The politics of prevention: ethnographers combat AIDS among drug users

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In an era of "zero tolerance" for even casual drug use in the United States, only the threat of AIDS mandated some humane concern for drug injectors, particularly given the risk to their sexual partners and unborn children. However, the federal government's approach to AIDS intervention in [The author] outlines the arguments and assumptions of two competing approaches to AIDS prevention among drug users. The first part examines the theoretical and subsequent methodological differences between a more traditional public health model for intervention and an innovative outreach strategy based on the principles of ethnographic research. The bulk of the chapter focuses on the "ethnographic" outreach approach to AIDS intervention, using data obtained through a participant-observation study of one such demonstration project. Thus, the analysis begins with the character and frustrations of outreach work itself. [The author] then discusses how the continuation of outreach services depends on the scientific component, on documenting the success of outreach. This mutual interdependence leads to escalating tensions that are often played out in conflicts within the project between the goals of outreach workers and administrators. In the final part [the author] traces these conflicts back to the state-imposed conditions on funding and the way the law inhibits the effectiveness of outreach. [The author] concludes with a discussion of the implications of these limitations for social service work, and applied ethnography more generally. This study used the technique of participant observation which is the study of people in their own time and space, and in their own everyday lives. (Extract of the publication)