavior must be self-monitored according to the perspective of the generalized Other. Noticing that forms and contents of contemporary family mealtime talk about good manners are surprisingly similar to those described by Elias in his seminal work on the social history of good manners, the article documents that mealtime still constitutes a privileged cultural site where children are multimodally introduced to morality concerning not only specific table manners, but also more general and overarching assumptions, namely the conception of the body as an entity that should be (self)monitored and shaped according to moral standards.
Assuntos
Comportamento Infantil , Comportamento Alimentar , Refeições , Socialização , Humanos , Refeições/psicologia , Itália , Masculino , Feminino , Criança , Comportamento Infantil/psicologia , Comportamento Alimentar/psicologia , Princípios Morais , Pré-Escolar , Família/psicologia , Relações Pais-FilhoRESUMO
BACKGROUND: In the perioperative care of individuals with obesity, it is imperative to consider the presence of risk factors that may predispose them to complications. Providing optimal care in such cases proves to be a multifaceted challenge, significantly distinct from the care required for non-obese patients. However, patients with morbidities regarded as self-inflicted, such as obesity, described feelings of being judged and discriminated in healthcare. At the same time, healthcare personnel express difficulties in acting in an appropriate and non-insulting way. In this study, the aim was to analyse how registered nurse anaesthetists positioned themselves regarding obese patients in perioperative care. METHODS: We used discursive psychology to analyse how registered nurse anaesthetists positioned themselves toward obese patients in perioperative care, while striving to provide equitable care. The empirical material was drawn from interviews with 15 registered nurse anaesthetists working in a hospital in northern Sweden. RESULTS: Obese patients were described as "untypical", and more "resource-demanding" than for the "normal" patient in perioperative care. This created conflicting feelings, and generated frustration directed toward the patients when the care demanded extra work that had not been accounted for in the schedules created by the organization and managers. CONCLUSIONS: Although the intention of these registered nurse anaesthetists was to offer all patients equitable care, the organization did not always provide the necessary resources. This contributed to the registered nurse anaesthetists either consciously or unconsciously blaming patients who deviated from the "norm".
Assuntos
Enfermeiros Anestesistas , Assistência Perioperatória , Humanos , Enfermeiros Anestesistas/psicologia , Obesidade/cirurgia , Fatores de Risco , SuéciaRESUMO
Narratives, and other forms of discourse, are powerful vehicles for informing, entertaining, and making sense of the world. But while everyday language often describes discourse as moving quickly or slowly, covering a lot of ground, or going in circles, little work has actually quantified such movements or examined whether they are beneficial. To fill this gap, we use several state-of-the-art natural language-processing and machine-learning techniques to represent texts as sequences of points in a latent, high-dimensional semantic space. We construct a simple set of measures to quantify features of this semantic path, apply them to thousands of texts from a variety of domains (i.e., movies, TV shows, and academic papers), and examine whether and how they are linked to success (e.g., the number of citations a paper receives). Our results highlight some important cross-domain differences and provide a general framework that can be applied to study many types of discourse. The findings shed light on why things become popular and how natural language processing can provide insight into cultural success.
Assuntos
Semântica , Filmes Cinematográficos , Publicações , TelevisãoRESUMO
Violence in family caregiving, once a social taboo, is now emerging as a topic of scientific inquiry. Engaging with a non-normative approach to care and critical reflection on research of abusive caregiver behaviour and elder abuse, this study argues that as caregiver violence is increasingly addressed in research, it is crucial to understand it as a complex issue within its social context. The study adds to this understanding by conducting a discourse analysis of violence prevention programmes in Finland, where third sector organisations have taken the initiative in addressing caregiver violence. Based on analysis of project materials, media texts and expert interviews related to two such violence prevention programmes, the study illuminates how caregiver violence is made intelligible through a combination of three kinds of understanding: institutional, humane and therapeutic. It is suggested that these understandings offer a way forward in thinking about the complex, sensitive topic of caregiver violence in sociological research on care.
