Abstract

HIV outreach among Amazonian indigenous migrants living in Lima-Peru

I. Alva^1,2, M. Blas^1,2, R. Orellana³, C. Medrano², E. Hurley⁴, J.C. Bartolo², C. Zavaleta⁵, N. Cueva⁵, J. Reategui⁶, S. Santos², R. Cabello<sup>2

1</sup>Universidad Peruana Cayetano Heredia, School of Public Health, Lima, Peru, ²Via Libre, Lima, Peru, ³Portland State University, Portland, United States, ⁴University of Washington, Seatlle, United States, ⁵Centro Nacional de Salud Intercultural, Lima, Peru, ⁶Asociación Interétnica de Desarrollo de la Selva Peruana, Lima, Peru

Issues: Most residents of Lima, the capital of Peru, are migrants from other parts of the country. Many migrate from or pass through Amazonian cities with HIV prevalences higher than the national average. While there are a few programs focusing on HIV prevention with indigenous people in their communities of origin, there currently exist no programs focused on HIV/STI prevention among Amazonian indigenous populations living in Lima.
Description: From 2008-2009, we identified approximately 200 Amazonian indigenous migrants in Lima. We approached gay and heterosexual males to offer them HIV testing, condoms and HIV/STI information. We also contacted traditional midwives, healers, college students, and community leaders to interview them about their knowledge and perceptions of HIV.
Lessons learned:
1) Interdisciplinary work with their closest health providers from the Ministry of Health and with their local and national indigenous leaders favored the success of our field work activities
2) The majority of Amazonian indigenous migrants we identified in Lima belonged to the Shipibo-Konibo and Awajun ethnic groups. These populations need customized approaches according to their cultural beliefs and migration patterns.
3) Understanding the interests and experiences of Amazonian migrants, involving local and national indigenous leaders and collaborating with Ministry of Health providers is critical for the design and acceptance of health intervention with this population
4) Culturally appropriate approaches for HIV-prevention among indigenous peoples are needed not only in rural but also in urban settings.
Next steps: We plan to expand beyond HIV services, implementing STI prevention and testing for other more frequent infections including human papilloma virus, hepatitis B and genital herpes; and beyond Lima to other coastal cities with sizable populations of indigenous migrants. Furthermore, more advocacy is needed to improve access to health care and other social services in neglected migrant populations.