Mobility and the spread of human immunodeficiency virus into rural areas of West Africa

Lagarde, Emmanuel; M, Schim van der Loeff; Enel, Catherine; Holmgren, Birgitta; Dray‐Spira, Rosemary; Pison, Gilles; Jp, Piau; Mboup, Souleymane; Ndoye, Ibra; Cœuret-Pellicer, Mireille; Whittle, Hilton; Aaby, Péter

doi:10.1093/ije/dyg111

Cited by 124 publications

(97 citation statements)

References 18 publications

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“…The model overestimated the HIV-2 prevalence in older individuals in 1990 which could be due to an overestimation of sexual risk behaviour in these age groups relative to younger age groups, or because the two samples in 1990 and 1997 were drawn from slightly different populations. The latter possibility is compatible with the large age-specific changes in HIV-2 prevalence in women between 1990 and 1997 and the known high mobility of the people living in the area [37].…”

Section: Sensitivity Analysissupporting

confidence: 56%

Behaviour change and competitive exclusion can explain the diverging HIV-1 and HIV-2 prevalence trends in Guinea–Bissau

et al. 2007

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SUMMARYThe aim of this study was to determine whether a temporary rise in sexual risk behaviour during war in Guinea–Bissau could explain the observed trends in HIV-1 and HIV-2 prevalence, and to explore the possible contribution of competitive elimination of HIV-2 by HIV-1. A simulation model of the heterosexual transmission of sexually transmitted infections was parameterized using demographic, behavioural and epidemiological data from rural Guinea–Bissau, and fitted to the observed HIV-1 and HIV-2 trends with and without a historic rise in risk behaviour. The observed trends could only be simulated by assuming a temporary rise in risk behaviour. Around 30% of the projected decline in HIV-2 prevalence from a peak of 8·7% to 4·3% in 2010 was due to competitive elimination by HIV-1. Importantly for public health, HIV-1 prevalence was predicted to continue increasing and to become the dominant HIV type by 2010. Data collection is required to validate this prediction.

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Section: Sensitivity Analysissupporting

confidence: 56%

Behaviour change and competitive exclusion can explain the diverging HIV-1 and HIV-2 prevalence trends in Guinea–Bissau

et al. 2007

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“…[42][43][44][45] Migration and mobility are associated with family separation, disintegration of social networks, sudden changes in the cultural environment, homelessness, poverty, social isolation, and a greater sense of anonymity, which may enable riskier behaviors. [46][47][48][49][50] In one study, social pressures, including legal problems, entering drug treatment, and the desire to conduct illegal activities, were primary reasons for travel. 51 Mobile IDUs may lack established social networks for obtaining drugs, leading them to inject in unsafe settings.…”

mentioning

confidence: 99%

Individual, Social, and Environmental Influences Associated With HIV Infection Among Injection Drug Users in Tijuana, Mexico

Strathdee

Lozada²,

Pollini

et al. 2008

JAIDS Journal of Acquired Immune Deficiency Syndromes

144

179

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Objective-We examined correlates of HIV infection among injection drug users (IDUs) in Tijuana, Mexico, a city bordering the United States, which is situated on major migration and drug trafficking routes.Methods-IDUs aged ≥18 years were recruited using respondent-driven sampling. Participants underwent antibody testing for HIV and syphilis and structured interviews. Weighted logistic regression identified correlates of HIV infection.Results-Of 1056 IDUs, the median age was 37 years, 86% were male, and 76% were migrants. HIV prevalence was higher in female participants than in male participants (8% vs. 3%; P = 0.01). Most IDUs testing HIV-positive were previously unaware of their serostatus (93%). IDUs reported injecting with a median of 2 people in the prior 6 months and had been arrested for having injection stigmata (ie, "track-marks") a median of 3 times. Factors independently associated with HIV infection were being female, syphilis titers consistent with active infection, larger numbers of recent injection partners, living in Tijuana for a shorter duration, and being arrested for having track-marks.Conclusions-Individual, social, and environmental factors were independently associated with HIV infection among IDUs in Tijuana. These findings suggest the need to intervene not solely on individual risk behaviors but on social processes that drive these behaviors, including problematic policing practices. Policing practices may have a significant impact on IDUs' ability to adhere to safe injection practices, thereby influencing their risk of acquiring HIV. Qualitative evidence shows that local policing practices influence how, where, and under what circumstances IDUs obtain and use injection equipment. 28,[30][31][32][33][34] Disruptions to IDUs' risk reduction practices and engagement in HIV risk behavior have been linked to high-visibility policing and fear of arrest or detainment, 30 which exacerbates withdrawal symptoms. Quantitative studies report that aggressive policing practices are associated with higher levels of needle sharing [35][36][37][38] and lower utilization of syringe exchange programs (SEPs). 39,40 In an ecologic study of the macrolegal environment in 89 metropolitan areas in the United States, Friedman and colleagues 41 showed that higher levels of legal repressiveness were positively associated with HIV prevalence among IDUs. Studies are lacking to determine how such effects interplay alongside individual and social network factors. KeywordsMobility is emerging as an important risk factor in the transmission dynamics of communicable diseases, including HIV. [42][43][44][45] Migration and mobility are associated with family separation, disintegration of social networks, sudden changes in the cultural environment, homelessness, poverty, social isolation, and a greater sense of anonymity, which may enable riskier behaviors. [46][47][48][49][50] In one study, social pressures, including legal problems, entering drug treatment, and the It is legal to purchase or carry syringes without ...

