robin root | CUNY - Baruch College (original) (raw)

Papers by robin root

Development in Practice, 2017

Faith-based organisations (FBOs) have long been involved in HIV and AIDS impact mitigation and hu... more Faith-based organisations (FBOs) have long been involved in HIV and AIDS impact mitigation and humanitarian relief, but most are not equipped to intervene in the structural drivers of food insecurity and attendant health inequities. Acknowledging limitations is as paramount a task for organisational effectiveness as maximising strengths. This paper reports findings from a study of HIV-positive care supporters (N=490) who volunteer with a church run home-based care organisation in Swaziland. The paper seeks to assess the impact of chronic food insecurity on antiretroviral adherence practices and how these individuals manage daily food shortages. Findings highlight the limited capacities of FBOs in highly vulnerable settings and the imperative for international and governmental coordination.

Medical Anthropology, 2016

York approved the research protocol. Ethical research processes, including informed consent, were... more York approved the research protocol. Ethical research processes, including informed consent, were rigorously implemented. The authors declare no conflict of interest. The authors are grateful to the women and men of Shiselweni Home-based Care for their participation in the study; Casey Golomski for his invaluable contributions to the research process; and manuscript reviewers whose feedback contributed considerable value to the final product.

International Encyclopedia of Public Health, 2017

The anthropology of human reproduction is a dynamic field of research, generating new methods, ty... more The anthropology of human reproduction is a dynamic field of research, generating new methods, types of data, and hypotheses on biological, political economic, and sociocultural factors that mediate human reproduction. Current research incorporates perspectives from archeological, biological, sociocultural, and linguistic anthropology to explore: (1) the dynamic effects of interactions among culture, class, race, and ethnicity on reproduction and reproductive health; (2) cross-cultural patterns of women's and men's experiences with assisted reproductive technologies; and (3) struggles for reproductive rights and reproductive justice within the contexts of global health programs and human rights legislation. Cross-cultural studies of sexuality and reproduction are casting new light on the evolution of sexual norms and behavior, social organization, and family structures. Long underexplored, researchers are focusing increasing attention on male physiology, sexuality, and cultural concepts of paternity as they affect human reproductive activities.

African journal of AIDS research : AJAR, Jan 20, 2015

International Encyclopedia of Public Health, 2008

The anthropology of human reproduction is a dynamic field of research, generating new methods, da... more The anthropology of human reproduction is a dynamic field of research, generating new methods, data, and hypotheses on the biological, political-economic, and sociocultural factors that mediate human reproduction. Current research incorporates perspectives from all three domains to explore: (1) the effects of culture, class, race, and ethnicity on reproduction and reproductive health; (2) cross-cultural patterns of experiences with reproductive technologies; and (3) reproductive rights in the context of global health programs and human rights legislation. Cross-cultural studies of sexuality and reproduction are casting new light on the evolution of sexual norms and behavior, social organization, and family structures. Long underexplored, researchers are also studying male physiology, sexuality, and cultural concepts of paternity as they affect human reproductive activities.

