Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T14:44:02.921Z Has data issue: false hasContentIssue false
  • English
  • Français

LIFE WITH HIV: ‘STIGMA’ AND HOPE IN MALAWI'S ERA OF ARVS

Published online by Cambridge University Press:  09 November 2012

Jessica Johnson
Get access Rights & Permissions [Opens in a new window]

Abstract

Anti-retroviral therapies have radically transformed the HIV epidemic in rural southern Malawi and this article explores the ways in which women are learning to live with the virus in a matrilineal setting. Through discussion of the experiences of HIV-positive women, I argue that stigma can only be understood through an appreciation of the pre-existing, and often complicated, social relations into which new information about a person is folded. The women's narratives reveal a tentative hope for the future, which is replicated in my own optimism that the anthropology of HIV is undergoing a parallel reorientation towards the study of life with HIV, rather than death by AIDS.

Resumé

Les thérapies antirétrovirales ont transformé l’épidémie de VIH de manière radicale dans la région rurale du sud du Malawi, et cet article examine la manière dont les femmes apprennent à vivre avec le virus dans un contexte matrilinéaire. En relatant les expériences de femmes séropositives, l'auteur affirme que la seule manière de comprendre la réprobation dont elles sont l'objet est d'apprécier les relations sociales préexistantes et souvent compliquées dans lesquelles s'intègrent les nouvelles informations concernant une personne. Ces récits de femmes révèlent un début d'espoir pour l'avenir que l'on retrouve dans l'optimisme que nourrit l'auteur de voir l'anthropologie du VIH marquer une réorientation parallèle vers l’étude du vivre avec le VIH, plutôt que du mourir du SIDA.

