TY - JOUR
T1 - Challenging the Paradigm
T2 - Anthropological Perspectives on HIV as a Chronic Disease
AU - McGrath, Janet W.
AU - Winchester, Margaret S.
AU - Kaawa-Mafigiri, David
AU - Walakira, Eddy
AU - Namutiibwa, Florence
AU - Birungi, Judith
AU - Ssendegye, George
AU - Nalwoga, Amina
AU - Kyarikunda, Emily
AU - Kisakye, Sheila
AU - Ayebazibwe, Nicolas
AU - Rwabukwali, Charles B.
N1 - Funding Information:
Funding for this study was provided by the US National Institute of Health (R24HD056917, McGrath PI). The content of this report is solely the responsibility of the authors and does not necessarily represent the official view of the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health.
PY - 2014/7
Y1 - 2014/7
N2 - 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.
AB - 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.
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U2 - 10.1080/01459740.2014.892483
DO - 10.1080/01459740.2014.892483
M3 - Article
C2 - 24661100
AN - SCOPUS:84903535129
SN - 0145-9740
VL - 33
SP - 303
EP - 317
JO - Medical Anthropology: Cross Cultural Studies in Health and Illness
JF - Medical Anthropology: Cross Cultural Studies in Health and Illness
IS - 4
ER -