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In recent years there has been a worldwide recognition of the disparity of HIV treatment available in the West and in Sub-Saharan Africa. The West African nation of Senegal was early to implement measures that allowed for the distribution of highly effective anti-HIV therapy known as Antiretroviral (ARV) therapy to a limited number of patients. This thesis explores how patients living in Senegal who are infected with HIV have engaged in various negotiations to obtain access to treatment and other resources to meet the needs posed by their infection. These negotiations are framed by various historically embedded notions of how to engage relationships in the search for care. Strategies are also shaped by the biopolitically-laden discourse that guides the distribution of ARV therapy. This thesis traces the structure, evolution, and effects of patients' strategic negotiations in response to the introduction of this therapeutic technology.