Language and Social sciences Education

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Browsing Language and Social sciences Education by Subject "ART"

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    Exploring ‘therapeutic citizenship’ as a governmentality of health issue in adhering to antiretroviral treatment (ART) for primary and secondary school teachers in Zambia.
    (ARC, 2022-08) Mulubale, Sanny; Ngambi, Stabile; Kalimaposo, Kalisto; Mufalo, Setwin
    The psychosocial concerns of HIV medicalization and bracketing of wellbeing in medical sense should not just be ‘normalised’ by clinical approaches. HIV medicalisation has become the basis of normalisation among citizens without being questioned. Therefore, the aim of this paper is to examine the extent to which HIV governmentality as mediated through a ‘therapeutic citizenship’ status, among school teachers, especially those on antiretroviral treatment (ART), have an effect on their everyday and development in Zambia. Semi-structured interviews with 41 (20 females and 21 males) purposively sampled HIV positive teachers in Zambia aged between 25 – 55 were conducted in western and southern provinces. Transcripts were processed using NVivo Pro 12®, following an inductive thematic analytic methodology. Results indicate that though a treatable illness, HIV has both latent and visible varying effects based on locality, language, gender, age, career, health care provisions, policy and social strata. Findings show that HIV has strong effect on individual identity and collective affect through past experiences, present events and medico-social uncertainties; stigma is still high and a big problem hindering disclosure; treatment access and adaptation are hard for some people; anxieties and mental health issues/stigma are high but unattended as they are outside set diagnostic medical categories; knowledge and information is averagely low. The govermentalisation of health through ART seem ‘de-normalising’ for 60% of participants who think ART is a form of ‘pharmaceutical colonialism’ that is stagnating Zambia’s national development.
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    Exploring ‘therapeutic citizenship’ as a governmentality of health issue in adhering to antiretroviral treatment (ART) for primary and secondary school teachers in Zambia.
    (ARC, 2022-08) Mulubale, Sanny; Ngambi, Stabile; Kalimaposo, Kalisto; Mufalo, Setwin
    The psychosocial concerns of HIV medicalization and bracketing of wellbeing in medical sense should not just be ‘normalised’ by clinical approaches. HIV medicalisation has become the basis of normalisation among citizens without being questioned. Therefore, the aim of this paper is to examine the extent to which HIV governmentality as mediated through a ‘therapeutic citizenship’ status, among school teachers, especially those on antiretroviral treatment (ART), have an effect on their everyday and development in Zambia. Semi-structured interviews with 41 (20 females and 21 males) purposively sampled HIV positive teachers in Zambia aged between 25 – 55 were conducted in western and southern provinces. Transcripts were processed using NVivo Pro 12®, following an inductive thematic analytic methodology. Results indicate that though a treatable illness, HIV has both latent and visible varying effects based on locality, language, gender, age, career, health care provisions, policy and social strata. Findings show that HIV has strong effect on individual identity and collective affect through past experiences, present events and medico-social uncertainties; stigma is still high and a big problem hindering disclosure; treatment access and adaptation are hard for some people; anxieties and mental health issues/stigma are high but unattended as they are outside set diagnostic medical categories; knowledge and information is averagely low. The govermentalisation of health through ART seem ‘de-normalising’ for 60% of participants who think ART is a form of ‘pharmaceutical colonialism’ that is stagnating Zambia’s national development. In the conclusion and final proposition, this paper shows that HIV can seem like a disappearing disease yet the challenges for ART are more medico-social and psychological than physiological. Since antiretroviral drugs increase life longevity, research focus and policy interventions should now shift from quantity (span) to quality of life on ART.
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    Situating HIV stigma in health facility settings: a qualitative study of experiences and perceptions of stigma in ‘clinics’ among healthcare workers and service users in Zambia.
    (Sage, 2022-05-12) Mulubale, Sanny; Clay, Sue; Squire, Corinne; Bond, Virginia; Kasoka, Kasoka; Stackpool-Moore, Lucy; Oraro-Lawrence, Tessa; Chonta, Mutale; Chiiya, Chipo
    The study focused on the representations, processes and effects of HIV stigma for healthcare workers living with HIV within health facilities in Zambia. A descriptive study design was deployed. A total of 56 health workers and four service user participants responded to a structured questionnaire (n=50) or took part in key informant interviews (n=10) in five high HIV-prevalence provinces. Most participants did not disclose if they were living with HIV, except for four participants who responded to the questionnaire and were selected for being open about living with HIV. Semi-structured interviews were carried out with health workers in key government health facility positions. The questionnaire questions were standardized and used a Likert scale. Descriptive statistical and thematic analyses were applied to the data. Results show that antiretroviral treatment (ART) has an impact on stigma reduction. Almost half the participants agreed that treatment is changing levels of HIV stigma. However, fears of exposure of HIV status and labelling and judgemental attitudes remain prevalent. No comprehensive stigma reduction policies and guidelines in healthcare facilities were mentioned. Informal flexible systems to deliver HIV services were in place for health workers living with HIV, illustrating how stigma can be quietly navigated. Lack of confidentiality in healthcare facilities plays a role in fuelling disclosure issues and hampering access to testing and treatment. Stigma reduction training needs standardization. Further, codes of conduct for ‘stigma-free healthcare settings’ should be developed.