Co-Infections in Mining Communities - Integrated STI Surveillance Reveals Public Health Priorities
1
Key Populations: Health Systems Division, The Aurum Institute, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A616
ABSTRACT
INTRODUCTION:
The social and living conditions of mineworkers contribute to rapid transmission of HIV/AIDS and STIs, namely syphilis, hepatitis B, and hepatitis C.¹ The triple burden of syphilis, hepatitis B, and hepatitis C are public health crises due to clinical complications that arise when these infections are untreated.¹,² Peri-mining communities frequently face significant challenges in accessing healthcare services, including STI testing, treatment, and preventative interventions.¹,³
METHODS:
The study surveyed 1634 adults aged 18 years and older living in communities surrounding platinum mines in the North West Province. Participants completed structured interviews and provided blood specimens for laboratory testing. Participants were tested for HIV (enzyme immunoassay with viral load for positive results), syphilis (RPR/TPHA algorithm), hepatitis B (HBsAg), and hepatitis C (antibody/antigen testing). Prevalence estimates by age group and sex were calculated using appropriate survey weights, with all findings reported with 95% confidence intervals.
RESULTS:
Multi-pathogen surveillance revealed distinct epidemiological patterns. HIV prevalence was 23.8% (95% CI: 20.2–27.9), exceeding national averages.⁴ Syphilis prevalence reached 2.3% (95% CI: 1.3–3.9), with peak burden among those aged 31–40 years (4.1%; 95% CI: 1.5–10.7), women (3.0%; 95% CI: 1.4–6.5), and individuals in relationships (4.0%; 95% CI: 1.1–13.2). HBV affected 0.8% of participants (n=13), while HCV prevalence was 0.2% (n=5). The STI age distribution differed from HIV: syphilis peaked in younger adults (31–40 years) compared to a peak in older groups (51–59 years, 38.5%). Educational disparities persisted across pathogens, with those having primary education or less showing elevated syphilis (3.0%) and HIV (32.7%) prevalence.²
CONCLUSIONS:
These findings strongly support one-stop testing services covering HIV and STIs, with immediate treatment for treatable infections.⁵ Different age groups face different risks requiring tailored interventions. Integrated sexual health services with strengthened syphilis control efforts, especially among people already living with HIV, are necessary to reduce the compounding effects of co-infection.⁵
The social and living conditions of mineworkers contribute to rapid transmission of HIV/AIDS and STIs, namely syphilis, hepatitis B, and hepatitis C.¹ The triple burden of syphilis, hepatitis B, and hepatitis C are public health crises due to clinical complications that arise when these infections are untreated.¹,² Peri-mining communities frequently face significant challenges in accessing healthcare services, including STI testing, treatment, and preventative interventions.¹,³
METHODS:
The study surveyed 1634 adults aged 18 years and older living in communities surrounding platinum mines in the North West Province. Participants completed structured interviews and provided blood specimens for laboratory testing. Participants were tested for HIV (enzyme immunoassay with viral load for positive results), syphilis (RPR/TPHA algorithm), hepatitis B (HBsAg), and hepatitis C (antibody/antigen testing). Prevalence estimates by age group and sex were calculated using appropriate survey weights, with all findings reported with 95% confidence intervals.
RESULTS:
Multi-pathogen surveillance revealed distinct epidemiological patterns. HIV prevalence was 23.8% (95% CI: 20.2–27.9), exceeding national averages.⁴ Syphilis prevalence reached 2.3% (95% CI: 1.3–3.9), with peak burden among those aged 31–40 years (4.1%; 95% CI: 1.5–10.7), women (3.0%; 95% CI: 1.4–6.5), and individuals in relationships (4.0%; 95% CI: 1.1–13.2). HBV affected 0.8% of participants (n=13), while HCV prevalence was 0.2% (n=5). The STI age distribution differed from HIV: syphilis peaked in younger adults (31–40 years) compared to a peak in older groups (51–59 years, 38.5%). Educational disparities persisted across pathogens, with those having primary education or less showing elevated syphilis (3.0%) and HIV (32.7%) prevalence.²
CONCLUSIONS:
These findings strongly support one-stop testing services covering HIV and STIs, with immediate treatment for treatable infections.⁵ Different age groups face different risks requiring tailored interventions. Integrated sexual health services with strengthened syphilis control efforts, especially among people already living with HIV, are necessary to reduce the compounding effects of co-infection.⁵
| eISSN: | 2654-1459 |
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