De maatschappelijke veranderingen als gevolg van de HIV-epidemie

Kenya, Tanzania and Zambia all have very serious, though stable HIV epidemics. The three countries are also currently actively scaling up access to antiretroviral treatment (ART), which means that more and more people are now living longer and healthier lives with HIV. As a direct result, there has been an increase in demand for more and alternative care and support services for those infected and affected by HIV, including client-centered services provided by others living with the disease. These demands cannot be absorbed by the already overburdened healthcare services, nor by kinship networks already stretched to the limit by HIV and Africa’s ongoing economic crisis. To fill the emergent gap in care and support needs and desires, People Living with HIV (PLHIV) are therefore taking the initiative, as can be witnessed by the rapid growth of PLHIV-centered organisations geared toward meeting these ends. 

The main hypothesis of this research programme is that social institutions are being transformed in radical and significant ways to meet the care and support needs of communities overburdened by HIV. We argue that knowledge of these transformations is best gained by studying social institutions that have been particularly shaped by HIV/AIDS. To this end, the main aim of this Integrated Programme will be to conduct in-depth comparative qualitative research in Kenya, Tanzania and Zambia into three key areas of AIDS care and support particularly bound to social and cultural norms: 1) community-based care and treatment of orphans; 2) the provision of HIV/AIDS counselling and treatment by lay providers; and 3) the emergence and transformation of support groups for people infected with and affected by HIV/AIDS.

The research will consist of independent but inter-related comparative studies using primarily qualitative methods. Main objectives are:

1. To describe the ways that social life in rural and urban communities has been transformed by efforts to provide care and support for those infected and affected by HIV/AIDS in Tanzania, Kenya and Zambia;
2. To investigate the ways community-initiated AIDS care and support is understood and delivered in rural areas least served by health services;
3. To identify and document existing best practices for filling AIDS care and support gaps as demonstrated by various non-governmental actors, including kinship networks, community based organizations (CBOs), faith-based organizations (FBOs), lay counsellors, and PLWA activists and support groups;
4. To make policy-relevant recommendations for improving the continuum of quality health care and support for those infected and affected by AIDS.