Type
Research Article
Information
Africa , Volume 82 , Issue 4 , November 2012 , pp. 632 - 653
Copyright
Copyright © International African Institute 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Ashforth, A. (2010) ‘Spiritual insecurity and AIDS in South Africa’ in Dilger, H. and Luig, U. (eds), Morality, Hope and Grief: anthropologies of AIDS in Africa. Oxford: Berghahn Books.Google Scholar
Avert (2011) ‘HIV & AIDS in Malawi’, <http://www.avert.org/aids-malawi.htm>, accessed 11 January 2011.,+accessed+11+January+2011.>Google Scholar
Becker, F. and Geissler, P. W. (eds) (2009) AIDS and Religious Practice in Africa. Leiden: Brill.CrossRefGoogle Scholar
Beckmann, N. and Bujra, J. (2010) ‘The “politics of the queue”: the politicization of people living with HIV/AIDS in Tanzania’, Development and Change 41 (6): 1041–64.Google Scholar
Biehl, J. (2006) ‘Pharmaceutical governance’ in Petryna, A., Lakoff, A. et al. (eds), Global Pharmaceuticals: ethics, markets, practices. Durham NC and London: Duke University Press.Google Scholar
Biehl, J. (2007) Will to Live: AIDS therapies and the politics of survival. Princeton NJ and Oxford: Princeton University Press.Google Scholar
Bryceson, D. F. and Fonseca, J. (2006) ‘Risking death for survival: peasant responses to hunger and HIV/AIDS in Malawi’, World Development 34 (9): 1654–66.Google Scholar
Castro, A. and Farmer, P. (2005) ‘Understanding and addressing AIDS-related stigma: from anthropological theory to clinical practice in Haiti’, American Journal of Public Health 95 (1): 53–9.Google Scholar
Chanock, M. (1985) Law, Custom and Social Order: the colonial experience in Malawi and Zambia. Cambridge: Cambridge University Press.Google Scholar
Chirwa, W. C. (1999) ‘Sexually transmitted diseases in colonial Malawi’ in Setel, P. W., Lewis, M. et al. (eds), Histories of Sexually Transmitted Disease and HIV/AIDS in Sub-Saharan Africa. Westport CT and London: Greenwood Press.Google Scholar
Cole, J. and Thomas, L. M. (eds) (2009) Love in Africa. Chicago IL and London: University of Chicago Press.Google Scholar
Comaroff, J. (2007) ‘Beyond bare life: AIDS, (bio)politics, and the neoliberal order’, Public Culture 19 (1): 197–219.CrossRefGoogle Scholar
Das, V. (2001) ‘Stigma, contagion, defect: issues in the anthropology of public health’, paper presented at the conference on ‘Stigma and Global Health: developing a research agenda’, Fogarty International Center, Bethesda MD, 5–7 September 2001.Google Scholar
Dilger, H. (2003) ‘Sexuality, AIDS, and the lures of modernity: reflexivity and morality among young people in rural Tanzania’, Medical Anthropology 22 (1): 23–52.Google Scholar
Dilger, H. (2008) ‘“We are all going to die”: kinship, belonging, and the morality of HIV/AIDS-related illnesses and deaths in rural Tanzania’, Anthropological Quarterly 81 (1): 207–32.Google Scholar
Dilger, H. (2010) ‘“My relatives are running away from me!” Kinship and care in the wake of structural adjustment, privatization and HIV/AIDS in Tanzania’ in Dilger, H. and Luig, U. (eds), Morality, Hope and Grief: anthropologies of AIDS in Africa. Oxford: Berghahn Books.Google Scholar
Doran, M. (2007) ‘Reconstructing mchape ’95: AIDS, Billy Chisupe, and the politics of persuasion’, Journal of Eastern African Studies 1 (3): 397–416.Google Scholar
Englund, H. (1999) ‘The self in self-interest: land, labour and temporalities in Malawi's agrarian change’, Africa 69 (1): 138–59.Google Scholar
Englund, H. (2006) Prisoners of Freedom: human rights and the African poor. Berkeley CA: University of California Press.Google Scholar
Englund, H. (2008) ‘Extreme poverty and existential obligations: beyond morality in the anthropology of Africa?’, Social Analysis 52 (3): 33–50.Google Scholar
Fassin, D. (2007) When Bodies Remember: experiences and politics of AIDS in South Africa. Berkeley CA: University of California Press.Google Scholar
Frank, E. (2009) ‘Shifting paradigms and the politics of AIDS in Zambia’, African Studies Review 52 (3): 33–53.Google Scholar
Garrett, L. (2007) ‘The challenge of global health’, Foreign Affairs 86 (1): 14–38.Google Scholar
Goffman, E. (1963) Stigma: notes on the management of spoiled identity. Harmondsworth: Penguin Books.Google Scholar
Hirsch, J. S., Wardlow, H., Smith, D. J., Phinney, H. M., Parikh, S. and Nathanson, C. A. (2009a) ‘Conclusion: “World enough and time”: navigating opportunities and risks in the landscape of desire’ in Hirsch, J. S., Wardlow, H. et al. (eds), The Secret: love, marriage, and HIV. Nashville TN: Vanderbilt University Press.Google Scholar
Hirsch, J. S., Wardlow, H., , D. J. Smith, H. M., Phinney, S., Parikh, and Nathanson, C. A.. (eds) (2009b) The Secret: love, marriage, and HIV. Nashville TN: Vanderbilt University Press.Google Scholar
