Mining communities' transient populations can be high risk environments for sexually transmitted infections. Are there particular groups in these communities that are most at risk? If so, how can these groups' sexual behaviour change and how can the population as a whole be protected from infection?

The National Institute for Medical Research, Tanzania, together with the Medical Research Council, UK, looked at sexual behaviour in a small gold mining town in north-western Tanzania to discover who was most at risk of contracting HIV and other sexually transmitted infections. Miners and sex workers are commonly identified as two potentially high risk groups. Miners come for short-term jobs without their wives and families, whilst sex workers visit the town to look for business. Sex workers are often blamed for the spread disease within and between communities.

In such communities it can be difficult to distinguish between sex workers and women receive payment for sex.  A third of the women surveyed who work in the recreation industry, such as bars, hotels, restaurants and dance halls, said they had been paid for sex in the week before the survey. Almost half of all women surveyed in the recreation industry were HIV positive.

Paying for sex and having more than one partner is normal behaviour amongst many men in the mining community. To exacerbate the problem, the majority of men do not use condoms for paid sex. Subsequently, women who are faithful to their husbands are still at risk of HIV if they have an unfaithful husband.

The study found that:

• It is difficult to distinguish between people who are at high risk and those at low risk. However certain places are linked with higher levels of sexual activity, for example, bars, discos and video evenings.
• ‘Modern’ values were important in the town surveyed. The townspeople valued brand-name clothes and looked down on rural traders who were poor and uneducated.
• The town is seen as a place of opportunity and wealth. Sex workers are attracted to the town as a source of income, while men were attracted to the greater freedom the town has to offer.

Gold mining towns are high sexual health risk environments for all residents and visitors. Their relative wealth attracts large flows of people. This can make prevention and management more difficult. The study recommends that:

• Health education should be presented in ways that are considered modern and popular, such as through video shows, music and theatre.
• Miners should be prioritised for health education, for example, on the need for condoms. These men are held in high esteem by the town and are likely to be opinion leaders.
• In addition, health programmes should target certain groups, for example, the technical advisors at the mine, unemployed girls who live together and are more likely to sell sex, and young people at discos and video shows.
• Low cost housing schemes could be set up so miners can bring their families with them.
• The income inequalities between the town and the surrounding areas should be lessened by creating jobs in rural areas.

Source(s):
‘A typology of groups at risk of HIV/STI in a gold mining town in north-western Tanzania’, Social Science and Medicine 60(8): 1739-1749, by Nicola Desmond et al, 2005
HINARI subscribers can access the full-text article here. Full document.

Funded by: Kahama Mining Corporation Limited

id21 Research Highlight: 8 December 2005

Further Information:
Nicola Desmond
National Institute for Medical Research
NIMR/AMREF/LSHTM Collaborative Projects
PO Box 11936, Mwanza
Tanzania

Contact the contributor: nic_desmond@hotmail.com

National Institute for Medical Research (NIMR), Tanzania

Medical Research Council, UK

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