The social construction of the PrEP1519 study: conditions of possibility for advances in HIV/AIDS prevention

This paper analyzed the genesis of the PrEP1519 study and feasibility conditions for its construction. A qualitative-approach study was conducted using the Bourdieusian sociology framework to reconstruct the dynamics of the social environment where PrEP1519 emerged during 2015-2018. A document analysis and ten in-depth interviews were carried out to analyze the trajectory of the project. Pre-exposure prophylaxis (PrEP) was introduced in Brazil as a public policy in 2017. The lack of scientific evidence available among the adolescent population led to the development of a demonstrative cohort study, associated with an intervention, aimed at combining the prevention and treatment of sexually transmitted infections at three sites in Brazil. PrEP1519 sought to generate evidence for global use and to help the Brazilian Ministry of Health apply PrEP among adolescents. The articulation of bureaucratic, scientific, and activist stakeholders enabled this study. The feasibility conditions for developing PrEP1519 included a favorable relationship of national organizations with international organizations, the favorable approach that public administrators had at the time towards new technologies and prevention strategies, the researchers’ previous experience in studies with the target population or with PrEP, articulation efforts with social movements, civil society organizations, and other public agencies, and the integration between scientific institutions, which allowed using international resources and developing a response to the problem. Completing this study at a moment when conservatism advances in Brazil demands that the scientific community and activists closely monitor and take stances on PrEP to ensure its availability for adolescents as a public policy.

本文分析了PrEP1519研究的起源及其筹备实施的可行性条件。本研究采用布迪厄社会学框架开展质性研究，重构2015至2018年PrEP1519诞生时所处社会环境的动态演化逻辑。研究通过文献分析法与10次深度访谈，剖析了该项目的发展历程。暴露前预防（Pre-exposure prophylaxis，简称PrEP）于2017年作为公共政策在巴西正式推行。由于青少年群体中缺乏相关科学证据支撑，研究团队在巴西三地开展了一项配套干预措施的示范性队列研究，旨在整合性传播感染的预防与诊疗工作。PrEP1519研究旨在为全球范围内的应用提供科学依据，并助力巴西卫生部在青少年群体中推广PrEP。官僚机构、科研群体与行动主义利益相关方的协同联动，为该研究的开展提供了必要保障。PrEP1519研究的开展可行性条件包括：国内机构与国际组织的良性合作关系；彼时公共管理者对新技术与预防策略的包容态度；研究人员此前针对目标群体或PrEP相关研究的实践经验；与社会运动、民间组织及其他公共机构的协同推进工作；以及科研机构间的整合协作，这使得研究能够利用国际资源并针对该问题制定应对方案。在巴西保守主义思潮抬头的当下完成此项研究，要求科研界与行动主义者密切关注PrEP并明确立场，以确保青少年群体能够以公共政策的形式获得PrEP服务。