The meaning of health and sexuality as experienced by Tanzanian men and women living with HIV/AIDS

Background: Sub-Saharan Africa has for more than two decades been hit by the human immunodeficiency virus/acquired immune-deficiency syndrome, HIV/AIDS pandemic. In Tanzania, the prevalence of HIV is estimated to 7 percent and about 1.8,million Tanzanians are living with HIV. Women are the hardest hit and the most vulnerable are young women 1524 years old, who are three times more likely to be infected than young men in the same age group. The prevalence is higher in urban than in rural areas.

Aim: The overall aim of this thesis was to explore the meaning of health and sexuality among men and women living with HIV/AIDS.

Methods: Two studies were conducted in Dar es Salaam, Tanzania, during January and February in 2004 (1, 11). Twenty participants were recruited (10 men and 10 women) by the help of health staff and sampled purposely in order to get an equal variety of age, education, religion, sex, and marital status. The interviews took place at one district hospital, and at two different clinics run by Non -Governmental Organizations (NGO) one located in a business area in central town and the other outside town in an industrial area. The interviews were transcribed and translated into English. A phenomenological - hermeneutic approach was used to collect and analyse the data. The text was analysed following Ricoeur's interpretation theory for text.

Findings: This thesis presents aspects of men's and women's experiences of living with HIV/AIDS. Adjustment to living with the virus was different between men and women. Men often conceived a growing suspicion that they might be infected by HIV, while women had to be asked by relatives or had to wait for others to be tested. The overwhelming fear of being tested was related to the fear of being stigmatised. Understanding the meaning of health and sexuality when living with HIV/AIDS, was for men living life with a preserved sense of integrity and self-esteem, this meant not to be seen as victims. To the women, however, the reality was that it meant being cast into poverty and created devastation of intimate relations. Men had learnt to perform safe sex and had chosen to live with one partner/wife, giving them an opportunity to develop new aspects of their intimate life. Conversely, the women felt miserable and had not accepted their diagnosis in the same way. They lacked resources to maintain health and the ability to support their children. The women who lived in a single household had abandoned sex life, their worries and deep concerns were for their children, who brought meaning and joy in their lives.

Conclusion: For both men and women the meaning of health and sexuality had changed after knowing their sero-status. The men had accepted to live with an altered health and treated symptoms early. They were able to handle feelings, they felt optimistic and strived to live a normal life as possible. Health had for the women lost meaning in that sense it was not possible to maintain. The men viewed their sex life still important, and tried to be able live a normal life. The women had accepted a life there sexuality had no place. To prevent further HIV infection meant to be educated and fully understand how to prevent the spread of HIV, to act in a responsible way, to be faithful, and/or to accept abstinence. This new way of living meant to be a caring man or woman. The use of condoms had not been completely accepted as the knowledge on how to use the condoms properly was not entirely accomplished. Support from counsellors and peers were proved invaluable adjust to a life of living with HIV/AIDS.

List of scientific papers

I. Balaile G, Kayombo J, Ransjo-Arvidson AB, Hojer B (2007). "Sexuality and health: a study of Tanzanian mens experiences of living with HIV/AIDS in Tanzania." [Submitted]

II. Balaile G, Laisser R, Ransjo-Arvidson AB, Hojer B (2007). "Poverty and devastation of intimate relations Tanzanian womens experience of living with HIV/AIDS." Journal of the Association of Nurses in AIDS care. [Accepted]
https://pubmed.ncbi.nlm.nih.gov/17889320