Dissonance of Choice: Biomedical and Lived Perspectives on HIV Treatment-Taking. Issue 8 (16th November 2020)

• Record Type: Journal Article
• Authors: Horter, Shona; Seeley, Janet; Bernays, Sarah; Kerschberger, Bernhard; Lukhele, Nomthandazo; Wringe, Alison
• Is Part Of: Medical anthropology. Volume 39:Issue 8(2020)
• Page Start: 675
• Page End: 688
• Publication Date: 2020-11-16
• Subjects: Eswatini -- decision-making -- engagement with care -- HIV -- Treat-all; Medical anthropology -- Periodicals; 362.1
• DOI: 10.1080/01459740.2020.1720981
• Languages: English
• ISSNs: 0145-9740

Abstract

ABSTRACT: Treat-all recommends prompt treatment initiation for those diagnosed HIV positive, requiring adaptations to individuals' behavior and practice. Drawing on data from a longitudinal qualitative study in Eswatini, we examine the choice to initiate treatment when asymptomatic, the dissonance between the biomedical logic surrounding Treat-all and individuals' conceptions of treatment necessity, and the navigation over time of ongoing engagement with care. We reflect on the perspectives of healthcare workers, responsible for implementing Treat-all and holding a duty of care for their patients. We explore how the potentially differing needs and priorities of individuals and the public health agenda are navigated and reconciled. Rationalities regarding treatment-taking extend beyond the biomedical realm, requiring adjustments to sense of self and identity, and decision-making that is situated and socially embedded. Sense of choice and ownership for this process is important for individuals' engagement with treatment and care.