UC San Diego

Papua New Guinea's large landmass and population of 7 million stand out among the scattered islands of the Pacific region. A 2009 estimate by the National Department of Health estimated that 0.92% of the adult population was living with HIV. In the Highlands region, the prevalence is higher--just over one percent. Paul Farmer has written that epidemic disease is not merely a matter of biological transmission, but traces paths of vulnerability along steep gradients of inequality. I argue, however, that inequality must be understood in ways that are culturally and historically specific. Pacification, conversion, and participation in wage labor and the cash economy led to rapid and significant changes in Huli lifestyle. Furthermore, a thread of Melanesianist ethnographic theory associated with Roy Wagner and Marilyn Strathern emphasizes that the values and precepts of Western individualism can be misleading in a Melanesian context, where higher value is placed on social relationships, and personhood is treated as both multiple and 'dividual.' These considerations make metrics of inequality oriented to an individualist value system problematic in the Huli context. In this paper, I propose that a careful extension of Farmer's theory to include forms of relational and dividual inequality can help us to better understand the course of the HIV epidemic against a background of rapid cultural change. I suggest that attention social uncertainties, indexed by interpretative and diagnostic practice, can reveal these entanglements of disease and cultural change