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Date of Award


Access Type

Campus Access

Document type


Degree Name

Doctor of Philosophy (PhD)

Degree Program


First Advisor

Julie D. Hemment

Second Advisor

Elizabeth L. Krause

Third Advisor

Barbara Cruikshank

Subject Categories

Political Science | Social and Cultural Anthropology | Urban Studies


This dissertation examines the cultural and political forces that shape and direct AIDS policy in the United States. Through a multi-sited, ethnographic research project in Springfield, Massachusetts, a post-industrial city with the 11th highest per capita AIDS rate in the nation, this project investigates the political culture that informs and directs needle exchange legislation. With a move toward a more politically engaged ethnography, this research blends political activism, participant observation, openended interviews and political analysis to provide an “insider” study of the policymaking process as it unfolded on the ground –from the Massachusetts State House and Springfield City Hall to an illegal needle exchange program operated by local AIDS activists. The political antagonism at the center of my investigation is a conflict between, on the one hand, the scientific consensus on the efficacy of needle exchange, and on the other, the moralizing discourse associated with injection drug use. Here, the often-contradictory forces of science and morality form a paradox within the policymaking process: although there is scientific consensus on the efficacy of needle exchange, needle exchange legislation is continuously defeated on moral grounds. Locating this paradox in the propensity of the American state - beginning with the Reagan administration in the early 1980s - to calibrate social policy through a juridical combination of an enhanced liberal individualism with neoliberal economic reforms, this dissertation interrogates the means by which policymakers harness a particular worldview of human nature–individual will, personal responsibility, entrepreneurship, economic man–to make sense of the AIDS epidemic. To what extent can we locate the present role of moralism in American social policy as indicative of our contemporary political culture? Do social policies operate as forms of moral regulation to govern people in alignment with “the common sense of our age?” If so, can we then argue that social policies are an essential feature of liberal statecraft, a system of moral governance that is reconfiguring the contemporary relationship between individual and society? The immediate concern for democratic politics is the prospect that social policies directed at the needs of politically marginalized groups may not motivated by social concerns alone but based on the cultural stigma associated with their practices.