Self-medication practices and medicine supply channels among individuals working in gold mining in French Guiana (2022–2025)

In French Guiana, people working on illegal gold mining sites live in remote areas with limited access to healthcare. This study aimed to estimate the prevalence of self-medication among artisanal and small-scale gold mining (ASGM) workers, and to describe associated factors, the medicines used, and their supply channels. We analysed two cross-sectional surveys conducted within the Curema project, Orpal_3 (2022) and Orpal_4 (2024–2025), at ten cross-border sites along the Maroni and Oyapock rivers. Adults who had worked on an illegal gold mining site in the previous seven days were recruited through chance encounters and snowball sampling, and interviewed face-to-face using the same self-medication question. Self-medication was defined as reporting at least one medicine bought without a prescription at the most recent purchase (no fixed recall period). Medicines were classified by ATC code, route of administration, regulatory status in France and Brazil, and supply channel (formal/informal; Orpal_4 only). Prevalence was compared using the chi-square test, and associated factors were explored using univariate logistic regression. Overall, 1,019 participants were included. Self-medication prevalence was 71.1% [95% CI: 67.1–74.8] in 2022 and 66.9% [95% CI: 62.5–71.0] in 2024–2025 ( p = 0.149). No factor was consistently associated with self-medication across both surveys. Analgesics (paracetamol: 13.0% vs. 24.8%), anti-inflammatory drugs (diclofenac: 7.9% vs. 4.8%), and antibiotics predominated. Antibiotics decreased from 39.4% to 8.4% of self-medicating participants. In Orpal_4, the main indications were headache (23.0%), musculoskeletal pain (17.5%), and fever (14.2%), and medicines were obtained from pharmacies in Brazil, Suriname, or French Guiana (66.3%) or through informal channels (33.8%). Participants reported using medicines withdrawn from the French market for safety reasons, as well as injectable medicines (9.2% vs. 5.1%) and treatments requiring medical supervision. Self-medication was widespread among gold miners in French Guiana, including use of medicines withdrawn from the French market. Informally sourced and injectable medicines may expose users to risks such as substandard products, adverse effects, treatment failure and injection-related infections. Although antibiotic self-medication decreased, continued monitoring is warranted given the potential risk of antimicrobial resistance. Further research should assess whether self-medication reflects barriers to healthcare access, to inform context-adapted risk-reduction strategies.