La macroestructura y los tópicos del discurso

It is important to define terminologies that have been used in this thesis, whether they are interlinked in terms of literature, specific country context or with a view to capture the expression of participants’ experience in interviews for this research. Initially, when HIV was identified in people in Nepal, HIV was viewed as an outcome of “bad” sexual behaviour, meaning having sex with multiple partners, something that has been considered outside social norms and values in Nepalese society (Beine, 2002; Nepal & Ross, 2010). In this thesis, “discovery” refers to the diagnosis of HIV, usually after a medical test in a hospital or clinics run by organizations working in the field of HIV. Many PLHIV in the present research expressed surprise at this discovery of the new “disease” (HIV infection). The research thus attempts to capture the feelings expressed when HIV was discovered in their lives. “Stigma” is widely used to refer to the disgrace of a person in terms of physical disorder and, more than that, its structural precondition, meaning explanations of how it could happen to somebody (Goffman, 1963). Stigma as used by Goffman is the shame or disgrace attached to HIV as well, considering what other people would think if it became apparent that one was involved in sexual activities with others beyond their married spouse, and/or sharing needles for drug use. Such behaviours cut across social norms and values in Nepal.

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“Discrimination” refers to PLHIV being treated differently in family, society and workplaces because of their HIV (Parker, Aggleton, Attawell, Pulerwitz, & Brown, 2002). In this study, discrimination is used as a relative term, contrasting two groups: PLHIV and HIV-negative people. Because of HIV stigma and discrimination, PLHIV are adversely affected in attaining their optimum quality of life: this is termed “disruption” (Hatzenbuehler, Phelan, & Link, 2013). Stigma and discrimination associated with HIV have affected the quality of life of PLHIV in terms of limiting their chances of being married or remarried, having sexual relations with their spouse, and earning money by going overseas. Such deficits of opportunities are termed disruption.

“Stigma”, “discrimination” and “disruption” are attached to the identity of PLHIV, resulting in a “spoiled identity” (Anderson et al., 2008). These negative impacts on their lives are termed spoiled identity in this study consistent with the existing stigma literature. “Transitional identity” describes the movement of PLHIV from spoiled identity toward reconstructed identity, involving positive changes in their lives as previously mentioned: “a transition to ordinariness after the diagnosis of a chronic illness” (Baumgartner, 2007, p. 920). From transitional identity, PLHIV move further into identity reconstruction, managing stigma, discrimination and disruption to a greater extent, as a result of experiencing better health and positive socio-economic changes in their lives. This is termed “reconstructed identity” in this study. The term “relapse identity” applies to what results when PLHIV again devalue themselves after having experienced identity reconstruction. Relapse identity may result, for instance, from economic hardship because of job termination. This is explored in this research.

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“Collectivism” is used to describe the collective spirit of all family members caring for each other, and “individualism” primarily focuses on self-development (Kastenmüller, Greitemeyer, Jonas, Fischer, & Frey, 2010). Many PLHIV in this study, especially females, experienced a collective spirit before being HIV diagnosed, when they and their husbands contributed to their family economically, with the husband often working outside the home, and the wife doing household chores. “Individualism” is used to refer to an individual spirit, giving priority to self-development socially and economically, rather than to co-operative living with other members of the family. It often occurs after a person has been stigmatised and discriminated against by family and society, because of his/her HIV status.

“Resource” in the Nepalese literature, especially in the field of migration, has been widely used in terms of availability of public services, overseas employment, and land, , and especially in terms of economic opportunities, economic motives, their access, including aspects of and family economic support. Availability of public services (especially access to communication, transportation, hospitals, health personnel, etc.), as well as the availability of fertile land, jobs and good income in Nepal have often been regarded as pull factors for migration as resource bases (Subedi, 1988; KC, 2003, 2004). Land is also seen as an important resource that in rural-to-rural migration, previously western to eastern Nepal along the hills and north to south after the success of a malaria eradication programme after the 1950s (Subedi, 1988). In addition, a resource is a source of any external help or internal strength which a person has available to draw upon. External resources include family as economic supporters (especially, in this study, such as husbands or parents). An example of an internal resource is resilience

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that can help a successful individual’s development in an adverse situation (Kalil, 2003).

In the Nepalese context, the term “formal” education generally refers to a process of learning or education through recognised schools and campuses, with a view to gaining recognised qualifications at various levels of attainment. “Informal” education refers to training or teaching by parents, relatives, community leaders or organizations, conducting casual or short-term education programmes for those people who do not have opportunities of attending any formal education through a school or college, because of their poor economic status, gender status, or illiteracy. Informal education does not usually lead to a recognised qualification, but can help equip a person for everyday life, employment or other roles in society.