Life extended: the intimate politics of the antiretroviral era in Northern Nigeria
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Date
27/11/2014Author
Kingsley, Peter Alden
Metadata
Abstract
For more than thirty years, the HIV pandemic has caused immense harm
across sub-Saharan Africa. From the middle of the last decade, however,
a treatment revolution has been underway, as effective antiretroviral drugs
(ARVs) have become available to millions of ordinary people. This
thesis examines the far-reaching consequences of this new reality in
Northern Nigeria. It argues that the significance of the ARV era cannot be
fully understood simply by monitoring how many patients are receiving
treatment, but instead must be explained in terms of the multifaceted
changes it has driven in institutions and the lives of HIV positive people.
This study uses ethnographic case studies and participatory methods to
understand this new historical moment from ‘below’. It provides new
empirical perspectives on how the ARV era has profoundly altered the ways
in which HIV positive people suffer. The difficulties of daily life when
subjected to opportunistic infections, side effects from drugs, and social
stigma are compounded by memories of past trauma and fears for an
uncertain future.
Previous studies have indicated HIV positive people often form new
relationships (e.g. Rhine, 2009), but rarely have these post-HIV relationships
been described. This study argues that these new relationships, often distant
from conventional family supervision, have a unique character, blending
traditional forms with ‘modern’ ideas about romance.
After a HIV disclosure, incomes and assets (particularly those reliant on
family relationships) are often reduced. Along with the cost of treatment
(broadly defined to include a range of curative practices), this forces those
living with HIV to adapt their livelihood strategies, often using networks of
solidarity between positive people.
The process of lobbying for improvements in medical care is also explored.
Both doctors and NGOs advocate on behalf of HIV positive people, but do so
with strikingly different tactics and results. This has important implications
for continuing debates about working ‘with the grain’ (Crook and Booth,
2011) for development in patrimonial states.
In summary, whilst HIV treatment has saved the lives of millions, inventing
drugs and getting them to the people who need them are merely the first
steps in alleviating suffering. The thesis traces the most important tasks in
securing wellbeing in the ARV era – those pursued by HIV positive people
themselves.