title: The Framing and Fashioning of Therapeutic Citizenship Among People Living With HIV Taking Antiretroviral Therapy in Uganda.
abstract: In this article, we examine how people living with HIV (PLWH) were able to reconceptualize or "reframe" their understanding of HIV and enhance their capacity to self-manage the condition. Two in-depth interviews were held with 38 PLWH (20 women, 18 men) selected from three government and nongovernment antiretroviral therapy (ART) delivery sites in Wakiso District, and the narratives analyzed. ART providers played an important role in shaping participants' HIV self-management processes. Health workers helped PLWH realize that they could control their condition, provided useful concepts and language for emotional coping, and gave advice about practical self-management tasks, although this could not always be put into practice. ART providers in this setting were spaces for the development of a collective identity and a particular form of therapeutic citizenship that encouraged self-management, including adherence to ART. Positive framing institutions are important for many PLWH in resource-limited settings and the success of ART programs.
authors.affiliation: University of East Anglia, Norwich, United Kingdom s.russell@uea.ac.uk.
authors.forename: Steve
authors.initials: S
authors.lastname: Russell
authors.affiliation: Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Stella
authors.initials: S
authors.lastname: Namukwaya
authors.affiliation: Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Flavia
authors.initials: F
authors.lastname: Zalwango
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D012648:Self Care; D014454:Uganda
chemical_list: D000998:Antiviral Agents
keywords: Africa, Sub-Saharan; HIV/AIDS; adherence / compliance; coping and adaptation; health care, users’ experiences; illness and disease, experiences; research, qualitative; self-care