@article{fdi:010086081,
  title = {{W}hat can lead to late diagnosis of {HIV} in an illegal gold mining environment ? : a qualitative study at the {F}rench {G}uiana's border with {B}razil},
  author = {{F}loersheim, {C}harlotte and {M}usso, {S}. and {E}ubanks, {A}. and {D}ouine, {M}. and {S}pire, {B}. and {S}agaon {T}eyssier, {L}uis and {P}arriault, {M}. {C}. and {G}irard, {G}. and {M}osnier, {E}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective {T}he present study aimed to understand what factors can lead to late {HIV} diagnosis of illegal gold miners at {F}rench {G}uiana's border with {B}razil. {D}esign {A}n exploratory qualitative study with in-depth interviews and observations was conducted between {N}ovember 2019 and {F}ebruary 2020. {S}etting {T}he study was conducted in the main medical healthcare service and two non-governmental organisation premises in the {O}yapock border region, which is a supply area for illegal gold mining sites. {P}articipants {F}ifteen people living with {HIV} diagnosed with {CD}4 count <350 cells 10(6)/{L} were interviewed. {S}even women and eight men participated; they were between 31 and 79 years old, and the median time since {HIV} diagnosis was 6 years. {E}ight had links to illegal gold mining. {F}indings {T}hree key themes for late {HIV} diagnosis emerged: (1) the presence of economic and political structural factors which constitute risks for this illegal activity, specifically the repression of gold mining sites by {F}rench {A}rmed {F}orces and the distance from healthcare facilities; (2) representations of the body and health, related to the living conditions of this population; prioritisation of health emergencies and long-term self-medication; and (3) gender roles shaping masculinity and heterosexuality contributing to a perception of not being at risk of {HIV} and delaying testing. {C}onclusion {T}his study highlights structural, group-based and individual factors that reduce access to {HIV} testing and healthcare in general for a population of migrant workers in an illegal gold mining area. {F}aced with harsh living conditions and state repression, these workers develop a vision of health which prioritises the functionality of the body. {A}ssociated with gender roles which are partly shaped both by the mining activity and its geographical location, this vision can lead to late {HIV} diagnosis.},
  keywords = {{HIV} & {AIDS} ; {P}ublic health ; {E}pidemiology ; {GUYANE} {FRANCAISE}},
  booktitle = {},
  journal = {{BMJ} {O}pen},
  volume = {12},
  numero = {9},
  pages = {e061237 [9 ]},
  ISSN = {2044-6055},
  year = {2022},
  DOI = {10.1136/bmjopen-2022-061237},
  URL = {https://www.documentation.ird.fr/hor/fdi:010086081},
}