By means of critical ethnography with a focus on historical dimensions, this article delineates the ways Chamorro with HIV/AIDS negotiate interaction with Western health staff. This effort targets a largely unstudied and disenfranchised population of a U.S. territory (Guam) through qualitative methods. Results indicate that (a) foundational historical patterns inform covert behaviors, that is, the longstanding colonization of Chamorro culture has implications for communication, and (b) the residual influence of the investigation of lytico-bodig affects conceptualization and discussion of disease. At the same time, historically grounded forms such as the use of healers offer clients culturally sanctioned means of resistance to hegemonic medical structures. Findings have implications for nursing practice in the clinical setting.
Bodeker, G., Kabatesi, D., King, R., & Homsy, J. (2000). A regional task force on traditional medicine and AIDS. Lancet, 355(9211), 1284.
2.
Bolton, R. (1995). Rethinking anthropology: The study of AIDS. In H. T. Brummelhuis & G. H. Herdt (Eds.), Culture and sexual risk: Anthropological perspectives on AIDS (pp. 285-313). Australia: Gordon & Breach .
3.
Brewis, A.A. (1992). Sexually-transmitted disease risk in a Micronesian atoll population. Health Transition Review, 2(2), 195-213.
4.
Browne, A.J., & Fiske, J.-A. (2001). First Nations women's encounters with mainstream health care services. Western Journal of Nursing Research , 23(2), 126-147.
5.
Carano, P. & Sanchez, P.C. (1964). A complete history of Guam. Rutland, VT: Charles E. Tuttle.
6.
Centers for Disease Control and Prevention. ( 2002). U.S. HIV and AIDS cases reported through 1998. HIV/AIDS Surveillance Report, 14, 10.
7.
Choi, K.H., Lew, S., Vittinghoff, E., Catania, J.A., Barrett, D.C., & Coates, T.J. (1996). The efficacy of brief group counseling in HIV risk reduction among homosexual Asian and Pacific Islander men. AIDS, 10(1), 81-87.
8.
Chu, N.S. (2001). Effects of betel chewing on the central and autonomic nervous system. Journal of BiomedicalSciences, 8(3), 229-236.
9.
Community Planning Group (CPG).1997 report. Aguna, Guam: Author.
10.
Cook, K.E. (2005). Using critical ethnography to explore issues in health promotion. Qualitative Health Research, 15(1), 129-138.
11.
Cruise, P.L., & Dunn, S.M. (1994). Ethnography and AIDS: A methodology for identifying culturally relevant risk-reducing behaviors. Journal of the Association of Nurses in AIDS Care, 5(4), 21-27.
12.
Denzin, N. K., & Lincoln, Y. S. (Eds.). (1994). Handbook of qualitative research. Thousand Oaks, CA: Sage.
13.
Downs, A. (1999). Realities about urban sprawl. Brookings Institute. Retrieved June 18, 2007, from http://www.brook.edu/views/papers/downs/199908.pdf
14.
Eipper, C. (1998, Dec.). Anthropology and cultural studies: Difference, ethnography and theory. Australian Journal of Anthropology , 310-319.
15.
Ernst, E. (2002). The risk-benefit profile of commonly used herbal therapies: Gingko, St. John's wort, ginseng, echinacea, saw palmetto, and kava. Annals of Internal Medicine, 136(1), 42-53
16.
Fiske, J. (1994). Audiencing: Cultural practice and cultural studies . In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (pp. 189-198). Thousand Oaks, CA: Sage.
17.
Foote-Ardah, C.E. (2004). Sociocultural barriers to the use of complementary and alternative medicine for HIV. Qualitative Health Research , 14(5), 593-611.
18.
Foucault, M. (1975). The birth of the clinic: An archeology of medical perception (A. M. Sheridan Smith, Trans.). New York: Vintage Books.
19.
Foucault, M. (1978). The history of sexuality: An introduction. New York: Vintage Books.
20.
