Perspectives on sexual and reproductive health among women in an ancient mining area in Brazil

Abstract

The purpose of this study was to describe the reproductive profile and frequency of genital infections among women living in the Serra Pelada, a former mining village in the Pará state, Brazil. A descriptive study of women living in the mining area of Serra Pelada was performed in 2004 through interviews that gathered demographics and clinical data, and assessed risk behaviors of 209 randomly-selected women. Blood samples were collected for rapid assay for HIV; specimens were taken for Pap smears and Gram stains. Standard descriptive statistical analyses were performed and prevalence was calculated to reflect the relative frequency of each disease. Of the 209 participants, the median age was 38 years, with almost 70% having less than four years of education and 77% having no income or under 1.9 times the minimum wage of Brazil. About 30% did not have access to health care services during the preceding year. Risk behaviors included: alcohol abuse, 24.4%; illicit drug abuse, 4.3%; being a sex worker, 15.8%; and domestic violence, 17.7%. Abnormal Pap smear was found in 8.6%. Prevalence rates of infection were: HIV, 1.9%; trichomoniasis, 2.9%; bacterial vaginosis, 18.7%; candidiasis, 5.7%; Chlamydial-related cytological changes, 3.3%; and HPV-related cytological changes, 3.8%. Women living in this mining area in Brazil are economically and socially vulnerable to health problems. It is important to point out the importance of concomitant broader strategies that include reducing poverty and empowering women to make improvements regarding their health.

What is known about sexual and reproductive health in Latin American and Caribbean mining contexts? A systematic scoping review

“…HIV was significantly associated with history of syphilis and not having used condom with last casual sex partner. Miranda et al (2009) [ 39 ] Brazil, Pará (AR) Gold ASM a Describe the reproductive profile of and prevalence of STDs among women living in a former mining village Women attending to a local health facility ( n = 209) Prevalence of HIV = 1.9%, gonorrhea = 2.4%, and HPV = 3.8%. History of previous STDs = 11%, having been involved in prostitution = 15.8%, domestic violence reported = 17.7%, having been raped = 10%, and having had an abortion = 29.2%.…”

“…The 11 studies reviewed, conducted between 1995 and 2016 [ 36 – 46 ], were set in gold-mining contexts in South American countries, nine in Amazon areas. One study was set in a period previous to a mining exploitation phase [ 37 ] and one in a period of mining decline [ 39 ]. The other nine were set in periods of full mining operations.…”

“…However, the study by Astete et al [ 37 ] considered temporality and provided a baseline in a pre-exploitation period to evaluate the health impacts of mining during the subsequent phases. Three studies sampled mostly or exclusively male miners [ 41 , 43 , 44 ], one included only women [ 39 ] and one focused on indigenous population [ 40 ]. The rest of the studies were sampled from the general population.…”

“…For most of the studies reviewed, the construct mining referred either to the setting that delimits the location of research (the mining community, the mining camp) or an individual sociodemographic variable (the mineworker occupation). Astete et al [ 37 ] and Miranda et al [ 39 ] also considered the stage of mining production in their research approach, suggesting differential effects of the time of mining on SRH. Nevertheless, only Orellana et al [ 40 ] explored and reflected on mining and other resource-extraction activities as contextual factors that interact with others to determine a “risk environment” for the spread of HIV/STDs.…”

How does the mining industry contribute to sexual and reproductive health in developing countries? A narrative synthesis of current evidence to inform practice

“…Sexual and reproductive health risk factors for women living in communities near mining sites include alcohol and illicit drug use, sex work, domestic violence and poor access to health facilities. These factors are associated with an increase in the prevalence of STIs and HPV-related cytological changes on cervical smears (Clift et al 2003, Miranda et al 2009, Silitonga et al 2011.…”