Public Health, Personal Beliefs: Battling HIV in Papua New Guinea

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According to the Papua New Guinea National AIDS Council Secretariat and the Department of Health, there were a total of 4,075 HIV cases in Papua New Guinea as of July 2001. This number may seem small compared to those reported for many African and Asian nations; however, it is widely acknowledged that the number of reported cases is just an indication of the much greater number of cases that go unreported. High rates of other sexually transmitted diseases, high rates of urbanization and male migration to mines and other resource development sites, and cuts in government spending for health all suggest that HIV/AIDS could profoundly impact Papua New Guinea. A recent report commissioned by the Australian Agency of International Development (AusAID), titled Potential Economic Impacts of an HIV/AIDS Epidemic in Papua New Guinea, hypothesizes that Papua New Guinea may face an epidemic as devastating as that which has impacted sub-Saharan Africa.

While the cultures and history of Papua New Guinea obviously differ from those of African and Asian countries, Papua New Guinea does share with those regions some structural features that have put its citizens at high risk. Like many parts of Africa, Papua New Guinea has high rates of male migration to mining sites, urban areas, and other sites of potential employment. For example, Southern Highlands Province was deliberately cultivated during the colonial period as a source of labor for coffee and copra plantations located in other provinces, and high rates of male out-migration for wage labor have continued into the present.

Epidemiological and anthropological research from other areas of the world demonstrates that this pattern of labor facilitates the transmission of sexually transmitted diseases because men may be more likely to seek out extra-marital sexual and emotional relationships if they are separated from their spouses and communities for long periods of time. Since most mining companies and other businesses do not provide housing for families, obtaining wage labor usually entails such long absences. Moreover, wives--monogamous or not--are also put at risk by this pattern of labor: if men do contract a sexually transmitted infection, they can transmit it to their wives when they are able to return home.

Another feature of the social landscape that Papua New Guinea shares with other world areas where people are vulnerable to HIV is the emergence of prostitution--or sex work, as it is now often called in social science literature--as an economic niche for some women. It is difficult to generalize about the nature, causes, and consequences of prostitution in Papua New Guinea since these aspects seem to vary from place to place. For example, Huli pasinja meri (literally, passenger women) may or may not conform to many common assumptions about prostitution. On the one hand, they do exchange sex for money, have many sexual partners, and are stigmatized for this behavior. On the other hand, they do not depend on the money to survive since they often continue to perform traditional female duties such as gardening, they are not controlled by pimps, they do not work out of brothels or any one location, many of them have never been to an urban area, and most of them were not initially motivated by the need or desire for money. When asked to recount events that impelled them to sell sex for money, most of them described incidents where they felt betrayed and abandoned by their husbands or male relatives, and their reactions to these feelings might better be described as "revenge promiscuity" rather than as "prostitution."

One Case

Ogai (a pseudonym), for example, had two children and had endured a difficult marriage for a number of years before she began to pasinja raun (literally, passenger around, which, for women, has connotations of sexual promiscuity). Her husband worked at a gold mine not far from Huli territory, but he rarely gave her money, he rarely came home, and she knew that he had sex with other women. However, she put up with the situation, and it was only after she was raped--and her husband and brothers refused to do anything about it--that she abandoned her husband and their children and started having sex for money. When she told her brothers about the rape, they responded that she was a married woman (her husband had paid bridewealth for her) and it was therefore her husband's responsibility to take the culprit to court and demand compensation. Her husband, however, refused to leave work and come home, and when he finally did come home, he said that since there were no witnesses to the assault, it wasn't worth the trouble of a village court case.

When I interviewed her she said that she was so angry she considered committing suicide (rates of suicide among adult women are high in Papua New Guinea) but instead engaged in extra-marital sex. She began by sneaking off to local "bush discos," rural, late-night dance parties, where she would dance with a number of men and then have sex with one of them for a few dollars. Later she joined a group of women who also self-identified as passenger women. Usually the leader of the group would organize for the women to meet with a group of men, often in the privacy of clan men's houses. Clan men's houses were traditionally, and for the most part still are, off-limits to women, but in some instances they now seem to be used for men's sexual escapades. According to Ogai, if her husband and brothers were going to treat her as if she didn't "belong to them," then she was going to act as if she didn't belong to them. In other words, if they weren't willing to protect and defend her sexuality, she would use it as she saw fit.

Ogai's narrative is typical of Huli women who consider themselves passenger women. According to Ogai, the decision to act as a passenger woman is precipitated by a trigger event, most often rape, violence to female kin, or abandonment, and the subsequent failure of a woman's husband or male relatives to pursue proper justice. Ogai, for example, said that in the past the response to her assault would have been for her husband and her brothers to demand compensation from her assailant, and to threaten a tribal attack on the assailant's clan if compensation was not forthcoming. But kin today, many Huli women bitterly asserted, "are just greedy for bridewealth" and do not value or protect a woman and her sexuality as much as they should or did in the past. Women expressed concern that because people in rural areas do not have adequate access to wage labor, they are more likely to use bridewealth payments as a means to gain access to cash; men concurred that this was, indeed, the case. Men increasingly request that bridewealth for their daughters and sisters be given in the form of cash instead of the traditional pigs. According to many Huli women, relatives are too eager to accept bridewealth cash, but do not provide economic or moral support during a time of crisis, leading women to feel that in the current context they are treated olsem maket (like a market good). In the past, many Huli women asserted, women were the valuables for whom one gave bridewealth; now, cash is the valued item for which one gives women.

