Gender relations in hiv and aids home-based care in Uriri sub-county, Migori county

Abstract

This was a cross-sectional study on gender relations in HIV and AIDS home-based care in Uriri Sub-County, Migori County, Western Kenya. The study examined the players in HIV and AIDS caregiving, the role played by caregivers to HIV and AIDS patients and the challenges faced by caregivers in HIV and AIDS care. The study population comprised all the caregivers and data were obtained through in-depth interviews, key informant interviews and case narratives. The study was guided by the gender relations theory and cultural production and reproduction. Data analysis was done using the constant comparative method which is consistent with the grounded theory approach. The findings indicate that home-based HIV and AIDS caregiving is a gender-segregated occupation, at the centre of which lie stereotypes and beliefs about the appropriate roles for males and females, hence, a large number of women and girls are kept in unpaid, voluntary HIV and AIDS caregiving while men are kept out of it. Males providing care against such dominant ideas were labelled ‘circumstantial’ ‘feminine’ and ‘atypical’ indicating incidences of denigration and ridicule to male care providers. Caregiving has resulted in social, physical and psychological stress and distress with women and young girls being disproportionately affected. Moreover, there are lost opportunities for education, careers and income among the caregivers besides their increased vulnerability to infection exacerbated by the lack of adequate training, mentoring and support. The study concludes that unequally distributed caregiving activities between males and females in Uriri Sub-County have resulted in feminisation of HIV and AIDS care sustained by gender status beliefs and stereotypes. The study recommends that the National and County governments should provide cash transfers to mitigate the disadvantages experienced by unpaid caregivers living in the rural areas with high levels of poverty. There should be a concerted effort to use the male champions to spearhead defeminisation of care as part of changing rigid attitudes and values that continue to reinforce gender essentialism and male primacy in division of labour in the context of caregiving. Moreover, an action research on “compensations for the under-valued” to quantify and give visibility to the contributions of home-based caregivers in mitigating the impact of HIV and AIDS in the households should be undertaken. This will be important in developing bottom-up approach in policy and programmatic interventions.