Coming of age with HIV: a temporal understanding of young women’s experiences in Zambia

Constance R S Mackworth-Young,Virginia Bond,Anne L Stangl,Mutale Chonta,Alison Wringe

doi:10.1080/09540121.2019.1709616

Abstract

ABSTRACT Young perinatally-infected women living with HIV in Zambia grew up alongside antiretroviral therapy (ART) roll-out and expanding prevention programmes. We used Bonnington’s temporal framework to understand how HIV impacted the experiences of these women over time. Data were drawn from two sequential studies with a cohort of young women living with HIV: a qualitative study in 2014–16 and an ethnographic study in 2017–18. Data from workshops, in-depth interviews, participant observation and diaries were analysed thematically, guided by three temporalities within the framework: everyday, biographical and epochal time. In everyday time, repetitive daily treatment-taking reminded young women of their HIV status, affecting relationships and leading to secrecy with ART. In biographical time, past events including HIV disclosure, experiences of illness, and loss shaped present experiences and future aspirations. Lastly, in epochal time, the women’s HIV infection and their survival were intimately interlinked with the history of ART availability. The epochal temporal understanding leads us to extend Reynolds Whyte’s notion of “biogeneration” to conceptualise these women, whose experiences of living with HIV are enmeshed with their biosocial environment. Support groups for young women living with HIV should help them to process biographical events, as well as supporting their everyday needs.

Highlights

Young people living with HIV are viewed as a focal population in the HIV response (World Health Organization, 2018)
HIV was first identified in Zambia in the 1980s, and by the 1990s the epidemic had escalated, leaving the country grappling with affected families, HIV care, and education programming in the absence of effective treatment (Simpson & Bond, 2014)
Through the lens of everyday, biographical and epochal time, we provide an understanding of the impact of HIV on this generation of young women

Summary

Introduction

Young people living with HIV are viewed as a focal population in the HIV response (World Health Organization, 2018). Our understandings of their lives are often drawn from cross-sectional studies or research with limited follow-up periods (Salam, Das, Lassi, & Bhutta, 2016). In 2004, antiretroviral therapy (ART) became available in public health facilities, enabling transformations for some people living with HIV from ill-health to relative wellness (Simpson & Bond, 2014). Those who were saved by the introduction of ART have been described as constituting a “biogeneration”, due to their shared relationship to ART when this biotechnology became widely accessible Those who were saved by the introduction of ART have been described as constituting a “biogeneration”, due to their shared relationship to ART when this biotechnology became widely accessible (Reynolds Whyte, 2014, p. 11)

Methods

Results

Conclusion