RESUMO
Conceptualisations of grief have transformed significantly in recent decades, from an experience accepted and expressed in community spaces to a diagnosable clinical phenomenon. Narratives of this transformation tend to focus on grief's relationship to major depression, or on recent nosological changes. This paper examines the possibility of a new narrative for medicalisation by grounding in the networks of language and power created around 'grief' through a critical discourse analysis of psy-discipline articles (n = 70) published between 1975 and 1995. Focusing on shifts in definitions of, methods used to approach, and rationales motivating study of the experience, it posits that the psy-disciplines exerted exclusive expertise over grief decades before its creation as a diagnosis. By reconceptualising grief in the terms of psy-specific symptoms and functional performance and by approaching it with the decontextualising and interventionist methods of an increasingly scientific psy-discipline, the psy-community medicalised grief between 1975 and 1995. Identifying neoliberal and other cultural influences shaping this process of medical construction and reconsidering narratives of grief's history mindful of the powers exerted in medicalisation, this paper establishes that these moments played a critical role in the development of the present's grief.
RESUMO
Between 2017 and 2020, the UN Special Rapporteur (SR) Dainius Puras published three reports that called for significant changes to organisation, funding and service provision in mental health care in ways that emphasise inclusive, rights-oriented, democratic and sustainable community health services. This article aims to examine formal organisational responses to the UN mental health reports and consider the underlying arguments that either support or delegitimise the SR stance on the need for a paradigmatic shift towards a human rights-based approach to mental health. By combining several different search strategies to identify organisational responses across the web, a total of 13 organisational responses were included in the analysis. Given the political nature of the responses, concepts from discourse theory were used to analyse the responses. The analysis showed how the responses articulated two binary positions and contesting articulations of good mental health care, which formed a backdrop for rejecting the SR reports in defence of psychiatry. The discussion elucidates how the responses tend to resemble previous ways in which critique has been dealt with mainly by 'biological psychiatry', but that the counter-critical nature of the medical and psychiatric organisational responses remains in contrast to the broader reception within the UN community.
Assuntos
Saúde Mental , Psiquiatria , Humanos , Direitos Humanos , Serviços de Saúde Comunitária , Nações UnidasRESUMO
Emerging technologies of artificial intelligence (AI) and automated decision-making (ADM) promise to advance many industries. Healthcare is a key locus for new developments, where operational improvements are magnified by the bigger-picture promise of improved care and outcomes for patients. Forming the zeitgeist of contemporary sociotechnical innovation in healthcare, media portrayals of these technologies can shape how they are implemented, experienced and understood across healthcare systems. This article identifies current applications of AI and ADM within Australian healthcare contexts and analyses how these technologies are being portrayed within news and industry media. It offers a categorisation of leading applications of AI and ADM: monitoring and tracking, data management and analysis, cloud computing, and robotics. Discussing how AI and ADM are depicted in relation to health and care practices, it examines the sense of promise that is enlivened in these representations. The article concludes by considering the implications of promissory discourses for how technologies are understood and integrated into practices and sites of healthcare.
RESUMO
Human immunodeficiency virus (HIV) continues to present a public health problem, and pre-exposure prophylaxis (PrEP) offers a promising preventative intervention; however, its uptake remains low, so investigating determinants of use is essential. This article applies queer critical discourse analysis to a corpus of 121 TikToks sampled via the TikTok algorithm, coded and refined into three overarching content categories: 'what makes a PrEP user?', 'what is PrEP as a drug?', and 'sexual health and HIV'. Examples from within these categories reveal four underlying discursive themes: (1) stigmatisation of HIV as a 'gay disease' with a poor prognosis; (2) stigmatisation of gay men as unsafe, high-risk and untrustworthy; (3) stigmatisation of PrEP as increasing 'unsafe' sexual practices; (4) poor healthcare and education gay men and other beneficiaries of PrEP. These themes are influenced by a broad spectrum of homophobic and heteronormative discourses available with specific examples reflecting parts of this spectrum from predominantly perpetuating to occasionally challenging. The findings report complementary evidence obtained from other media platforms yet offer a unique take while suggesting useful avenues for future public health messaging relating to PrEP which may be used to inform the next steps against HIV.