Abstract

Knowledge and perceptions of HIV and STIs among Amazonian indigenous health students in Peru

E. Hurley¹, I. Alva^2,3, M.A. Mercer⁴, R. Orellana^5,6, J. Reategui⁷, B. da Costa Thome<sup>1

1</sup>University of Washington, Health Services, Seattle, United States, ²Universidad Peruana Cayetano Heredia, Lima, Peru, ³Via Libre, Lima, Peru, ⁴University of Washington, Global Health, Seattle, United States, ⁵Portland State, Portland, United States, ⁶Columbia University, New York, United States, ⁷Asociacion Interetnica de Desarrollo de la Selva Peruana, Lima, Peru

Background: Elevated rates of HIV and STIs have been reported in the Peruvian Amazon; indigenous populations have not been exempt. This study aimed to increase understanding of indigenous health students' insights about HIV and STIs in their communities. Indigenous health students were chosen as key informants due to their familiarity with both indigenous culture and western medicine. Their views are significant as they are the future health care providers of the Amazon.
Methods: In June and July of 2009, we conducted 18 semi-structured interviews with a purposive sample of indigenous health students from six Amazonian ethnic groups (Achuar, Awajun, Quechua-Lamista, Murui, Shipibo-Konibo, and Wampis) in four cities in Peru. Participants were current or recent students of medicine, nursing and pharmacy. Participants from these diverse geographic, cultural, and educational backgrounds were asked about their knowledge and perceptions of HIV and STIs in their communities. Interviews were transcribed and ATLAS.ti was used to conduct a conventional content analysis.
Results: We found:
1) indigenous populations lack education, outreach and care for HIV and STIs;
2) many indigenous people seek traditional medicine for treatment of HIV and STIs;
3) indigenous health workers conduct HIV and STI outreach more effectively than non-indigenous health workers;
4) indigenous students face barriers to accessing education in health related fields;
5) health posts in indigenous communities are understaffed;
however, most indigenous health students plan to return to their community's closest health post to practice. Participants recommended strengthening health systems in the Amazon; developing culturally competent, multi-lingual health outreach programs; supporting shamans and traditional medicine; and enhancing the capacity of indigenous people to study and work in health fields.
Conclusions: This study gives voice to indigenous health students of the Peruvian Amazon and illustrates the need to address their recommendations, as well as, provide opportunities for indigenous people to pursue careers in health.
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