Short report: migration among persons living with HIV

Abstract

Data from the first national probability sample of persons with HIV, the HIV Cost of Services and Utilization Survey (HCSUS), are used to examine migration patterns among persons with HIV/AIDS in the USA. Persons with serious illness may choose to relocate to receive better care or support. This migration has implications for the distribution of resources. This study describes the frequency and reasons that persons with HIV move to different communities. An analytic file of 3014 respondents was obtained from the first national probability sample of persons with HIV/AIDS, the HCSUS. A migration section of the baseline questionnaire questioned respondents on their residential history. Persons were defined as movers if they moved across state lines or to a non-contiguous county after knowing they were HIV positive but before the HCSUS baseline interview. Forty percent of movers said that their HIV status was a very important factor in their decision to move. Although earlier studies of limited generalizability found movement among the HIV population from urban to rural counties, this study found only eight percent of HIV migration was from urban to rural counties, just slightly more than the migration from rural to urban counties. In addition, the vast majority of people who were moving were not moving to return home. Major factors in the decision to move included being near caregivers and being in a community with shared needs and interests. Significant numbers of persons also moved to obtain care from a physician knowledgeable in HIV treatment or to get away from discrimination. Financial assistance and the availability of Medicaid also played a prominent role in many decisions to move. Persons with HIV/AIDS are more likely to move than non-infected persons in the general population. Moreover, they are almost twice as likely to be moving out-of-state. Persons with HIV who move are similar to persons with HIV who do not move on most demographic characteristics including age, region of the country, and income.