Social Policy Research Centre, The University of New South Wales, Sydney, Australia.
Am J Public Health. 2013 Aug;103(8):1367-75. doi: 10.2105/AJPH.2013.301301. Epub 2013 Jun 13.
When HIV prevention targets risk and vulnerability, it focuses on individual agency and social structures, ignoring the centrality of community in effective HIV prevention. The neoliberal concept of risk assumes individuals are rational agents who act on information provided to them regarding HIV transmission. This individualistic framework does not recognize the communities in which people act and connect. The concept of vulnerability on the other hand acknowledges the social world, but mainly as social barriers that make it difficult for individuals to act. Neither approach to HIV prevention offers understanding of community practices or collective agency, both central to success in HIV prevention to date. Drawing on examples of the social transformation achieved by community action in Australia and Brazil, this article focuses on this middle ground and its role in effective HIV prevention.
当 HIV 预防以风险和脆弱性为目标时,它侧重于个人能动性和社会结构,而忽略了社区在有效 HIV 预防中的核心地位。风险的新自由主义概念假设个人是理性的行动者,他们会根据提供给他们的有关 HIV 传播的信息采取行动。这种个人主义框架没有认识到人们行动和联系的社区。另一方面,脆弱性的概念承认社会世界,但主要是将其视为使个人难以采取行动的社会障碍。这两种 HIV 预防方法都没有理解社区实践或集体能动性,而这些都是迄今为止 HIV 预防成功的核心。本文以澳大利亚和巴西社区行动实现的社会转型为例,重点讨论了这一中间立场及其在有效 HIV 预防中的作用。