Fitting condoms on culture: rethinking approaches to HIV prevention in the Trobriand Islands of Papua New Guinea

In tandem with the relentless spread of HIV infection throughout the world is a proliferation of ways of comprehending the virus and its effects, as different knowledge and belief systems converge and interact to produce meaning. Responding effectively to the challenges of the pandemic in diverse cultural settings involves an obligation to "continually reevaluate the concepts through which we understand HIV, looking closely at how the multiple levels of experience and the multiple forms of knowledge interrelate and change over time" (Patton 2002, xxiv). Yet communication about HIV and AIDS is based persistently on biomedical and epidemiological constructions of meaning, with little consideration for how such information interacts dynamically with diverse and changing cultural beliefs and practices. These models infuse the language of HIV prevention with predominantly Western assumptions and moralities about human sexuality, gender relations, and individual behavior (Brummelhuis and Herdt 1995; Herdt and Lindenbaum 1992). The global migration of this "discursive epidemiology" potentially inhibits the capacity for clarifying local understandings of sexuality and making meaningful connections between local knowledge and new information about HIV prevention (Jolly and Manderson 1997, 19).