Space-time migration patterns and risk of HIV acquisition in rural South Africa

Dobra, A., Bärnighausen, T., Vandormael, A. and Tanser, F. (2017) Space-time migration patterns and risk of HIV acquisition in rural South Africa. AIDS, 31 (1). pp. 137-145. ISSN 0269-9370

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Objective: To quantify the space-time dimensions of human mobility in relationship to
the risk of HIV acquisition.
Methods: We used data from the population cohort located in a high HIV prevalence,
rural population in KwaZulu-Natal, South Africa (2000–2014). We geolocated
8006 migration events (representing 1 028 782 km traveled) for 17 743 individuals
(15 years of age) who were HIV negative at baseline and followed up these
individuals for HIV acquisition (70 395 person-years). Based on the complete geolocated residential history of every individual in this cohort, we constructed two detailed
time-varying migration indices. We then used interval-censored Cox proportional
hazards models to quantify the relationship between the migration indices and the risk
of HIV acquisition.
Results: In total, 17.4% of participants migrated at least once outside the rural study
community during the period of observation (median migration distance ¼ 107.1 km,
interquartile range 18.9–387.5). The two migration indices were highly predictive of
hazard of HIV acquisition (P < 0.01) in both men and women. Holding other factors
equal, the risk of acquiring HIV infection increased by 50% for migration distances of
40 km (men) and 109 km (women). HIV acquisition risk also increased by 50% when
participants spent 44% (men) and 90% (women) of their respective time outside the
rural study community.
Conclusion: This in-depth analysis of a population cohort in a rural sub-Saharan
African population has revealed a clear nonlinear relationship between distance
migrated and HIV acquisition. Our findings show that even relatively short-distance
migration events confer substantial additional risk of acquisition

Additional Information:cited By 32
ID Code:37481
Deposited On:07 Oct 2019 14:11

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