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Lay Definitions of Antiretroviral Treatment: Unpacking the Paradoxes and Dilemmas of Therapeutic Efficacy in Rural Tanzania

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Children and Young People Living with HIV/AIDS

Part of the book series: Cross-Cultural Research in Health, Illness and Well-Being ((CCRHIWB))

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Abstract

Global and national initiatives have led to expanded access to antiretroviral treatment (ART) in Tanzania. Antiretroviral treatment is now recognized as an essential component of comprehensive response to the epidemic, which include HIV prevention, treatment and care and impact mitigation. The 3 by 5 initiative of the WHO increased access to ART and opened up ways to accelerate prevention, promote demand for testing, support HIV status disclosure, help to change attitudes about HIV/AIDS and contribute to the reduction of denial and stigma. However, there is paucity of evidence about lay definitions and responses to increased availability of ART among the general population and in particular young people. This chapter presents various definitions attached to ART and the potential implications of HIV treatment roll out from a phenomenological perspective of young people in rural Tanzania.

Experiences from Tanzania indicate that local definitions and meanings attached to ART are informed by shared ideas about the restorative and symbolic significance of therapeutic medicines in the community. ART has introduced a paradigm shift in locally relevant therapeutic definitions of drugs and conceptions about the HIV-positive body. As ART becomes more accessible, people receiving treatment become healthy, resume routine social activities and consequently become indistinguishable (invisible by physical appearance) from HIV-negative persons. However, individuals on antiretroviral therapy face personal and structural challenges that affect their bodily needs and sexual lives. While persons on ART may wish to exercise their right to enjoy sexual lives, there is constant recognition of the risks involved in transmitting the virus to uninfected people. Generally, antiretroviral therapy has the potential to produce both positive and negative consequences to public health. While ART may sustain the lives of people on medication, it may potentially be perceived to increase risk sexual behaviors and stigmatize people perceived to be or blamed for intentionally spreading HIV to uninfected individuals in the community. Finally, this chapter highlights the dilemmas facing lay community in coming up with a clear and shared definition what constitutes intentional HIV spread. While some HIV-positive people may be accused of intentionally infecting others with the virus, the wider social context in which this might occur is a subject of continued debate and exploration. The chapter highlights how local definitions of ART are situated within the wider definition of HIV risk and vulnerability.

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References

  • Adeneye, A. K., Adewole, T. A., Musa, A. Z., Onwujekwe, D., Odunukwe, N. N., Araoyinbo, I. D., Gbajabiamila, T. A., Ezeobi, P. M., & Idigbe, E. O. (2006). Limitations to access and use of antiretroviral therapy (ART) among HIV positive persons in Lagos, Nigeria. World Health and Population, 8(2), 46–56.

    Article  Google Scholar 

  • Atuyambe, L., Neema, S., Otolok-Tanga, E., Wamuyu-Maina, G., Kasasa, S., & Wabwire-Mangen, F. (2008). The effects of enhanced access to antiretroviral therapy: A qualitative study of community perceptions in Kampala city, Uganda. African Health Sciences, 8(1), 13–19.

    Google Scholar 

  • Bateganya, M., Colfax, G., Schafer, L. A., Kityo, C., Mugynyi, P., Serwadda, D., Mayanja, H., & Bangsberg, D. (2005). Antiretroviral therapy and sexual behavior: A comparative study between antiretroviral-naïve and experienced patients at an urban HIV/AIDS care and research centre in Kampala, Uganda. AIDS Patient Care and STDs, 19, 760–768.

    Article  Google Scholar 

  • Beck, U. (1992). Risk society: Towards a new modernity. New Delhi: Sage.

    Google Scholar 

  • Boholm, A. (1996). Risk perception and social anthropology: Critique of cultural theory. Ethnos, 61(1–2), 64–84.

