International Journal of Epidemiology 2003;32:744-752
© International Epidemiological Association 2003
Special Theme: Infectious Diseases |
Mobility and the spread of human immunodeficiency virus into rural areas of West Africa
uret-Pellicer1
1 Institut National de la Santé et de la Recherche Médicale, U88-IFR69, Saint-Maurice, France.
2 Medical Research Council Laboratories, Fajara, The Gambia.
3 Institut National d’Etude Démographique, Paris, France.
4 Programme de recherche sur le SIDA de l’Institut de Recherche et Développement, Montpellier, France.
5 Laboratoire Population-Environnement-Developpment UME 151 IRD-Université de Provence, Marseille, France.
6 Laboratoire de virologie-bactériologie de l’hôpital Le Dantec, Dakar, Sénégal.
7 Comité National de Lutte contre le SIDA, Dakar, Sénégal.
8 Projecto de Saúde de Bandim, Bissan, Guinea-Bissau and Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen, Denmark.
9 Members of the MECORA group (Etude Multisite des Comportements et MST en zone Rurale d’Afrique) are listed at the end of the paper.
Emmanuel Lagarde, INSERM U88, 14 rue du Val d’Osne, Hôpital National de Saint Maurice, 94410 SAINT MAURICE, France. E-mail: emmanuel.lagarde{at}st-maurice.inserm.fr
Background In eastern and southern Africa, the human immunodeficiency virus (HIV) epidemic appeared first in urban centres and then spread to rural areas. Its overall prevalence is lower in West Africa, with the highest levels still found in cities. Rural areas are also threatened, however, because of the population’s high mobility. We conducted a study in three different communities with contrasting infection levels to understand the epidemiology of HIV infection in rural West Africa.
Method A comparative cross-sectional study using a standardized questionnaire and biological tests was conducted among samples in two rural communities of Senegal (Niakhar and Bandafassi, 866 and 952 adults, respectively) and a rural community of Guinea-Bissau (Caio, 1416 adults). We compared the distribution of population characteristics and analysed risk factors for HIV infection in Caio at the individual level.
Results The level of HIV infection was very low in Niakhar (0.3%) and Bandafassi (0.0%), but 10.5% of the adults in Caio were infected, mostly with HIV type 2 (HIV-2). Mobility was very prevalent in all sites. Short-term mobility was found to be a risk factor for HIV infection among men in Caio (adjusted odds ratio (aOR) = 2.06; 95% CI: 1.06–3.99). Women from Caio who reported casual sex in a city during the past 12 months were much more likely to be infected with HIV (aOR = 5.61 95% CI: 1.56–20.15). Short-term mobility was associated with risk behaviours at all sites.
Conclusions Mobility appears to be a key factor for HIV spread in rural areas of West Africa, because population movement enables the virus to disseminate and also because of the particularly risky behaviours of those who are mobile. More prevention efforts should be directed at migrants from rural areas who travel to cities with substantial levels of HIV infection.
Keywords Africa, HIV infection, migration, Senegal, Guinea-Bissau, prevention
Accepted 31 January 2003
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. M. Sunmola, B. O. Olley, and G. E. Oso Predictors of condom use among sexually active persons involved in compulsory national service in Ibadan, Nigeria Health Educ. Res., August 1, 2007; 22(4): 459 - 472. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M Sunmola, D. Adebayo, M. Olapegba, and A. Alarape The experience of condom use and other sexual risk practices among male brewery employees who recently migrated in Nigeria Health Education Journal, September 1, 2006; 65(3): 288 - 301. [Abstract] [PDF]
|
|
|
|
 |
|
 T Hesketh, L Li, X Ye, H Wang, M Jiang, and A Tomkins HIV and syphilis in migrant workers in eastern China Sex. Transm. Inf., February 1, 2006; 82(1): 11 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. S Brachman Infectious diseases--past, present, and future Int. J. Epidemiol., October 1, 2003; 32(5): 684 - 686. [Full Text] [PDF]
|
|
|
|
|
|
R. G White Commentary: What can we make of an association between human immunodeficiency virus prevalence and population mobility? Int. J. Epidemiol., October 1, 2003; 32(5): 753 - 754. [Full Text] [PDF]
|
|