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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.

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Religious institutions, which contribute to understanding of and mobilization in response to illness, play a major role in structuring social, political, and cultural responses to HIV and AIDS. We used institutional ethnography to explore how religious traditions--Catholic, Evangelical, and Afro-Brazilian--in Brazil have influenced HIV prevention, treatment, and care at the local and national levels over time. We present a typology of Brazil's division of labor and uncover overlapping foci grounded in religious ideology and tradition: care of people living with HIV among Catholics and Afro-Brazilians, abstinence education among Catholics and Evangelicals, prevention within marginalized communities among Evangelicals and Afro-Brazilians, and access to treatment among all traditions. We conclude that institutional ethnography, which allows for multilevel and interlevel analysis, is a useful methodology.

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The HIV epidemic has raised important tensions in the relationship between Church and State in many parts of Latin America where government policies frequently negotiate secularity with religious belief and doctrine. Brazil represents a unique country in the region due to the presence of a national religious response to HIV/AIDS articulated through the formal structures of the Catholic Church. As part of an institutional ethnography on religion and HIV/AIDS in Brazil, we conducted an extended, multi-site ethnography from October 2005 through March of 2009 to explore the relationship between the Catholic Church and the Brazilian National AIDS Program. This case study links a national, macro-level response of governmental and religious institutions with the enactment of these politics and dogmas on a local level. Shared values in solidarity and citizenship, similar organizational structures, and complex interests in forming mutually beneficial alliances were the factors that emerged as the bases for the strong partnership between the two institutions. Dichotomies of Church and State and micro and macro forces were often blurred as social actors responded to the epidemic while also upholding the ideologies of the institutions they represented. We argue that the relationship between the Catholic Church and the National AIDS Program was formalized in networks mediated through personal relationships and political opportunity structures that provided incentives for both institutions to collaborate.

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Brazil's national response to AIDS has been tied to the ability to mobilize resources from the World Bank, the World Health Organization, and a variety of donor agencies. The combination of favorable political economic opportunities and the bottom-up demands from civil society make Brazil a particularly interesting case. Despite the stabilization of the AIDS epidemic within the general Brazilian population, it continues to grow in pockets of poverty, especially among women and blacks. We use resource mobilization theories to examine the role of Afro-Brazilian religious organizations in reaching these marginalized populations. From December 2006 through November 2008, we conducted ethnographic research, including participant observation and oral histories with religious leaders (N = 18), officials from the National AIDS Program (N = 12), public health workers from Rio de Janeiro (N = 5), and non-governmental organization (NGO) activists who have worked with Afro-Brazilian religions (N = 5). The mobilization of resources from international donors, political opportunities (i.e., decentralization of the National AIDS Program), and cultural framings enabled local Afro-Brazilian religious groups to forge a national network. On the micro-level, in Rio de Janeiro, we observed how macro-level structures led to the proliferation of capacity-building and peer educator projects among these religious groups. We found that beyond funding assistance, the interrelation of religious ideologies, leadership, and networks linked to HIV can affect mobilization.

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Religious beliefs have had a key role in shaping local responses to HIV and AIDS. As the world's largest Catholic country, Brazil is no exception. Yet little research has been conducted to document how the religious doctrine is enacted in practice among its lay leaders and followers. In this article, we present ethnographic research from Recife, Brazil, conducted to understand the way in which religious doctrines are interpreted on a local level. Contextualized within the sociology of contemporary Brazilian Catholicism, we draw on interviews with clergy members, lay leaders and parishioners in order to discuss how the Catholic Church's vision of sexuality translates into the everyday lives of its followers by. We explore the disjuncture between the Catholic ideals of fidelity and delaying sex until marriage with the everyday reality of the Church's followers, highlighting the role that gender plays in defining sexual roles and expectations. We conclude posing questions for future research and HIV prevention strategies considering the formal institutional response of the Brazilian Catholic Church to AIDS on one hand, and the social and cultural contexts in which Catholics live their daily lives on the other.

