Papua New Guinea (PNG) is in a phase of scaling up access to antiretroviral therapy (ART), and adherence to the newly available drug therapy is becoming an important issue. This paper examines adherence to ART in a sample of 374 HIV-positive people in six provinces in PNG. Participants were recruited to the study using non-probability sampling. Sixty-two % of participants reported complete adherence (no missed or late doses in the past week) and 79% reported not missing any doses in the last week. Revival church members were significantly more likely to report having missing a treatment dose(s) (66%). Those living in the Highlands and those attending Catholic health clinics were significantly more likely to be adherent to their treatment. Age, gender, marital status, education level and employment type did not show significant association with treatment adherence. Adherence rates in PNG are not alarming, indicating that people with HIV can adhere to treatment despite the challenges of living in PNG.
Sexual violence against women and girls is commonplace in Papua New Guinea (PNG). While the experiences of women are rightly given central place in institutional responses to sexual violence, the men who perpetrate violence are often overlooked, an oversight that undermines the effectiveness of prevention efforts. This paper draws on interviews conducted with young men as part of a qualitative longitudinal study of masculinity and male sexuality in a rural highland area of PNG. It explores one aspect of male sexuality: men's narratives of sexual violence. Most striking from the data is that the collective enactment of sexual violence against women and girls is reported as an everyday and accepted practice amongst young men. However, not all women and girls were described as equally at risk, with those who transgress gender roles and roles inscribed and reinforced by patriarchal structures, at greater risk. To address this situation, efforts to reduce sexual violence against women and girls require an increased focus on male-centred intervention to critically engage with the forms of patriarchal authority that give license to sexual violence. Understanding the perceptions and experiences of men as perpetrators of sexual violence is a critical first step in the process of changing normative perceptions of gender, a task crucial to reducing sexual violence in countries such as PNG.
This paper presents findings from a qualitative study carried out in three secondary schools in Eastern Highlands Province, Papua New Guinea (PNG). Seventy-three Year 12 students took part in eight gender-specific focus group discussions (three female and five male). Irrespective of gender, respondents predominately understood sex as being for the sole purpose of reproduction within marriage. When discussing sex and sexual relationships, young men used explicit language and referred specifically to sexual organs and activities. Young women did not. Less concerned for privacy, young men talked in public spaces and in groups with same-sex peers about sex and sexual expression, whereas young women discussed such matters one-on-one and in private. These gender differences provide useful entry points for developing appropriate sex and HIV education programmes involving young people in PNG.
To map the context of HIV in closed settings in Papua New Guinea (PNG), semi-structured interviews were undertaken with 56 prisoners and detainees and 60 key stakeholders. The nature of HIV-related risk differs for detained women and men, and reflects important gender-based issues present in PNG society more broadly. Women in detention are vulnerable to sexual violence and exploitation and at greatest risk of HIV while detained in police holding cells, where they are typically supervised by male officers, in contrast to prisons, where they have little contact with male staff. HIV risk for men in prison is associated with consensual and non-consensual sex; this risk is perpetuated by a pervasive culture of denial and institutionalised homophobia. The illegal nature of sodomy and male-to-male sex provides Correctional Services the legal grounds by which to refuse access to condoms for prisoners. Addressing HIV risk among detained men and women in PNG requires the reform of legislation, police and prison practices and an understanding of broader structural problems of gender-based violence and stigma and discrimination.
This paper examines condom use in intimate relationships amongst Papua New Guineans on antiretroviral therapy (ART). These findings are from a mixed-method study in six provinces throughout Papua New Guinea (PNG). A total of 374 HIV-positive adult Papua New Guineans, over the age of 16 and on ART for more than two weeks were recruited using a non-probability, convenience sampling methodology. Participants were recruited through ART prescribing sites, People Living with HIV/AIDS (PLWHA) drop-in clinics and support groups. A small number (36) also participated in in-depth interviews. Of the sample 226 (60.4%) were women and 148 (39.6%) were men. The majority of the sample was aged below 40 years, with a median age of 30 years. Of the sample who were in a regular relationship 64.7% identified themselves as being in a relationship where both they and their partner were HIV-positive (seroconcordant). Smaller proportions (21.0%) reported being in a relationship with a HIV-negative partner (serodiscordant), or in a relationship where they were not aware of their partner's HIV status (14.3%). The majority of participants who reported having a regular partner also reported having disclosed their HIV serostatus to their partner (91.8%). A significantly greater proportion of participants who reported being in relationships where they did not know the status of their partner, also reported living in the Southern Region of PNG (52.9%), while the majority of those in seroconcordant relationships lived in the Highlands Region (71.2%). There did not appear to be any differences in sexual practice of using condoms between the three groups. Knowledge of serostatus is important for "positive prevention".
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