“结构-关系-主体”框架下的艾滋病预防--扩展“疾病”的社会学想象

AIDS prevention under the“structure-relationship-subject”framework and in a broader sociological perspective

本文综合作者多年来针对女性性工作者的实地调研与艾滋病干预工作经验,归纳了与女性性工作者的艾滋病风险相关的各类因素,构建出"结构—关系—主体"的分析框架。其中,"结构"包括:扫黄政策、艾滋病防治政策、经济与贫困、社会歧视、性与社会性别文化、社会流动等;"关系"涉及:性产业的组织形式,小姐与妈咪、客人、邻居、警察及小姐之间的权力与互动关系;"主体"则是关于小姐个人在专业知识、工作实践、认同方面的能动性与主体性。相比于以"疾病"为中心的医学框架,本文提出的"结构—关系—主体"的分析框架关注到小姐人群所面临及关心的健康问题远远不止艾滋病,而是更为宽泛的包括暴力、一般妇科问题、社会歧视、心理健康、性病与艾滋病在内的"职业健康"问题。这个框架不仅扩展了对"艾滋病"的社会学想象,更有利于指导实际的健康促进工作。

Based on the empirical research and evaluation work among female sex workers （FSW）in China since 1999,this paper constructs a framework consisting of＇structure-relationship-subject＇fac-tors which have close relationships with AIDS risks.Structural factors include anti-prostitution poli-cies,AIDS prevention policies,economic problems and poverty,social stigmas,sexuality and gender culture,and social mobility.Relationship factors include organizational types of FSW,the power and interactive relationship between FSW and managers,clients,neighbors,local police and so on.Sub-j ective factors mainly refer to FSW＇s initiative and subj ectivity concerning their professional knowledge as well as their self-identity.Such a framework aims at the FSW＇s occupational health,which includes not only AIDS problems but also other issues such as violence,gynecological diseases,social stigmas, psychological pressure,VD,etc.Compared to the traditional disease-oriented medical framework, this one has a broader sociological perspective and may help the related work in China.