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. 2017 Jun;94(3):350-363.
doi: 10.1007/s11524-017-0145-2.

A Novel Modeling Approach for Estimating Patterns of Migration into and out of San Francisco by HIV Status and Race among Men Who Have Sex with Men

Alison J Hughes  1 , Yea-Hung Chen  2   3 , Susan Scheer  2 , H Fisher Raymond  2   3
Affiliations

A Novel Modeling Approach for Estimating Patterns of Migration into and out of San Francisco by HIV Status and Race among Men Who Have Sex with Men

Alison J Hughes et al. J Urban Health. 2017 Jun.

Abstract

In the early 1980s, men who have sex with men (MSM) in San Francisco were one of the first populations to be affected by the human immunodeficiency virus (HIV) epidemic, and they continue to bear a heavy HIV burden. Once a rapidly fatal disease, survival with HIV improved drastically following the introduction of combination antiretroviral therapy in 1996. As a result, the ability of HIV-positive persons to move into and out of San Francisco has increased due to lengthened survival. Although there is a high level of migration among the general US population and among HIV-positive persons in San Francisco, in- and out-migration patterns of MSM in San Francisco have, to our knowledge, never been described. Understanding migration patterns by HIV serostatus is crucial in determining how migration could influence both HIV transmission dynamics and estimates of the HIV prevalence and incidence. In this article, we describe methods, results, and implications of a novel approach for indirect estimation of in- and out-migration patterns, and consequently population size, of MSM by HIV serostatus and race in San Francisco. The results suggest that the overall MSM population and all the MSM subpopulations studied decreased in size from 2006 to 2014. Further, there were differences in migration patterns by race and by HIV serostatus. The modeling methods outlined can be applied by others to determine how migration patterns contribute to HIV-positive population size and output from these models can be used in a transmission model to better understand how migration can impact HIV transmission.

Keywords: HIV/AIDS; Men who have sex with men; Migration; Population size estimation.

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Conflict of interest statement

Funding was provided by the Center for Disease Control and Prevention HIV Surveillance Cooperative Agreement (Award Number: U62PS004022-04) and National HIV Behavioral Surveillance Cooperative Agreement (Award Number: 5U1BPS003247).

Figures

Fig. 1
Fig. 1
HIV-positive and HIV-negative MSM population size, San Francisco, 2006–2014
Fig. 2
Fig. 2
HIV-positive and HIV-negative white MSM population size, San Francisco, 2006–2014
Fig. 3
Fig. 3
HIV-positive and HIV-negative black MSM population size, San Francisco, 2006–2014
See this image and copyright information in PMC

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