Reference Module in Biomedical Sciences, 2015

Journal of the International AIDS Society, 2013

Introduction: Antiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for indi... more Introduction: Antiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for individuals in many parts of the world. Adherence, however, is integral to achieving chronicity. Studies have shown both relatively high ART adherence rates in sub-Saharan Africa and the importance of community home-based care (CHBC) to facilitating this process. In light of diminished HIV and AIDS funding globally and increased reliance on CHBC throughout Africa, a better understanding of how CHBC may strengthen ART adherence is essential to improving patients' quality of life, tending to the needs of care supporters and achieving healthier populations. Methods: This article reports findings from a qualitative study of a CHBC organiztion serving an estimated 2500 clients in rural Swaziland. Semi-structured questionnaires with 79 HIV-positive clients [people living with HIV and AIDS (PLWHA)] yielded data on diverse aspects of being HIV positive, including insights on whether and how PLWHA perceived care supporters to facilitate ART adherence in a high stigma and structurally impoverished setting. Results: Ninety-two percent of participants said their health had improved since care supporters came into their lives. A major finding was that an estimated 53% of participants said they would have died, a few from suicide had the care supporter never intervened. More than one in four participants (27.9%) sought HIV testing after a care supporter began visiting them. Nearly a third (31%) commenced ART after and largely as a consequence of care supporter intervention. Approximately one in four (23%) reported that their care supporter had helped them to disclose their HIV-positive status to family members. Twenty-seven percent said they had felt discouraged or had been discouraged from taking ART by members of their family or community. Discussion: General inductive analysis of participant reports suggested two social mechanisms of CHBC impact on ART adherence: (i) cultivating client-care supporter ''talk'' to enhance treatment uptake and literacy, reduce felt stigma and challenge social pressures to desist from ART and (ii) real-time interactions between clients and care supporters whereby the care ''relationship'' was itself the ''intervention,'' providing lay counsel, material and financial assistance, and encouragement when clients suffered stigma, side effects and other obstacles to adherence. These social dynamics of adherence generally fall outside the purview of conventional clinical and public health research. Conclusions: PLWHA reports of care supporter practices that enabled ART adherence demonstrated the pivotal role that CHBC plays in many PLWHA lives, especially in hard to reach areas. Relative to clinic personnel, care supporters are often intensely engaged in clients' experiences of sickness, stigma and poverty, rendering them influential in individuals' decision-making. This influence must be matched with ongoing training and support of care supporters, as well as a clear articulation with the formal and informal health sectors, to ensure that PLWHA are correctly counselled and care supporters themselves supported. Overall, findings showed that PLWHA experiences of CHBC should be captured and incorporated into any programme aimed at successfully implementing the Joint United Nations Programme on HIV and AIDS (UNAIDS) Treatment 2.0 agenda Pillar 4 (increasing HIV testing uptake and care linkages) and Pillar 5 (strengthening community mobilization).

We draw on a study of a church-run community home-based care organization in Swaziland to explore... more We draw on a study of a church-run community home-based care organization in Swaziland to explore how individuals living with HIV perceived caregivers’ impact on well-being. Our primary concern was to examine how religion, as a heuristic practice of Christian-based caregiving, was felt to be consequential in a direly underserved region. Part of a larger medical anthropological project, we conducted semi-structured interviews with 79 community home-based care clients, of whom half (53%) said they would have died, some from suicide, without its services. We utilized a critical phenomenological approach to interpret semantic and latent themes, and explicated these themes within a ‘healthworld’ framework. Participants were resolute that caregivers be Christian, less for ideological positioning than for perceived ontological sameness and ascribed traits: “telling the truth” about treatment, confidentiality, and an ethos of unconditional love that restored clients’ desire to live and adhere to treatment. Findings are intended to help theorize phenomenological meanings of care, morality, health, and sickness, and to interrogate authoritative biomedically based rationalities that underwrite most HIV-related global health policy.

With the world's highest antenatal HIV prevalence rate (39.2%), Swaziland has also been described... more With the world's highest antenatal HIV prevalence rate (39.2%), Swaziland has also been described as among the most stigmatising. Yet, only recently was an anti-HIV stigma and discrimination (S&D) platform included in the government's National Multisectoral HIV and AIDS Policy. This study draws on a medical anthropological project in rural Swaziland to examine experiences of stigma among people living with HIV/AIDS (PLWH). Qualitative methods included a semi-structured questionnaire and interviews (n 040) to identify patterns of stigma across three domains: verbal, physical and social. Key informant interviews (n05) were conducted with health personnel and support group leaders. Descriptive statistics were situated within a thematic analysis of open-ended content. Among the findings, participants reported extensive HIV-related rumouring (36.4%) and pejorative name-calling (37.5%). Nearly one in five (18.2%) could no longer partake of family meals. Homesteads, which are an organising principle of Swazi life, were often markedly stigmatising environments. In contrast to documented discrimination in health care settings, the health centre emerged as a space where PLWH could share information and support. Given the UNAIDS call for national partners to 'know your epidemic' by tracking the prevalence of HIV-related S&D, results from this study suggested that unless 'knowing your epidemic' includes the lived experiences of HIV stigma that blister into discernible patterns, effectiveness of national initiatives is likely to be limited. Multidisciplinary and locale-specific studies are especially well suited in examining the cultural dynamics of HIV stigma and in providing grounded data that deepen the impact of comprehensive HIV/ AIDS policies and programming.

