[How to manage HIV seropositive or AIDS patients in rural Burkina Faso?].

This article is based on an ethnographical study carried out in 1996. It describes and analyzes the methods of medical and family management of HIV-positive and full-blown AIDS patients in the rural environment of Burkinabé. A number of recommendations are made. Biomedical management of these patients is almost non-existent (currently there is no serology or screening advice available at the dispensary). The patient is never informed of an AIDS diagnosis. The relations between the medical personnel and the patients are dominated by a sense of powerlessness and constant fear of infection. None of the traditional doctors of the region admits to treating AIDS although traditional medicine is used throughout the illness. Family management ranges from complete rejection of the patient to supportive but often misdirected care. It is determined by at least five elements: (1) the composition of the family unit and the nature of relations between the sick individual and the rest of the family, (2) the economic status of the patients, his family group and his parents, (3) the initial uncertainties of the diagnosis of the illness, (4) the fear of contagion and (5) the fear of gossip. Management of these patients would be improved by: (1) real access to counseling and screening, (2) the involvement of health workers in this activity and in the notification of the diagnosis to the peripheral medical organizations, (3) the education of the staff about the risks of contamination and care of the terminally ill, (4) reeducation of the public about the non-contagious nature of the sick by personal counseling given by health care professionals and (5) the material support of families. This is of vital importance but is difficult to achieve in the context of chronic poverty.