Migration, Mobility and Sexual Risk Behavior in Mumbai, India: Mobile Men with Non-Residential Wife Show Increased Risk

Abstract

This paper examines the relationship of migration and mobility of husband and wife to sexual risk behaviors among married men living in economically marginal communities in Mumbai, India. Non-migrant men reported significantly more often than the migrant men that they had one or more sex partners other than their wives in the last year. Further, men with occupational mobility reported significantly more often than the men who were not mobile that they had one or more non-spousal sexual partners in the last 1 year. Married men living in Mumbai with wives residing in their area of origin and who reported occupational mobility had the highest sexual risk behaviors, controlling for socio-demographic characteristics and migration. Interventions aimed at prevention of HIV among men require special focus on both migrant and non-migrant men with greater occupational mobility, with particular emphasis on migrant men whose wives have remained in their pre-migration home areas.

Male Migration/Mobility and HIV Among Married Couples: Cross-Sectional Analysis of Nationally Representative Data from India

“…Male mobility was based on a single item assessing whether the male participant had stayed away from the current residence for more than one month at least once in the past 12 months; men reporting yes to this item were defined as mobile. These definitions of migrant and mobility are consistent with previous regional research on male migration and mobility within India [23,29]. Based on these created migrant and mobility variables, a final variable combining these concepts was created with the following categories: (a) non-migrant and non-mobile, (b) non-migrant but mobile, (c) migrant but not mobile, and (d) migrant and mobile.…”

“…Such findings are paralleled at national levels where, again, rates of HIV infection are particularly high in countries with higher rates of migration and employment-related mobility [16,23,26]. Within India, migration most commonly occurs among men who move from rural to urban areas primarily for work [21,23]. Subsequent to acquiring the infection away from home [21], these men periodically return to their village of origin and ''bridge'' the infection to these areas, specifically to their wives [27].…”

“…Across India, it is estimated that approximately 30 million men buy sex [9], placing these men at increased risk for HIV acquisition as well as HIV transmission to their wives and other female sex partners. Cross-nationally, research demonstrates that migrant men and mobile men (e.g., truck drivers) pose even greater risk to their wives, relative to non-migrant and non-mobile men, due to these men's multi-partner sexual networking, including involvement with female sex workers [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Within India, studies additionally document that migrant men residing away from their spouses are even more likely than migrant men generally to engage in commercial sex and become infected with HIV or other sexually transmitted infections (STIs) [22][23][24].…”

“…Strikingly, Indian states with high HIV prevalence rates (e.g., Maharashtra, Andhra Pradesh, Tamil Nadu, and Karnataka) are also characterized as having some of the greatest numbers of migrant and mobile residents in the country [24,25]. Such findings are paralleled at national levels where, again, rates of HIV infection are particularly high in countries with higher rates of migration and employment-related mobility [16,23,26]. Within India, migration most commonly occurs among men who move from rural to urban areas primarily for work [21,23].…”

Social Factors Affecting Women's Susceptibility to HIV in India

“…Previous studies of transmission of HIV in India have illustrated that mobile labor could be a contributing factor to men's sexual risk behavior (Gupta et al 2010;Saggurti et al 2008;Saggurti et al 2009). This is because they are more likely to have sexual contact with CSWs when working away from home.…”