The purpose of this study is to explore the concept of religious health assets (RHA) and its rele... more The purpose of this study is to explore the concept of religious health assets (RHA) and its relevance to HIV/AIDS. This manuscript describes the experiences of caregivers with a church-run home-based care organisation in Swaziland, site of the world’s highest HIV prevalence (42%). In light of reduced antiretroviral treatment rollout in some areas of Africa, strengthening mechanisms of treatment support with HIV prevention has never been more critical. One modality may be
community home-based care (CHBC), a core feature of the World Bank’s Multi-Country HIV/AIDS Program for Africa. Yet, these entities, and the frontline activities of local congregations, remain underexplored. Part of a larger anthropological study of religion and HIV/AIDS in Swaziland, this manuscript draws on 20 semi-structured caregiver interviews to discern patterns in motivations; perceived client needs; care practices; and meanings of religiosity. Thirteen participants were care coordinators who oversaw approximately 455 caregivers across nearly half of the 22 communities served. Grounded theory analysis suggested that caregivers facilitated vital decisions around HIV testing, HIV disclosure, treatment uptake/adherence, as well as reduced HIV stigma. Also
salient was the importance of a Christian ethos, in the form of ‘talk’ and ‘love’, as critical culturally situated care practices. Having expanded to an estimated 600 caregivers and 2500 home-based clients between 2006 and 2009, participants’ reports intimated their roles as agents of broader social transformation. This article contributes to the expanding study of RHA and challenges authoritative global public health strategies that have largely marginalised local religious aspects of HIV/AIDS. Future applied research examining how ‘home’ and ‘church’ may be vital public health settings outside of, but integral to, formal health services and HIV programming is warranted.

The article is a descriptive statistical analysis of a community home-based care (CHBC) organizat... more The article is a descriptive statistical analysis of a community home-based care (CHBC) organization in the Kingdom of Swaziland that depicts the organization's expanding operations and health impact between 2008-2013. Comprised of 899 care supporters who tend to 2 909 clients in 33 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many communities throughout Africa that have mobilized, at varying degrees of formality, to address the suffering and resilience associated with HIV/AIDS. To better understand the local impacts of global shifts in HIV/AIDS programming, especially an increased reliance on lay health workers and promotion of treatment-asprevention initiatives, we analyzed longitudinal data concerning both care supporter (gender/age/client load) and client (gender/age/HIV status/TB status/clinical referral/client ART and TB treatment status) cohorts; most CHBC studies report data from only one cohort. Foremost, our analysis demonstrates the convergence of CHBC expansion with substantially improved health outcomes, most dramatically a reduction in overall mortality. Between 2008 and 2013, overall client mortality declined 66.9% (nearly double the national HIV-related mortality rate) from 35.3% to 11.7% of SHBC's client base. SHBC has achieved these goals through comprehensive HIV/AIDS counseling, disclosure brokering, testing and treatment education, and antiretroviral treatment and TB medication adherence support. Findings strongly suggest the indispensability of properly designed home-based care and concurrent data collection capabilities that enable self-monitoring and evaluation to guide care supporter training and services expansion. SHBC's cultivation of "partnerships" and ongoing challenges to create "linkages" with the formal health sector and other NGOs highlight the opportunities and obstacles that CHBCs face more broadly. Detailed study of SHBC operations and impact is essential for advancing the treatment-as-prevention and associated decentralization agendas in Swaziland and similarly profiled settings.

