Governing by Prevention. The Contemporary Biopolitics of Sexual Health

This presentation aims to analyse the transformations underway since the early 2000s in the field of HIV prevention from Foucault's analyses in his course on biopolitics (1979) to show that they come under a rationality properly neoliberal. The multiplication of preventive tools for different publics and biomedicalization have prompted public actors and associations to redefine their message and therefore their understanding of both the prevention environment and the preventive subject. On the one hand, the objective of governmental action to develop a space by offering several preventive tools and by leaving a priori the possibility for individuals to choose their prevention mode allows to glimpse an environmental technology that Foucault had already noticed as a specificity of the neoliberal art of governing. On the other hand, it will be a question of considering the subject of governmental action as a homo economicus, "entrepreneur of himself", responsible for his health which is assimilated to a capital to be protected through choices and preferences, which he seeks to maximize. Consequently, if individuals are subjects of interests, it is possible to rationalize their behaviours, "reduced to choices and oriented towards ends" (Dubuisson-Quellier, 2018). This will be the role of “Mesopolitics” (Taylan, 2013) which will link ancillary knowledge (from public health and social sciences) to power devices in order to formulate, within the environment, incentives to which individuals will respond. The French national prevention campaigns, but also the ongoing biomedical paradigm in the sexual Health prevention, illustrate the two sides of this neoliberal governmentality through "diversified" prevention which seeks, in the first instance, an adaptation of the offer to sexual practices rather than the practices’ adaptation to the preventive offer. The preventive framework is organized as a "market" where individuals must achieve preferential choices between the various tools while the rationalization of sexuality through the construction of risk groups allows to make conducts governable. Thus, freedom of choice can’t be separated from the production of a rational subject who will guide itself in prevention according to control and surveillance devices. Choices, far from being completely autonomous, are shaped by a subjectivity which results from the connection of knowledge to power devices. The new preventive strategies therefore illustrate the neoliberal idea of a rational, autonomous but above all adaptable individual to the variations of an environment constantly reshaped by public policies. Homo economicus is, here, the one who responds to the transformations of public action in that he is "eminently governable". The use of neoliberalism allows to show that prevention policies are the result of a co-construction between the organization of an artificial environment and the production of a specific preventive subject. This governmentality acts "at a distance" through the prevention environment and illustrates a “conduct of conducts” more precise. Nevertheless, it must be examined through a critical analysis in order to highlight in what extend the individual understanding from an economic perspective undermines the social approach of dispositions which influence people’s choices.