Giddens, A. (2001). Sociology (4th ed.). Cambridge, UK: Polity Press.
21.
Gordon, D.B., Pellino, T.A., Miaskowski, C., McNeill, J.A., Paice, J.A., Laferriere, D., et al. (2002). A 10-year review of quality improvement monitoring in pain management: Recommendations for standardized outcome measures. Pain ManagementNursing, 3(4), 116-130.
22.
Guba, E.G., & Lincoln, Y.S. (1994). Competing paradigms in qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (Chapter 6). Thousand Oaks, CA: Sage.
23.
Hagstom, D., Hubbard, R., Hurtig, C., Mortola, P., Ostrow, J., & White, V. (2000). Teaching is like . . .?Educational Leadership, 57(8), 24-27.
24.
Haney, L. (2002). Inventing the needy: Gender and the politics of welfare in Hungary. Berkeley: University of California Press.
25.
Hardt, H. (1998). Interactions. Lanham, MD: Rowman & Littlefield.
26.
Hawkeswood, W.G. (1993). AIDS ain't a gay thing: The impact of AIDS on gay black men. Transforming Anthropology, 4(1-2), 27-38.
27.
Henderson, L., Yue, Q.Y., Bergquist, C., Gerden, B., & Arlett, P. (2002). St John's wort (Hypericum perforatum): Drug interactions and clinical outcomes. British Journal of Clinical Pharmacology , 54, 349-356.
28.
Huberman, A.M., & Miles, M.B. (1994). Data management and analysis methods. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (pp. 428-444). Thousand Oaks, CA: Sage.
29.
Huston, R., & Berridge, M. (1997). Positive life: Portraits of women living with HIV. Philadelphia: Running Press .
30.
Inglis, F. (1993). Cultural studies. Oxford, UK: Blackwell.
31.
Janesick, V.J. (1994). The dance of qualitative research design: Metaphor, methodology, and meaning. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (pp. 209-219). Thousand Oaks, CA: Sage.
32.
Jemmott, L., Erme, M., & Bush, E. (1999). Hearing our voices: Assessing HIV prevention needs among Asian and Pacific Islander women. Journal of TransculturalNursing, 10(2), 102-111.
33.
Knudson, M. (1998). Attitudes about homosexuality and knowledge of HIV/AIDS among students at the University of Guam. Mangilao : University of Guam Anthropology Resource & Research Center.
34.
Kohut, H. (1985). Self psychology and the humanities. New York: W. W. Norton.
35.
Lamont, M., & Wuthnow, R. (1990). Betwixt and between: Recent cultural sociology in Europe and the United States. In G. Ritzer (Ed.), Frontiers of social theory: The new synthesis (pp. 287-315). New York: Columbia University Press.
36.
Lather, P., & Smithies, C. (1997). Troubling the angels: Women living with HIV/AIDS . Boulder, CO: Westview Press.
37.
Liverpool, J., Alexander, R., Johnson, M., Ebba, K., Ebba, M.D., Francis, S., et al. (2004). Western medicine and traditional healers: Partners in the fight against HIV/AIDS. Journal of the National Medical Association, 96(6), 822-825.
38.
Marshall, M. (1996). Problematizing impairment: Cultural competence in the Carolines. Ethnology, 35(4), 249-263.
39.
Meleis, A.F. (1996). Culturally competent scholarship: Substance and rigor. Advances in NursingScience, 19(2), 1-6.
40.
Miaskowski, C., Dodd, M., West, C., Schumacher, K., Paul, S., Tripathy, D., et al. (2004). Randomized clinical trial of the effectiveness of a self-care intervention to improve cancer pain management. Journal ofClinical Oncology, 22(9), 1713-1720.
41.
Moffitt, P.M. (2004). Colonization: A health determinant for pregnant Dogrib women. Journal of TransculturalNursing, 15(4), 323-330.
42.