Introduction: Antiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for indi... more Introduction: Antiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for individuals in many parts of the world. Adherence, however, is integral to achieving chronicity. Studies have shown both relatively high ART adherence rates in sub-Saharan Africa and the importance of community home-based care (CHBC) to facilitating this process. In light of diminished HIV and AIDS funding globally and increased reliance on CHBC throughout Africa, a better understanding of how CHBC may strengthen ART adherence is essential to improving patients' quality of life, tending to the needs of care supporters and achieving healthier populations. Methods: This article reports findings from a qualitative study of a CHBC organiztion serving an estimated 2500 clients in rural Swaziland. Semi-structured questionnaires with 79 HIV-positive clients [people living with HIV and AIDS (PLWHA)] yielded data on diverse aspects of being HIV positive, including insights on whether and how PLWHA perceived care supporters to facilitate ART adherence in a high stigma and structurally impoverished setting. Results: Ninety-two percent of participants said their health had improved since care supporters came into their lives. A major finding was that an estimated 53% of participants said they would have died, a few from suicide had the care supporter never intervened. More than one in four participants (27.9%) sought HIV testing after a care supporter began visiting them. Nearly a third (31%) commenced ART after and largely as a consequence of care supporter intervention. Approximately one in four (23%) reported that their care supporter had helped them to disclose their HIV-positive status to family members. Twenty-seven percent said they had felt discouraged or had been discouraged from taking ART by members of their family or community. Discussion: General inductive analysis of participant reports suggested two social mechanisms of CHBC impact on ART adherence: (i) cultivating client-care supporter ''talk'' to enhance treatment uptake and literacy, reduce felt stigma and challenge social pressures to desist from ART and (ii) real-time interactions between clients and care supporters whereby the care ''relationship'' was itself the ''intervention,'' providing lay counsel, material and financial assistance, and encouragement when clients suffered stigma, side effects and other obstacles to adherence. These social dynamics of adherence generally fall outside the purview of conventional clinical and public health research. Conclusions: PLWHA reports of care supporter practices that enabled ART adherence demonstrated the pivotal role that CHBC plays in many PLWHA lives, especially in hard to reach areas. Relative to clinic personnel, care supporters are often intensely engaged in clients' experiences of sickness, stigma and poverty, rendering them influential in individuals' decision-making. This influence must be matched with on-going training and support of care supporters, as well as a clear articulation with the formal and informal health sectors, to ensure that PLWHA are correctly counselled and care supporters themselves supported. Overall, findings showed that PLWHA experiences of CHBC should be captured and incorporated into any programme aimed at successfully implementing the Joint United Nations Programme on HIV and AIDS (UNAIDS) Treatment 2.0 agenda Pillar 4 (increasing HIV testing uptake and care linkages) and Pillar 5 (strengthening community mobilization).

A major challenge of medical anthropology is to assess how biomedicine, a dynamic assemblage of t... more A major challenge of medical anthropology is to assess how biomedicine, a dynamic assemblage of texts, technologies, and practices, shapes experiences of self, body. and society. Through narrative analyses of in-depth, semi-structured interviews with 158 pregnant women in southern California, this paper explores how the culture of biomedicine, encountered formally at prenatal care checkups and informally through diverse media, influences pregnant women's perceptions of appropriate prenatal behavior. In the spirit of recent social scientific work that draws on and challenges Foucauldian insights to explore social relations in medicine, we posit a spectrum of compliance and resistance to biomedical norms upon which individual prenatal practices are assessed. We suggest that pregnancy is, above all, characterized by a split subjectivity in which women straddle the authoritative and the subjugated, the objective and the subjective, and the haptic as well as the optic, in telling and often strategic ways. In so doing, we identify the intersection between the disciplinary practices of biomedicine and the practices of pregnant women as a means of furnishing more fruitful insights into the oft-used term " power " and its roles in constituting social relations in medicine.

The article is a descriptive case study of a community home-based care (CHBC) organisation in Swa... more The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that
depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care
supporters who tend to 3 839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care
(SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying
degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better
understand the potential significance of global and national health policy/programming reliance on community
health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008
to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis demonstrated a dramatic
decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although
the study was not designed to establish statistical significance or causality between SHBC expansion and health
impact, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in
client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and
community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community
health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical
health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing
government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland
and similarly profiled settings.

