AIDS in France

France has a higher number of AIDS cases than any other European country (except Switzerland which
shows a higher level of cases per inhabitants) but France took longer than Britain to formulate public
policy.

the geographical spread of the epidemic in France was unequal.

at the end of 1990,52% were located in the Parisian area (He de France) and 14% in the Marseille area
(Provence-Alpes-Cote d'Azur)

Defining a public policy on such a new and unexpected issue as AIDS was disturbed, occasionally
delayed, by electoral uncertainty which weakened the capacity for consensus of French society and the
legitimacy of public intervention. The strong criticisms of the 'political class' during the 80s illustrate this
weakness

AIDS decision depended on political decision, internal differences within the scientific community

Internal debates had to be overcome and alliances across different fields built up between researchers,
homosexuals and public officials, in order to establish and reinforce authority.

The 'decade of AIDS' coincided with unusually frequent elections, several changes of government and
major electoral reforms. In the 1981 presidential and general elections, the socialists came into power
for the first time for nearly fifty years Cohabitation Franois Mitterrand (socialist President) &
Jacques Chirac (liberal Prime Minister)

Health and social admin. occupy a weak position, growing control by the Ministry of Finance, reforms
might weaken the hierarchy ->

Pasteur Institute - discovery of the virus early in 1983 was hardly noticed in France. It became a public
interest when the Americans announced it.

Since there were other issues on modernity at the time (eg. TGV, electrification, nuclear programme),
professional or administrative constituency to take it up and provide sufficient legitimacy for a big
national project.

there is little public mobilization for health issues in France. the French social security system is
managed by social partners, i.e. the trade unions and employers' unions (not by the State?) Unlike in
Germany where health policies have always been considered as part of general economic and social
policies, health policies in France are considered as medical issues, concerning doctors.

The French homosexual community was initially not prepared to take up the AIDS problem which caused
great uncertainty about the future of the community, fear of renewed marginalisation and internal
onflict about the basis on which to organise the struggle against the epidemic and its consequences.

the blood transfusion centres acted as representatives of the haemophiliac patients and as their
mediator in all public relations.

The first news about AIDS reached France in June 1981

The first public intervention began in the summer of 1983.

the General Department of Health issued three 'recommendations:

the blood transfusion centres (which organise all blood donation in France) that they 'avoid risk groups'
(homosexuals, intravenous drug users, persons of African and Caribbean origin and their partners);
established a surveillance system

2 hypotheses :

- the majority of cancer, immunology and virology specialists considered that AIDS was some
normal infection that would only strike persons already weakened from other infections or
disease and therefore, it would not be easily transmitted;
- a minority of less known specialists, among them a number of virologists and the Pasteur
research team led by Professor Montagnier, declared that AIDS was an infectious disease caused
by an active viral agent

By the end of 1983, more than 100 cases of AIDS were already diagnosed in France, most of them in the
Parisian area with an overwhelming majority of homosexual men, half of whom had travelled to the
States, Haiti or central Africa. One haemophiliac case was already known but no intravenous drug users
at that stage. The first year of AIDS policies in France was characterised by a lack of consensus within the
scientific community. Health authorities were thus unable to take any further action.

The Pasteur blood test was developed experimentally during 1984 and largescale production started in
the spring of 1985.

Daneil Derferts 'AIDES', emerged at the end of 1984 and started operating in early 1985. It aimed to
promote solidarity with patients, to spread information and to establish preventive measures both
against the epidemic and against the risk of group stigmatization.

The association rapidly became a pressure group urging voluntary, free test facilities and preventive
measures, such as publicity for condoms and free sale of syringes

March 1984 - High blood donation in the Paris area + high level of homosexuals contamination with HIV
-> more hemophiliacs were infected

The French position on the scientific front was strengthened by the isolation of the second AIDS virus in
the Pasteur Institute in February 1986 and by growing consensus in the international scientific
community.

AIDS was added to the list of compulsorily notifiable diseases (decree of 10 June 1986); a circular on 3
September 1986 opposed restrictions on patients with AIDS travelling by air. This was the first step
towards preserving freedom of international travel and cutting down demands for segregationist
policies.

There was 110 million francs for research projects on treatment and vaccine (for a two-year period,
1987 and 1988); 40 million francs of extra funding to Parisian hospitals; and a subsidy of half a million to
the 'AIDES' association to promote information and prevention campaigns. The 1988 budget made a
special allowance of 760 million francs to the national health insurance fund which henceforth had to
reimburse the cost of all voluntary blood tests, according
Dissemination of public information, promotion of sex ed., abolishment of ad. on condoms

Main points:

Many elections, complicated system, socialist president with a conservative prime minister: clash
(cohabitation)

Association of HIV in France: homosexuality,

The conjunction that relates exclusively to homosexuality

Republican universalism & Frenchness (universal approach), weak identity groups (?)

Daniel Defert Stephane

Sexuality is a private matter (Public & private matters)

Lack of public discourse on sexuality

Desire not to stigmatize become stigmatization