Risky Business: Cultural Conceptions of HIV/AIDS in Indonesia

Piper Crisovan

PhD Thesis 2006

This research examines Indonesian cultural conceptions of HIV/AIDS, including perceptions of “risk.” Two years of fieldwork allowed for an in-depth assessment of three diverse and important populations in Jogjakarta, Indonesia: (1) female sex workers, (2) waria, Indonesia’s third-gender, and (3) university students. Surveys (N=413) and interviews (N=60) were partnered with anthropological participant observation to form a more holistic understanding of the impact and efficacy of available HIV/AIDS education programs. Results suggest that Western notions of “risk” are utilized to define, construct, and fund HIV/AIDS education programs throughout the archipelago. These constructions often fail to adequately consider Indonesian cultural conceptions relating to HIV/AIDS.

This dissertation problematizes notions of “high-risk” groups, as well as “high-risk” behaviors. An anthropological understanding of the nuances of local cultural perceptions around HIV and “risk” helps to illustrate how Western notions of “risk” are incompatible with local Indonesian realities. For instance, fieldwork with Indonesian sex workers illuminates the importance of understanding identity as it applies to perceived “risk.” Islamic ideas of polygyny often create an acceptable “non-risky” identity for sex workers as lesser wives. Information collected from and about Indonesia’s third gender illustrates how cultural categories within the parameters of religious ideologies allows a niche market in which sex with a waria, not being between a man and a woman, is not considered “sex” nor “high-risk.” Interviews with Indonesian university students exemplify how local realities and definitions of “high-risk” sex and “low-risk” monogamy often differ greatly from the definitions assumed by HIV/AIDS prevention and education programs.

HIV/AIDS programs based on Western biomedical and cultural models can create pockets of misinformation and confusion when they fail to fully incorporate critical Indonesian cultural categories, identities, and definitions. Results of this study suggest that more effective HIV/AIDS educational programs in Indonesia would result from recognizing: (a) the multifaceted identities of the people for whom programs are provided; (b) the importance of cultural categories and how they operate within complex state and religious ideologies; and (c) that cultural and programmatic definitions of “risk” are often inconsistent. Understanding Indonesian cultural conceptions allows for a deeper understanding of effective ways to implement culturally sensitive and appropriate HIV/AIDS programs and policies throughout the archipelago.