Concealment tactics among HIV-positive nurses in Uganda

Area of Science:

• Medical Anthropology
• Public Health
• Sociology of Health

Background:

• A significant proportion of nurses in rural Ugandan health centers are HIV-positive.
• Many HIV-positive healthcare professionals conceal their status due to stigma.
• Antiretroviral therapy (ART) can cause side effects, such as skin rashes, that risk revealing a patient's HIV status.

Purpose of the Study:

• To explore the experiences of HIV-positive nurses during ART scale-up in rural Uganda.
• To document the coping mechanisms and innovative care strategies developed by these nurses.
• To analyze the negotiation of biomedical and traditional healing practices within HIV care.

Main Methods:

• Ethnographic fieldwork conducted over two-and-a-half years in two rural Ugandan health centers.
• Participant observation and in-depth interviews with nurses and patients.
• Analysis of the development and advocacy for a herbal skin cream treatment.

Main Results:

• HIV-positive nurses formed clandestine support circles to discuss their challenges.
• Innovative self-care technologies, including a herbal skin cream, were developed to manage ART-induced rashes.
• Nurses, patients, and a traditional healer collaboratively challenged biomedical exclusivity by advocating for the inclusion of herbal medicine in ART programs.

Conclusions:

• HIV-positive nurses demonstrated resilience and innovation in managing their health and professional roles.
• The study highlights the potential for integrating traditional and biomedical approaches in HIV care.
• Addressing stigma and supporting healthcare workers living with HIV is crucial for effective public health interventions.