Engaging therapeutic citizenship and clientship: Untangling the reasons for therapeutic pacifism among people living with HIV in urban Zambia

ABSTRACT

This article explores the reasons for therapeutic pacifism among people living with HIV (PLHIVs) in urban Zambia. It contributes to a growing ethnography on global health, biosociality, and patient-provider dynamics. Therapeutic citizenship is a biopolitical citizenship that includes claims and ethical projects that emerge from techniques to control and manage bodies. In some contexts, therapeutic citizenship has included activism and claims-making against local, national, and international power brokers. This article investigates therapeutic citizenship in the specific context of impoverished urban Zambian compounds, sites of food insecurity, unemployment, and political exclusion, as well as targets for donor, NGO, and faith-based organisation projects and PLHIV support group proliferation. The article utilises data from participant observations at two Lusaka AIDS clinics, interviews, and focused discussions with support groups of PLHIVs. It argues that PLHIVs continuously negotiate subjectivities related to kinship, clientship, religious belief, and political citizenship in processes that complicate therapeutic citizenship. Rather than fostering participation in PLHIV support groups or challenging ‘politics as usual’ through activist claims-making to institutions of biopower, these processes lead to therapeutic pacifism.

KEYWORDS:

• Therapeutic citizenship
• kinship
• social hierarchies
• HIV/AIDS
• Zambia

Acknowledgements

Earlier versions of this manuscript benefitted from comments from Nadine Beckmann, Mila Dragojević, Louise Rasmussen, and the two anonymous reviewers. The author credits one reviewer with the term ‘therapeutic pacifism’.

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Funding

The Zambian fieldwork was supported by the Fulbright Commission [grant number 48419112].