Geographic mobility and potential bridging for sexually transmitted infections in Agbogbloshie, Ghana

Abstract

Short-term mobility can significantly influence the spread of infectious disease. In order for mobile individuals to geographically spread sexually transmitted infections (STIs), individuals must engage in sexual acts with different partners in two places within a short time. In this study, we considered the potential of mobile individuals as bridge populations - individuals who link otherwise disconnected sexual networks and contributed to ongoing STI transmission. Using monthly retrospective panel data, we examined associations between short-term mobility and sexual partner concurrency in Agbogbloshie, Ghana. We also examined bridging by the location of sex acts and the location of sexual partners in concurrent triads, and whether mobile individuals from our sample were more likely to be members of geographic bridging triads. Although reported rates of sexual partnership concurrency were much higher for men compared to women, mobility was only associated with increased concurrency for women. Additionally, this association held for middle-distance mobility and short-duration trips for women. Taking into account the location of sex acts and the location of sexual partners, about 22% of men (21.7% and 22.4% for mobile and non-mobile men, respectively) and only 3% of women (1.4% and 3.3% for mobile and non-mobile women, respectively) were potential bridges for STIs over the last year. Our results highlight the gendered nature of mobility and sexual risk behavior, reflecting the normative social context that encourages women to conceal certain types of sexual behavior.

Keywords: Circular migration; HIV; Partner concurrency; STI; Sexual network.

Fig. 1

Event history calendar scheme. Partial responses from a hypothetical individual depict an individual with mobility episodes and a concurrent partnership.

Fig. 2

Map of short-term mobility destination per person-month of MHG survey respondents, by gender.

Fig. 3

The proportion of individuals who had any ongoing partnership, had a concurrent partnership, a geographical or a linked geographically bridging concurrent partnership in the last year, by mobility and gender. Notes: These figures represent individuals and their cumulative behavior over the course of one year. Each subsequent category is a subset of the previous category. Any ongoing partnership represent an individual that had a sexually active partnership at any time in the last year. Concurrent partnership represents whether the individual had an overlapping partnership at any point in the last year. Geographic bridging triad are individuals in a concurrent triad and either had sexual intercourse outside of Agbogbloshie or had a sexual partner who lived outside of Agbogbloshie at any point in the last year. Linked geographic bridging triad are individuals in a geographic bridging triad who also had sexual intercourse within Agbogbloshie or had a sexual partner who lived inside Agbogbloshie.