AIDS the Islamic Way: Treatment, Masculinity, and Ethics of Care in Northern Nigeria.

Abstract

This dissertation is an ethnographic account of the AIDS epidemic among Muslims in Northern Nigeria. Based on research among HIV-positive people in clinical and support group settings and with different types of healing practitioners who treat them, I examine how the transmission, treatment, and care of HIV/AIDS are imagined and enacted in the region. My research demonstrates how Northern Nigerians draw upon the moral authority of Islam to make assertions about where HIV/AIDS comes from, what obligations arise from the disease, and how it should be prevented and treated. The research further reveals that despite recent efforts to assert a unified Islamic response to AIDS, substantive disagreements persist over how to intervene in the epidemic, which treatments are most efficacious, and how those living with disease should be morally evaluated. This dissertation makes four main scholarly contributions. First, it advances the critical medical anthropology of infectious disease and global health programs by demonstrating the interaction of micro- and macro-level forces that impact the AIDS epidemic in a specific cultural context. I do this by analyzing local responses to the United States President’s Emergency Plan for AIDS Relief, a program that has significantly improved the life prospects of HIV-positive people. Relatedly, I examine how patients negotiate different healing systems this era of expanding therapeutic options with an account of the expansion of Islamic prophetic medicine in the region. I show how this is linked to the broader Islamic reorientation of Northern Nigerian society since 2000. Third, I contribute to masculinity and health studies with in-depth accounts of the lives of HIV-positive Muslim men, demonstrating how HIV infection paradoxically brings about heightened obligations and opportunities to achieve ideal masculinity. I demonstrate, however, how these same masculine expectations have foreclosed upon addressing the epidemic among men who have sex with men, and argue that this has broad social and epidemiological implications in a society where heterosexual marriage is compulsory. I conclude the dissertation by suggesting several culturally appropriate interventions that would lessen the burden of the epidemic in Northern Nigeria.