TY - JOUR
T1 - “It’s When the Trees Blossom”
T2 - Explanatory Beliefs, Stigma, and Mental Illness in the Context of HIV in Botswana
AU - Becker, Timothy D.
AU - Ho-Foster, Ari R.
AU - Poku, Ohemaa B.
AU - Marobela, Shathani
AU - Mehta, Haitisha
AU - Cao, Dai Thi Xuan
AU - Yang, Lyla S.
AU - Blank, Lilo I.
AU - Dipatane, Vincent Ikageng
AU - Moeng, Letumile Rogers
AU - Molebatsi, Keneilwe
AU - Eisenberg, Marlene M.
AU - Barg, Frances K.
AU - Blank, Michael B.
AU - Opondo, Philip Renison
AU - Yang, Lawrence H.
N1 - Funding Information:
We wish to thank the staff of the Princess Marina Hospital’s IDCC and Bontleng Community Center for supporting recruitment and data collection. Special thanks is offered to Calvin Gontse, Thuto Salepito, and Mpho Kepaletswe for carrying out interviews and interpretation and to Patlo Entaile for translation and transcription of recorded data. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a grant and core support services from the Penn Mental Health AIDS Research Center (PMHARC), an NIH-funded program (P30MH097488), the Focus for Health Foundation, and the Penn Center for Global Health. The study also benefited from core support services provided by the Penn Center for AIDS Research, an NIH-funded program (P30AI045008). Writing of this manuscript was also supported by Fogarty NIH Grant to Dr. Yang, PI (R21 TW 011084-01).
Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a grant and core support services from the Penn Mental Health AIDS Research Center (PMHARC), an NIH-funded program (P30MH097488), the Focus for Health Foundation, and the Penn Center for Global Health. The study also benefited from core support services provided by the Penn Center for AIDS Research, an NIH-funded program (P30AI045008). Writing of this manuscript was also supported by Fogarty NIH Grant to Dr. Yang, PI (R21 TW 011084-01).
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Mental illness is a common comorbidity of HIV and complicates treatment. In Botswana, stigma impedes treatment of mental illness. We examined explanatory beliefs about mental illness, stigma, and interactions between HIV and mental illness among 42 adults, from HIV clinic and community settings, via thematic analysis of interviews. Respondents endorse witchcraft as a predominant causal belief, in addition to drug abuse and effects of HIV. Respondents describe mental illness as occurring “when the trees blossom,” underscoring a conceptualization of it as seasonal, chronic, and often incurable and as worse than HIV. Consequently, people experiencing mental illness (PEMI) are stereotyped as dangerous, untrustworthy, and cognitively impaired and discriminated against in the workplace, relationships, and sexually, increasing vulnerability to HIV. Clinical services that address local beliefs and unique vulnerabilities of PEMI to HIV, integration with peer support and traditional healers, and rehabilitation may best address the syndemic by facilitating culturally consistent recovery-oriented care.
AB - Mental illness is a common comorbidity of HIV and complicates treatment. In Botswana, stigma impedes treatment of mental illness. We examined explanatory beliefs about mental illness, stigma, and interactions between HIV and mental illness among 42 adults, from HIV clinic and community settings, via thematic analysis of interviews. Respondents endorse witchcraft as a predominant causal belief, in addition to drug abuse and effects of HIV. Respondents describe mental illness as occurring “when the trees blossom,” underscoring a conceptualization of it as seasonal, chronic, and often incurable and as worse than HIV. Consequently, people experiencing mental illness (PEMI) are stereotyped as dangerous, untrustworthy, and cognitively impaired and discriminated against in the workplace, relationships, and sexually, increasing vulnerability to HIV. Clinical services that address local beliefs and unique vulnerabilities of PEMI to HIV, integration with peer support and traditional healers, and rehabilitation may best address the syndemic by facilitating culturally consistent recovery-oriented care.
KW - Botswana
KW - explanatory models
KW - mental illness
KW - qualitative
KW - stigma
KW - syndemic
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U2 - 10.1177/1049732319827523
DO - 10.1177/1049732319827523
M3 - Article
C2 - 30739566
AN - SCOPUS:85061563394
SN - 1049-7323
VL - 29
SP - 1566
EP - 1580
JO - Qualitative Health Research
JF - Qualitative Health Research
IS - 11
ER -