    Article  Google Scholar 

  • Bunnell, R., Ekwaru, J. P., Solberg, P., Wamai, N., Bikaako-Kajura, W., Were, W., Coutinho, A., Liechty, C., Madraa, E., Rutherford, G., & Mermin, J. (2006). Changes in sexual behaviour and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. AIDS, 20, 85–92.

    Article  Google Scholar 

  • Cameron, E., Burris, S., & Clayton, M. (2008). HIV is a virus, not a crime: Ten reasons against criminal statutes and criminal prosecutions. Journal of the International AIDS Society, 11(7), 1–7.

    Google Scholar 

  • Cockcroft, A., Andersson, N., Milne, D., Mokoena, T., & Masisi, M. (2007). Community views about routine HIV testing and antiretroviral treatment in Botswana: Signs of progress from a cross sectional study. BMC International Health and Human Rights, 7(5), 1–11.

    Google Scholar 

  • Cohen, D., McCubbin, M., Collin, J., & Perodeau, G. (2001). Medications as social phenomena. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 5(4), 441–469.

    Google Scholar 

  • Cohen, M. S., Gay, C., Angela, D. M., Kashuba, D. M., Pharm, D., Blower, S., & Paxton, L. (2007). Narrative review: Antiretroviral therapy to prevent the sexual transmission of HIV-1. Annals of Internal Medicine, 146(8), 591–601.

    Article  Google Scholar 

  • Cohen, C. R., Montadon, M., Carrico, A. W., Shiboski, S., Bostrom, A., Obure, A., Kwena, Z., Bailey, R. C., Nguti, R., & Bukusi, E. A. (2009). Association of attitudes and beliefs towards antiretroviral therapy with HIV-seroprevalence in the general population of Kisumu, Kenya. PLoS ONE, 4(3), e4573. doi:10.1371/journal.pone.0004573.

    Article  Google Scholar 

  • Craddock, S. (2000). Disease, social identity, and risk: Rethinking the geography of AIDS. Transactions of the Institute of British Geographers, 25(2), 153–168.

    Article  Google Scholar 

  • Crepaz, N., Hart, T. A., & Marks, G. (2004). Highly active antiretroviral therapy and sexual risk behavior: A meta-analytic review. JAMA, 292, 224–236.

    Article  Google Scholar 

  • Dake, K. (1992). ‘Myths of nature’: Culture and the social construction of risk. The Journal of Social Issues, 48(4), 21–37.

    Article  Google Scholar 

  • Davis, M. (2007). Identity, expertise and HIV risk in a case study of reflexive medical technologies. Sociology, 41(6), 1003–1019.

    Article  Google Scholar 

  • Detels, R. M. A., McFarlane, G., Kingsley, L. A., Margolick, J. B., Giorgi, J., Shrager, L. K., & Phair, J. P. (1998). Effectiveness of potent antiretroviral therapy on time to AIDS and death in men with known HIV infection duration. Multicenter AIDS cohort study investigators. JAMA, 280(17), 1497–1503.

    Article  Google Scholar 

  • Dilger, H. (2007). Healing the wounds of modernity: Salvation, community and care in a neo-Pentecostal church in Dar es Salaam, Tanzania. Journal of Religion in Africa, 37, 59–83.

    Article  Google Scholar 

  • Douglas, M. (1992). Risk and blame: Essays in cultural theory. London: Routledge.

    Book  Google Scholar 

  • Douglas, M., & Wildavsky, A. (1982). Risk and culture: An essay on the selection of technical and environmental dangers. Berkeley: University of California Press.

    Google Scholar 

  • Ezekiel, M. J., Talle, A., Juma, J. M., Mnyika, K. S., & Klepp, K.-I. (2008). Attitudes and perceived impact of antiretroviral drug therapy on risk sexual behaviour among young people in Kahe, Moshi rural district, Tanzania. Tanzania Journal of Health Research, 10(4), 203–212.

