Narratives of Nationhood and HIV/AIDS: Reflections on Multidisciplinary Research on the HIV/AIDS Epidemic in Zambia over the Last 30 Years.

AIDS; AIDS & society; AIDS epidemiology; HIV infection epidemiology; Antiretroviral agents; AIDS prevention; Zambian history, 1964-

The HIV/AIDS epidemic, exacerbated by global processes, has affected most aspects of life in Zambia. The country's demographic profile has changed, with significant losses among those of reproductive age, and a huge increase in the number of orphans has placed additional burdens on families and on the delivery of health and education services. HIV/AIDS has engendered profound changes in personal and national identity. Shifts in Zambian narratives of nationhood emerge from this overview of the history of HIV made through the lens of research over a stretch of 30 years. One key narrative change concerns ideas of integrity and respect. Discussion of, and instruction in, sexual matters has become a topic of public debate about right conduct at all levels in society, thus reframing ideas of respect towards those in authority who have addressed this crisis. Another key narrative involves changes in the locus of responsibility and rights. The HIV response has both contested and pushed the reach of the state further into health and well-being, alongside an unprecedented involvement of local and international non-governmental agencies and church organisations. Thus HIV has both changed Zambia as a nation and changed what it means to be Zambian. Within opportunities created by HIV for academic research, focus has swung between the social and the bio-technological. This pendulum of research has gradually allowed Zambian agency in research to become more assertive, culminating in a National Health Research Bill in 2013. Free access to antiretroviral therapy (ART), which has in many ways transformed the landscape of HIV/AIDS from one of fear and despair to one of hope, is not without its own uncertainties and challenges at the personal, community and national levels. In the face of bio-technological solutions, there remains a need to draw on the social – the responsibility of the state and changed ideas of respect, sex and health. [ABSTRACT FROM PUBLISHER]