Connecting gender norms and sexual behavior among Indigienous people of the Peruvian jungle region: Improving HIV/AIDS and STI prevention strategies

ackground: The jungle cities of Peru show some of the highest rates of HIV/AIDS in the nation. In this study gender norms and sexual behavior among the surrounding Indigenous communities are explored to inform future public health interventions and further study in the region. Methods: Subjects were selected by snowball sampling among Indigenous communities near four major Peruvian jungle cities. Interviews were conducted using a rapid ethnographic assessment approach. Ten were selected for secondary analysis. Among these, a grounded theory qualitative approach was used to clarify themes related to gender norms and sexual behavior. Results: Communities have a collective sense of identity and within these communities ‘men' and ‘women' also have collective identities. Adults interact in an economic environment that requires men, primarily, to leave the community to work in regional industries. Men are seen as more empowered to determine particularities of sexual behavior within relationships. Women are considered a source of health knowledge. Youth's sexual behavior is seen as mitigated by adult supervision. Conclusions: HIV/STI Prevention programs seeking to reduce high risk sexual behaviors among indigenous men and women of the Peruvian Amazon region may have greater success with interventions geared toward communities or men and women as respective groups within the community, rather than individual targets. Additionally, structural interventions that provide job opportunities, in or nearby the community, may not only reduce environmental degradation, but will also prevent men from seeking work in logging or mining camps where sex work is rampant, impacting HIV/STI risk within communities.