Although many women are disturbed and angered by this expedient attitude toward women and bridewealth, experiences such as Ogai's turn attitude into action. Passenger women's behavior can be an effective form of revenge, even if it also can have deleterious consequences for the women themselves. Unmarried passenger women shame their families with their illicit sexual behavior and make themselves undesirable as wives, denying their kin the bridewealth they expect and often need. Married passenger women abandon their gardens, pigs, and children. Huli passenger women can, to some extent, be considered a consequence of the way in which labor structures and increasing monetization of the economy interact in complex ways with local social formations to change the meaning and function of "traditional" customs like bridewealth.

It is important to keep in mind, however, that prostitution does not have the same pattern or meaning throughout Papua New Guinea. Research in other areas of the country has revealed other dynamics at work. Lawrence Hammar, working in Daru, Western Province, found a quite different picture from that described above for Huli women in Southern Highlands Province. In Daru, a much more economically marginal area, where land is short and the population has a very difficult time surviving, women do engage in the sale of sex because of economic need and a lack of viable alternatives. In this context, women do not always demonstrate the autonomy of Huli passenger women. Hammar found, for example, that in Daru, husbands, fathers, and other male relatives sometimes solicit sexual partners for their wives, daughters, and other female kin, and unlike Huli passenger women, women in Daru do not always have control over the money they earn.

In another more broad-based study, researchers from the Papua New Guinea Institute of Medical Research trained and employed "indigenous ethnographers" to learn about people's sexual and reproductive histories throughout the country, and found a wide range of knowledge and experiences. Some relatively common themes emerged, however, including a multitude of ways in which widespread male dominance and female subordination in Papua New Guinea put women at risk for sexually transmitted disease. The belief that women should have limited autonomy and should continue to abide by traditional customs means that women are very vulnerable to sexual violence when they are perceived to be too "modern," too autonomous, or too independent.

Condom Use

As in many areas of the world, condom use to prevent HIV is advocated in Papua New Guinea, and, as in many other areas, there are many obstacles to this strategy for prevention.

Most of the Huli women I interviewed were unfamiliar with condoms, and if they did know about them, they either associated them with "bad" women or said that they could not imagine taking the initiative to ask a man to use them. Such initiative would demonstrate inappropriate knowledge about, and autonomy in, sexuality. Not only were they afraid of how men would react, they were also uncomfortable with behavior that felt so "unwomanly." Many women also asserted that they were afraid of condoms since they had heard that condoms could fall off inside of them, or be deliberately left inside by malevolent sexual partners, get stuck, and eventually cause death.

Many Huli men, on the other hand, were quite open to the idea of using condoms, and the Papua New Guinea Institute of Medical Research team obtained similar findings from men in other areas of Papua New Guinea. Since in many parts of Papua New Guinea there are long-standing beliefs about the powerful and potentially dangerous nature of women's sexual substances, men sometimes feel themselves to be vulnerable during sex and consequently feel more of a need to protect themselves. Condoms were perceived by some Huli men as a "modern" way to achieve that protection. According to Huli men, the obstacle to condom use was not a lack of willingness to use them, but rather a lack of availability. Most men who had used condoms said they were unavailable at local health centers and stores, and they claimed that the only way to obtain them was if a friend brought some back from an urban center. The lack of a reliable distribution system may thus be a more significant impediment to condom use than local beliefs or a lack of information.

Conclusion

HIV/AIDS is cause for increasing concern in Papua New Guinea, and while local beliefs and customs must be understood for any public health intervention to succeed, in many ways Papua New Guinea people are made vulnerable to the pandemic for the same reasons that people are elsewhere: male absence from the community for wage labor, inegalitarian gender relations, increasing poverty, and inadequate health resources and infrastructure.

Holly Wardlow is an assistant professor of anthropology at the University of Toronto. Her research focuses on gender, sexuality, and international health. She can be reached at hwardlow@chass.utoronto.ca.

References & further reading

Center for International Economics (2002). Potential Economic Impacts of HIV/AIDS Epidemic in Papua New Guinea. Report Prepared for AusAID. http://www.dfat.gov.au/aid/Pages/australias-aid-program.aspx

Hammar, L. (1998). AIDS, STDs, and Sex Work in Papua New Guinea. In Modern Papua New Guinea. Zimmer-Tamakoshi, L., Ed. Kirksville, MO: Thomas Jefferson University Press.

Hammar, L. (1996). Bad Canoes and Bafalo: the Political Economy of Sex on Daru Island, Western Province, Papua New Guinea. Genders 23, pp 212-243.

The National Sex and Reproduction Research Team & Jenkins, C. (1994). Sexual and Reproductive Knowledge and Behaviour in Papua New Guinea. Papua New Guinea Institute of Medical Research Monograph No. 10. Goroka: PNGIMR.

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