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This article examines the role of civil society in shaping HIV and AIDS policies and programs in Brazil. It focuses on the historical context of the redemocratization of Brazilian society during the 1980s, when the initial response to the epidemic took shape, and emphasizes the role of social movements linked to the progressive Catholic Church, the sanitary reform movement in public health, and the emerging gay rights movement in the early response to the epidemic in Brazil. It highlights the broad-based civil society coalition that took shape over the course of the 1990s and the political alliances that were built up shortly after the 1996 International AIDS Conference in Vancouver, Canada, to pass legislation guaranteeing the right to access to antiretroviral treatment. It emphasizes the continued importance of civil society organizations-in particular, AIDS-related nongovernmental organizations-and leading AIDS activists in exerting continued pressure to guarantee the sustainability of treatment access and the impact that action focused on HIV and AIDS has had on the Brazilian public health system more broadly, particularly through strengthening health infrastructures and providing a model for health-related social mobilization.

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Esse texto discute questões relacionadas à sexualidade e HIV / AIDS na América Latina, enfocando as formas pelas quais as culturas sexuais organizam representações e práticas que podem levar à vulnerabilidade em relação à infecção pelo HIV. Discute-se, ainda, o desenvolvimento de um programa amplo de prevenção à infecção para homens que fazem sexo com homens. O texto sugere que intervenções para reduzir o risco de infecção pelo HIV não devem ser limitadas no âmbito comportamental, mas, principalmente, no das representações que os indivíduos têm sobre suas práticas sexuais. Mudanças comportamentais devem ser conceituadas como parte de um processo mais abrangente de mudanças sociais - processo este que é, por natureza, menos técnico do que social, cultural e político.

This essay examines issues related to sexuality and HIV/AIDS in Latin America. It focuses on the ways in which sexual cultures organize representations and practices that may lead to vulnerability in relation to HIV infection, and discusses the development of a large-scale prevention program in Brazil for men who have sex with men. It suggests that interventions to reduce the risk of HIV infection must seek to function not only at the level of behavior, but more importantly at the level of the representations that people hold about their sexual practices. Changes in behavior must be conceptualized as part of a more broad-based process of social change - a process which is less technical than social, cultural and political in nature.

Ce texte discute les questions rélatifs à la sexualité et le SIDAlHIV en Amérique Latine, en focalisant sur les formes par lesquelles les cultures sexuelles organisent représentations et pratiques que peuvent apporter la vulnerabilité en ce qui conceme l'infection par HIV. L'article discute aussi le développement d'un programme ample pour prévenir I ínfection des hommes que ont relations sexuelles avec d'autres hommes. Le texte sugere que les interventions pour réduire le risque d'infection par HIV ne doivent pas être lirnitées eu niveau du comportement, mais surtout au niveau des représentations que les individus ont sur leur pratiques sexuelles. Changements de comportement doivent être conçus comme partie d'un proces plus large de changements sociales - un proces, par nature, moins technique que social, culturel et politique.

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Analisa as complexas ligaçöes entre as diversas forças que atuam no processo de ajustar políticas formuladas para combater a epidemia de HIV/AIDS e aponta algumas tendências das políticas relacionadas à AIDS que podem se revelar contraproducentes no que se refere ao objetivo máximo da luta contra a epidemia. (JSL)

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Esse ensaio examina o desenvolvimento das pesquisas sobre sexualidade à luz da epidemia do HIV/AIOS. Ele sugere que, embora a AIOS tenha chamado atenção para a negligência histórica em relação às pesquisas sobre sexualidade e tomado disponíveis maiores recursos para o apoio às atividades de pesquisa direcionadas à sexualidade, a maioria do trabalho realizado em resposta à AIOS tem, entretanto, sido limitado por paradigmas teóricos e metodológicos anti­quados, assim como pela ausência de uma agenda de pesquisas clara e coerente. Especialmente dentro do campo da Saúde Pública, os modelos biomédicos e as preocupações epidemiológicas têm estabelecido o tipo de atividades de pesqui­sa, mas falhado em fornecer dados e análises capazes de contribuir efetivamente para a prevenção da AIOS. Como alternativa às estruturas teoréticas tradicio­nais, o artigo chama atenção para um foco emergente sobre a construção social e cultural da experiência sexual, e indica a importância do desenvolvimento de uma nova agenda de pesquisa para o estudo da sexualidade que terá mais capacidade de se dedicar ao contexto intersubjetivo da educação sobre e da prevenção contra a AIOS...

