Industrial mining and HIV risk: evidence from 39 mine openings across 16 countries in sub-Saharan Africa

Abstract

Objectives: The aim of this study was to assess the impact of natural resource extraction projects on HIV transmission risks in local communities in sub-Saharan Africa.

Design: Difference-in-differences design using repeated cross-sectional data from around newly opened mines.

Methods: We combined data on mine openings with HIV data from the Demographic and Health Surveys (DHS). Using logistic regression models, we compared HIV-related indicators between mining (i.e. up to 10 km distance from the mine) and comparison (i.e. 10-50 km) areas before and after mine opening to identify their impact on HIV prevalence, sexual behavior and HIV knowledge.

Results: A total of 33 086 individuals across 39 mine openings were analyzed. Adjusting for baseline differences and temporal trends in the study regions, mine opening increased the odds of HIV infection almost two-fold [odds ratio (OR): 1.93, 95% confidence interval (CI): 1.19-3.14]. Strongest effects were seen in high-prevalence countries and in the 20-29 years age group. In mining communities around operational mines, there was a tendency towards lower HIV knowledge (OR: 0.81, 95% CI: 0.63-1.04). New mine openings increased the odds of risky sexual behaviors, such as having multiple sex partners (OR: 1.61, 95% CI: 1.02-2.55), high-risk sexual partners (OR: 1.45, 95% CI: 1.03-2.05) and unprotected sex with high-risk partners (OR: 1.77, 95% CI: 1.18-2.67).

Conclusion: The findings suggest that in our sample of households surrounding industrial mines, HIV infection risks substantially increase upon mine opening. Existing strategies for addressing mining-related risks for HIV transmission seem to be insufficient. Further efforts for mitigating and monitoring impacts of mines are needed.

Fig. 1

Flow chart showing the selection of Demographic and Health Surveys data around mining sites.

Fig. 2

Left: location of industrial mines and study countries included in the final dataset. Right: visualization of mining and comparison areas around a selected mine. Source basemap: Esri, Maxar, GeoEye, Earthstar Geographics, CNES/Airbus DS, USDA, USGS, AeroGRID, IGN, and the GIS User Community.

Fig. 3

Stratified analyses for the impact of mine openings on HIV status, HIV knowledge, and risky sexual behaviors. The crude odds ratio for the interaction effect of proximity to a mine (<10 vs. 10–50 km) and mining activity (operational vs. premining phase) together with their 95% confidence intervals are shown on the log-scale. Results are stratified for country HIV prevalence, sex, and age group.