"It's When the Trees Blossom": Explanatory Beliefs, Stigma, and Mental Illness in the Context of HIV in Botswana.

Journal: Qualitative health research

Volume: 29

Issue: 11

Year of Publication: 2020

Affiliated Institutions:  University of Pennsylvania, Philadelphia, Pennsylvania, USA. Boston University, Boston, Massachusetts, USA. University of Botswana, Gaborone, Botswana. Columbia University, New York City, New York, USA. University of Rochester, Rochester, New York, USA. Princess Marina Hospital, Gaborone, Botswana. University of Botswana School of Medicine, Gaborone, Botswana.

Abstract summary 

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.

Authors & Co-authors:  Becker Ho-Foster Poku Marobela Mehta Cao Yang Blank Dipatane Moeng Molebatsi Eisenberg Barg Blank Opondo Yang

Study Outcome 

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Statistics
Citations :  Angel R, & Thoits P (1987). The impact of culture on the cognitive structure of illness. Culture,Medicine and Psychiatry, 11(4), 465–494. 10.1007/BF00048494
Authors :  16
Identifiers
Doi : 10.1177/1049732319827523
SSN : 1049-7323
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Botswana;explanatory models;mental illness;qualitative;stigma;syndemic
Study Design
Study Approach
Country of Study
Botswana
Publication Country
United States