This essay examines the development of research on sexuality in the wake of the HIV/AIOS epidemic. It suggests that although AIOS called attention to the historic neglect of sexuality research, and made available expanded resources for the support of research activities focusing on sexuality, the majority of the work carried out in responde to AIOS, has nonetheless been limited by inade­quate and outmoded theoretical and methodological paradigms as well as by the lack of a clear and coherent research agenda. Particularly within the field of public health, biomedical models and epidemiological concerns have guided the design of research activities, but have falled to provide data and analyses capable of contributing effectively to AIOS prevention. As an alternative to traditional theoretical frameworks, the article calls attention to an emerging focus on the social and cultural construction of sexual experience, and points to the importance of developing a new research agenda for the study of sexuality that will be better able to address the intersubjective context of AIOS education and prevention...

Cet essai examine le développement des recherches sur Ia sexualité par rapport à I' épidémie de HIV /SIOA. Il estime que, bien que le SIOA ait attiré I' attention sur Ia négligence historique en ce qui concerne les recherches sur Ia sexualité et ait apporté plus de ressources pour l'appui aux activités de recherche liées à Ia sexualité, Ia majorité du travail réalisé en réponse au SIOA est, cependant, limité par des paradigmes théoriques et méthodologiques dépassés ainsi que par l'absence d'un programme de recherche clair et cohérent. Oans le domaine de Ia santé publique, les modeles biomédicaux et les préoccupations épidémio­logiques déterminent le type d' activités de recherche, mais ne donnent pas assez d'éléments et d'analyses capables de vraiment contribuer à Ia prévention du SIDA. Comme une option aux structures théoriques traditionnelles, l'article attire I' attention sur un aspect important de Ia construction sociale et culturelle de l'expérience sexuelle et montre I'importance d'un nouveau programme de recherche pour I'étude de Ia sexualité qui sera plus capable de se vouer au contexte intersubjectif de I'éducation sur le SIDA et sa prévention...

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Oferece uma visäo geral da epidemia da AIDS no Brasil, detalhando a epidemiologia em nível nacional. Examina o impacto social da epidemia, volando-se aos fatores sociais e culturais. Finaliza examinando as políticas públicas e as respostas políticas que a sociedade brasileira tem desenvolvido perante a AIDS (AU)

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Richard parker, uma vez mais, nos oferece um exemplo de como o conhecimento acadêmico pode ser postoa serviço da vida, sem abrir mão das regras do jogo de linguagem que lhe é particular.No que pensa e no que faz mostra que o "humanamente útil" ainda é o que de melhor podemos produzir na universidade. Afinal, para que saber e por que saber? - senão para construirmos, junto com os outros, uma vida mais bela e mais feliz! Até segunda ordem, esta é a ética neopragmática. É assim que interpreto a démarche intelectual de Richard. É assim que vejo sua tentativa de ajudar-nos a "construir" a solidariedade perdida, esquecida ou pouco lembrada. Acho que dele não podemos dizer menos nem pedir mais. (AU)

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Explora o relacionamento entre sexualidade, política e AIDS na sociedade brasileira. Examina o desenvolvimento social da epidemia, o complexo relacionamento entre sexualidade, homossexualidade e AIDS e as distintas posturas políticas construídas como resposta à epidemia. Analisa as consequências da injustiça e da intolerância na sociedade brasileira e defende como combate a epidemia, uma política de solidariedade baseada no respeito à diferença cultural e na luta por justiça social

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Oferece uma visão geral da epidemia da AIDS no Brasil, detalhando a epidemiologia em nível nacional. Examina o impacto social da epidemia, volando-se aos fatores sociais e culturais. Finaliza examinando as políticas públicas e as respostas políticas que a sociedade brasileira tem desenvolvido perante a AIDS

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Avalia três aspectos relacionados à epidemia de HIV/AIDS no Brasil: a) as análises sócio-demográficas sobre a progressão da epidemia; b) as questões teórico-metodológicas colocadas pela epidemiologia; c) as respostas coletivas às possíveis modificações do padrão epidemiológico observado. Analisa as dimensões sociais da epidemia HIV/AIDS no Brasil, destacando assuntos ligados à pauperização, discriminação e a vulnerabilidade individual e coletiva

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