“A Body Like a Baby”: Social Self-Care among Older People with Chronic HIV in Mombasa

Abstract

As part of the chronic disease paradigm now widely used for HIV in sub-Saharan Africa, antiretroviral treatment programs emphasize self-care. In the informal settlements of Mombasa, Kenya, the management of stress-associated with economic precariousness-plays a significant role in self-care practices and ideologies. Based on ethnographic fieldwork, we examine how local narratives of stress and self-care intertwine with social responsibilities of older HIV-positive people. For older Mombassans, living with 'chronic' HIV means living with an unpredictable body, which affects how they are able to care for their kin. The physical reality of living with HIV thus shapes relational networks, making self-care a social practice. While, for some self-care entails managing the body so that its needs are hidden from loved ones, a kind of 'protective secrecy,' others enlist the support of their children and grandchildren in managing their body, and in that process subtly redefine generational expectations and responsibilities.

Monitoring the body: grandmothers’ ability to provide ‘expert’ care for grandchildren living with HIV in northwest Tanzania

“…Clinic measurements are compared with physical strength, food advice is integrated with notions of satiation, and adherence becomes entwined with physical closeness and an intimate special relationship. Care then is not about individual responsibility; it is deeply embedded in social and family networks (Meinert 2013;Moyer 2014;De Klerk and Moyer 2017).…”

“…'Grandmother care' then has broader aims than just ensuring physical health and adherence: it is geared towards social inclusion. While patients in treatment programmes in sub-Saharan Africa have been described as self-disciplined 'experts' , who care for their bodies with the help of others (Whyte 2014;De Klerk and Moyer 2017), it is the caregivers and what can be called 'expert care' , that is the focus of this article. What does expert care entail and what shapes or hinders its enactment?…”

Función motora en adultos que viven con VIH

“…Si bien en Colombia se han reportado casos desde 1983 (1), aún se desconoce la magnitud de los cambios que la función motora puede tener asociados al envejecimiento y al uso de medicamentos que hacen parte del tratamiento de esta enfermedad (2).…”

“I Could See Little Bits of How I Progressed”: Coordinating Rhythms in a Midwest Gender‐affirming Health Clinic

“…While recent anthropological work on chronicity and illness has investigated how chronic conditions such as cancer and HIV interface with gendered embodiment and corresponding social gender expectations across cultural contexts (de Klerk and Moyer 2017; Manderson and Smith‐Morris 2010; Stansbury et al. 2003), employing the use of time‐maps allows for fine‐grained analysis of the spontaneous reactions bodies might have to specific biomedical interventions.…”

“…While recent anthropological work on chronicity and illness has investigated how chronic conditions such as cancer and HIV interface with gendered embodiment and corresponding social gender expectations across cultural contexts (de Klerk and Moyer 2017;Manderson and Smith-Morris 2010;Stansbury et al 2003), employing the use of time-maps allows for fine-grained analysis of the spontaneous reactions bodies might have to specific biomedical interventions. Outlining the body's participation in the maintenance of bureaucracy reveals specific targets in U.S. clinical bureaucracy for alleviating health disparities arising from binarist understandings of gender-sex difference.…”