“We are just afraid of what others may say about us” - Maintaining honour and respect in processes of disclosure in Bamako, Mali

With the widespread availability of antiretroviral therapies in Mali since 2004, the physical aspects of HIV/AIDS have become less visible. Although the immediate danger of death no longer looms for patients, those on treatment must now live with a carefully guarded secret: their HIV-positive status. While most prefer to keep their status secret, a combination of medical advice, legal regulations and moral norms encourage disclosure. For most, decisions about to whom to disclose and how to confide their secret are a complex and risky matter in which notions of trust play a key role. Central to the anxiety around disclosure is a desire to preserve positive social recognition, conceptualized as the good name (tògò nyuman). The good name is of crucial importance for the maintenance of agency, and its loss is equivalent to isolation and exclusion, that is, to social death. This article explores the practical and reflective efforts taken by people living with HIV to balance the risks of disclosure with the desire to maintain honour and respect in their everyday lives. On the basis of two case studies taken from long-term ethnographic research, I demonstrate the dynamic aspects involved in dealing with disclosure, and illustrate various ways of communicating about the disease in different settings.