Global Public Health, 2011

The purpose of this study is to explore the concept of religious health assets (RHA) and its rele... more The purpose of this study is to explore the concept of religious health assets (RHA) and its relevance to HIV/AIDS. This manuscript describes the experiences of caregivers with a church-run home-based care organisation in Swaziland, site of the world's highest HIV prevalence (42%). In light of reduced antiretroviral treatment rollout in some areas of Africa, strengthening mechanisms of treatment support with HIV prevention has never been more critical. One modality may be community home-based care (CHBC), a core feature of the World Bank's Multi-Country HIV/AIDS Program for Africa. Yet, these entities, and the frontline activities of local congregations, remain underexplored. Part of a larger anthropological study of religion and HIV/AIDS in Swaziland, this manuscript draws on 20 semi-structured caregiver interviews to discern patterns in motivations; perceived client needs; care practices; and meanings of religiosity. Thirteen participants were care coordinators who oversaw approximately 455 caregivers across nearly half of the 22 communities served. Grounded theory analysis suggested that caregivers facilitated vital decisions around HIV testing, HIV disclosure, treatment uptake/adherence, as well as reduced HIV stigma. Also salient was the importance of a Christian ethos, in the form of ‘talk’ and ‘love’, as critical culturally situated care practices. Having expanded to an estimated 600 caregivers and 2500 home-based clients between 2006 and 2009, Participants' reports intimated their roles as agents of broader social transformation. This article contributes to the expanding study of RHA and challenges authoritative global public health strategies that have largely marginalised local religious aspects of HIV/AIDS. Future applied research examining how ‘home’ and ‘church’ may be vital public health settings outside of, but integral to, formal health services and HIV programming is warranted.

Global Public Health, 2010

With the world's highest antenatal HIV prevalence rate (39.2%), Swaziland has also been d... more With the world's highest antenatal HIV prevalence rate (39.2%), Swaziland has also been described as among the most stigmatising. Yet, only recently was an anti-HIV stigma and discrimination (S&D) platform included in the government's National Multisectoral HIV and AIDS Policy. This study draws on a medical anthropological project in rural Swaziland to examine experiences of stigma among people living with HIV/AIDS (PLWH). Qualitative methods included a semi-structured questionnaire and interviews (n=40) to identify patterns of stigma across three domains: verbal, physical and social. Key informant interviews (n=5) were conducted with health personnel and support group leaders. Descriptive statistics were situated within a thematic analysis of open-ended content. Among the findings, participants reported extensive HIV-related rumouring (36.4%) and pejorative name-calling (37.5%). Nearly one in five (18.2%) could no longer partake of family meals. Homesteads, which are an organising principle of Swazi life, were often markedly stigmatising environments. In contrast to documented discrimination in health care settings, the health centre emerged as a space where PLWH could share information and support. Given the UNAIDS call for national partners to 'know your epidemic' by tracking the prevalence of HIV-related S&D, results from this study suggested that unless 'knowing your epidemic' includes the lived experiences of HIV stigma that blister into discernible patterns, effectiveness of national initiatives is likely to be limited. Multidisciplinary and locale-specific studies are especially well suited in examining the cultural dynamics of HIV stigma and in providing grounded data that deepen the impact of comprehensive HIV/AIDS policies and programming.

Journal of Religion in Africa, Jan 1, 2011

Health Care for Women International, Jan 1, 2009

In the 1970s, Malaysia launched an export-oriented development strategy as a means of financing t... more In the 1970s, Malaysia launched an export-oriented development strategy as a means of financing the nation&amp;amp;amp;amp;amp;#39;s modernization. The success of the strategy hinged significantly on intensive recruitment of women for factory employment. I draw on descriptive qualitative research, including interviews (51), surveys (106), and ethnography in Malaysia to investigate factory women&amp;amp;amp;amp;amp;#39;s experiences of work and work-related health risks. Discourse analysis surfaced a latent consciousness of bodily changes in relation to work. A grounded theory analysis showed a compromised access to occupational risk knowledge that may bear negatively on women&amp;amp;amp;amp;amp;#39;s well-being and the role women&amp;amp;amp;amp;amp;#39;s new labor identities played in mediating the meanings of work and risks. Given the predominance of women workers in low-end manufacturing globally, I aimed to contribute to theoretical and applied understandings of gender, globalization, and health.

