Your health is worth gold: prevalence and vulnerabilities to HIV and sexually transmitted infections and male profiles among gold mining workers in the Tapajós River Basin, Amazon Region, Brazil

Abstract

HIV/aids infection in Brazil is characterized as a concentrated epidemic. In so-called key populations, such as men who have sex with other men, female sex workers, and drug users, HIV prevalence is over 5%. However, in certain population subgroups, considered as bridge populations, since they relate to the most vulnerable populations, HIV prevalence is unknown. This group includes hard-to-reach populations such as miners, as they have specific and still poorly characterized vulnerabilities that may increase risk of HIV acquisition and/or HIV disease progression and of acquiring other STIs. Second-generation surveillance epidemiological studies, conducted combining quantitative surveys with qualitative analyses are useful to assess particular aspects of the infection dynamics in hard-to-reach populations in combination with sero-surveys that estimate the prevalence of these conditions. This study aims to determine the prevalence of HIV infection, syphilis, hepatitis B and C and risk factors for metabolic diseases in gold mining sites in the largest of gold extraction area in Brazil and to identify vulnerabilities associated with STIs in this context. In addition, we aim to characterize masculinity profiles in this population that may be associated with increased vulnerability to HIV acquisition and disease progression. The study will be conducted in the municipalities of Santarém, Itaituba and Novo Progresso, located in the southwestern region of Pará state. Initially, quantitative and qualitative formative research will be carried out to support characterization of masculinity profiles. Subsequently, a serosurvey will be conducted using the Respondent Driven Sampling method, in which the subjects will be tested for HIV, syphilis, hepatits B and C and will answer a questionnaire about sociodemographic and behavioral feature related to beliefs, attitudes and practices associated with exposure to HIV and other STIs. We expect the study to estimate the prevalence of HIV infection, and other STIs in this hidden population and to identify behaviors, practices and masculinity profiles that may be associated with enhanced individual, social and programmatic vulnerability to the HIV acquisition and disease progression in this hard-to-reach population. (AU)