Making Sense of AIDS: Culture, Sexuality, and Power in Melanesia

Edited by Leslie Butt and Richard Eves

University of Hawaii Press, Honolulu (2008)

Paperback, 320 pages, including index

ISBN 978-0-8248-3249-0

Melanesia has provided endless experiences both exotic and erotic for adventurers and material for anthropologists ever since this part of the pacific was revealed to the wider world. Including Margaret Mead, Bronislaw Malinowski, and Gilbert Herdt, Melanesian cultures have had their sexuality examined and reported on. This book aims to make sense of culture, sexuality and power as it relates to HIV in Melanesia. This is some undertaking considering Melanesia is home to myriad language groups extending from the island of New Guinea in the west, Fiji in the east, New Caledonia in the south, and Nauru and Kiribati in the north.

While the island of New Guinea has been affected the most by HIV to date, the remaining island nations of Melanesia have small numbers of cases relative to other countries, leading some commentators to talk about a Melanesian style HIV epidemic; meaning that Melanesia has an HIV epidemic pattern that is neither Sub-Saharan African nor Asian. Evidence from bio-behavioural surveys as well as behavioural surveillance has shown that HIV is found in the usual vulnerable populations of female sex workers, men who have sex with men, male to female transgender, men working in the transport sector, injecting drug users, and those with multiple sexual partners. Debate among public health professionals continues as to whether the island of New Guinea is experiencing a generalised epidemic or a large concentrated epidemic.

Making Sense of AIDS is a collection of essays from 12 female and three male anthropologists who have performed field work in Solomon Islands, Vanuatu, New Caledonia, West Papua, and from the four regions of Papua Niugini: Southern, Momase, Highlands, and Islands. With the exception of the contributions from the applied anthropologists, the essays are mostly opinion pieces from the author’s fieldwork using ethnographic research to provide insights into the sexual and health causality belief systems of some of the cultures in Melanesia as it applies to the manifestations of HIV.

Although many of the chapters focus on Melanesian cultural linkages of sex with the negative and fearsome subjects, such as sorcery, rape, abuse, death, sin, judgment, mortality, degeneracy, faith healings etc, the Trobriand Islands are a beacon of light where sex and the erotic are celebrated. What is missing in this book is more research on what is ‘sexy’ in Melanesian contexts, what is erotic, or what women and men want or expect from their different sexual encounters. The continuance in the practice of ‘bride price’ and the price of sex or selling of sex are not unrelated and are worthy of anthropological exploration in the context of the epidemics of sexually transmissible infections and HIV.

I would point readers to Holly Buchanan-Aruwafu and Rose Maebiru’s chapter “Smoke and Fire: Desire and Secrecy” for its anthropological application of behavioural survey data. Kathy Lepanis’ chapter “Fitting Condoms on Culture” and Maggie Cummings chapter “The Trouble with Trousers” contrast the differences across Melanesia between permissiveness and prudery.

While the editors and reviewers tout for a wider audience, the book will most appeal to anthropologists and social scientists with an interest in Melanesia and for whom social science jargon is their second language. The content is interesting and mostly useful, but the deciphering the language is somewhat distracting. It may disappoint sexual health clinicians, public health professionals or policy-makers expecting new insights into belief systems behind sexual behaviours in order to design and implement effective programs, but it does make for some disturbing reading for those who have an interest in the diversity that is human sexual behaviour and belief systems. The editorial is critical of much of the current responses to HIV in Melanesia (with some good reason) but fails to put forward viable alternatives or suggestions for what needs to improve and how.

While it is not the intention of the book, it does not make use of available epidemiological evidence, such as the 2006 World Bank and Family Health International bio-behavioural survey of West Papua, or the biannual sentinel behavioural surveillance from Papua New Guinea. This is unfortunate as these are rich sources of data which need to be mined in order to more clearly understand what the drivers of the epidemic are in the largest island in Melanesia.

All in all, a disparate collection of pieces that are individually interesting and provide some anthropological perspectives to some of the factors that impact on the HIV epidemic in Melanesia, but despite the editors’ attempts, it is difficult to see how they all combine to make sense of AIDS in this neglected part of the Asia-Pacific.

Kel Browne

Sexual Health Nurse, National Department of Health

Papua New Guinea