This study examines in the use of traditional heating in the care and treatment of people living with HIV/AIDS, and the rituatju:ed management of the emotional, psychological and spiritual effects of HIV infection. In particular, this dissertation research seeks to understand, through an examination of traditional heating in Shona society, how the purposeful enhancement of the therapeutic process with highly charged symbols and ritualized communication transforms the embodied experience of HIV infection and the cultural performance of dying. Given that traditional healers provide the majority of care and treatment for HIV infection in rural Zimbabwe, how they represent HIV within therapeutic consultations directly affects personal meanings and interpretations of the embodied experience of HIV infection. Therefore, it is important to consider how understanding the socially and culturally constructed causality of disease that transforms the meaning of illness. This question will be explored through a textual analysis of the performance of the Shona therapeutic process. The following propositions will be examined: (1) The ritual language of traditional healing will reveal a) the psychological and social dimensions of health and healing, b) the integration of the body, mind and spirit in the experience of illness, and c) the configuration of the person, self and society through therapeutic language; (2) The ritual language of traditional healing performatively reconfigure the interpretations and meaning of HIV infection today by using cultural beliefs about disease and dying inherited from a circumscribed past; (3) Through ritual language, traditional heaters, their assistants, and patients create a holistic understanding of the misfortune of HIV infection that affect the subjective meaning and everyday lived experience of HIV infection for the afflicted: Data will include the following six components: (1) a preliminary rapid health assessment; (2) an ethnographic study of all the performances of healing (healer, patient and interpreter) within the Shona therapeutic process; (3) post- performance evaluation; (4) retrospective illness narrative; (5) longitudinal examination of therapeutic outcome; and (6) volunteered HIV testing. The research design involves three group comparisons. The primary comparison will be between the spirit mediums (Group 1) and the diviners (Group 2) to assess the ethnomedical explanatory models of HIV infection and identify the different performative strategies employed by each diagnostic modality. The second level of comparison will be between the traditional care group (Group 3) and the biomedical care group (group 4) to explore the effects of ritual healing on the quality of life with HIV infection. The third level of comparison is between the spirit mediums' interpreters (Group 5), diviners (Group 2) and spirit mediums (Group 1) to determine how the reported speech of the ancestors is adjusted or altered the process of translation.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Small Research Grants (R03)
Project #
1R03MH062250-01
Application #
6211599
Study Section
Special Emphasis Panel (ZMH1-CRB-M (07))
Program Officer
Weise, Richard E
Project Start
2000-09-30
Project End
2002-08-31
Budget Start
2000-09-30
Budget End
2002-08-31
Support Year
1
Fiscal Year
2000
Total Cost
$31,500
Indirect Cost
Name
University of Pennsylvania
Department
Social Sciences
Type
Schools of Arts and Sciences
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Taylor, Tonya N; Dolezal, Curtis; Tross, Susan et al. (2009) Reliability and validity of two HIV/AIDS-specific quality of life instruments adapted for use in HIV-positive Zimbabweans. AIDS Care 21:598-607
Taylor, Tonya N; Dolezal, Curtis; Tross, Susan et al. (2008) Comparison of HIV/AIDS-specific quality of life change in Zimbabwean patients at western medicine versus traditional African medicine care sites. J Acquir Immune Defic Syndr 49:552-6