In the process of knowing : making sense of HIV and AIDS in the Trobriand Islands of Papua New Guinea

Abstract

Concurrent with the global spread of HIV, the human immunodeficiency virus, are multiple ways of comprehending the retrovirus as different knowledge and belief systems converge and interact. Biomedical and epidemiological models of disease, risk, and behaviour change, and the sexual moralities these models impute, influence the interpretive process of making sense of HIV and AIDS in diverse cultural contexts, potentially affecting the capacity to articulate local knowledge and form cognitive links with new information. My thesis aims to contribute to understanding the social and cultural complexities that influence the spread of HIV in different contexts by considering bow the epidemic is manifesting in the Trobriand Islands of Milne Bay Province, Papua New Guinea. I am concerned primarily with the signification of the epidemic, specifically, the discursive and interpretive process of making sense of representations of HIV and AIDS in relation to cultural knowledge and embodied experience of gender, sexuality, reproduction, and disease. Acknowledging the flux of meanings as discourses and models traverse cultural domains, I argue for the importance of supporting local responses to the challenges posed by the global pandemic. Viewing the production of knowledge as a social process, I argue that effective HIV communication approaches require dialogic interaction with cultural knowledge in order to close the persistent gap between people's awareness about HIV and the behaviour change necessary for prevention. Based on ethnographic research undertaken in 2003, the key research questions are concerned with how people individually and collectively make sense of the awareness and prevention information that is reaching them. How do Trobrianders perceive HIV prevention messages in relation to cultural models of sexuality, and how do they use the information to evaluate their own sexual practice? How do they perceive and mediate notions of risk? What are the gendered dimensions of these perceptions? What are the views and practices of Trobriand women and men regarding condom use for the prevention of HIV infection and transmission? How do models of HIV and AIDS correspond with Trobriand concepts of disease and illness? In the Trobriands, the representation of AIDS as a looming threat from beyond the islands provides a pivotal reference for assertions of cultural identity and belonging, as people contemplate HIV prevention in relation to the valued efficacy of sexual practice in maintaining social relations. My thesis reflects on the inherent irony of an epidemic manifesting in a cultural ethos of fecundity and social regeneration, and considers Trobriand sexuality and sociality not in terms of risk but as a foundation for HIV prevention. The thesis supports the identified need for theoretical and applied anthropological research to inform the national response to the HIV epidemic in Papua New Guinea. Research involved close collaboration with three Trobriand women who accompanied me on visits to villages throughout the islands, helping with language translation during group discussions and interviews, and facilitating awareness sessions on HIV and AIDS. The Trobriand context offers a strong argument for communication approaches that encourage the dialogic engagement of local meanings of sexuality and disease in the process of learning and knowing about HIV and AIDS. Show more