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“…The results underline the importance of developing culturally appropriate HIV policies and interventions for migrants (Poudel et al, 2004;Agha & Nchima, 2004;Cheng, 2000;Lagarde et al, 2003;Nyanzi et al, 2003) that incorporate local understandings of knowledge about HIV (Abril, 2002). For example, the issues that polygynously married men have in problematising polygyny alongside an understanding that an increased number of partners increases overall risk of infection.…”

Section: Discussionmentioning

confidence: 94%

“…Substantial rural-urban migration occurs throughout sub-Saharan Africa, where over half of the population will live in urban areas by 2025 (Zulu et al, 2004). Migration has been identified as an independent individual risk factor for the acquisition of HIV in a wide range of settings Brockerhoff and Biddlecom, 1999;Hope, 2000;Lagarde, Pison & Enel, 1996;Lagarde, Schim van der Loeff, Enel, Holmgren, Dray-Spira, & Pison et al, 2003;Lurie, Williams, Zuma, Mkaya-Mwamburi, Garnett & Sturm et al, 2003a, b;MacDonald, 1996;McCoy, Weatherby & Yu, 1999;Nunn, Wagner, Kamali, Kengeya-Kayondo & Mulder, 1995;Pison, Guenno, Lagarde, Enel & Seck, 1993;Simonet, 2004;Soskolne & Shtarkshall, 2002;Zuma, Gouws, Williams & Lurie 2003) and circular migration impacts on the propagation of HIV between communities (Coffee, Garnett & Lurie, 2000).…”

Section: Introductionmentioning

confidence: 99%

Local understandings of, and responses to, HIV: Rural–urban migrants in Tanzania

Coast

2006

Social Science & Medicine

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Migration is an important process of change for rural populations in developing countries. Migration is a primary cause of behaviour change -by their very act of migrating, migrants are different from those who do not migrate. The focus of the current study is male rural-urban migration in Tanzania and its interaction with sexual behaviour.The analysis presents results from a comparison with individual-level analyses of two populations, one (composed of recent rural-urban migrants) in an urban area and one in a rural area. Detailed migration histories (n=96 rural-urban migrants) and in-depth interviews (n=96 rural-urban migrants, n=51 rural residents) form the basis of the study. Three key research questions are addressed: How does the sexual behaviour of migrants differ from that of rural residents? How do HIV knowledge levels vary between rural-urban migrants and rural residents? What factors are associated with either intentions of behaviour change or reported behaviour? The results are counter-intuitive: rural-urban migrants -both married and unmarried -are not having sex in town. Despite limited understanding of the nature of HIV, the migrant population studied here regulates its behaviour in a way that reflects local understandings of the disease. This finding it important, not least because it challenges the view that HIV in sub-Saharan Africa is largely transmitted to rural areas by return migrants. Maasai rural-urban migrants in Tanzania -both married and unmarried -are not having sex in town. The policy and service provision implications of the results are explored.Abstract word count: 241

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Mobility and the spread of human immunodeficiency virus into rural areas of West Africa

Cited by 124 publications

References 18 publications

Behaviour change and competitive exclusion can explain the diverging HIV-1 and HIV-2 prevalence trends in Guinea–Bissau

Behaviour change and competitive exclusion can explain the diverging HIV-1 and HIV-2 prevalence trends in Guinea–Bissau

Individual, Social, and Environmental Influences Associated With HIV Infection Among Injection Drug Users in Tijuana, Mexico

Local understandings of, and responses to, HIV: Rural–urban migrants in Tanzania

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