Living with HIV postdiagnosis: a qualitative study of the experiences of Nairobi slum residents
- 1London School of Economics—Social Policy, London, UK
- 2Population Council, Reproductive Health Program, Nairobi, Kenya
- Correspondence to Dr Eliud Wekesa;
- Received 23 November 2012
- Revised 18 February 2013
- Accepted 25 March 2013
- Published 3 May 2013
Objectives To characterise the experiences of heterosexual men and women living with HIV postdiagnosis and explain these experiences in relation to their identity and sexuality.
Design Qualitative study using in-depth interviews and a theoretically informed biographic disruption theory.
Setting Interviews were conducted in two Nairobi slums (Kenya).
Participants 41 HIV-infected heterosexual men and women aged 18 years or older.
Results People living with HIV have divergent experiences surrounding HIV diagnosis. Postdiagnosis, there are multiple phases of identity transition, including status (non-)disclosure, and attempts at identity repair and normalcy. For some people, this process involves a transition to a new self-identity, incorporating both HIV and antiretroviral treatment (ART) into their lives. For others, it involves a partial transition, with some aspects of their prediagnosis identity persisting, and for others it involves a rejection of HIV identity. Those people who were able to incorporate HIV/AIDS in their identity, without it being disruptive to their biography, were pursuing safer sexual and reproductive lives. By contrast, those people with a more continuous biography continued to reflect their prediagnosis identity and sexual behaviour.
Conclusions People living with HIV/AIDS (PLWHA) had to rework their sense of identity following diagnosis in the context of living in a slum setting. Men and women living with HIV in slums are poorly supported by health systems and services as they attempt to cope with a diagnosis of HIV. Given the availability of ART, health services and professionals need to support the rights of PLWHA to be sexually active if they want to and achieve their fertility goals, while minimising HIV transmission risk.
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