Married women in rural Papua New Guinea are at risk for HIV primarily because of their husbands' extramarital relationships. Labor migration puts these men in social contexts that encourage infidelity. Moreover, many men do not view sexual fidelity as necessary for achieving a happy marriage, but they view drinking and "looking for women" as important for male friendships. Although fear of HIV infection is increasing, the concern that men most often articulated about the consequences of extramarital infidelity was possible violent retaliation for "stealing" another man's wife. Therefore, divorced or separated women who exchange sex for money are considered to be "safe" partners. Interventions that promote fidelity will fail in the absence of a social and economic infrastructure that supports fidelity.
The "culture concept" has been challenged on a number of fronts, both by medical anthropologists researching AIDS and in the discipline of cultural anthropology more generally. Medical anthropologists have argued against the "etiologization" of culture, and cultural anthropologists have taken issue with the tendency to treat beliefs and practices as static and seamlessly shared. Using the narrative of one Huli woman's shifting explanation of a diagnosis of syphilis, this article argues that, rather than avoid the notion of culture, we should strive for representations that demonstrate how individuals use discourses in expedient, ad hoc, and yet deeply felt ways. This article also argues for the importance of a sociology of knowledge approach to understanding local notions of etiology. The woman's understanding of her situation was strongly influenced by her entry into a new "community" of women who had similarly been diagnosed with a sexually transmitted disease.
The globalization of standardized knowledge about HIV and AIDS depends in part on local AIDS awareness educators who receive training from national and international organizations and then, ideally, disseminate what they have learned. In this article I analyze textual and observational data from a five-day introductory AIDS awareness workshop in rural Papua New Guinea. Although the instructor adhered to the handbook provided by the National AIDS Council for much of the information, she departed from it significantly when informing participants about the "root causes" of HIV's spread and in giving them advice about prevention. I explicate where her extratextual knowledge came from as well as its overall message to target audiences. I suggest that textual silences in AIDS awareness handbooks can motivate local HIV translators to embark on a kind of semiosis-the ongoing production of new, hybrid knowledge about HIV.
By juxtaposing a contemporary myth with an exegesis of Huli "passenger woman" (physically and sexually mobile women), I address the gendered nature of modernity. Huli women are expected to enact tradition, both through their consumption practices and through participation in the bridewealth system. Passenger women become modern through their repudiation of these roles. An analysis of women's experiences suggests that modern forms of identity can emerge in response to the shifting meanings and practices of social reproduction, [modernity, bridewealth, social reproduction, sexuality, myth] Once there was a Huli woman who had two lawini (boy-or girlfriend, romantic interest), one who lived at home in Tari and another who had a job in Port Moresby, the capital city of Papua New Guinea. She was willing to marry either one of the young men, but the latter's family was able to assemble the necessary bridewealth pigs and money first, and so she married him. Her husband remained in Port Moresby, and she moved in with his mother and sisters, helping them to make gardens until he sent her a plane ticket and asked her to come join him. Wanting to show her husband how happy she was that he-unlike many husbands-desired her company in the city, she decided to bring him some taro, a food symbolic for the Huli of intimacy, rituals remembered if no longer practiced, and the value of hard physical labor. Better than words, a gift of taro would tell him about the kind of wife she would be and would perhaps reassure him that city life would not make her lazy or selfindulgent. So she rushed off to her garden without telling anyone where she was going.Her other lawini had never forgiven her for marrying someone else, and all this time he had been spying on her and plotting how to take his revenge. Seeing his opportunity, he followed her to her garden, attacked her with a bush knife, and chopped her head off. When her body was finally found, a message was sent to her husband in Port Moresby, but-as messages often do-it went astray, and he never received it. So the woman's ghost took her plane ticket, wrapped a scarf around her neck, and got on the plane to Port Moresby as scheduled. When her husband met her at the airport, he thought that her skin looked a little sallow, and it seemed odd that she never removed her scarf, but he was so happy to see her that he insisted on carrying all of her baggage, and he loaded her up with a profusion of gifts-shoes, watches, purses, sunglasses, and radios.After they had lived in Port Moresby for almost a year, they decided together that it was time to make a visit to Tari. When they got off the plane, there was a white fourwheel-drive Toyota Land Cruiser waiting for them. The woman jumped into the driver's seat, her husband took his place in the passenger seat, and he was amazed and proud that she was able to drive. She drove him to a permanent fiberboard house Ampriran Ethnologist29H ):5-32.
