Access Type

Open Access Dissertation

Date of Award

January 2015

Degree Type


Degree Name




First Advisor

Andrea P. Sankar


This dissertation is concerned with the HIV epidemic in Rwanda, specifically related to the support associations for people living with HIV. In it, I examine the reshaped individual subjectivities that emerged within the group, the emergent socialities that came to life, and the influences of the governmental and nongovernmental institutions in the wider Rwandan context. The study design combined three main features – historical research and key informant interviews on the historical forms and practices of coming together in Rwanda, ethnography on the daily activities of five specific associations and ethnographic research on the ways in which the associations shaped the experiences of HIV for its members and maintained the guidance of the shifting local and national policies. The dissertation research took place from January 2012 until December 2012, with additional field visits in November of 2013.

Findings explore the complex social setting of Rwandan HIV associations in a post-genocide context alongside national and international health policies and programs. The associations emerged under the guise of a government mandate of coming together to solve local problems. The idea of coming together is unpacked and the rhetoric of coming together scrutinized. Coming together in the HIV support group led to both intentional and inadvertent disclosure of HIV status in the community, often leading to akato (Rwanda’s version of something like stigma). Findings also delve into the ways in which members of the groups maneuvered their way through different channels to support their families. The groups provided a space to create new networks after networks were broken due to the akato from HIV disclosure.

Subjectivities were reshaped by the group mandates that required members to live within a moral order that often conflicted with the existing moral code. The ways in which association members, as well as those who elected not to join the group, were excluded and made vulnerable are examined. New changes to create income-generating groups are explored as new policies urged self-reliant citizens. In conclusion, the idea of fluid subjectivities is explored as a way to explain how people and governments respond to health epidemics.