    Google Scholar 

  • Foucault, M. (1990). The history of sexuality (Vol. 1, Trans. Hurley). Harmondsworth: Penguin

    Google Scholar 

  • Fox, N. J., & Ward, K. J. (2008). What are health identities and how may we study them? Sociology of Health and Illness, 30(7), 1007–1021.

    Article  Google Scholar 

  • Gebrekristos, H. T., Mlisana, K. P., & Karim, Q. A. (2005). Patients’ readiness to start highly active antiretroviral treatment for HIV. British Medical Journal, 331, 772–775.

    Article  Google Scholar 

  • Giddens, A. (1991). Modernity and self-identity. Cambridge: Polity.

    Google Scholar 

  • Giddens, A. (1998). Risk society: The context of British politics. In J. Franklin (Ed.), The politics of risk society (pp. 23–34). Cambridge: Polity.

    Google Scholar 

  • Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York: Simon & Schuster.

    Google Scholar 

  • Greene, R., & Ward, D. (2002). ‘Let’s call it HIV infection, not AIDS’. Poster presented at the 4th international AIDS conference, Barcelona, 7–14 July.

    Google Scholar 

  • Haram, L. (1999). ‘Women out of sight’: Modern women in gendered worlds. The case of Meru women of northern Tanzania. Unpublished PhD thesis, University of Bergen, Norway.

    Google Scholar 

  • Hardon, A. P., Akurut, D., Comoro, C., Ekezie, C., Irunde, H. F., Gerrits, T., Kglatwane, J., Kinsman, J., Kwasa, R., Maridadi, J., Moroka, T. M., Moyo, S., Nakiyemba, A., Nsimba, S., Ogenyi, R., Oyabba, T., Temu, F., & Laing, R. (2007). Hunger, waiting time and transport costs: Time to confront challenges to ART adherence in Africa. AIDS Care, 19(5), 658–665.

    Article  Google Scholar 

  • Helman, C. G. (1990). Culture, health and illness (2nd ed.). Oxford: Butterworth-Heinemann Ltd.

    Google Scholar 

  • Helman, C. G. (2007). Culture, heaath and illness (5th ed.). London: Hodder Arnold.

    Google Scholar 

  • IPASC & EQUINET. (2009). Acceptability and accessibility of HIV testing and treatment services in Bembeyi, Bunia, North Eastern Democratic Republic of Congo. Available at www.equinetafrica.org. Accessed 1 June 2009.

  • Izugbara, C. O., & Wekesa, E. (2011). Beliefs and practices about antiretroviral medication: A study of poor urban Kenyans living with HIV/AIDS. Sociology of Health & Illness, 33, 869–883.

    Article  Google Scholar 

  • Janssen, R. S., Holtgrave, D. R., Valdiserri, R. O., Sherperd, M., Gayle, H. D., & De Cock, K. M. (2001). The serostatus approach to fighting the HIV epidemic: Prevention strategies for infected individuals. American Journal of Public Health, 91(7), 1019–1024.

    Article  Google Scholar 

  • Jejeebhoy, S. J., Shah, I., & Thapa, S. (2005). Sex without consent: Young people in developing countries. London: Zed Books.

    Google Scholar 

  • Kalipeni, E., Craddock, S., Oppong, J., & Gosh, J. (Eds.). (2004). HIV and AIDS in Africa: Beyond epidemiology. Malden: Blackwell.

    Google Scholar 

  • Kapiga, S. H., Sam, N. E., Mlay, J., Aboud, S., Ballard, R. C., Shao, J. F., & Larsen, U. (2006). The epidemiology of HIV-1 infection in northern Tanzania: Results from a community based study. AIDS Care, 18(4), 379–387.

    Article  Google Scholar 

  • Kleinman, A. (1980). Patients and healers in the context of culture. Berkeley: University of California Press.

    Google Scholar 

  • Kleinman, A. (1998). The illness narratives: Suffering, healing and the human condition. New York: Basic Books.

    Google Scholar 

  • Klepp, K.-I., Fisher, A., & Kaaya, S. F. (Eds.). (2008). Promoting adolescent sexual and reproductive health in East and Southern Africa. Cape Town: HRSC Press.

