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HIV & AIDS

Narrative Methods and Sociocultural Linguistic Approaches in Facilitating In-depth Understanding of HIV Disclosure in a Cohort of Women and Men in Cape Town, South Africa

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The South African National Department of Health has rapidly extended free public- sector
antiretroviral treatment for people living with HIV from 2007. Approximately 6 million
people are living with HIV in South Africa, with 3.1 million currently on treatment. HIV disclosure
stigma has been reduced in high prevalence, generalized epidemic settings, but
some remains, including in research interviews. This paper documents the unexpected
reactions of people living with HIV to interviewers. It highlights shifts over time from discussing
daily events with researchers to later expressing distress and then relief at having
an uninvolved, sympathetic person with whom to discuss HIV disclosure. While there
are commonalities, women and men had gendered responses to interviewers. These
are apparent in men’s uncharacteristic emotional responses and women’s shyness in
revealing gendered aspects of HIV acquisition. Both women and men expressed stress
at not being allowed or able to fulfill dominant expected masculine or feminine roles. The
findings underline the role of research interviewers in study participants confiding and
fully expressing their feelings. This greater confidence occurred in follow-up interviews
with researchers in busy health facilities, where time of health-care providers is limited. It
underlines the methodological value of narrative inquiries with research cohorts. These
allowed richer data than cross-sectional interviews. They shaped the questions asked
and the process of interview.

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English
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Subject(s)
HIV disclosureCommonalities
Feminine roles
Ethical dilemmas
Health facilities
Epidemic settings
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Article
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