Caught in Transition: The Struggle to Live a ‘Normal’ Life with HIV in Tanzania

Abstract

According to global health discourses, antiretroviral treatment (ART) enables ever more people living with HIV to resume a ‘normal’ life: a return to health and the reconstruction of social relations. Based on 15 months of fieldwork in Tanga, Tanzania, I explore the extent to which patients ‘on the ground’ have experienced the shift of HIV from an acute and rapidly deteriorating condition to a ‘normal chronic’ condition. Drawing on semistructured interviews and participant observation in treatment centers and private households, I juxtapose the discourse of health care providers on ‘normalcy’ with patients’ narratives of everyday life with HIV. I argue that in the context of severe poverty and persistent stigmatization, the transition to normalcy suggested by health care providers during treatment preparation has been difficult for many patients to achieve. Their social quandaries and moral dilemmas suggest that ART introduces new uncertainties into their lives, which keep them trapped in a state of ‘permanent transition.’

Keywords:

• antiretroviral treatment
• chronicity
• HIV/AIDS
• normalcy
• sub-Saharan Africa
• Tanzania

ACKNOWLEDGMENTS

I would like to thank the editors of this special issue, Hansjörg Dilger, Claire Beaudevin, and the Arbeitskreis Medical Anthropology of the Institute of Social and Cultural Anthropology, Freie Universität Berlin, for their insightful comments on earlier versions of this article. I also thank the anonymous reviewers for their detailed and constructive critique. Finally, I am greatly indebted to the medical professionals and the people living with HIV in Tanga who readily granted me insight into their work and lifeworlds.

FUNDING

This article is based on research generously supported by the Fritz Thyssen Foundation.

Notes

1. 1.All names in this article are pseudonyms. Katherine herself was not HIV-positive but like many other HIV-negative nurses referred to “us” in order to create a sense of solidarity and cohesion.

Additional information

Notes on contributors

Dominik Mattes

Dominik Mattes is a research associate at the Institute of Social and Cultural Anthropology, Freie Universität Berlin. His doctoral research focuses on social dynamics within the public HIV/AIDS treatment program in Tanzania and the impact of treatment on patients’ and their families’ lifeworlds, conceptualizations of ‘healing,’ and the more general discourse of HIV/AIDS.