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Perceptions of HIV, AIDS and tuberculosis among patients on antiretroviral therapy in Bulawayo, Zimbabwe: implications for the provision of HIV and TB care services

Alexander Rödlach
Riitta A Dlodlo
Zanele E Hwalima


The objectives of the research were to explore perceptions of HIV, AIDS and tuberculosis (TB) among individuals enrolled in antiretroviral therapy (ART) at two municipal clinics in Bulawayo, Zimbabwe, and to assess the implications of  these perceptions on the provision of HIV and TB care services. Data were collected using the freelist technique to elicit the elements of a cultural domain as well as open-ended interviews with ART clients, conducted during June and July 2009. Participants were recruited through non-probability convenience sampling. The freelist data were analysed using multidimensional scaling and  hierarchical clustering, and the interview data were analysed using the grounded theory method. The results suggest that: 1) the participants had substantial knowledge about HIV, AIDS and TB; 2) the participants’ perceptions of HIV, AIDS and TB constituted three distinct, though overlapping, cultural domains; 3) because of the availability of ART and TB treatment, a diagnosis of HIV infection or TB alone was generally perceived with hope that one would be able  to live a normal life, while AIDS illness or TB/HIV coinfection were associated  with notions of death and despair; and, 4) such perceptions may negatively  impact the uptake of testing for HIV and TB, and thereby contribute to delayed  start of the respective treatment. Health messages should build on these meanings which have the potential to either enhance or compromise available health programmes and their use by people living with HIV or TB.

Keywords: Africa, cultural domains, freelist technique, hierarchical clustering, multidimensional scaling, research methods, TB/HIV co-management

African Journal of AIDS Research 2012, 11(2): 99–112