ABSTRACT
In a recent ethnographic study, Susan Bernstein (1991) used the metaphor of “playing the game” to describe the task of managing service contracts in nonprofi t agencies. By the early 1990s, ACT UP affi nity groups, including the Treatment and Data, Housing, and Syringe Exchange committees recognized that to achieve their stated aims, they needed to work more closely with government and industry. For some, the next step in direct action involved service delivery. Some evolved into nonprofi t organizations. In the years that followed, they were faced with the question of how to play within the system. For those involved in harm reduction-the housing and syringe exchange groups-this meant playing the game in a way that included socially vulnerable populations: homeless people suffering from chemical dependence, injection drug users, and others who had traditionally been excluded. Including these populations would require the new organizations to radically alter traditional paradigms of service delivery.
