In this article, I elaborate the concept of narrative navigation to analyze the subjective and intersubjective ways in which people struggle through experiences of illness by constructing multiple,... Show moreIn this article, I elaborate the concept of narrative navigation to analyze the subjective and intersubjective ways in which people struggle through experiences of illness by constructing multiple, ambiguous and non-linear narratives that may continuously change, as they reposition themselves within changing circumstances. Drawing on ethnographic material on HIV care in Aceh, Indonesia, I show how subjunctivity and open-endedness are crucial narrative ways in which people living with HIV, their relatives, medical doctors and support group workers adjust to possibilities and limitations of care over time, thereby continuously negotiating what good care may be. Unfolding within a changing Indonesian healthcare system, their narrative navigations reveal caregiving to be a complex and contradictory process, thereby problematizing boundaries between good care and neglect. Show less
Wijnen, B.F.M.; Oberje, E.J.M.; Evers, S.M.A.A.; Prins, J.M.; Nobel, H.E.; Nieuwkoop, C. van; ... ; Bruin, M. de 2019
Clostridium difficile infection (CDI) affects significant numbers of hospitalized patients and is an increasing problem in the community. It is also among the most commonly isolated pathogens in... Show moreClostridium difficile infection (CDI) affects significant numbers of hospitalized patients and is an increasing problem in the community. It is also among the most commonly isolated pathogens in HIV patients with diarrheal illness and is >= 2 fold more common in HIV-seropositive individuals. This association is stronger in those with low absolute CD4 T cell counts or meeting clinical criteria for an AIDS diagnosis, and was most pronounced before the wide availability of highly active antiretroviral therapy. The presentation and outcome of CDI in HIV appears similar to the general population. The increased risk can in part be attributed to increased hospitalization and antimicrobial use, but HIV related alterations in fecal microbiota, gut mucosal integrity, and humoral and cell mediated immunity are also likely to play a role. Here we review the evidence for these observations and the relevance of recent advances in the diagnosis and management of CDI for the HIV clinician. Show less
Muslim communities have never responded to the HIV/AIDS pandemic in a homogenous way. There have always been differences of opinion and approaches to dealing with HIV/AIDS. The following analyses... Show moreMuslim communities have never responded to the HIV/AIDS pandemic in a homogenous way. There have always been differences of opinion and approaches to dealing with HIV/AIDS. The following analyses Muslim attitudes towards fellow Muslims living with HIV/AIDS by comparing the approaches of two Muslim AIDS prevention and support groups in South Africa. Show less
