Fan Elsa L
a Department of Behavioral and Social Sciences , Webster University , St. Louis , MO , USA.
Glob Public Health. 2014;9(1-2):85-97. doi: 10.1080/17441692.2014.881520. Epub 2014 Feb 5.
In this paper, I examine the emergence of goumai fuwu, or contracting with social organisations to provide social services, in the HIV/AIDS sector in China. In particular, I interrogate the outsourcing of HIV testing to community-based organisations (CBOs) serving men who have sex with men (MSM) as a means of scaling-up testing in this population, and how the commodification of testing enables new forms of surveillance and citizenship to emerge. In turn, I tie the scaling-up of testing and its commodification to the sustainability of CBOs as they struggle to survive. In recent years, the HIV/AIDS response in China has shifted to expanding testing among MSM in order to reduce new infections. This response has been catalysed by the transition to sexual contact as the primary transmission route for HIV and the rising rates of infection among MSM, leading government institutions and international donors to mobilise CBOs to expand testing. These efforts to scale-up are as much about testing as they are about making visible this hidden population. CBOs, in facilitating testing, come to rely on outsourcing as a long-term funding base and in doing so, unintentionally extend the reach of the state into the everyday lives of MSM.
在本文中，我探讨了中国艾滋病防治领域中“购买服务”（即与社会组织签约以提供社会服务）的出现情况。具体而言，我审视了将艾滋病检测外包给为男男性行为者（MSM）服务的社区组织（CBO）这一做法，将其作为扩大该人群检测规模的一种手段，以及检测的商品化如何促使新的监测形式和公民身份形式出现。相应地，我将检测规模的扩大及其商品化与社区组织在艰难求存时的可持续性联系起来。近年来，中国的艾滋病防治工作已转向在男男性行为者中扩大检测，以减少新感染病例。这种转变是由艾滋病主要传播途径转变为性接触以及男男性行为者感染率上升所推动的，促使政府机构和国际捐助者动员社区组织扩大检测。这些扩大检测规模的努力，在很大程度上既是为了检测，也是为了让这个隐藏人群浮出水面。社区组织在推动检测过程中，开始依赖外包作为长期资金来源，而这样做无意间将国家的影响力扩展到了男男性行为者的日常生活中。
