Lover, mother or worker: women's multiple roles and the HIV/AIDS and reproductive health agenda in Tanzania

Abstract

International and national campaigns to prevent HIV/AIDS and efforts to promote reproductive health remain separate in terms of conceptualisation and implementation. Local negotiations around reproductive health issues similarly seem to lack explicit attention to HIV/AIDS. This paper argues that even in reproductive health clinics a gap exists between the extent of knowledge of HIV/AIDS and AIDS talk. There also appears to be a mismatch between collective knowledge of the behavioural and biomedical context of HIV/AIDS and the socio-economic context of AIDS as a lived experience. Using an ethnographic account, I explore how one woman's lived experience and her knowledge of AIDS can teach us to take HIV/AIDS into account when theorising, promoting or providing services for improving African women's reproductive health. The background for this ethnography comes from data collected during 25 months of fieldwork at 10 maternal and child health/family planning (MCH/FP) clinic sites in the Morogoro, Ruvuma and Kilimanjaro regions of Tanzania. Rehema's story shows that AIDS, like other diseases, is significantly linked to host-susceptibility and economic vulnerability. Separate and competing vertical programmes on AIDS and MCH/FP, as commonly encountered throughout Africa, cannot meet the needs of women in countries like Tanzania. Yet, we still hear most often of abstinence, anti-retrovirals and condom use as the primary focus of HIV/AIDS prevention and intervention in Africa.