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Paper short abstract

This paper examines how HIV policies are sustained amid the “destruction of the State” in Argentina. Drawing on ethnography, it follows state agents, health workers, and activists’ reliance on discretion, relations, and creativity to preserve HIV care and prevention despite institutional erosion.

Paper long abstract

This paper examines how HIV-related prevention and care public policies are sustained in Argentina under Javier Milei’s administration whose political project explicitly promotes the “destruction of the State”, dismantling public health structures and undermining institutions that historically guaranteed access to health and other social rights. Within the National HIV Directorate, drastic budget cuts, the elimination of key programmatic areas, and the dismissal of a large proportion of professional staff, have weakened support and coordination of nationwide HIV-related interventions.

The paper explores how, amid shrinking institutional capacity, State agents, healthcare professionals, and activists continue to make HIV prevention and care possible. Drawing on ethnographic research, it brings together participant observation and interviews conducted in a long standing LGBTQ+ civil society organization (forced to close due to defunding) alongside in-depth interviews with actors positioned across municipal, national, and international health arenas, including program directors and consultants from global health agencies.

In a political environment marked by sexually conservative, anti-human rights and anti-social rights politics, certain public health interventions (including HIV/STI prevention and healthcare) face heightened scrutiny or imminent shutdown. To protect policies formerly legitimized through a human-rights framework, actors now rely on discretion and partial visibility: renaming interventions, limiting public communication or downplaying the scope of certain actions, aim to keep them “under the radar”. Approaching policy in-the-making, this paper examines situated practices involving creativity, improvisation, ethical commitment, and forms of mutual recognition rooted in long-standing relationships. In this context, affect, friendship, trust, and credibility emerge as central in sustaining HIV-related policies.