“ARVs” as sickness and medicine: Examining children's knowledge and experience in the HIV era in urban Zambia

Abstract

Since the roll out of no cost antiretroviral drugs (ARVs) in health centers in Zambia in 2004, the number of Zambians receiving treatment has substantially increased. While research has addressed adult responses to ARVs in Zambia and elsewhere, there is little known about how children experience and respond to the presence of treatment in their communities and households. The increasing acknowledgment that children provide care and treatment support to people with HIV in their households demands a better understanding of children's knowledge of HIV and ARVs. To examine children's ARV knowledge, this article focuses on three children's workshops carried out with 38 children ages 8–12, who participated in a yearlong ethnographic study in 2007 and 2008. All children lived in a low-income and heavily HIV-affected residential area in Lusaka, and many children lived with parents or guardians who had HIV. Findings suggest that, when the children discussed ARVs, they made two intersecting points: (1) local conditions make living with HIV, even while on antiretroviral therapy (ART), difficult; and (2) children face particular challenges, concerns, and insecurities when caring for and living with the ill. Children's discussions about ARVs offer a deeper understanding of experiences of HIV and childhood in a disproportionately HIV-affected and low-resource area. Such insights might productively inform future programming and research aimed at assisting children and adults.

Keywords:

• HIV/AIDS
• antiretroviral therapy
• children
• Zambia

Acknowledgments

I would like to acknowledge Emily Banda and Olivious Moono who offered research assistance for this project. This work was made possible by my affiliation with the Zambia AIDS-Related TB Project (ZAMBART). The study was conducted with a Dissertation Fieldwork Grant from the Wenner-Gren Foundation for Anthropological Research and a Fulbright IIE fellowship. Writing was supported by a grant from National Institutes of Health National Cancer Institute Community Networks Program Centers (U54 CA153460; Colditz).