Unregulated small-scale mining activities (galamsey) not only degrade the forests, pollute farmlands and river bodies with heavy metals and contribute to fatal health problems, but the activities also provide a conducive environment facilitating the spread of HIV at an alarming rate. According to research conducted by the Swiss Tropical and Public Health Institute, any time a mining operation is setup in a community in Sub-Saharan Africa including Ghana, the community’s HIV cases doubled afterwards. Which means that the local population living in the community becomes twice as likely to be HIV positive as before the mine opened. Mining operations also increase the likelihood of multiple sex partners by 70%, high-risk sex partners by 30%, and sex without a condom by 70%. In addition, 20% of the people living in mining communities have less knowledge about HIV than people living in non-mining areas. These findings suggest that mining activities significantly increase the risk of HIV among local populations. Consistently, data from the national HIV surveillance reports have revealed that regions such as Ahafo, Ashanti, Bono, Bono East, Eastern, Greater Accra, Western, and Western North have had their HIV prevalence higher than the rest of the regions or greater than the national prevalence. According to the 2020 National HIV prevalence report, Ashanti Region recorded the highest number of people living with HIV and also the region with the highest number of HIV new infections. Bono East recorded the highest HIV prevalence with the lowest prevalence occurring in the Northern Region and North East. Interestingly, these eight regions (mentioned above) with the highest number of HIV cases in Ghana are also hotspots for mining activities including galamsey. The Northern Regions, including Upper East and Upper West have consistently recorded the lowest prevalence of HIV over the years, however, HIV cases are gradually increasing amidst the springing-up of new mines. Currently, no extensive research has been carried out in Ghana to explore the contextual links between mining activities in the communities and HIV infections to better inform policy and appropriate interventions. According to the Ghana Aids Commission´s National Strategic Plan 2021-2025 final report, miners are considered vulnerable groups and one of the priority populations that need to be reached with HIV interventions. But the present working conditions and risky behaviour of unregulated miners are very much conducive for the transmission of new HIV infections and therefore require more urgent attention.
We have overly talked about mining activities whether legal or illegal in this country but we seem grossly oblivious of the realities regarding the public health repercussions of unregulated mining activities that are bedevilling the communities and the country as a whole. Unregulated mining sites in the communities are now like camps where jobless people, mostly the youth, work for their masters on a daily basis to make a living. Most of the people come from the various regions, including foreigners from neighbouring countries and live in the mining camps where they work for months. Some move from regions with high prevalence of HIV to these camps. Furthermore, some of the people come to the mining camps living separately from their wives or partners. Also, the abuse of drugs such as tramadol is very common in these camps. Indiscriminate sexual activities and transactional sex practices are rampant in the camps. The camps are also fertile grounds for the activities of commercial sex workers. In addition to the dangers posed by the working conditions of the mines, the social conditions and interactions in the camps make the miners vulnerable to high risk sexual partners, multiple sex partners and risky sexual behaviours. Thus the host communities of these mining camps become the recipient of the consequences of these risky social and sexual behaviours.
So far, tremendous efforts have been achieved in the fight against HIV but its elimination agenda is being threatened. we cannot afford to backslide to pay a hefty price later. As we conclude the year with the festivities, here are some reminders of the behaviours and conditions that put people at greater risk of contracting HIV:
1. studies have shown that a lot of people get HIV through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment. Without using condoms or taking medicines such as Antiretroviral therapy (ART) to prevent HIV, anal sex is the most risky type of sex that leads to contracting HIV. You are also at higher risk of contracting HIV and other infections such as hepatitis B and C if you share needles, syringes and other injection equipment with a person who is infected with HIV.
2. if you have tested positive for a sexually transmitted disease such as gonorrhoea, chlamydia, syphilis, herpes and bacterial vaginosis then get another test for HIV because your risk of contracting HIV is high and you need to check your behaviour.
3. the most common way children contract HIV is through mother-to-child transmission. During pregnancy, birth and breastfeeding a baby can get infected by the mother. However, this can be prevented through early detection and taking of HIV medicines.
4. oral sex presents little to no risk of contracting HIV. But when body fluids such as semen come into contact with oral ulcers, genital sores, and bleeding gums there can be a risk of transmission of HIV. Note that oral sex can lead to the transmission of other sexually transmitted diseases.
5. at the workplace injury with a contaminated needle or sharp object can lead to the transmission of HIV. So take immediate action in such an injury situation to get a Post-Exposure Prophylaxis (PEP) if necessary. PEP is also known as emergency HIV medicine.
Note that the only way to determine your HIV status is by testing. The sooner you know your HIV status the better. Knowing your HIV status helps you to make informed decisions to stay safe, healthy and protect your partners. HIV Self-testing is now available and can enhance your preventive measures and facilitate access to early ART treatment towards suppressed viral load and healthy life.
Dietler D et al. Industrial mining and HIV risk: evidence from 39 mine openings across 16 countries in sub-Saharan Africa. AIDS 36: 1573-1581, 2022 (open access).