The impact of out-migrants and out-migration on the HIV/AIDS epidemic: a case study from south-west India-猫眼课题宝

DOI：

10.1097/01.aids.0000343774.59776.95

发表时间：

2008-12-01

期刊：

AIDS

影响因子：

3.8

通讯作者：

中科院分区：

医学2区

文献类型：

作者：

Deering, Kathleen N.;Vickerman, Peter;Boily, Marie-Claude

目标：季节性移徙可能是印度艾滋病毒流行的一个重要驱动因素;然而，移徙者性行为数据有限。本研究评估了移民在多大程度上可以解释印度卡纳塔克邦Bagalkot地区艾滋病毒流行率的异质性，研究了与移民相关的重要艾滋病毒传播风险因素及其对预防的影响。设计：我们使用数学模型来探讨不同季节性移民模式对艾滋病毒流行率的潜在影响。建立了异性性传播HIV感染的确定性房室数学模型。六个移民方案进行了探讨，这取决于人口迁移（男性/客户只/女性性工作者; FSW），以及当地人口确定的需求，而商业性migrants ware.Results：移民的影响变化很大，在六个移民方案。移民不太可能解释艾滋病毒流行率的异质性，除非所有男性中有一小部分人移民，而且当地的FSW推动了对商业性服务的需求。即使在移徙目的地存在非常高风险的移徙者性行为，也将干预目标定为30%-100%。从2004年至2015年，当地核心群体的艾滋病毒/艾滋病感染率最多可预防12%-40%的新感染（87%的避孕套有效）。有针对性的移民在当地和目的地可能有高达1.6倍的影响，针对移民只在其destination.Conclusions：结果表明，核心组的干预措施，因为当地引进的困难，达到移民人口仍然是有益的。了解当地性网络在移徙期间如何变化，对于了解移徙对艾滋病毒传播的影响和设计艾滋病毒预防干预措施至关重要。(C)2008年威科健康|利平科特威廉姆斯&威尔金斯

Objective: Seasonal migration may be an important driver of the HIV epidemic in India; however, migrant sexual behaviour data are limited. This study assessed the extent to which migration could explain heterogeneity in HIV prevalence in Bagalkot district, in Karnataka state, India, examining important migration-related risk factors for HIV transmission and implications for prevention.Design: We used mathematical modelling to explore the potential impact of different seasonal migration patterns on HIV prevalence.Methods: A deterministic compartmental mathematical model of heterosexually transmitted HIV infection was developed. Six migration scenarios were explored, depending on which population migrated (men/clients only/female sex workers; FSW), and which local population determined the demand for commercial sex while migrants were away.Results: The impact of migration varied substantially across the six migration scenarios. Migration was unlikely to explain heterogeneity in HIV prevalence unless a fraction of all men migrated and local FSW drove the demand for commercial sex. Even with very high-risk migrant sexual behaviour in the migration destination, targeting interventions at 30%-100%. of local core groups could prevent a maximum of 12%-40% of new infections (87% effective condoms), from 2004-2015. Targeting migrants locally and at their destination Could have up to 1.6-times the impact of targeting migrants only at their destination.Conclusions: Results suggest that core group interventions introduced locally because of the difficulty of reaching migrant populations could still be beneficial. Understanding how local sexual networks change during migration is crucial for understanding the impact of migration on HIV transmission, and for designing HIV preventive interventions. (C) 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

The impact of out-migrants and out-migration on the HIV/AIDS epidemic: a case study from south-west India

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