Shifting meanings of HIV among Mapuche people in Chile: transmission, diagnosis and treatment narratives.

Abstract

This article explores processes of meaning-making following an HIV diagnosis among Mapuche Indigenous people in Chile, focusing on how understandings of diagnosis, transmission and treatment evolve over time. Drawing on data from qualitative interviews with Mapuche individuals from urban and rural areas in two key regions, the study examines how sexuality, gender and ethnicity intersect to shape these shifting meanings. Key findings underscore the role of medical pluralism, in which biomedical and traditional Mapuche healing practices converge in participants' conceptualisations of HIV. The article emphasises the role of stigma in shaping risk perceptions, delaying diagnosis and complicating treatment engagement. It demonstrates that stigma fosters a distancing from HIV, leading to an underestimation of risk and delayed diagnosis - particularly among women. The study argues that HIV should not be understood as a static public health issue in Indigenous contexts but as a fluid experience shaped by individuals' lived realities. It advocates for research and policy that recognise the dynamism of HIV-related meanings, centre Indigenous perspectives and reduce stigma while improving access to medical and emotional support.