Mobility and HIV in Tanzanian couples: both mobile persons and their partners show increased risk

Abstract

More sexual risk behavior and an increased risk of HIV infection were seen not only in mobile persons, but also in partners staying behind. Interventions aiming at reducing risk behavior due to mobility should therefore include partners staying behind.

Reduction of Health-Related Risks Among Female Commercial Sex Workers: Learning From Their Life and Working Experiences

“…We recommend that approaches dealing with the health of commercial sex workers should be expanded to include protection of their human rights, access to health care without discrimination and attention to psychosocial health issues, such as addiction and violence, because they have specific needs as sex workers in addition to general reproductive and sexual health needs (Chacham et al, 2007). The social impact of limited resources and adverse social conditions (Kishamawe et al, 2005;Dworkin and Ehrhardt, 2007), especially among commercial sex workers in Maputo, Mozambique, should be addressed to allow them to achieve a stable healthy life. We believe the results regarding the skills of commercial sex workers will be useful to develop strategies and methods of health education to improve the condition of health and promote healthy living in this population living under fragile conditions.…”

Exploring the relationship between population mobility and HIV risk: Evidence from Tanzania

“…The ward includes an urban centre situated around the main road, a peri-urban area surrounding the urban centre, with the remainder of the ward classified as rural (Boerma, Urassa, Senkoro, Klokke, & Ngweshemi, 1999), and is increasingly under the sphere of influence of Mwanza city. The study site was chosen as it was the site of two previous statistical studies on mobility and HIV (Kishamawe et al, 2006;Vissers et al, 2008) that came to different conclusions (Deane et., al 2010), and also reported high levels of mobility, with 60% of men and 43% of women classified as mobile in the study by Kishamawe et al (2006). Sexual behaviours reported in these studies suggested that approximately 30% of the male population had a casual partner, and that around 45% of men had two or more sex partners (Kishamawe et al 2006).…”

“…The study site was chosen as it was the site of two previous statistical studies on mobility and HIV (Kishamawe et al, 2006;Vissers et al, 2008) that came to different conclusions (Deane et., al 2010), and also reported high levels of mobility, with 60% of men and 43% of women classified as mobile in the study by Kishamawe et al (2006). Sexual behaviours reported in these studies suggested that approximately 30% of the male population had a casual partner, and that around 45% of men had two or more sex partners (Kishamawe et al 2006). Vissers et al (2008) report that in their sample, 67.8% of coresidents and 86.6% of couples living apart had unprotected sex at their last extramarital sex act.…”

“…Although it remains unclear to what extent the lessons from these case studies can be extrapolated across all mobile populations, they are, with some exceptions (Thomas, Haour-Knipe, & Aggleton, 2010) generally accepted. Beyond these well-known case studies, further investigation of the relationship between migration/mobility and HIV risk tests for statistically significant differences in HIV prevalence or sexual risk behaviours (or both) between 'non-mobile' and 'mobile' groups (Coffee et al, 2005;Khan et al, 2008;Kishamawe et al, 2006;Lagarde et al, 2003;Lydie et al, 2004;Mmbaga et al, 2008;Vissers et al, 2008). However, evidence from these studies is inconclusive, inconsistent, and in some cases contradictory, with no universal correlation between mobility and HIV risk for men or women (Deane, Parkhurst & Johnston 2010).…”

“…Further, studies on truck drivers and mineworkers highlight that risky sexual behaviours are related to a range of factors, such as unsafe working and living conditions (Campbell, 1997;Kamwanga et al, 2006) that are not necessarily related to 'being away', challenging the standard narrative. A final concern is that statistical analyses fail to generate new policy conclusions beyond suggesting that mobile groups should be 'targeted' with standard prevention programmes such as behaviour change campaigns and STI treatment (Khan et al, 2008;Lagarde et al, 2003), or in some cases that couples should be encouraged to move together (Kishamawe et al, 2006). Therefore, whilst migration and mobility are strongly associated with the epidemic, this is a relationship that requires further unpacking.…”