Gendered dimensions of population mobility associated with HIV across three epidemics in rural Eastern Africa
Gendered dimensions of population mobility associated with HIV across three epidemics in rural Eastern Africa
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DOI：
10.1016/j.healthplace.2019.05.002
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发表时间：
2019-05-01
期刊：
影响因子：
4.8
通讯作者：
Charlebois, Edwin D.
中科院分区：
文献类型：
--
作者：
Camlin, Carol S.;Akullian, Adam;Charlebois, Edwin D.
撒哈拉以南非洲的流动性将地理上不同的艾滋病毒流行病联系起来，通过促成更高风险的性行为加剧了传播，并扰乱了护理。这项基于人群的观察性队列研究测量了乌干达和肯尼亚农村地区流动性的复杂维度。从2016年开始，每6个月从三个地区12个社区的2308名成年人中随机抽样收集调查数据，按干预组，基线居住稳定性和艾滋病毒状态分层。分析是调查加权的，并按性别、地区和艾滋病毒状况分层。在这项研究中，有很大的差异，在不同地区之间，男性和女性之间的流动性和规模，并通过艾滋病毒的状态，我们发现，成年人的迁移有很大的地区差异，男性的比例高于女性在过去的一年和五年内迁移，和男性占主导地位的所有，但最本地化的规模的迁移：一个较高的比例比男性在原籍国内迁移。与工作相关的流动在男性中比女性更常见，而女性更有可能因非劳动原因而旅行。与劳动相关的流动性与男性和女性的艾滋病毒阳性状态相关，并根据年龄和地区进行调整，但这种关联在女性中尤其明显。东非人口流动的形式、驱动因素和相关因素十分复杂，而且性别差异很大。对流动性的深入了解可能有助于改进执行工作，并解决艾滋病毒预防和护理连续性方面的差距。
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.