Montbriand, M.J. (2005). Herbs or natural products that may cause cancer and harm: Part four of a four-part series. Retrieved July 12, 2005, from http://www.ons.org/publications/journals/ONF/Volume32/Issue1/320132.asp
43.
Mulder, D., Kurland, L., & Iriarte, L.G. (1954). Neurological diseases on the island of Guam. United States Armed Forces Medical Journal, 5, 1724-1739.
44.
Nelson, D.L., McEvoy, C.L., & Schreiber, T.A. (1998). The University of South Florida word association, rhyme, and word fragment norms. Retrieved June 18, 2007, from http://w3.usf.edu/FreeAssociation/
45.
Ogan, C.L. (1992). Communication policy options in an era of rapid technological change. TelecommunicationsPolicy, 16(7), 565-575.
46.
Piscitelli, S.C., Burstein, A.H., Welden, N., Gallicano, K.D., & Falloon, J. (2002). The effect of garlic supplements on the pharmacokinetics of saquinavir. Clinical Infectious Diseases, 34(2), 234-238.
47.
Pitt, D. (1987). Guidelines for undertaking qualitative anthropological research on psychosocial aspects of HIV infection. Prevention and control-report to WHO global programme on AIDS. Applied Anthropology, 103. Available June 2000 from www.who.int
48.
Rabinow, P. (1989). Norms and forms of the social environment. Cambridge, MA: MIT Press.
49.
Saffo, P. (1992). `Paul Saffo and the 30-year rule'. Design World, 24.
50.
Sanchez, P.C. (1989). Guahan/Guam: The history of our island. Agana, Guam: Author.
51.
Sandstrom, K.L. (1990). Confronting deadly disease: The drama of identity construction among gay men with AIDS. Journal of Contemporary Ethnography, 9(3), 271-294.
52.
Sardar, Z. (1998). Postmodernism and the Other: The new imperialism of Western culture. London: Pluto Press.
53.
Silenzio, V. (2003). Anthropological assessment for culturally appropriate interventions targeting men who have sex with men. American Journal of Public Health, 93(6), 867-871.
54.
Stanley, D. (1992). Micronesia handbook. Chico, CA: Moon.
55.
Thompson, L. (1991). Beyond the dream: A search for meaning. Guam: University of Guam Press.
56.
Tuchman, G., & Levine, H.G. (1993). New York Jews and Chinese food: The social construction of an ethnic pattern. Journal of Contemporary Ethnography , 22, 382-407.
57.
Underwood, R.A. (2000). Supreme Court of Guam Kotten Mås Takheló Guåhan . In Pacific Islands Report. Pacific Islands Development Program/East-West Center for Pacific Islands Studies/University of Hawai'i at Manoa.
58.
U.S. Agency for Health Care Policy and Research. (1992). Acute pain management in adults: Operative procedures (Publication no. 92-0019). Rockville, MD: Department of Health and Human Services.
59.
Williams, R. (1977). Marxism and literature. London : Oxford University Press.
60.
Willings, D., & Chamberlin, N.J. (1992). Autonomous imagery: A new approach to meetings. Gifted Education International, 8(1), 10-15.
61.
Workman, A.P., Cruz-Ortiz, L., & Kamindga-Quintata, D. (1994). Use of traditional medicine and healers on Guam. In R. Workman (Ed.), Fauna, flora, folk and medicine: Science of Pacific Island people (pp. 204-219). Suva, Fiji: Institute of Pacific Studies, University of the South Pacific.
62.
Workman, A.P., & Quintata, K. (1996). Epidemiology as labeling: Neurological diseases and stigma on Guam. Isla: A Journal of MicronesianStudies , 4(1), 47-69.
63.
Workman, R.L. (1998). In pursuit of happiness: A study of substance use in Guam. Mangilao: University of Guam.
64.
Wortley, P.M., Metler, R.P., Hu, D.J., & Fleming, P.L. (2000). AIDS among Asians and Pacific Islanders in the United States. American Journal of Preventive Medicine, 18(3), 208-214.
