Challenging the Paradigm: Anthropological Perspectives on HIV as a Chronic Disease

Janet W. McGrath, Margaret S. Winchester, David Kaawa-Mafigiri, Eddy Walakira, Florence Namutiibwa, Judith Birungi, George Ssendegye, Amina Nalwoga, Emily Kyarikunda, Sheila Kisakye, Nicolas Ayebazibwe, Charles B. Rwabukwali

Research output: Contribution to journalArticlepeer-review

67 Citations (SciVal)


Recently HIV has been framed as a 'manageable' chronic disease in contexts in which access to effective care is reliable. The chronic disease paradigm emphasizes self-care, biomedical disease management, social normalization, and uncertainty. Data from a longitudinal study of patients (N = 949) in HIV care at two sites in Uganda, collected through semistructured interviews and ethnographic data, permit examination of the salience of this model in a high burden, low resource context struggling to achieve the promise of a manageable HIV epidemic. Our data highlight the complexity of the emerging social reality of long-term survival with HIV. Participants struggle to manage stigma as well as to meet the costs involved in care seeking. In these settings, economic vulnerability leads to daily struggles for food and basic services. Reconceptualizing the chronic disease model to accommodate a 'social space,' recognizing this new social reality will better capture the experience of long-term survival with HIV.

Original languageEnglish (US)
Pages (from-to)303-317
Number of pages15
JournalMedical Anthropology: Cross Cultural Studies in Health and Illness
Issue number4
StatePublished - Jul 2014

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Anthropology


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