I shouldn’t talk of medicine only: Biomedical and religious frameworks for understanding antiretroviral therapies, their invention and their effects

ABSTRACT

Medical pluralism offers a long-standing means of analysing the different ways in which health and illness can be interpreted and responded to. It is not unusual for multiple health systems and meanings to co-exist at any one moment in time, offering different ways of understanding and responding to illness and disease. In addition to biomedical frameworks, religious beliefs offer another important means of facilitating healing. Based on qualitative interviews with 36 people living with HIV on antiretroviral therapies (ART) in Papua New Guinea (PNG), this paper examines the ways in which people bring together and synthesise religious and biomedical therapeutic approaches to the treatment and management of HIV. For most, ART is viewed as a divine gift to complement a regime of spiritual salvation, and adherence to treatment carries with it strong religious undertones. At the same time, ART provides a sense of hope for those living with a virus that was previously associated only with death. Brought together, these narratives provide important insights into the meanings of ART and the role of religion, prayer and repentance for people in PNG. The study also provides new insight into how people with HIV actively synthesise different approaches to health and healing.

KEYWORDS:

• Christianity
• HIV
• Papua New Guinea
• medical pluralism

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Peter Aggleton http://orcid.org/0000-0001-5966-4969

Patti Shih http://orcid.org/0000-0002-9628-7987

Notes

1 This policy was approved by the National Executive Committee in 2007 and formally launched in 2009. It explicitly excludes the use of sorcery as a form of traditional medical practice. (Macfarlene, 2009).

2 A study on the pharmacological impacts of traditional plants used in Papua New Guinea shows that some may adversely affect the effectiveness of ART (Larson et al., 2014).

3 There is an important body of literature from the anthropology of Christianity in the Pacific including the work of Robbins, Baker, Scott and Hardin. Although we recognise this work, we are not grounding our work in this area. (Barker, 2003; Hardin, 2016; Robbins, 2004; Scott, 2005).

4 Zocca notes that the churches that make up the Pentecostal category in the 2006 Census are not clear. It is likely this includes denominations such as Four Square Church, Revival Churches and others. Zocca, F., 2014. Religious affiliation in Papua New guinea according to the 2006 census. Catalyst 44, 107–116.

5 Street’s work in the Madang Provincial Hospital also highlights how Christianity comes to be reflected in the decoration in the hospital, including clocks that adorn images of Jesus and the Virgin Mary with a patient saying that the hospital had turned into a church. (Street, 2010).

6 The authors acknowledge the important role of the early career researchers in conducting the interviews from which this paper is based. These include Agnes Mek, Somu Nosi, Lucy Walizopa, Barbara Kepa, Martha Kupul, Francis Akuani, Lawrencia Pirpir. Brenda Cangah and Rebecca Emori.

7 Since the study, one area where the study was undertaken has now been declared a separate province.

8 A recent issue of the journal Medical Anthropology problematises the binary between the sexual and the religious/sacred, arguing that secular medicine relies upon particular forms of religion and religiosity. (Whitmarsh & Roberts, 2016).

Additional information

Funding

This Art of Living study was financed by the Papua New Guinea National AIDS Council Secretariat with financial support from the Government of Australia.