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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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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