Governing at a Distance: Mainstreaming of Australian HIV/AIDS Treatments and Services 1989-1996 Reconsidered

This article examines the controversy around the proposal in the late 1980s and early 1990s to mainstream HIV/AIDS treatment, services, and care in Australia. With the predicted increase in HIV infections, and with improved prophylaxis and antiretroviral therapy (such as AZT) extending the lives of people with HIV/AIDS, mainstreaming was proposed as a strategy that could meet the anticipated increased demand in HIV/AIDS services. Our analysis suggests that mainstreaming was strategically positioned as a necessary intermediary step between specialist and community control, one in which general practitioners and local health workers would serve as conduits through which specialist knowledge and information could be deployed. The strategy also reflected a general shift in thinking and acting on public health that emerged in the late 1980s, a shift that sought, inter alia, to reorientate health services towards fostering the self-managing capacities of HIV/AIDS affected communities.