School Teachers’ Health and ‘Therapeutic Citizenship’ in Zambia: Problems and Prospects

Abstract

A treatable illness, HIV (Human Immunodeficiency Virus) has both latent and visible psychological, social and economic effects on infected and affected individuals. School teachers as a key population and large civil service workforce in Zambia, appear to have distinct representations of HIV citizenship and ART (Antiretroviral Therapy) experiences. This study employed a qualitative and thematic analytical approach to examine the notion of therapeutic citizenship as represented by school teachers in Zambia. The aim of this paper is to explore ways through which HIV positive teachers position themselves in citizen experiences of living with HIV and on ART, which are important framings of ‘therapeutic citizenship’. Semi-structured interviews with 41 HIV positive teachers in Zambia aged between 25 and 55 were conducted. Transcripts were processed using NVivo Pro 12®, following a thematic analytic methodology. The results show that gender, location, social and professional life play a role in how HIV-citizenship is represented and appropriated. The unending treatment practices around HIV can portray individuals’ self-narratives as ‘resistant’ subjects by, for instance, describing them as victims of ‘pharmaceutical colonialism’ in Zambia. Findings suggest that identity entanglements and fragmentation of selfhood in biomedicine and biopolitics seem to be a pivot for critical citizens, such as the participants of this study. HIV programmes must be aimed at people in Zambia who know little about some newer aspects of HIV treatment which if known about could be destigmatising for people who are negative and positive and could help reduce incidence for younger and older people.