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AIDS, marriage, and the management of ambiguity in northern Nigeria

AIDS, marriage, and the management of ambiguity in northern Nigeria
Kathryn Angela Rhine

2010

Department of Anthropology, Brown University, Providence RI 02912, UNITED STATES OF AMERICA.

ABSTRACT

This is a dissertation about the lived experience of HIV as it is interwoven in the recent history of global health intervention in Nigeria. I explore the aspirations, dilemmas, and everyday lives of women participating in the world that HIV prevention and treatment campaigns have opened up. Across sub-Saharan Africa, a positive diagnosis has widely been considered a death sentence, presumed to jeopardize not only one’s health, but also her education, work, family, and social reputation. Once an undetectable disease whose sufferers lived and died of a sickness with an unspeakable cause, HIV-positive persons collecting antiretroviral therapies in Nigeria now number in the hundreds of thousands, with as many as a million more awaiting treatment. Physicians and counselors no long emphasize to their patients the pathology of HIV or the forms its progression takes; instead, they focus upon the life-prolonging effects of medications. Individuals are assured that they would remain healthy if they adhered to their medications.

This dissertation explores broadly the intersections between global health agendas, biomedicine, kinship, and gender relations in northern Nigeria. What are the cultural values, assumptions, and practices that inform global and local interventions to understand and curtail the epidemic in Nigeria? How do the moral evaluations that accompany these political, medical, and popular assumptions grant credibility to certain forms of knowledge surrounding HIV and its effects upon the body? How do HIV- positive women, in turn, respond to and navigate these social, ethical, and moral challenges surrounding testing, care, and treatment? What is the role of the family in these pursuits? How do local political economic dynamics and inequalities shape women’s social and illness trajectories in resource-poor settings? What is it, precisely, that prevents women from reproducing the expectations of health citizenship encouraged by these global health campaigns?