    Google Scholar 

  • Lekas, H., Siegel, K., & Schrimshaw, E. (2006). Continuities and discontinuities in the experiences of felt and enacted stigma among women with HIV/AIDS. Qualitative Health Research, 16(9), 1165–1190.

    Article  Google Scholar 

  • Lema, L. A., Katapa, R. S., & Musa, A. S. (2008). Knowledge on HIV/AIDS and sexual behaviour among youths in Kibaha District, Tanzania. Tanzania Journal of Health Research, 10(2), 79–83.

    Article  Google Scholar 

  • Leventhal, H., Kelly, K., & Leventhal, E. A. (1999). Population risk, actual risk, perceived risk and cancer control: A discussion. Journal of the National Cancer Institute Monographs, 25, 81–85.

    Article  Google Scholar 

  • Liamputtong, P., Haritavorn, N., & Kiatying-Angsulee, N. (2015). Local discourses on antiretrovirals and the lived experiences of women living with HIV/AIDS in Thailand. Qualitative Health Research, 25, 253–263.

    Article  Google Scholar 

  • Lucas, S. B., De Cock, K. M., Hounnou, A., Peacock, C., Diomande, M., Hondé, M., Beaumel, A., Kestens, L., & Kadio, A. (1994). Contribution of tuberculosis to slim disease in Africa. British Medical Journal, 308(6943), 1531–1533.

    Article  Google Scholar 

  • Luke, N. (2005). Investigating exchange in sexual relationships in sub Saharan Africa using survey data. In S. J. Jejeebhoy, I. Shah, & S. Thapa (Eds.), Sex without consent: Young people in developing countries (pp. 105–124). London: Zed Books.

    Google Scholar 

  • Mmbaga, E. J., Hussein, A., Leyna, G. H., Klouman, E., Masenga, E., Sam, N., Mnyika, K. S., & Klepp, K.-I. (2006). Incidence of HIV-1 infection and changes in prevalence of reproductive tract infections and sexual risk behaviours: A population based longitudinal study in rural Tanzania. African Journal of AIDS Research, 5(3), 281–288.

    Article  Google Scholar 

  • Mmbaga, E. J., Hussein, A., Leyna, G. H., Mnyika, K. S., Sam, N., & Klepp, K.-I. (2007). Prevalence and risk factors for HIV-1 infection in rural Kilimanjaro region of Tanzania. Implications for prevention and treatment. BMC Public Health, 7, 58. doi:10.1186/1471-2458-7-58. Available at http://www.biomedcentral.com/1471-2458/7/58.

  • Mmbaga, E. J., Hussein, A., Leyna, G. H., Mnyika, K. S., Sam, N., & Klepp, K.-I. (2008). The role of in-migrants in the increasing rural HIV-1 prevalence pandemic: Results from a village population survey in Kilimanjaro region of Tanzania. International Journal of Infectious Diseases, 12(5), 519–525.

    Article  Google Scholar 

  • Mnyika, K. S., Klepp, K.-I., Kvåle, G., & Ole-King’ori, N. (1996). Risk factors for HIV-1 infection among women in the Arusha region of Tanzania. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 11(5), 484–491.

    Article  Google Scholar 

  • Mshana, G. H., Wamoyi, J., Busza, J., Zaba, B., Changalucha, J., Kaluvya, S., & Urassa, M. (2006). Barriers to accessing antiretroviral therapy in Kisesa Tanzania: A qualitative study of early rural referrals to the national programme. AIDS Patient Care and STDs, 20, 649–657.

    Article  Google Scholar 

  • Mwaluko, G., Urassa, M., Isingo, R., Zaba, B., & Boerma, J. T. (2003). Trends in HIV and sexual behaviour in a longitudinal study in a rural population in Tanzania, 1994–2000. AIDS, 17, 2645–2651.

