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HIV and syphilis prevalence in indigenous communities in the Peruvian Amazon: exploring some risk factors
C. Zavaleta1, H. Razuri1, C. Fernandez2, A. Lescano3, E. Bartlett4, S. Vilcarromero1, Y. Valderrama2, K. Konda5, S. Vermund4, E. Gotuzzo1
Background: In 2004, we found a high prevalence of HIV (7.5%) and syphilis (6.3%) in an indigenous community in the Peruvian Amazon. We returned to this area to assess the extent of the HIV epidemic in neighboring and equally vulnerable communities.
Methods: We conducted a cross-sectional study to determine the prevalence of HIV and syphilis and explore associated risk factors. Twenty out of 80, communities in seven river basins in Loreto, Peru were surveyed between 2006-7. After approval from community leaders, local health promoters applied a previously validated questionnaire to inhabitants 15+ years old. Consenting participants provided serum samples and were screened for HIV (immuno-chromatography with Western Blot confirmation) and for syphilis (RPR with TPHA confirmation).
Results: We enrolled 733 individuals, 50.8% male with an mean age of 31.7 years. 677 (92.4%) reported having had sex, with a median initiation age of 15 years. Three people, all men, had HIV (0.4%, 95% CI: 0.1-1.2%) and 13 (8 women and 5 men), had syphilis (1.8%, 95% CI: 1.0-3.0%). Male same-sex behavior was reported by: 28.6% in their lifetime, 6.7% in the last year, and 11.7% at sexual initiation. Men traveled more often than women (89% vs. 74%), more had heard about HIV (68% vs. 46%), more could identify one transmission mechanism (39% vs. 20%), and more knew about condoms (73.3% vs. 39.2%) all p<0.001. Additionally, only 3.5% of the women reported any previous condom use while 29.7% of the men had used it previously (p<0.001). Twenty percent of males had previously served in the Peruvian Army.
Discussion: The HIV prevalence observed is lower than our previous findings, but these communities are not isolated from HIV. MSM behavior and migration may connect these communities with high-risk groups in urban surroundings. Lack of knowledge about HIV and safe sex practices among women increased their vulnerability to HIV/AIDS.
AIDS 2008 – XVII International AIDS Conference
Abstract no. MOPE1079
“C.Zavaleta, et al. HIV and syphilis prevalence in indigenous communities in the Peruvian Amazon: exploring some risk factors. : AIDS 2008 – XVII International AIDS Conference: Abstract no. MOPE1079”