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Paper short abstract

This paper examines how the HIV and sexual health response is sustained amid the "destruction of the State" in Argentina. Drawing on ethnographic research, it follows how state agents rely on discretion, relations, and creativity to preserve these interventions amid institutional erosion.

Paper long abstract

This paper examines how HIV and sexual health responses are sustained in Argentina under 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, many of whom are care workers and activists, continue to make HIV and sexual health responses possible. Drawing on ethnographic research, it centers on in-depth interviews with state agents positioned across municipal, national, and international health arenas, including current and former 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 like HIV/STI prevention and healthcare, but also trans health and abortion access, face heightened scrutiny or imminent shutdown.

To protect policies formerly legitimized through a human-rights framework, these agents 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, trust, and credibility emerge as central in sustaining the HIV and sexual health response.