    Article  Google Scholar 

  • Nachega, J. B., Lehman, D. A., Hlatshwayo, D., Mothopeng, R., Chaisson, R. E., & Karstaedt, A. S. (2005). HIV/AIDS and antiretroviral treatment knowledge, attitudes, beliefs and practices in HIV-infected adults in Soweto, South Africa. Journal of Acquired Immune Deficiency Syndrome, 38(2), 196–201.

    Article  Google Scholar 

  • National AIDS Control Programme (NACP). (2005). HIV/AIDS/STI surveillance report No.19. December 2004. Dar es salaam: Epidemiology Unit, NACP. Ministry of Health, Tanzania Mainland, Issued September 2005.

    Google Scholar 

  • Nettleton, S. (2006). ‘I just want permission to be ill’: Towards a sociology of medically unexplained symptoms. Social Science & Medicine, 62, 1167–1178.

    Article  Google Scholar 

  • Nichter, M., & Vuckovic, N. (1994). Agenda for an anthropology of pharmaceutical practice. Social Science & Medicine, 39(1), 1509–1525.

    Article  Google Scholar 

  • Nkosana, J., & Rosenthal, D. (2007). Saying no to intergenerational sex: The experience of schoolgirls in Botswana. Vulnerable Children and Youth Studies, 2(1), 1–11.

    Article  Google Scholar 

  • Persson, A. (2004). Incorporating pharmakon: HIV, medicine and body shape change. Body and Society, 10(4), 45–67.

    Article  Google Scholar 

  • Renn, O. (2010). Precautionary principle: Risk, uncertainty and rational action. Available at www.allchemeseminars.org . Accessed 25 Jan 2010.

  • Rice, E., Batterham, P., & Rotheram-Borus, M. J. (2006). Unprotected sex among youth living with HIV before and after the advent of highly active antiretroviral therapy. Perspectives on Sexual and Reproductive Health, 38(3), 162–167.

    Article  Google Scholar 

  • Roura, M., Urassa, M., Busza, J., Mbata, D., Wringe, A., & Zaba, B. (2008). Scaling up HIV stigma? The effects of antiretroviral roll-out on stigma and HIV testing. Early evidence from rural Tanzania. SexuallyTransmitted Infections, 85, 308–312.

    Article  Google Scholar 

  • Roura, M., Busza, J., Wringe, A., Mbata, D., Urassa, M., & Zaba, B. (2009). Barriers to sustaining antiretroviral treatment in Kisesa, Tanzania: A follow-up study to understand attrition from the antiretroviral programme. AIDS Patient Care and STDs, 23(3), 203–210.

    Article  Google Scholar 

  • Schrimshaw, E. W., Siegel, K., & Lekas, H. (2005). Changes in attitudes toward antiretroviral medication: A comparison of women living with HIV/AIDS in the pre-HAART and HAART eras. AIDS and Behaviour, 9(3), 267–279.

    Article  Google Scholar 

  • Setel, P. W. (1999). A plague of paradoxes: AIDS, culture and demography in northern Tanzania. Chicago: The University of Chicago Press.

    Google Scholar 

  • Simon, V. (2002). Local culture: Risk or resource in times of AIDS? A case study of Mbulu in northern Tanzania. Unpublished Master of Philosophy thesis, University of Bergen, Norway.

    Google Scholar 

  • Sjoberg, L. (1998). Why do people demand risk reduction? In S. Lydersen, G. K. Hansen, & H. A. Sandtorv (Eds.), ESREL-98: Safety and reliability (pp. 751–758). Trondheim: A.A. Balkema.

    Google Scholar 

  • Stillwaggon, E. (2003). Racial metaphors: Interpreting sex and AIDS in Africa. Development and Change, 34(5), 809–832.

    Article  Google Scholar 

  • Stoeckle, M., Mchomvu, R., Hatz, C., Battegay, M., Aris, E. A., Mshinda, H., & Tanner, M. (2006). Moving up from 3 by 5. The Lancet Infectious Diseases, 6(8), 460–461.

