Abstract:
Antiretroviral therapy (ART) is becoming increasingly more accessible within the health care system in
Tanzania. However, the impact of the increased availability of ART on local conceptions about medicines,
health and physical wellbeing has not been fully explored. In this article we examine how ART is
constituted within local discourses about treatment and healing. Based on 21 focus group discussions
with young people aged 14–24 years in a rural area (Kahe), we examine how local terms and descriptions
of antiretroviral therapy relate to wider definitions about the body, health, illness and drug efficacy.
Findings illustrate how local understandings of ART draw on a wider discourse about the therapeutic
functions of medicines and clinical dimensions of HIV/AIDS. Therapeutic efficacy of antiretroviral
medication appeared to overlap and sometimes contradict locally shared understandings of the clinical
functions of medicines in the body. Implications of ART on bodily appearance and HIV signs may
influence conceptions about sick role, perpetuate stigma and affect local strategies for HIV prevention.
Structural inequities in access, limited information on therapeutic efficacy of ART and perceived difficulties
with status disclosure appear to inform local conceptions and possible implications of ART. Policy
and programme interventions to foster public understanding and acceptability of ART should emphasize
treatment education about the benefits and limitations of therapy and increased access to ART in rural
areas, and should integrate voluntary status disclosure and HIV prevention.
