OBJECTIVES: Migration is associated with HIV infection, but the relationship has been mostly assessed in cross-sectional studies. In a prospective study, we investigated whether out-migrants are a selection of high-risk individuals and whether rural-to-urban migration results in risky sexual behaviour for HIV incidence. METHODS: A population cohort was enrolled in a stratified household census in four different community types in Manicaland, east Zimbabwe, between July 1998 and February 2000, and followed-up after 3 years. Out-migrants to the national capital (Harare), the provincial capital (Mutare) and other study areas were followed-up. A structured questionnaire was administered and an HIV test was conducted at each interview. HIV prevalence and sexual risk behaviour at baseline, and HIV incidence and sexual behaviour during follow-up were compared for out-migrants and residents. RESULTS: At baseline, future migrants were significantly younger, better educated and more likely to be single than residents. For males, migration was highest from subsistence farming areas and roadside trading centres and lowest from estates. After adjusting for age, education, marital status and location, there were no differences in HIV prevalence and sexual risk behaviour between future migrants and residents at baseline, for either sex. No significant differences in HIV incidence or sexual behaviour during follow-up were detected between rural-to-urban out-migrants and residents. CONCLUSIONS: Out-migrants from rural Zimbabwe did not have higher levels of HIV infection or sexual risk behaviour than residents either before or after they moved. These findings may be related to the mature stage of the HIV epidemic and the social and living conditions of migrants in Zimbabwean cities. © 2006 Blackwell Publishing Ltd.

Zimbabwe migrant Sexual risk behaviour Prospective study rural-to-urban

education prospective study rural area HIV Infections Sub-Saharan Africa sexual behavior Human immunodeficiency virus infection demography poverty Population Surveillance follow up Prospective Studies human Southern Africa HIV test middle aged Agriculture rural health family size Human immunodeficiency virus Urban Health marriage living standard Humans geography Adolescent male female Africa Zimbabwe diagnostic test high risk population population research prevalence Incidence commercial phenomena Article high risk behavior epidemic Risk-Taking Diagnostic Tests, Routine major clinical study adult migration age international migration Sex Distribution Emigration and Immigration rural to urban migration future migrant out migrant Harare [Zimbabwe] structured questionnaire Manicaland roadside trading center living resource social behavior