Health policies and the problems they constitute are deeply shaped by multiple publics. In this article we conceptualize health policy counterpublics: temporally bounded socio-political forms that aim to cultivate particular modes of conduct, generally to resist trajectories set by arms of the state. These counterpublics often emerge from existing social movements and involve varied forms of activism and advocacy. We examine a health policy counterpublic that has arisen in response to new forms of HIV public health surveillance by drawing on public documents and interview data from 2021 with 26 stakeholders who were critical of key policy developments. Since 2018, the national rollout of molecular HIV surveillance (MHS) and cluster detection and response (CDR) programs in the United States has produced sustained controversies among HIV stakeholders, including among organized networks of people living with HIV. This article focuses on how a health policy counterpublic formed around MHS/CDR and how constituents problematized the policy agenda set in motion by federal health agencies, including in relation to data ethics, the meaningful involvement of affected communities, informed consent, the digitization of health systems, and HIV criminalization. Although familiar problems in HIV policymaking, concerns about these issues have been reconfigured in response to the new sociotechnical milieu proffered by MHS/CDR, generating new critical positions aiming to remake public health. Critical attention to the scenes within which health policy controversies play out ought to consider how (counter)publics are made, how problems are constituted, and the broader social movement dynamics and activist resources drawn upon to contest and reimagine policymaking in public life.

中文翻译：

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卫生政策反公众：对美国艾滋病毒分子监测以及集群检测和应对计划进行集体抵制。


卫生政策及其造成的问题深受多个公众的影响。在本文中，我们对卫生政策反公众进行了概念化：受时间限制的社会政治形式，旨在培养特定的行为模式，通常是为了抵制国家军队设定的轨迹。这些反公众往往来自现有的社会运动，并涉及各种形式的激进主义和宣传。我们利用 2021 年的公开文件和采访数据，对针对新形式的艾滋病毒公共卫生监测而出现的卫生政策反公众进行了研究，采访了 26 位对关键政策制定持批评态度的利益相关者。自 2018 年以来，美国在全国范围内推出艾滋病毒分子监测 (MHS) 和集群检测与应对 (CDR) 计划，在艾滋病毒利益相关者之间（包括有组织的艾滋病毒感染者网络之间）引发了持续的争议。本文重点介绍如何围绕 MHS/CDR 形成卫生政策反公众，以及选民如何对联邦卫生机构制定的政策议程提出问题，包括与数据伦理、受影响社区的有意义参与、知情同意、健康数字化相关的问题系统和艾滋病毒刑事定罪。尽管艾滋病毒政策制定中存在常见问题，但为了应对 MHS/CDR 提供的新社会技术环境，对这些问题的担忧已经重新配置，产生了旨在重塑公共卫生的新关键立场。对卫生政策争议发生的场景的批判性关注应该考虑如何产生（反）公众、如何构成问题，以及更广泛的社会运动动力和活动资源，以争夺和重新构想公共生活中的政策制定。