Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 2;31(1):137-145.
doi: 10.1097/QAD.0000000000001292.

Space-time migration patterns and risk of HIV acquisition in rural South Africa

Adrian Dobra  1 , Till Bärnighausen, Alain Vandormael, Frank Tanser
Affiliations

Space-time migration patterns and risk of HIV acquisition in rural South Africa

Adrian Dobra et al. AIDS. .

Abstract

Objective: To quantify the space-time dimensions of human mobility in relationship to the risk of HIV acquisition.

Methods: We used data from the population cohort located in a high HIV prevalence, rural population in KwaZulu-Natal, South Africa (2000-2014). We geolocated 8006 migration events (representing 1 028 782 km traveled) for 17 743 individuals (≥15 years of age) who were HIV negative at baseline and followed up these individuals for HIV acquisition (70 395 person-years). Based on the complete geolocated residential history of every individual in this cohort, we constructed two detailed time-varying migration indices. We then used interval-censored Cox proportional hazards models to quantify the relationship between the migration indices and the risk of HIV acquisition.

Results: In total, 17.4% of participants migrated at least once outside the rural study community during the period of observation (median migration distance = 107.1 km, interquartile range 18.9-387.5). The two migration indices were highly predictive of hazard of HIV acquisition (P < 0.01) in both men and women. Holding other factors equal, the risk of acquiring HIV infection increased by 50% for migration distances of 40 km (men) and 109 km (women). HIV acquisition risk also increased by 50% when participants spent 44% (men) and 90% (women) of their respective time outside the rural study community.

Conclusion: This in-depth analysis of a population cohort in a rural sub-Saharan African population has revealed a clear nonlinear relationship between distance migrated and HIV acquisition. Our findings show that even relatively short-distance migration events confer substantial additional risk of acquisition.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Map of the spatial distribution of the migration locations in South Africa (orange dots).
Fig. 2
Fig. 2
Relationship between the hazard of HIV acquisition and migration distance expressed in kilometers per year for men (top) and women (bottom).
Fig. 3
Fig. 3
Relationship between the hazard of HIV acquisition and time outside the rural study community expressed in years for men (top) and women (bottom).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Joint United Nations Programme on HIV/AIDS (UNAIDS). The GAP Report 2014. http://files.unaids.org/en/media/unaids/contentassets/documents/unaidspu... [Accessed 14 September 2016]; 2014.
    1. Anglewicz P. Migration, marital change, and HIV infection in Malawi. Demography 2012; 49:239–265. - PMC - PubMed
    1. Goldenberg SM, Strathdee SA, Perez-Rosales MD, Sued O. Mobility and HIV in Central America and Mexico: a critical review. J Immigr Minor Health 2012; 14:48–64. - PubMed
    1. Veary J. Learning from HIV: exploring migration and health in South Africa. Glob Public Health 2012; 7:58–70. - PubMed
    1. Weine SM, Kashuba AB. Labor migration and HIV risk: a systematic review of the literature. AIDS Behav 2012; 16:1605–1621. - PMC - PubMed

Publication types