Acknowled gments This book is based on research carried out over almost ten years, and there are consequently many, many individuals and organizations to thank for their assistance, friendship, and support. As always, my deepest thanks go to Mary Tamia and June Pogaya, my beloved besties in Tari, who have shared everything with me-stories, food, families, insights, laughter, tears, fear, and, fury. I am also deeply thankful for Jacinta Hayabe's friendship since 1996. During our many long, cigarette-filled, latenight conversations, she proved an invaluable interlocutor and especially helped me understand the complex political field of women's groups in the region. I am grateful to Michael Parali, Luke Magala, Ken Angobe, and Thomas Mindibi, the four wonderful men who worked as my field assistants in 2004, were brave enough to pose forthright questions about love, sex, marriage, extramarital relationships, and HIV to their peers, and had no compunction about telling me when interview questions were problematic. My deepest condolences go to the family of Joseph Warai, who directed the Community Based Health Care (CBHC) NGO in the mid 2000s and was very supportive of my 2004 research project. Joseph and the whole CBHC team persevered in delivering health promotion and income-generating projects to people in the Tari area during a desperate and precarious period, and they were a source of hope and inspiration for many. I was also sad to learn that Sister Pauline Agilo had died. She was a comfort to many people living with HIV and AIDS, and especially helped people as best she could in the pre-antiretroviral era. During my research stints in 2010, 2011, 2012, and 2013, a number of health workers assisted me by telling patients about my research and asking them if they were interested in being interviewed. They also, with the permission of patients, x Acknowledgments allowed me to observe some of their counselling sessions, and they shared with me their concerns about patients' living situations and about the sometimes unreliable availability of antiretrovirals and other essential medicines in Tari. I am especially grateful for Margaret Parale's friendship and assistance during this research. Employees of the Oil Search Health Foundation also assisted in recruiting participants for me, and provided me with useful data about Tari's HIV prevalence. Jethiro Harrison and Ruben Enoch were University of Papua New Guinea student interns with me in Tari for a few weeks in 2013. Among other things, they helped me to understand the powerful allure of Port Moresby that can attach itself to those who have lived there and attract other people when they return to rural areas. I am also grateful to the staff of Médecins sans frontières in Tari who were so generous to me, especially when my guesthouse did not have water or electricity. I feel profoundly lucky to belong to the Department of Anthropology at the University of Toronto, where I have wonderful and brilliant colleagues, whose ideas have influenced mine. I am also grateful to ...
This article examines beliefs about breast cancer and mammograms among low-income urban black women. Our research indicates that women associate breast cancer with domestic violence, believing that bruises resulting from physical abuse which is not reported or given medical attention can later turn into cancer. Some women fear that in "mashing" the breast, mammograms cause "knots" or bruises that can become cancerous. Mothers and daughters were found to have extensive knowledge of, and sense of responsibility for, each other's health. This bond can be used to encourage use of cancer screening procedures. While women assert that one's health is ultimately in God's hands, their faith appears to motivate health-seeking behavior rather than promote a fatalistic or passive orientation. Key words: Breast cancer, mammography, urban black womenBreast cancer is currently the most common form of cancer among women and the second leading cause of female cancer mortality. Frightening statistics assert that one out of every ten women will develop breast cancer at some point during the course of a lifetime. For low-income black women, the figures appear even worse. One recent study found that black women had a 2.1 times greater risk of dying from breast cancer than white women (Eley et al. 1994).There is good evidence that early detection of breast cancer increases the likelihood that the cancer will be localized, that less radical surgery will be required, and that the survival rate improves (Shapiro 1989). Among all screening methods, mammography has the lowest detection size threshold for tumors, enabling their discovery before cells metastasize and spread to the lymph nodes. However, screening mammography is underutilized, especially by low-income black women (Price et al. 1992). On average, black women are diagnosed at a later stage of tumor development than white women. Most studies attribute higher mortality rates among low-income black women to underutilization of mammography and other screening procedures (Satariano, Belle, and Swanson 1986). Programs that have tried to target low-income or minority populations by overcoming logistical barriers, such as expense and transportation, have found that it is also important to consider cultural factors that influence women's health-related behaviors . Ethnographic analyses can help elucidate why women do or do not use available screening services, and why health workers and their low-income black patients are sometimes at odds over the value of health-related technology. This article examines a number of issues surrounding mammography use for lowincome, urban black women, including ethno-etiologies for breast cancer, perceptions of mammograms, attitudes about doctor-patient interaction, the role of religious faith in health-seeking behavior, and the importance of female kin for the circulation of health-related information.
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