HIV and Syphilis in an indigenous community of Colombia: results of an intervention study

Rojas, Carlos

INTRODUCTION: Human Immunodeficiency Virus infection (HIV) is increasingly impacting Indigenous peoples in the Americas. This has been documented in Canada, The United States and Mexico. In Colombia, with an Indigenous population of 1.5 million (3.4% of the country’s population), the magnitude of the problem is unknown. Poverty, forced displacement, social and health inequities place Indigenous communities at increased risk of HIV and sexually transmitted infections (STIs). The objectives of this study were to estimate the prevalence of HIV and Syphilis in an Indigenous community in Antioquia, Colombia, and evaluate the effect of an educational intervention on the level of knowledge about these diseases.

METHODS: at baseline a cross-sectional study was conducted in a random sample of 295 community members between the ages of 15 and 49 years. We administered rapid tests for HIV and Syphilis and a validated questionnaire about sexuality, risk behaviors and knowledge about HIV. A multifaceted community-based educational intervention was delivered during one year targeting different groups of the community. There was no control group. At the end of the intervention a second survey with rapid testing was conducted. The project received approval by community leadership and a research ethics board.

RESULTS: three cases of HIV were found, which corresponds to a prevalence of 1.07% (95% CI: 0.21-2.94). All new cases were women. The majority of sampled individuals had heard of HIV or AIDS but their level of knowledge about the mechanisms of virus transmission varied substantially. The level of knowledge increased significantly (p < 0.01) for most of the questions. There were not incident cases.

CONCLUSIONS: this study provided evidence that HIV has affected a medium sized Colombian Indigenous community, thus suggesting the potential for a broader problem among other Indigenous communities in Colombia. In this community, women were disproportionally more affected than men.