Résumé :
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This article seeks to examine the disclosure of HIV status in the context of limited public health care resources in Kenya. The article adopts a social constructionist approach, and is also guided by Goffman in making'sense'of the social discourses surrounding the dicsclosure of HIV status. The data used were assembled through semi-structured interviews with health care providers and a heterosexual sample of 14 patients diagnosed HIV-positive who presented for treatment in one STDs/HIV specialized tretment clinic in the city of Nairobi. In examining the effects of lack of privacy, confidentiality, and limited personnel on the the disclosure of HIV status, it is observed that such a disclosure is not simply a biomedical exercise which follows the normative ceremonial etiquette of the clinic, but an interactive social process of negotiations and bargaining between health care providers and people with HIV/AIDS whose outcome is highly unpredictable. Further it is observed that the tensions generated by a disclosure of seropositivity stem more from the negative social meanings associated with HIV/AIDS rather than from simply having the virus. It is concluded that resource limitations interrupt meaningful health care provider-AIDS patients interactions, and this has far-reaching implications in HIV/AIDS control efforts. Possible remedial measures on how the disclosure of HIV status can best be handled are discussed.
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