Migrant narratives, chronicity and HIV in London

Abstract

This thesis explores chronicity amongst a small group of migrants living with HIV and other illnesses in London. It elucidates their engagements and experiences with self-care, particularly in light of tenuous citizenship. Drawing on field work in London from 2010-2011 with support groups for persons with HIV, largely made up of refugees and asylum seekers, I look at how social vulnerability and frustrations of claims to citizenship are crucial factors in creating conditions for doubt – reservations that centre less on living normally with chronic illness, than living and pursuing a life. I suggest chronicity encompasses varying and contested temporalities that place pressure on what the body is expected to achieve and endure. The thesis argues the task is not only to identify sources of injury and suffering, but to consider different manifestations of how people carry on living, and the ordinary ethical orientations emerging therein. It makes a number of interdisciplinary contributions to studies of chronic illness, chronicity, HIV, ordinary ethics, and migration. It brings together subjects of migration and HIV in novel ways. In drawing attention to the accidental converging of HIV, pharmaceuticals and migration, it highlights the unpredictable forms in which citizenship claims take shape, and go adrift. The thesis thus highlights how the basis for social entry, as well as exclusion, is deeply troubled. Being sick with HIV initiates one into systems of care offered by hospitals and charities, and further services for some, without resolving the legal and political-economic barriers to employment and self-sufficiency. For scholars and practitioners working within areas of community and public health, this study adds to research on both the continued importance and limitations of support groups for HIV and chronic illness management. This thesis illustrates how multifaceted support groups are, in the activities and conversation that unfold, and how this diversity is also a matter of recognising the diversity of individuals and collectives within them. It contributes to ethnographies of HIV in terms of chronic illness and chronicity by focusing less on the integration and presence of HIV into everyday routine, than its lapsing into a wider ethos of wellness and optimism, common hardships and distractions. In considering not only how individuals suffer but also how they endure, this work contributes to the emerging body of scholarship on ordinary ethics, and the extent to which the pursuit of good is stitched into both everyday and extraordinary events and negotiations.