Development in Practice, 2017

Medical Anthropology, 2016

International Encyclopedia of Public Health, 2017

African journal of AIDS research : AJAR, Jan 20, 2015

International Encyclopedia of Public Health, 2008

Reference Module in Biomedical Sciences, 2015

Journal of the International AIDS Society, 2013

Introduction: Antiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for indi... more Introduction: Antiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for individuals in many parts of the world. Adherence, however, is integral to achieving chronicity. Studies have shown both relatively high ART adherence rates in sub-Saharan Africa and the importance of community home-based care (CHBC) to facilitating this process. In light of diminished HIV and AIDS funding globally and increased reliance on CHBC throughout Africa, a better understanding of how CHBC may strengthen ART adherence is essential to improving patients' quality of life, tending to the needs of care supporters and achieving healthier populations. Methods: This article reports findings from a qualitative study of a CHBC organiztion serving an estimated 2500 clients in rural Swaziland. Semi-structured questionnaires with 79 HIV-positive clients [people living with HIV and AIDS (PLWHA)] yielded data on diverse aspects of being HIV positive, including insights on whether and how PLWHA perceived care supporters to facilitate ART adherence in a high stigma and structurally impoverished setting. Results: Ninety-two percent of participants said their health had improved since care supporters came into their lives. A major finding was that an estimated 53% of participants said they would have died, a few from suicide had the care supporter never intervened. More than one in four participants (27.9%) sought HIV testing after a care supporter began visiting them. Nearly a third (31%) commenced ART after and largely as a consequence of care supporter intervention. Approximately one in four (23%) reported that their care supporter had helped them to disclose their HIV-positive status to family members. Twenty-seven percent said they had felt discouraged or had been discouraged from taking ART by members of their family or community. Discussion: General inductive analysis of participant reports suggested two social mechanisms of CHBC impact on ART adherence: (i) cultivating client-care supporter ''talk'' to enhance treatment uptake and literacy, reduce felt stigma and challenge social pressures to desist from ART and (ii) real-time interactions between clients and care supporters whereby the care ''relationship'' was itself the ''intervention,'' providing lay counsel, material and financial assistance, and encouragement when clients suffered stigma, side effects and other obstacles to adherence. These social dynamics of adherence generally fall outside the purview of conventional clinical and public health research. Conclusions: PLWHA reports of care supporter practices that enabled ART adherence demonstrated the pivotal role that CHBC plays in many PLWHA lives, especially in hard to reach areas. Relative to clinic personnel, care supporters are often intensely engaged in clients' experiences of sickness, stigma and poverty, rendering them influential in individuals' decision-making. This influence must be matched with on-going training and support of care supporters, as well as a clear articulation with the formal and informal health sectors, to ensure that PLWHA are correctly counselled and care supporters themselves supported. Overall, findings showed that PLWHA experiences of CHBC should be captured and incorporated into any programme aimed at successfully implementing the Joint United Nations Programme on HIV and AIDS (UNAIDS) Treatment 2.0 agenda Pillar 4 (increasing HIV testing uptake and care linkages) and Pillar 5 (strengthening community mobilization).

Global Public Health, 2011

The purpose of this study is to explore the concept of religious health assets (RHA) and its rele... more The purpose of this study is to explore the concept of religious health assets (RHA) and its relevance to HIV/AIDS. This manuscript describes the experiences of caregivers with a church-run home-based care organisation in Swaziland, site of the world's highest HIV prevalence (42%). In light of reduced antiretroviral treatment rollout in some areas of Africa, strengthening mechanisms of treatment support with HIV prevention has never been more critical. One modality may be community home-based care (CHBC), a core feature of the World Bank's Multi-Country HIV/AIDS Program for Africa. Yet, these entities, and the frontline activities of local congregations, remain underexplored. Part of a larger anthropological study of religion and HIV/AIDS in Swaziland, this manuscript draws on 20 semi-structured caregiver interviews to discern patterns in motivations; perceived client needs; care practices; and meanings of religiosity. Thirteen participants were care coordinators who oversaw approximately 455 caregivers across nearly half of the 22 communities served. Grounded theory analysis suggested that caregivers facilitated vital decisions around HIV testing, HIV disclosure, treatment uptake/adherence, as well as reduced HIV stigma. Also salient was the importance of a Christian ethos, in the form of ‘talk’ and ‘love’, as critical culturally situated care practices. Having expanded to an estimated 600 caregivers and 2500 home-based clients between 2006 and 2009, Participants' reports intimated their roles as agents of broader social transformation. This article contributes to the expanding study of RHA and challenges authoritative global public health strategies that have largely marginalised local religious aspects of HIV/AIDS. Future applied research examining how ‘home’ and ‘church’ may be vital public health settings outside of, but integral to, formal health services and HIV programming is warranted.

Global Public Health, 2010

Journal of Religion in Africa, Jan 1, 2011

Health Care for Women International, Jan 1, 2009