The genesis of the AIDS policy and AIDS Space in Brazil (1981-1989)

ABSTRACT OBJECTIVE To analyze the genesis of the policy for controlling AIDS in Brazil. METHODS Socio-historical study (1981-1989), based on Bordieu’s genetic sociology, by document analysis, bibliographical review, and in-depth interviews. It consisted of a connection between the analysis of the paths of 33 agents involved in the creation of a social space focusing on AIDS-related issues and the historical possibility conditions of the drafting of a specific policy. RESULTS AIDS Space is a gathering point for the paths of agents from several social fields (medical, scientific, political, and bureaucratic fields). A specific space for relationships, which enabled the drafting of a policy for controlling the AIDS epidemic, but also a place where the authority to talk about the meaning of the disease, the methods to prevent and treat it was under dispute. The analysis showed how the various structures (democratic administrations in Sao Paulo and at the national level, with public health officers taking important positions) and the lack of a specific therapy contributed to social agents of different ranks and backgrounds to initially set prevention as a priority. CONCLUSIONS The rise of the sanitary movement, the organization of SUS, and the dominance of the medical field at the AIDS Space contributed to foster treatment as a part of the measures to control the epidemic. These conditions allowed drafting a policy based on the integrality of care, by linking prevention and treatment in the following decade, with important participation from state bureaucracy and researchers.

【摘要】
目的：分析巴西艾滋病防控政策的生成路径。
方法：本研究为1981-1989年的社会史研究，以布迪厄（Bourdieu）的发生社会学为理论基础，通过文献分析、文献综述与深度访谈开展研究。研究将针对聚焦艾滋病相关议题的社会空间构建进程中，33名参与主体的行动轨迹，与特定政策制定的历史可能性条件建立关联。
结果：艾滋病空间（AIDS Space）是来自医学、科学、政治与官僚等多个社会场域的行动者（agent）轨迹的汇聚点。这一专属的关系性空间既为艾滋病疫情防控政策的制定提供了可行性支撑，同时也成为围绕疾病意义阐释、防控与治疗方法的话语权博弈场域。分析结果显示，圣保罗州与国家级的民主行政架构（公共卫生官员占据重要岗位）的多重结构，以及当时尚未出现针对性治疗手段的现状，推动不同层级与背景的社会行动者（agent）最初将预防作为工作优先级。
结论：卫生运动的兴起、巴西统一卫生系统（SUS）的组建，以及艾滋病空间中医学场域的主导地位，共同推动治疗成为艾滋病防控措施的组成部分。上述条件使得后续十年内能够构建起兼顾预防与治疗的整体性照护政策框架，并吸引国家官僚体系与研究者的广泛参与。