Negotiating borders: an analysis of HIV care on the Oyapock

C harlotte Floersheim will present the results of a health anthropology study into late HIV diagnoses on the border between French Guyana and Brazil. French Guiana is a region particularly hard hit by HIV infection, and a third of HIV tests are considered to be late.

Between 2018 and 2020, a qualitative study was carried out to try and understand the factors behind this delay in accessing care, in collaboration with Oyapock Coopération Santé, a bi-national project aimed at combating HIV and improving sexual health in the cross-border region. Care centres and community initiatives were observed, and around forty interviews were conducted with people living with HIV and health professionals.

From a problematic aimed at responding to a public health issue, ethnographic research has refocused on the question of borders: those between the healthy and the pathological, those between the entrance to and exit from gold panning camps, and those that shape inequalities between the two banks of the river and beyond.

Analysis of the life courses of patients diagnosed late highlights structural, collective and individual factors that reduce access to HIV screening and healthcare in general. The Oyapock basin is first and foremost an area where people move around and live, rather than being a barrier between two states, and we will be looking at how its peripheral location enables its inhabitants to move around in certain ways. HIV care on the banks of the Oyapock is an ongoing process, exceptional in many ways. Through the actions of local players, health mediators, medical staff and people living with HIV, the aim is to see how the border, in its geographical, political and legislative dimensions, is a source of negotiation through the prism of health issues and the fight against HIV.