Hunter, M. (2010) Love in the Time of AIDS: inequality, gender, and rights in South Africa. Bloomington IN: Indiana University Press.Google Scholar
Janes, C. R. and Corbett, K. K. (2009) ‘Anthropology and global health’, Annual Review of Anthropology 38: 167–83.Google Scholar
Jul-Larsen, E. and Mvula, P. (2009) ‘Security for many or surplus for the few? Customary tenure and social differentiation in southern Malawi’, Journal of Southern African Studies 35 (1): 175–90.Google Scholar
Kaler, A. (2001) ‘“Many divorces and many spinsters”: marriage as an invented tradition in southern Malawi, 1946–1999’, Journal of Family History 26 (4): 529–56.Google Scholar
Kaler, A. (2004a) ‘AIDS-talk in everyday life: the presence of HIV/AIDS in men's informal conversation in southern Malawi’, Social Science and Medicine 59 (2): 285–97.Google Scholar
Kaler, A. (2004b) ‘The moral lens of population control: condoms and controversies in southern Malawi’, Studies in Family Planning 35 (2): 105–15.Google Scholar
Kalofonos, I. A. (2010) ‘“All I eat is ARVs”: the paradox of AIDS treatment interventions in central Mozambique’, Medical Anthropology Quarterly 24 (3): 363–80.Google Scholar
Klaits, F. (2005) ‘The widow in blue: blood and the morality of remembering in Botswana's time of AIDS’, Africa 75 (1): 46–62.Google Scholar
Klaits, F. (2010) Death in a Church of Life: moral passion during Botswana's time of AIDS. Berkeley CA and London: University of California Press.Google Scholar
Lwanda, J. (2002) ‘Tikutha: the political culture of the HIV/AIDS epidemic in Malawi’ in Englund, H. (ed.), A Democracy of Chameleons: politics and culture in the new Malawi. Uppsala: Nordic Africa Institute.Google Scholar
McNeill, F. G. and Niehaus, I. (2009) Magic: AIDS review 2009. Pretoria: Centre for the Study of AIDS, University of Pretoria.Google Scholar
Médecins Sans Frontières. (2010) No Time to Quit: HIV/AIDS treatment gap widening in Africa. Brussels: Médecins Sans Frontières. <http://www.msf.org.uk/donor_retreat_20100525.news>, accessed 12 August 2011.,+accessed+12+August+2011.>Google Scholar
Médecins Sans Frontières Malawi and Ministry of Health and Population Chiradzulu District Malawi (2004) ‘Antiretroviral therapy in primary health care: experience of the Chiradzulu programme in Malawi’, World Health Organization, Geneva, <www.who.int/hiv/pub/prev_care/en/chiradzulu.pdf>, accessed 12 August 2011.,+accessed+12+August+2011.>Google Scholar
Mitchell, J. C. (1956) The Yao Village: a study in the social structure of a Nyasaland tribe. Manchester: Manchester University Press.Google Scholar
Miyazaki, H. (2004) The Method of Hope: anthropology, philosophy, and Fijian knowledge. Stanford CA: Stanford University Press.Google Scholar
Mogensen, H. O. (2010) ‘New hopes and new dilemmas: disclosure and recognition in the time of antiretroviral treatment’ in Dilger, H. and Luig, U. (eds), Morality, Hope and Grief: anthropologies of AIDS in Africa. Oxford: Berghahn Books.Google Scholar
National Statistical Office (NSO) (2008a) ‘Population and Housing Census Main Report’. Zomba, Malawi: NSO, <http://www.nso.malawi.net/index.php?option=com_content&view=article&id=107%3A2008-population-and-housing-census-results&catid=8&Itemid=6>, accessed 28 October 2011.,+accessed+28+October+2011.>Google Scholar
National Statistical Office (NSO) (2008b) ‘Population Characteristics’. Zomba, Malawi: NSO, <http://www.nso.malawi.net/index.php?option=com_content&view=article&id=107%3A2008-population-and-housing-census-results&catid=8&Itemid=6>, accessed 28 October 2011.,+accessed+28+October+2011.>Google Scholar
Nguyen, V.-K. (2005) ‘Antiretroviral globalism, biopolitics, and therapeutic citizenship’ in Ong, A. and Collier, S. J. (eds), Global Assemblages. Oxford: Blackwell.Google Scholar
Nguyen, V.-K. (2010) The Republic of Therapy: triage and sovereignty in West Africa's time of AIDS. Durham NC: Duke University Press.Google Scholar
Ngwani, Z. (2001) ‘“Real men reawaken their fathers’ homesteads, the educated leave them in ruins”: the politics of domestic reproduction in post-apartheid rural South Africa’, Journal of Religion in Africa 31 (4): 402–26.Google Scholar
Niehaus, I. (2007) ‘Death before dying: understanding AIDS stigma in the South African Lowveld’, Journal of Southern African Studies 33 (4): 845–60.Google Scholar
Niehaus, I. (2009) ‘Leprosy of a deadlier kind: Christian conceptions of AIDS in the South African Lowveld’ in Becker, F. and Geissler, P. W. (eds), AIDS and Religious Practice in Africa. Leiden: Brill.Google Scholar
Parker, R. (2001) ‘Sexuality, culture, and power in HIV/AIDS research’, Annual Review of Anthropology 30: 163–79.Google Scholar
Parker, R. and Aggleton, P. (2003) ‘HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action’, Social Science and Medicine 57 (1): 13–24.CrossRefGoogle ScholarPubMed
