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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