Gendered dimensions of population mobility associated with HIV across three epidemics in rural Eastern Africa

被引：38

作者：

Camlin, Carol S. ^{[1
,4
]}

Akullian, Adam ^{[2
,3
]}

Neilands, Torsten B. ^{[4
]}

Getahun, Monica ^{[1
]}

Bershteyn, Anna ^{[2
,3
]}

Ssali, Sarah ^{[5
]}

Geng, Elvin ^{[7
]}

Gandhi, Monica ^{[7
]}

Cohen, Craig R. ^{[1
]}

Maeri, Irene ^{[8
]}

Eyul, Patrick ^{[6
]}

Petersen, Maya L. ^{[9
,10
]}

Havlir, Diane, V ^{[7
]}

Kamya, Moses R. ^{[5
]}

Bukusi, Elizabeth A. ^{[8
]}

Charlebois, Edwin D. ^{[4
]}

机构：

[1] Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, Oakland, CA 94612 USA

[2] Inst Dis Modeling, 3150 139th Ave SE, Bellevue, WA 98005 USA

[3] Univ Washington, Dept Global Hlth, Seattle, WA 98195 USA

[4] Univ Calif San Francisco, Dept Med, Div Prevent Sci, 550 16th St 3rd Floor,UCSF Mail Code 0886, San Francisco, CA 94158 USA

[5] Makerere Univ, Coll Hlth Sci, Sch Med, Upper Mulago Hill Rd,New Mulago Hosp Complex, Kampala, Uganda

[6] IDRC, Plot 2C Nakasero Hill Rd,POB 7475, Kampala, Uganda

[7] Univ Calif San Francisco, Dept Med, Div HIV Infect Dis & Global Med, 1001 Potrero Ave, San Francisco, CA 94110 USA

[8] Kenya Govt Med Res Ctr, Ctr Microbiol Res, Box 19464, Nairobi 00202, Kenya

[9] Univ Calif Berkeley, 101 Haviland Hall,Suite 102, Berkeley, CA 94720 USA

[10] Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA

来源：

HEALTH & PLACE | 2019年 / 57卷

关键词：

HIV; Mobility; Migration; Gender; Kenya; Uganda; Population-based; HUMAN-IMMUNODEFICIENCY-VIRUS; TRUCK DRIVERS; ANTIRETROVIRAL THERAPY; FEMALE MIGRANTS; MIGRATION; RISK; PATTERNS; CARE; PREVALENCE; INFECTION;

D O I：

10.1016/j.healthplace.2019.05.002

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Mobility in sub-Saharan Africa links geographically-separate HIV epidemics, intensifies transmission by enabling higher-risk sexual behavior, and disrupts care. This population-based observational cohort study measured complex dimensions of mobility in rural Uganda and Kenya. Survey data were collected every 6 months beginning in 2016 from a random sample of 2308 adults in 12 communities across three regions, stratified by intervention arm, baseline residential stability and HIV status. Analyses were survey-weighted and stratified by sex, region, and HIV status. In this study, there were large differences in the forms and magnitude of mobility across regions, between men and women, and by HIV status. We found that adult migration varied widely by region, higher proportions of men than women migrated within the past one and five years, and men predominated across all but the most localized scales of migration: a higher proportion of women than men migrated within county of origin. Labor-related mobility was more common among men than women, while women were more likely to travel for non-labor reasons. Labor-related mobility was associated with HIV positive status for both men and women, adjusting for age and region, but the association was especially pronounced in women. The forms, drivers, and correlates of mobility in eastern Africa are complex and highly gendered. An in-depth understanding of mobility may help improve implementation and address gaps in the HIV prevention and care continua.

引用

页码：339 / 351

页数：13

共 41 条

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