Abstract
This paper is based on the author's ethnographic HIV prevention research at a community-based residence for women in New York City who have a history of homelessness and diagnosis of mental illness. The author presents the human face of this American tragedy, while exploring the ways in which larger social forces circumscribe these women's lives. The author also critically assesses the HIV prevention agenda, including the dominant paradigm in prevention intervention. Despite acceptance by the most prominent players in AIDS prevention in the United States, the most popular prevention theories are theoretically and substantively inadequate. While educational interventions and behavior change efforts may have some impact on inhibiting HIV transmission, the focus on the individual as the sole locus of change tends to obscure the social and material factors in the spread of the disease. An anthropologically informed alternative, integrating social responsibility and social justice, is explored. Also considered are dilemmas in applying anthropology to AIDS prevention research and how to translate theoretical abstractions into humane and pragmatic social programs.
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