The University of Southampton
University of Southampton Institutional Repository

Migration, sexual behaviour, and HIV risk: a general population cohort in rural South Africa

Migration, sexual behaviour, and HIV risk: a general population cohort in rural South Africa
Migration, sexual behaviour, and HIV risk: a general population cohort in rural South Africa
Background

Increased sexual risk behaviour and HIV prevalence have been reported in migrants compared with non-migrants in sub-Saharan Africa. We investigated the association of residential and migration patterns with sexual HIV risk behaviours and HIV prevalence in an open, general population cohort in rural KwaZulu-Natal, South Africa.

Methods

In a mainly rural demographic surveillance area in northern KwaZulu-Natal, South Africa, we collected longitudinal demographic, migration, sexual behaviour, and HIV status data through household surveillance twice per year and individual surveillance once per year. All resident household members and a sample of non-resident household members (stratified by sex and migration patterns) were eligible for participation. Participants reported sexual risk behaviours, including data for multiple, concurrent, and casual sexual partners and condom use, and gave a dried blood spot sample via fingerprick for HIV testing. We investigated population-level differences in sexual HIV risk behaviours and HIV prevalence with respect to migration indicators using logistic regression models.

Findings

Between Jan 1, 2005, and Dec 31, 2011, the total eligible population at each surveillance round ranged between 21?129 and 22?726 women (aged 17–49 years) and between 20?399 and 22?100 men (aged 17–54 years). The number of eligible residents in any round ranged from 24?395 to 26?664 and the number of eligible non-residents ranged from 17?002 to 18?891 between rounds. The stratified sample of non-residents included between 2350 and 3366 individuals each year. Sexual risk behaviours were significantly more common in non-residents than in residents for both men and women. Estimated differences in sexual risk behaviours, but not HIV prevalence, varied between the migration indicators: recent migration, mobility, and migration type. HIV prevalence was significantly increased in current residents with a recent history of migration compared with other residents in the study area in men (adjusted odds ratio 1·19, 95% CI 1·07–1·33) and in women (1·18, 1·10–1·26).

Interpretation

Local information about migrants and highly mobile individuals could help to target intervention strategies that are based on the identification of transmission hotspots.

Funding

Wellcome Trust.
2352-3018
e252-e259
McGrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Eaton, Jeffrey W.
38f42083-2bd0-48d3-a34f-efe05b4c53eb
Newell, Marie-Louise
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
McGrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Eaton, Jeffrey W.
38f42083-2bd0-48d3-a34f-efe05b4c53eb
Newell, Marie-Louise
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993

McGrath, Nuala, Eaton, Jeffrey W., Newell, Marie-Louise and Hosegood, Victoria (2015) Migration, sexual behaviour, and HIV risk: a general population cohort in rural South Africa. Lancet HIV, 2 (6), e252-e259. (doi:10.1016/S2352-3018(15)00045-4).

Record type: Article

Abstract

Background

Increased sexual risk behaviour and HIV prevalence have been reported in migrants compared with non-migrants in sub-Saharan Africa. We investigated the association of residential and migration patterns with sexual HIV risk behaviours and HIV prevalence in an open, general population cohort in rural KwaZulu-Natal, South Africa.

Methods

In a mainly rural demographic surveillance area in northern KwaZulu-Natal, South Africa, we collected longitudinal demographic, migration, sexual behaviour, and HIV status data through household surveillance twice per year and individual surveillance once per year. All resident household members and a sample of non-resident household members (stratified by sex and migration patterns) were eligible for participation. Participants reported sexual risk behaviours, including data for multiple, concurrent, and casual sexual partners and condom use, and gave a dried blood spot sample via fingerprick for HIV testing. We investigated population-level differences in sexual HIV risk behaviours and HIV prevalence with respect to migration indicators using logistic regression models.

Findings

Between Jan 1, 2005, and Dec 31, 2011, the total eligible population at each surveillance round ranged between 21?129 and 22?726 women (aged 17–49 years) and between 20?399 and 22?100 men (aged 17–54 years). The number of eligible residents in any round ranged from 24?395 to 26?664 and the number of eligible non-residents ranged from 17?002 to 18?891 between rounds. The stratified sample of non-residents included between 2350 and 3366 individuals each year. Sexual risk behaviours were significantly more common in non-residents than in residents for both men and women. Estimated differences in sexual risk behaviours, but not HIV prevalence, varied between the migration indicators: recent migration, mobility, and migration type. HIV prevalence was significantly increased in current residents with a recent history of migration compared with other residents in the study area in men (adjusted odds ratio 1·19, 95% CI 1·07–1·33) and in women (1·18, 1·10–1·26).

Interpretation

Local information about migrants and highly mobile individuals could help to target intervention strategies that are based on the identification of transmission hotspots.

Funding

Wellcome Trust.

Text
PIIS2352-3018(15)00045-4.pdf - Version of Record
Available under License Creative Commons Attribution.
Download (99kB)

More information

Accepted/In Press date: 12 March 2015
e-pub ahead of print date: 16 April 2015
Published date: June 2015
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 375953
URI: http://eprints.soton.ac.uk/id/eprint/375953
ISSN: 2352-3018
PURE UUID: c1cd0a44-0710-44fe-bbe4-6a22a91b3d7b
ORCID for Nuala McGrath: ORCID iD orcid.org/0000-0002-1039-0159
ORCID for Marie-Louise Newell: ORCID iD orcid.org/0000-0002-1074-7699
ORCID for Victoria Hosegood: ORCID iD orcid.org/0000-0002-2244-2518

Catalogue record

Date deposited: 21 Apr 2015 09:56
Last modified: 15 Mar 2024 03:47

Export record

Altmetrics

Contributors

Author: Nuala McGrath ORCID iD
Author: Jeffrey W. Eaton

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×