Migration and HIV infection in Malawi.
Migration and HIV infection in Malawi.
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DOI：
10.1097/qad.0000000000001150
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发表时间：
2016-08-24
期刊：
影响因子：
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通讯作者：
Kohler HP
中科院分区：
文献类型：
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作者：
Anglewicz P;VanLandingham M;Manda-Taylor L;Kohler HP
通过检查移民和艾滋病毒感染之间的时间顺序来评估搬迁会加剧艾滋病毒感染的假设，并调查不同移民目的地和长期居住地之间艾滋病毒感染的差异。我们采用了四波纵向数据（2004 年至 2010 年），这些数据来自马拉维农村地区的一项基于家庭的研究以及对移民的后续研究（2013 年），涉及 4,265 名男性和女性。利用这些数据，我们在移民前检查艾滋病毒状况。移民按目的地（农村、城镇、城市）和持续时间（回国、永久）分类；所有这些都与长期居住在农村的个人（“非移民”）进行比较。 HIV 阳性个体的迁移几率明显高于 HIV 阴性个体（OR 2.75；95% CI 1.89–4.01）。 HIV阳性显着增加了受访者成为城乡流动人口（RRR 6.28；95% CI 1.77–22.26）、农村流动人口（RRR 3.62；95% CI 1.24–10.54）和农村流动人口（RRR 4.09；95% CI 1.68–9.97）而非非流动人口的相对风险。 HIV 呈阳性会显着增加受访者搬迁并返回原籍村庄（RRR 2.58；95% CI 1.82–3.66）以及成为永久移民（RRR 3.21；95% CI 1.77–5.82）而不是不移民的相对风险。艾滋病毒呈阳性状态对流动性产生深远影响：艾滋病毒感染会导致我们研究中发现的各种形式的迁移显着提高流动性。这些发现强调，移徙不仅仅是艾滋病毒感染的一个独立风险因素：移徙者中艾滋病毒感染率较高的部分原因是选择了艾滋病毒阳性者进行移徙。
To evaluate the assumption that moving heightens HIV infection by examining the time-order between migration and HIV infection, and investigate differences in HIV infection by migration destination and permanence. We employ four waves of longitudinal data (2004–2010) for 4,265 men and women from a household-based study in rural Malawi, and a follow-up of migrants (2013). Using these data, we examine HIV status prior to migration. Migrants are disaggregated by destination (rural, town, urban), and duration (return, permanent); all compared to individuals who consistently resided in the rural origin (“non-migrants”). HIV positive individuals have significantly greater odds of migration than those who are HIV negative (OR 2.75; 95% CI 1.89–4.01). Being HIV positive significantly increases the relative risk that respondent will be a rural-urban migrant (RRR 6.28; 95% CI 1.77–22.26), rural-town migrant (RRR 3.62; 95% CI 1.24–10.54), and a rural-rural migrant (RRR 4.09; 95% CI 1.68–9.97), instead of a non-migrant. Being HIV positive significantly increases the relative risk that a respondent will move and return to the village of origin (RRR 2.58; 95% CI 1.82–3.66), and become a permanent migrant (RRR 3.21; 95% CI 1.77–5.82) instead of not migrating. HIV-positive status has a profound impact on mobility: HIV infection leads to significantly higher mobility through all forms of migration captured in our study. These findings emphasize that migration is more than just an independent risk factor for HIV infection: greater prevalence of HIV among migrants is partly due to selection of HIV positive individuals into migration.