    Article  Google Scholar 

  • Tanzania Ministry of Health. (2004, December). National AIDS control programme. HIV/AIDS/STI surveillance report no.19. Dar es Salaam.

    Google Scholar 

  • Tanzania Ministry of Health. (2007). Guidelines for HIV testing and counselling in clinical settings. Dar es salaam: Ministry of Health.

    Google Scholar 

  • Tulloch, J., & Lupton, D. (2003). Risk and everyday life. London: Sage.

    Google Scholar 

  • UNAIDS. (2006). Treatment education: A critical component of efforts to ensure universal access to prevention, treatment and care. Geneva: UNAIDS.

    Google Scholar 

  • UNAIDS. (2008). Reports on the global AIDS epidemic. Available at www.unaids.org/pub/globalreport/. Accessed 13 Apr 2009.

  • Van den Bergh, G. (2008). To risk or not to risk? Is it a question? Sexual debut, poverty and vulnerability in the times of AIDS: A case from Kigoma, Tanzania. In K.-I. Klepp, A. Fisher, & S. F. Kaaya (Eds.), Promoting adolescent sexual and reproductive health in East and Southern Africa (pp. 162–182). Cape Town: HRSC Press.

    Google Scholar 

  • Van der Geest, S., & Hardon, A. (2006). Social and cultural efficacies of medicines: complications for antiretroviral therapy. Journal of Ethnobiology and Ethnomedicine, 2, 48. doi:10.1186/1746-4269-2-48. Available at http://www.ethnobiomed.com/content/2/1/48.

  • Van der Geest, S., Whyte, S. R., & Hardon, A. (1996). The anthropology of pharmaceuticals: A biographical approach. Annual Review of Anthropology, 25(1), 153–178.

    Article  Google Scholar 

  • Veinot, T. C., Flicker, S. E., Skinner, H. A., McClelland, A., & Saulnier, P. (2006). “Supposed to make you better but it doesn’t really”: HIV-positive youths’ perceptions of HIV treatment. Journal of Adolescent Health, 38(3), 261–267.

    Article  Google Scholar 

  • Weiss, B. (1996). The making and unmaking of the Haya lived world: Consumption, commoditization and everyday practice. Durham: Duke University Press.

    Google Scholar 

  • WHO. (2008). Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector. Geneva: WHO.

    Google Scholar 

  • WHO/UNAIDS. (2003). Treating 3 million by 2005: Making it happen: The WHO strategy. Geneva: WHO.

    Google Scholar 

  • Whyte, S., Van der Geest, S., & Hardon, A. (2002). Social lives of medicines. Cambridge: Cambridge University Press.

    Google Scholar 

  • William, S. J., & Bendelow, G. (1998). The lived body: Sociological themes, embodied issues. London: Routledge.

    Book  Google Scholar 

  • Zinn, J. O. (2006). Recent developments in the sociology of risk and uncertainty. Historical Social Research, 31(2), 275–286.

    Google Scholar 

  • Zou, J., Yamanaka, Y., Muze, J., Watt, M., Ostermann, J., & Thielman N. (2009). Religion and HIV in Tanzania: Influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes. BMC Public Health, 9, 75. doi:10.1186/1471-2458-9-75. Available at http://www.biomedcentral.com/1472-2458/9/75.

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  1. School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, 65015, United Nations Road, Dar es Salaam, Tanzania

    Mangi J. Ezekiel

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    Pranee Liamputtong

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Ezekiel, M.J. (2016). Lay Definitions of Antiretroviral Treatment: Unpacking the Paradoxes and Dilemmas of Therapeutic Efficacy in Rural Tanzania. In: Liamputtong, P. (eds) Children and Young People Living with HIV/AIDS. Cross-Cultural Research in Health, Illness and Well-Being. Springer, Cham. https://doi.org/10.1007/978-3-319-29936-5_22

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