AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #49 - Care-giving and concealment: the case of HIV-positive nurses in Uganda
Authors: Presenting Author: Ms Margaret Kyakuwa - Makerere university
Additional Authors:
Aim: Study objective: To understand the ways in which interpersonal and individual experiences of care dialectically inform transformations in broader social structures and institutions of care giving.
Method / Issue: I conducted two and half years of ethnographic fieldwork in rural Ugandan health centres during a period of ART scale-up among HIV positive nurses and their patients. I used case studies and life histories as well as focused group discussions and in-depth interviews.
Results / Comments: HIV-positive expert clients help overburdened nurses manage a well-attended ART programme. Around one-third of the nurses are also HIV positive, but they conceal their status. The nurses feel threatened in their professional status by HIV-positive expert clients who are open about their own status and who actively acquire detailed knowledge of ART and its effects. HIV positive nurses set up a secret society to discuss the tensions between their professional status as nurses, and their HIV positive status. They are especially concerned about the side-effects of ART, such as skin rashes, which threaten to give them away. To confront this threat they advocate for the inclusion of a herbal skin cream in the ART program.
Discussion: The desire to maintain a symptom free body works on several levels, including experiences internal to the body – for example dizziness, altered mood, and headache – which cause nurses discomfort, and those external to the body – such as rashes and changed body shape – which others may see and pass judgement on. It is also influenced by experiences beyond the body, for example; of caring for others or being cared for, and the desire to do the things one likes. There is no standard dose for ARV treatment, and these nurses revealed that they had tried different combinations, with different outcomes. The embodiment of their experiences was dynamic, varying over time and across space, and were shaped by a multitude of experiences, discourses, practices, technologies, and ideologies. What has emerged is a multiplicity of bodily experiences – a dynamic form of embodiment – which invites a new mode of analysis and interpretation by care studies.
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