Short-Term Mobility and the Risk of HIV Infection among Married Couples in the Fishing Communities along Lake Victoria, Kenya

Abstract

ObjectiveMobility has long been associated with high HIV prevalence. We sought to assess sex differences in the relationship between mobility and risk for HIV infection among married couples in the fishing communities.MethodsWe conducted 1090 gender-matched interviews and rapid HIV testing with 545 couples proportionally representing all the different sizes of the fish-landing beaches in Kisumu County. We contacted a random sample of fishermen as our index participants and asked them to enrol in the study together with their spouses. The consenting couples were separated into different private rooms for concurrent interviews and thereafter reunited for couple rapid HIV counselling and testing. In addition to socio-economic and behavioural data, we collected information on overnight travels and divided couples in 4 groups as follows both partners not mobile, both partners mobile, only woman mobile, and only man mobile. Other than descriptive statistics, we used X2 and U tests to compare groups of variables and multivariate logistic regression to measure association between mobility and HIV infection.ResultsWe found significant differences in the number of trips women travelled in the preceding month (mean 4.6, SD 7.1) compared to men (mean 3.3, SD 4.9; p<0.01) and when the women did travel, they were more likely to spend more days away from home than their male partners (mean 5.2 [SD 7.2] versus 3.4 SD 5.6; p = 0.01). With an HIV prevalence of 22.7% in women compared to 20.9% among men, mobile women who had non-mobile spouses had 2.1 times the likelihood of HIV infection compared to individuals in couples where both partners were non-mobile.ConclusionThe mobility of fishermen’s spouses is associated with HIV infection that is not evident among fishermen themselves. Therefore, interventions in this community could be a combination of sex-specific programming that targets women and combined programming for couples.

Mobility among youth in Rakai, Uganda: Trends, characteristics, and associations with behavioural risk factors for HIV

“…These patterns delineate mobile youth in Rakai as a group at especially high risk of HIV. Previous research has demonstrated elevated HIV risk and risk behaviours among mobile populations, though largely among adults (Anglewicz, 2012; Bärnighausen et al, 2007; Brockerhoff & Biddlecom, 1999; Goldenberg et al, 2012; Kwena, Camlin, Shisanya, Mwanzo, & Bukusi, 2013; Tiruneh, Wasie, & Gonzalez, 2015; Zuma et al, 2003). Female migrants have been described as a particularly vulnerable group (Brockerhoff & Biddlecom, 1999; Camlin et al, 2014; Temin et al, 2013).…”

Brief Report

“…Studies in Kenya, Tanzania, Burkina Faso, Zimbabwe, South Africa and Cameroon have shown an association between increased mobility and increased levels of sexual behavior [1-3], increased risk of HIV infection [4, 5], or both [6-10]. These studies indicate population mobility may have a significant effect on HIV transmission in these countries.…”

Willingness to participate in HIV vaccine efficacy trials among high risk men and women from fishing communities along Lake Victoria in Uganda

“…In Uganda, over 2.5 million people are engaged in fishing as a means of gainful employment for unskilled workers such as fishermen, fish processors, traders and barmaids who often travel away from home for long periods, moving between temporary fishing camps [11]. This mobility has been linked to high risk sexual behaviour and bridges sexual networks into the general population [7]. Mobility could also pose a challenge to successful retention of individuals from fishing communities and it is not known if fishing communities can make a commitment to participate in trials.…”