Medical Anthropology Quarterly: Vol. 19, No. 4 (december 2005)
articles
"Carolina in the Carolines: A Survey of Patterns and Meanings of Smoking on a Micronesian Island"
Mac Marshall
Tobacco use---especially smoking industrially manufactured cigarettes---kills nearly 5 million people annually and is the leading preventable cause of death worldwide. Tobacco is a widely used global commodity embedded in cultural meanings, and its consumption involves a set of learned, patterned social behaviors. Seemingly, then, tobacco offers a most appealing anthropological research topic, yet its study has been relatively ignored by medical anthropologists when compared to research on alcoholic beverages and illegal drugs. To help fill this gap, this article sketches the historical background of tobacco in Micronesia, presents the results of a cross-sectional smoking survey from Namoluk Atoll, and describes contemporary smoking patterns and locally understood symbolic associations of tobacco. Intersections among history, gender, local meanings, the health transition, and the transnational marketing of tobacco are addressed, and cigarette smoking is seen as part of a new syndemic of chronic diseases in Micronesia.
"Partner Notification Methods for African American Men Being Treated for Trichomoniasis: A Consideration of Main Men, Second Hitters, and Third Players"
Bronwen Lichtenstein and Jane R. Schwebke
This pilot study sought information on African American men's preferences for partner notification methods for a common sexually transmitted infection called trichomoniasis. Two focus groups of African American men were convened at a public STI clinic where they were being treated for trichomoniasis. The groups identified a sexual hierarchy in men's preferences for methods of partner notification. The hierarchy consisted of main men (Cake Daddies), second men (Second Hitters), and third or fourth men (Third Players), with placement depending on age, income, and social status. Health department employees affirmed the existence of a sexual hierarchy in a separate focus group. Sexual and economic bartering formed the basis of the hierarchy, and the secrecy involved in such arrangements presented a considerable challenge for STI control. Disease intervention specialists who were responsible for contact tracing spoke of cat-and-mouse methods in contacting the men without understanding fully exactly how the hierarchy influenced men's responses to partner notification. The findings suggest that STI control efforts must take the sexual hierarchy and its privacy implications into account if partner notification methods are to be acceptable to African American men.
"' Taming Tradition': Medicalized Female Genital Practices in Western Kenya"
Astrid Christoffersen-Deb
This article considers the question of female genital practices at the hands of health workers in western Kenya. Recent articles in Medical Anthropology Quarterly have critically engaged with the biomedical arguments condemning such practices. This article studies the case of medicalized circumcision in which biomedical concerns over health risks have become incorporated in their vernacular practice. Although some suggest that medicalization may provide a harm-reduction strategy to the abandonment of the practice, research in one region challenges this suggestion. It argues that changing and conflicting ideologies of gender and sexuality have led young women to seek their own meaning through medicalized practice. Moreover, attributing this practice to financial motivations of health workers overlooks the way in which these "moral agents" must be situated within their social and cultural universe. Together, these insights challenge the view that medicine can remain neutral in the mediation of tradition."A Room for Reflection: Self-Observation and Transformation in Participatory HIV Prevention Work"
Anne-Lise Middelthon
This article looks at HIV prevention projects in which established stigmatized and stigmatizing roles were actively reversed and manipulated in pursuit of HIV harm reduction. In two Norwegian projects, sex workers and drug users carried out harm-reduction activities with other drug users and sex workers. Although HIV-related harm reduction was the aim of the projects, termination or reduction of drug use or sex work was not. Such changes nevertheless occurred among the sex workers and drug users who took active part in the project. The article considers these changes in order to reflect on the meanings and roles of participation in HIV prevention work. In particular, the discussion theorizes on possible ways in which alteration of roles and subject positions may produce self-reflective effects with transformative potentials.
book reviews
Religion and Healing in America; Complementary and Alternative Medicine in the United States; Consciousness and Healing: Integral Approaches to Mind-Body Medicine; Negotiating the Holistic Turn: The Domestication of Alternative Medicine
reviewed by Hans A. Baer
Divination and Healing: Potent Vision
reviewed by Carol Shepherd McClain
Medical Pluralism in the Andes
reviewed by Donald Joralemon
Nursing Against the Odds
reviewed by Deborah Shelton