FINDING THE MEANINGS OF AIDS: ARV treatment in an Eastern Cape village

What happens to the meanings of AIDS when treatment for it becomes universally available? The author asks this question in Lusikisiki, where a successful antiretroviral treatment programme in the district’s 12 clinics made treatment accessible. The most profound effect is a whittling away of public denial. As nurses begin successfully treating opportunistic infections, so villagers’ definition of AIDS broadens considerably; infections previously considered the work of witchcraft are now identified with AIDS. However, two years after the beginning of treatment, AIDS remained highly stigmatised. Although everyone knew where to go for treatment, some stayed at home and got sicker, while others tried to initiate treatment secretly. The future of the meaning of AIDS depends a great deal on whether the health system can maintain the quality of its service. If radically understaffed clinics begin finding ways to turn patients away, people will look increasingly to traditional and lay-healers for treatment and accept alternative explanations for illness.