As access to Antiretroviral Therapy (ART) in Tanzania has been
steadily improving in recent years, there has been concern that availability of
Antiretroviral Drugs (ARV) could fuel HIV transmission due to deliberate
unprotected sexual practices of persons receiving antiretroviral treatment.
There has been a debate about the need to enforce some institutional measures
to help manage and control what has been described as the deliberate spread of
HIV. However, there is no widespread consensus about what constitutes
‘deliberate transmission’.
Drawing on in-depth interviews with a sample of people receiving
ART and health workers providing care in a rural setting, this article examines
the context in which deliberate HIV transmission is defined and the ways
through which it can be controlled. The article demonstrates that people on ART
face the dilemma of reducing risk of spreading HIV and a desire to maintain
socially acceptable sexual and reproductive lives. Although many participants
reportedly remained sexually abstinent, they also revealed that some people on
treatment from within and beyond the study area were engaging in sexual
behaviours perceived to amount to deliberate spread of HIV.
Despite some reservations, formal sanctions to control
deliberate HIV transmission were generally highly approved by participants. The
article strongly recommends for a careful examination of needs of persons on
treatment and strengthened prevention in order to manage unintended
consequences of ART for individuals living with HIV/AIDS and uninfected population.
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