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  • Kalofonos (2010) All I Eat is ARVs The Paradox of AIDS Treatment Interventions in Central Mozambique
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Kalofonos, Ippolytos
       2010 All I Eat Is ARVs: The Paradox of AIDS Treatment Interventions in Central Mozambique. Medical Anthropology Quarterly 24(3):363--380.

       Kalofonos explores the effects of AIDS treatment interventions in Central Mozambique. This study began in 2003, before public sector antiretroviral treatment (ART) was offered, and continued until 2006, when ART was widespread. The major theme of this article is the paradox of AIDS treatment interventions. Specifically, Kalofonos shows that the perceived success of ART treatment is not completely accurate. Although lives have been saved, ART treatment has had dehumanizing effects by straining social solidarity and fostering mistrust in communities as individuals compete for limited food resources.

       HIV-positive individuals have higher nutritional and caloric requirements than other individuals due to a higher resting energy expenditure. Unfortunately, food insecurity in Mozambique has formed a deadly cycle with HIV as individuals engage in transactional sex to survive. Many  HIV positive individuals rely on social networks to survive and the strain on these relationships can be devastating. One of the Mozambicans Kalofonos interviewed describes this situation well, “When HIV arrives in a house, one knows that impoverishment has arrived as well. This disease is a guest…that consumes all of our things and will finish us all,” (Kalofonos 2010:367).

       Prior to the implementation of ART programs contracting AIDS meant social death as the ability to work and have children was lost. However, the realization that being HIV positive leads to food aid has created an environment of jealously and competition in Mozambique. As news of these free food resources spread more people did seek treatment, however, “The number of food baskets available at centers remained the same,” (Kalofonos 2010:369). Thus, the goal of food aid programs to promote and support solidarity amongst Mozambicans was undermined.  Many people abused the access to free food by exaggerating their food needs or quitting their jobs as they learned to become solely dependent on the food aid. According to a food distribution manager, Mozambicans are not interested in analyzing the real food scarcity problems, “The problem is that the people are used to receiving, eating, and insulting the people who give,” (Kalofonos 2010:371).

       While the author provides several insights on the effects of HIV and food scarcity on Mozambican life, the methodology in which the data was collected makes me slightly skeptical of the findings. Although research was conducted over a three year time period, the field work during these years was extremely brief and spread over large gaps of time. For instance, only six weeks of field work was conducted in 2003, prior to introducing ART services, which in my opinion is an inadequate amount of time to learn about a culture and their way of life. Furthermore, only 8 weeks of field work was conducted in 2004, the year ART was first introduced to the region. While 12 months of research was conducted from 2005-2006, the limited amount of time spent with the Mozambicans prior to treatment provides an insufficient baseline for the comparisons used to portray the impact of ART on society. 

Wow you are a tough reviewer!  I agree that 6 weeks is not enough time to get to know a culture, but it may be enough time to start research with a specific population. Kalofonos notes that this is part of a longer term study and cites (his?  her not sure) earlier work from 2008 so the investigator already seems quite familiar with Mozambique.   In any case this was an excellent choice for this assignment and a very good review.

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