An Institutional Field of People Living with HIV/AIDS Organizations in Tanzania: Agency, Culture, Dialogue, and Structure

James Olumide Olufowote

doi:10.3389/fcomm.2017.00001

Abstract

Communication research on public health organizations and people living with HIV/AIDS (PLWHA) have paid insufficient attention to PLWHA organizations. These organizations, constituted and operated by PLWHA, advocate on behalf of PLWHA with more powerful institutions in society and serve as sources of empowerment and support. I drew on the culture-centered approach to health communication and institutional perspectives on health organizations to explore PLWHA organizations in Tanzania, namely their cultural and structural contexts, agency, and dialogue. Tanzania has 1.5 million PLWHA and a 5.3% adult prevalence rate that ranks it as 12th highest in the world. Through interviews with leaders of 10 PLWHA organizations, I found a cultural context of HIV stigma and discrimination, a structural context consisting of both corruption and bureaucratic politics in governing bodies as well as lack of access to resources, agency to impact PLWHA and members of society in a variety of ways, and processes of dialogue within advocacy networks of PLWHA organizations and in network collaborations with the government. I conclude with implications for improving the organizations’ interactions with their structural context and for developing the contribution from the culture-centered approach to health communication on structures-as-health-organizations-and-systems.

Highlights

Specialty section: This article was submitted to Health Communication, a section of the journal Frontiers in Communication
Through interviews with leaders of 10 people living with HIV/ AIDS (PLWHA) organizations, I found a cultural context of HIV stigma and discrimination, a structural context consisting of corruption and bureaucratic politics in governing bodies as well as lack of access to resources, agency to impact PLWHA and members of society in a variety of ways, and processes of dialogue within advocacy networks of PLWHA organizations and in network collaborations with the government
One body of communication research on health organizations has recognized a variety of public health organizations (e.g., Cooren et al, 2008; Desouza and Dutta, 2008; Zoller, 2010; Cooper and Shumate, 2012) and another body of research on PLWHA has considered various contexts that shape and are shaped by PLWHA (e.g., Hardy et al, 2006; Miller and Rubin, 2007; Iwelunmor et al, People Living with HIV/AIDS Organizations 2010; Ho and Robles, 2011), neither body of work has focused much on PLWHA organizations

Summary

Introduction

Specialty section: This article was submitted to Health Communication, a section of the journal Frontiers in Communication. Communication research on public health organizations and people living with HIV/ AIDS (PLWHA) have paid insufficient attention to PLWHA organizations. These organizations, constituted and operated by PLWHA, advocate on behalf of PLWHA with more powerful institutions in society and serve as sources of empowerment and support. I drew on the culture-centered approach to health communication and institutional perspectives on health organizations to explore PLWHA organizations in Tanzania, namely, their cultural and structural contexts, agency, and dialogue. The United Nations (UN) estimated that 71% of worldwide HIV infections and 75% of AIDS-related deaths take place in sub-Saharan Africa (United Nations Programme on HIV/AIDS, 2015) These estimates point to the continuing importance of HIV/AIDS research in this context. Findings pointed to the cultural and structural contexts of the organizations, their exercises of agency, and their engagement with processes of dialogue

Methods

Results

Discussion

Conclusion