A case of chronic survivance: Decolonizing the epidemiology of HIV

This paper argues that integrating Native American art, tradition, and healing practices into public health offers an effective intervention for revitalizing conventional sexual health strategies within Native American and Two-Spirit communities. To illustrate, the paper conducts a comprehensive analysis of various practices employed by Sheldon Raymore, a Two-Spirit artist and storyteller from the Cheyenne River Sioux nation, including performance, tipi-making, and beading. To bridge the gap between care methodologies in settler clinics, focused on behavior change and biomedicine, and Native American healing practices rooted in tradition and ceremony, the paper introduces a conceptual framework termed “chronic survivance.” This framework merges Western epidemiological terminology with the Indigenous concept of “survivance,” coined by Anishinaabe cultural theorist Gerald Vizenor, which emphasizes themes of Indigenous survival and resistance amidst ongoing adversity. By employing this framework, the paper challenges the conventional understanding of HIV epidemiology, proposing that chronicity involves a complex interplay of discursive, cultural, and biopolitical practices, thus amenable to decolonization. Chronic survivance emerges as a tool for reimagining Indigenous well-being, bridging disparate traditions, and sustaining the enduring essence of Indigeneity amidst the persistence of U.S. settler colonialism.