Peters, P. E. (2002) ‘Bewitching land: the role of land disputes in converting kin to strangers and in class formation in Malawi’, Journal of Southern African Studies 28 (1): 155–78.Google Scholar
Peters, P. E. and Kambewa, D. (2007) ‘Whose security? Deepening social conflict over “customary” land in the shadow of land tenure reform in Malawi’, Journal of Modern African Studies 45 (3): 447–72.Google Scholar
Peters, P. E., Kambewa, D. and Walker, P. A. (2010) ‘Contestations over “tradition” and “culture” in a time of AIDS’, Medical Anthropology 29 (3): 278–302.Google Scholar
Peters, P. E., Walker, P. A. and Kambewa, D. (2008) ‘Striving for normality in a time of AIDS in Malawi’, Journal of Modern African Studies 46 (4): 659.CrossRefGoogle Scholar
Poulin, M. (2007) ‘Sex, money, and premarital partnerships in southern Malawi’, Social Science and Medicine 65 (11): 2383–93.Google Scholar
Prince, R. (2007) ‘Salvation and tradition: configurations of faith in a time of death’, Journal of Religion in Africa 37 (1): 84–115.Google Scholar
Probst, P. (1999) ‘“Mchape” ’95, or the sudden fame of Billy Goodson Chisupe: healing, social memory and the enigma of the public sphere in post-Banda Malawi’, Africa 69 (1): 108–37.Google Scholar
Rankin, W., Brennan, S., Schell, E., Laviwa, J. and Rankin, S. (2005) ‘The stigma of being HIV-positive in Africa’, Public Library of Science (PLoS) Medicine 2 (8): 702.Google Scholar
Rhine, K. (2009) ‘Support groups, marriage, and the management of ambiguity among HIV-positive women in northern Nigeria’, Anthropological Quarterly 82 (2): 369–400.Google Scholar
Robins, S. (2004) ‘“Long live Zackie, long live”: AIDS activism, science and citizenship after apartheid’, Journal of Southern African Studies 30 (3): 651–72.Google Scholar
Robins, S. (2006) ‘From “rights” to “ritual”: AIDS activism in South Africa’, American Anthropologist 108 (2): 312–23.Google Scholar
Schatz, E. (2005) ‘“Take your mat and go!” Rural Malawian women's strategies in the HIV/AIDS era’, Culture, Health and Sexuality 7 (5): 479–92.Google Scholar
Schoepf, B. G. (2001) ‘International AIDS research in anthropology: taking a critical perspective on the crisis’, Annual Review of Anthropology 30: 335–61.CrossRefGoogle Scholar
Simpson, A. (2009) Boys to Men in the Shadow of AIDS: masculinities and HIV risk in Zambia. Basingstoke: Palgrave Macmillan.Google Scholar
Smith, D. J. (2009) ‘Managing men, marriage, and modern love: women's perspectives on intimacy and male infidelity in southeastern Nigeria’ in Cole, J. and Thomas, L. M. (eds), Love in Africa. Chicago IL and London: University of Chicago Press.Google Scholar
Tawfik, L. and Watkins, S. C. (2007) ‘Sex in Geneva, sex in Lilongwe, and sex in Balaka’, Social Science and Medicine 64 (5): 1090–101.Google Scholar
Fund, The Global (2010) ‘Independent appeal panel report, 8th Februrary 2010’, <http://www.theglobalfund.org/en/trp/appealsreports/>, accessed 18 August 2011.,+accessed+18+August+2011.>Google Scholar
Fund, The Global (2011) ‘Country grant portfolio, Malawi’, <http://portfolio.theglobalfund.org/Country/Index/MLW?lang=en>, accessed 17 January 2011.,+accessed+17+January+2011.>Google Scholar
UNAIDS (2010) Global Report: UNAIDS report on the global AIDS epidemic. Geneva: Joint United Nations Programme on HIV/AIDS, <http://issuu.com/unaids/docs/unaids_globalreport_2010>, accessed 1 February 2011.,+accessed+1+February+2011.>Google Scholar
Vaughan, M. (1987) The Story of an African Famine: gender and famine in twentieth-century Malawi. Cambridge: Cambridge University Press.Google Scholar
Watkins, S. C. (2004) ‘Navigating the AIDS epidemic in rural Malawi’, Population and Development Review 30 (4): 673–705.CrossRefGoogle Scholar
WHO, UNAIDS and UNICEF (2010) Towards Universal Access: scaling up priority HIV/AIDS interventions in the health sector. Geneva: World Health Organization. <http://www.who.int/hiv/pub/2010progressreport/report/en/index.html>, accessed 17 January 2011.,+accessed+17+January+2011.>Google Scholar
Whyte, S. R. (2005) ‘Going home? Belonging and burial in the era of AIDS’, Africa 75 (2): 154–72.Google Scholar
Whyte, S. R., Whyte, M. A., Meinart, L. and Kyaddondo, B. (2006) ‘Treating AIDS: dilemmas of unequal access in Uganda’ in Petryna, A., Lakoff, A. et al. . (eds), Global Pharmaceuticals: ethics, markets, practices. Durham NC and London: Duke University Press.Google Scholar
Yang, L., Kleinman, A., Link, B., Phelan, J., Lee, S. and Good, B. (2007) ‘Culture and stigma: adding moral experience to stigma theory’, Social Science and Medicine 64 (7): 1524–35.Google Scholar
Zulu, E. M. (1996) ‘Social and Cultural Factors Affecting Reproductive Behavior in Malawi’. PhD thesis, University of Pennsylvania.Google Scholar