This article examines the pathways to health seeking as seen from the lived experiences of people with HIV/AIDS (PLWHA) in Zambia, as they negotiate their livelihoods in pluralistic health care settings. Zambia, together with several countries in sub-Saharan Africa, are undergoing the worst AIDS epidemics in the whole world, with coping mechanisms at national and community levels being stretched to breaking-points. While several studies have specifically documented general experiences of PLWHA, very few have actually investigated the linkages that exist in the context of pluralistic health delivery systems; with particular consideration of the formal bio-medical system and the traditional healer’s way of working.The main objective of the study is to explore, identify, describe and gain an in-depth understanding of medical pluralism in Zambia in the context of the lived experiences of PLWHA in their quest to access and utilise health care services. Conducted over a period of 5 months, from July to December 2004, this exploratory study triangulated various qualitative methodologies, which included 35 In-depth interviews, 15 focus group discussions. Participant observation of 2 male PLWHA over a period up to 3 months and later, a half-day stakeholders mini-workshop with 16 participants representing health workers, PLWHA, traditional healers and other relevant organisations. A semi-structured interview guide was used for interviews and FGD’s. The analysis conducted demonstrates how PLWHA negotiate their livelihoods, as seen from thematic areas which include options and dilemmas in health seeking, and pathways to accessing services in a multi-provider setting. The results show the benefits of effective, collaborative and networking interventions by service providers, while revealing the avoidable costs and dilemmas of thinly spread efforts by single providers. There are several qualitative factors that should be critically examined by HIV/AIDS practitioners, PLWHA, and other stakeholders working to improve the quality of life for all PLWHA.
[Key words: PLWHA, Health-seeking, HIV/AIDS, Traditional Healers, Bio-medicine, Pluralism]