The diagnostic state
Police discretion and the securitization of HIV/Aids in the United States
Bibliographic Data
| ID | 12664645 |
|---|---|
| Authors | P J Seth (0000-0002-4865-7699, University of Notre Dame, corresponding author) |
| Year | 2026 |
| Publication date | 2026-03-03 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Punishment & Society (JOURNAL) |
| Journal identifiers | ISSN: 1462-4745 • E-ISSN: 1741-3095 |
| Publisher | SAGE Publishing (PUBLISHER • US) |
| DOI | 10.1177/14624745261428571 |
| OpenAlex | W7134949838 |
| Language | EN |
| References cited | 50 |
How do law enforcement agencies shape public health responses during epidemics? While scholars have examined the role of established medical institutions such as the Centers for Disease Control and the World Health Organization, the police remain understudied. Through a multimethod analysis of archival materials, national survey data, and comparisons across New York and San Francisco, I argue that police functioned as informal medical knowledge producers who transformed HIV/AIDS from a public health challenge into a security threat requiring punitive intervention. Vague federal guidance opened a discretionary space that officers filled with their own ideas rather than medical evidence. I introduce the concept of the “diagnostic state” to describe how the structures of policing allowed officers to define what counts as illness and how it should be managed. In the absence of clear protocols, officers relied on visual heuristics to determine infection status, effectively constructing an extralegal diagnostic apparatus that operated parallel to—and often in contradiction with—public health guidance. These patterns established precedents that foreshadowed COVID-19 responses, illustrating the ways that institutional authority can either reinforce or disrupt efforts to address epidemics
Contradiction · Discretion · Enforcement · Heuristics · Law enforcement · Pretext · Public health · Punitive damages · Securitization · Data-Driven Disease Surveillance · Global Security and Public Health · Policing Practices and Perceptions
The Cultural, Definitional, and Institutional Politics of Healthcare
Punishing Disease
Unprepared
The Origins of the Urban Crisis: Race and Inequality in Postwar Detroit
A synergism of plagues
When the State Meets the Street
Documents and Bureaucracy
How the Rockefeller Laws Hit the Streets
A “Creation of the Media”
Implicit bias training for police
Sex Workers, Psychics, and Numbers Runners
Critical Disaster Studies
Epidemic Orientalism
Dying Inside
The Impact of Urban US Policing Practices on Black Men Who Have Sex with Men’s HIV Vulnerability
What Is an Epidemic? Aids in Historical Perspective
Sociology of diagnosis
Urban crisis
Culture and Science/Technology
Homosexuality as Deviance
Naming and Framing
Police Discretion
Police Are Our Government
Documents
Healthcare practitioners' construction of occupational risk during the Covid-19 pandemic
Towards a sociology of diagnosis
Haunting the Queer Spaces of Aids
To Protect and Serve Themselves
The Boundaries of Blackness
Économies morales et justices locales
Vital Systems Security
From Medicine to Health
Here and Everywhere
Medicalization and Social Control
The Generic Biothreat, Or, How We Became Unprepared
| Citation velocity | historical |
|---|---|
| Highly cited | No |