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"If We Have to Die, We Just Die": Challenges and Opportunities for Tuberculosis and HIV/AIDS Prevention and Care in Northern Thailand

Research fellow at the Research Institute of Tuberculosis (RIT), Japan Anti-TB Association (JATA), Tokyo, Japan, and the TB/HIV Research Foundation, Chiang Rai, Thailand

Anna Winkvist

Sahlgrenska Academy, Göteborg University, Göteborg, Sweden

Sarmwai Luangjina

TB/HIV Research Foundation, Chiang Rai, Thailand

Vinod Diwan

Division of International Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden

In this study, the authors identify opportunities for and challenges in reducing the risks of tuberculosi (TB) and HIV/AIDS transmission in Thailand. They carried out more than six repeated in-depth interviews with each of 13 participants who have been newly diagnosed with TB, 7 of whom were HIV positive, and their caregivers, until the patient recovered from TB or died. They performed extensive observations during relevant private and public activities and analyzed the data using grounded theory, focusing on behaviors affecting risk of transmission. Out of strong virtue, many caregivers felt a responsibility to care for their ill loved ones, thus putting themselves at risk of transmission. For the older generation, this was unimportant, as they had already completed their life cycle ("let it be"). However, strong human bonds encouraged the patients to complete TB treatment until cured or deceased. The authors discuss strategies to build on appropriate behaviors.

Key Words: TB/HIV • TB and HIV transmission • social behavior • Thailand

Qualitative Health Research, Vol. 15, No. 9, 1164-1179 (2005)
DOI: 10.1177/1049732305281616


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