Ensnared by AIDS: Cultural Contexts of HIV/AIDS in Nepal

Beine, David K

The way people make sense of illness is, in part, culturally determined. Existing beliefs and presuppositions shared by a community (cultural knowledge) regarding illness play a significant role in shaping an understanding of newly emerging illnesses in any given culture. This cultural knowledge is organized as cultural models, which are utilized to "make meaning" of new situations such as the HIV/AIDS epidemic. These cultural constructions (cultural models) of illness can also contribute to the spread of the epidemic. Ensnared By Aids: The Cultural Contexts of HIV/AIDS in Nepal examines the meaning and cultural contexts of HIV/AIDS in Nepal where AIDS is a relatively new and rapidly growing problem. Until now little had been known about how Nepalis understand the illness locally known only as AIDS rog. This book presents the results of a long- term study that examines the process by which the development of Nepalese cultural models of HIV/AIDS is occurring. It also introduces various illness schemata that underlie and inform these cultural models.

This book is based on the findings of two distinct studies conducted over a sixteen-month period in two locations of Nepal. The first study, employing traditional ethnoscience methods, explores illness beliefs and practices in rural Gorkha District of central Nepal. The findings suggest an emerging cultural model of HIV/AIDS that is based on an integration of 1) indigenous concepts (placing HIV/AIDS into a existing illness classification paradigm), 2) Western-based HIV/ AIDS prevention education messages, and 3) public discourses of HIV/AIDS. The second study, based on the linguistic analysis of thirty texts collected from persons with AIDS (PWAs) living in the capital city of Kathmandu, illuminates emotional and contextual aspects of the contested cultural models. It also discriminates between meanings of HIV/AIDS shared by those who suffer with it and members of the wider culture. Both studies are used to examine the cultural contexts and underlying schemata (universal and local, cultural and biological), which are involved in the construction of cultural models of HIV/AIDS in Nepal.

This book represents the first long-term field study of the cultural dimensions of HIV/AIDS in South Asia. It is also one of the few ethnographies of HIV/AIDS to emphasize the depth and diversity of the people's view and construction of the emerging illness. And it is the only HIV/AIDS ethnography to utilize a discourse analysis (linguistic) approach.

Although this book is written primarily for scholars of Nepal, other scholars such as anthropologists (especially medical anthropologists), social epidemiologists and public health professionals (especially health educators working with international NGOs) would also find, the topics covered of interest. It may also be of theoretical and methodological interest more widely to cognitive anthropologists, cognitive linguists and psychological anthropologists, because it explores the relationship between cognitive schemata and the creation of cultural models of meaning and provides a better understanding of how people incorporate new ideas into established cognitive systems. Cognitive linguists would also be interested because the successful use of the narrative analysis method provides cross-linguistic validity to the discourse analysis model, a relatively new model of linguistic research.

Table of Contents:


Section One: Background and theoretical underpinnings

  • Chapter One: Introduction
  • Chapter Two: Nepal
  • Chapter Three: AIDS
  • Chapter Four: AIDS in Nepal
  • Chapter Five: Cultural Models, Schema Theory and Cognitive Methodologies

Section Two: The Projects

  • Chapter Six: Saano Demre Revisted: Changing Models of Illness and Cultural Models of HIV/AIDS in a rural Nepali village of Central Nepal
  • Chapter Seven: HIV and Me – A Discourse an Analysis of HIV/AIDS Narratives

Section Three: Wrapping it up

  • Chapter Eight: Nepali Cultural Models of HIV/AIDS and underlying illness schemata
  • Chapter Nine: The Making of a Cultural Model
  • Chapter Ten: Conclusions

Section Four: In Their Own Words

  • Chapter Eleven: In their Own Words

Appendix A: Focus Group Interview Questionnaire
Appendix B: Village-wide Survey Questionnaire
Appendix C: Glossary of Nepali Terms

411 pages
ISBN 13:
ISBN 10:
5.5 × 8.5 × 0.75 in
1.1 lb
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