PLoS ONE
Volume 5, Issue 7, 2010

Gender, migration and HIV in rural Kwazulu-Natal, South Africa (Article) (Open Access)

Camlin C.S. , Hosegood V. , Newell M.-L. , Mcgrath N. , Bärnighausen T. , Snow R.C.
  • a Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
  • b Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom, Africa Centre for Health and Population Studies, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Somkhele, South Africa
  • c Africa Centre for Health and Population Studies, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Somkhele, South Africa, Centre for Paediatric Epidemiology and Biostatistics and Institute of Child Health, University College London, London, United Kingdom
  • d Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom, Africa Centre for Health and Population Studies, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Somkhele, South Africa
  • e Africa Centre for Health and Population Studies, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Somkhele, South Africa, Department of Global Health and Population, Harvard School of Public Health, Boston, MA, United States
  • f Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States

Abstract

Objectives: Research on migration and HIV has largely focused on male migration, often failing to measure HIV risks associated with migration for women. We aimed to establish whether associations between migration and HIV infection differ for women and men, and identify possible mechanisms by which women's migration contributes to their high infection risk. Design: Data on socio-demographic characteristics, patterns of migration, sexual behavior and HIV infection status were obtained for a population of 11,677 women aged 15-49 and men aged 15-54, resident members of households within a demographic surveillance area participating in HIV surveillance in 2003-04. Methods: Logistic regression was conducted to examine whether sex and migration were independently associated with HIV infection in three additive effects models, using measures of recent migration, household presence and migration frequency. Multiplicative effects models were fitted to explore whether the risk of HIV associated with migration differed for males and females. Further modeling and simulations explored whether composition or behavioral differences accounted for observed associations. Results: Relative to non-migrant males, non-migrant females had higher odds of being HIV-positive (adjusted odds ratio [aOR] = 1.72; 95% confidence interval [1.49-1.99]), but odds were higher for female migrants (aOR = 2.55 [2.07-3.13]). Female migrants also had higher odds of infection relative to female non-migrants (aOR = 1.48 [1.23-1.77]). The association between number of sexual partners over the lifetime and HIV infection was modified by both sex and migrant status: For male nonmigrants, each additional partner was associated with 3% higher odds of HIV infection (aOR = 1.03 [1.02-1.05]); for male migrants the association between number of partners and HIV infection was non-significant. Each additional partner increased odds of HIV infection by 22% for female non-migrants (aOR = 1.22 [1.12-1.32]) and 46% for female migrants (aOR = 1.46 [1.25-1.69]). Conclusions: Higher risk sexual behavior in the context of migration increased women's likelihood of HIV infection. © 2010 Camlin et al.

Author Keywords

[No Keywords available]

Index Keywords

rural area educational status household HIV Infections sexual behavior Human immunodeficiency virus infection physiology human sex difference sexuality middle aged condom rural population Human immunodeficiency virus infected patient Logistic Models groups by age South Africa marriage Young Adult sanitation Humans Adolescent male female prevalence Article employment status adult major clinical study migration infection risk Emigration and Immigration statistical model population migration water supply
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77955369000&doi=10.1371%2fjournal.pone.0011539&partnerID=40&md5=badd0fffdaf7194f60d15f61f34b2de3
DOI: 10.1371/journal.pone.0011539
ISSN: 19326203
Cited by: 64
Original Language: English