Structural Factors That Increase HIV/STI Vulnerability Among Indigenous People in the Peruvian Amazon

We examined structural factors—social, political, economic, and environmental—that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villag...

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Bibliographic Details
Published in:Qualitative health research 2013-09, Vol.23 (9), p.1240-1250
Main Authors: Orellana, E. Roberto, Alva, Isaac E., Cárcamo, Cesar P., García, Patricia J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Alcoholic Intoxication - complications
Alcoholic Intoxication - ethnology
Amazon Basin
Coitus
Female
Gender Identity
Health
Health Knowledge, Attitudes, Practice
HIV
HIV Infections - ethnology
HIV Infections - transmission
Homosexuality
Human immunodeficiency virus
Humans
Indigenous people
Male
Minority & ethnic groups
Peru
Politics
Population Groups - ethnology
Risk Factors
Rivers
Sex Work - ethnology
Sexual behavior
Sexually Transmitted Diseases - ethnology
Sexually Transmitted Diseases - transmission
Social Environment
Social Marginalization
Socioeconomic Factors
Unsafe Sex - ethnology
Vulnerability
Young Adult
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Summary:We examined structural factors—social, political, economic, and environmental—that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villages. Qualitative data revealed a complex set of structural factors that give rise to environments of risk where health is constantly challenged. Ferryboats that cross Amazonian rivers are settings where unprotected sex—including transactional sex between passengers and boat crew and commercial sex work—often take place. Population mobility and mixing also occurs in settings like the river docks, mining sites, and other resource extraction camps, where heavy drinking and unprotected sex work are common. Multilevel, combination prevention strategies that integrate empirically based interventions with indigenous knowledge are urgently needed, not only to reduce vulnerability to HIV transmission, but also to eliminate the structural determinants of indigenous people’s health.
ISSN:1049-7323
1552-7557
DOI:10.1177/1049732313502129