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Therapeutic Borderlands: Austerity, Maternal HIV Treatment, and the Elusive End of AIDS in Mozambique
Author(s) -
Chapman Rachel R.
Publication year - 2021
Publication title -
medical anthropology quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.855
H-Index - 55
eISSN - 1548-1387
pISSN - 0745-5194
DOI - 10.1111/maq.12613
Subject(s) - austerity , workforce , public health , stigma (botany) , human immunodeficiency virus (hiv) , scarcity , medicine , public sector , economic growth , service delivery framework , political science , environmental health , nursing , business , psychiatry , family medicine , service (business) , economics , politics , law , marketing , microeconomics
“End of AIDS” requires ambitious testing, treatment, and adherence benchmarks, like UNAIDS’ “90‐90‐90 by 2020.” Mozambique's efforts to improve essential maternal/infant antiretroviral treatment (ART) exposes how austerity‐related health system short‐falls impede public HIV/AIDS service‐delivery and hinder effective maternal ART and adherence. In therapeutic borderland s—where household impoverishment intersects with health‐system impoverishment—HIV+ women and over‐worked care‐providers circumnavigate scarcity and stigma. Worrisome patterns of precarious use emerge—perinatal ART under‐utilization, delayed initiation, intermittent adherence, and low retention. Ending HIV/AIDS requires ending austerity and reinvesting in a public sector health workforce to ensure universal health coverage as household and community safety nets.