Preface

Since the advent of HIV/AIDS, numerous publications have emerged on the subject, predominantly focussing on the biomedical aspects of the disease. In recent years, it has been recognized that HIV/AIDS is not just a medical condition, but also has political, social, psychological, economic and demographic ramifications that need to be dealt with. However, research addressing HIV/AIDS areas outside the biomedical side of research is limited.

This book was born out of desire among scholars researching in the field of HIV and AIDS to document the social and psychosocial aspects of HIV/AIDS epidemic, and the impact that these aspects have on HIV/AIDS-related behaviours. The book is titled "Social and Psychosocial Aspects of HIV/AIDS and their Ramifications" to reflect the multi-dimensionality of the HIV/AIDS epidemic. The book addresses key areas of HIV and AIDS, including, but not in any way limited to, care-seeking behaviour, adherence, access, psychosocial needs and support services, discrimination and the impact the epidemic has on various sectors of the economy. Researchers, students and other people interested in the HIV and AIDS in general will find this book informative and easy to read and understand. The book is an essential reading for academics, students and other people interested in the field of HIV and AIDS.

We are grateful for the helpful comments received from the various anonymous reviewers during the preparation of this book for publication. The facts and opinions expressed in this book are those of the authors/editors and do not necessarily reflect the views of the institutions they represent.

September 2011

**Gobopamang Letamo** 

Department of Population Studies University of Botswana

**Part 1** 

**Social Aspects of HIV / AIDS** 

**Part 1** 

**Social Aspects of HIV / AIDS** 

**1** 

*The Netherlands* 

**The Experiences and Complexities of** 

**HIV/AIDS: A Qualitative Study in Nigeria** 

Ngozi C. Mbonu, Bart Van Den Borne and Nanne K. De Vries

*Faculty of Health Medicine and Life Sciences, Maastricht University* 

*School of Public Health and Primary Care (CAPHRI)* 

**Care-Seeking Behavior of People Living with** 

In 2009, approximately 2.98 million people in Nigeria were living with HIV/AIDS. More than 192,000 deaths were caused by AIDS and 2.175 million AIDS orphans are now living in Nigeria (UNAIDS, 2010). The availability of anti-retroviral therapy (ART) implies that people living with HIV/AIDS (PLWHA) should be able to carry out daily activities like the rest of society. However, there are a number of hindrances to the utilization of care, leading to suboptimal effectiveness of available treatment (Hilhorst et al., 2006; Morolake et al., 2009). One of the factors seems to be stigma; PLWHA and their care givers have to cope with negative reactions from the people directly around them as well as from the community (Mwinituo & Mill, 2006; Mitchell et al., 2007; Sabin et al., 2008; Adewuya et al., 2009; Hejoaka, 2009; Demmer, 2011). A study carried out among home based care givers in KwaZulu Natal South Africa showed that home based care givers experience high levels of burden and are targets of HIV-related prejudice and discrimination (Singh et al., 2011). Not only does the discovery that one is infected with HIV lead to fear of progression into AIDS and fear of dying, it also creates an anticipation of negative social reactions among PLWHA. Sontag (1989) argues that it is not the suffering of the disease that is deeply feared, but the denigration that is suffered from having the disease that makes PLWHA vulnerable as individuals and within society. People in the community have a negative attitude towards PLWHA because they attribute the characteristic of promiscuity to those who are infected (Campbell et al., 2007). Societal norms and values in Nigeria are restrictive and secretive, while discussion about sex is often private for cultural and religious reasons (Ajuwon et al., 1998), making people who transgress these norms likely to be condemned

Several studies around the world (Amirkhanian et al., 2003; Singh et al., 2009; Stevelink et al., 2011; Vlassoff & Ali, 2011) and in Africa indicate that PLWHA are still discriminated against (Muyinda et al., 1997; Duffy, 2005; Shisana et al., 2005; Muula & Mfutso-Bengo, 2005; Hilhorst et al., 2006; Liamputtong et al., 2009; Morolake et al., 2009; Amuri et al., 2011), making them resort to varied ways of coping with their problems (Mbonu et al., 2009). Despite these studies indicating the presence of stigma, literature have equally acknowledged that one of the positive noticeable interventions in the fight of HIV/AIDS

**1. Introduction** 

because norms are very strong and strict.
