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

ABSTRACT:

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?=?107.1?km, interquartile range 18.9-387.5). The two migration indices were highly predictive of hazard of HIV acquisition (P?ConclusionThis 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.

SUBMITTER: Dobra A 

PROVIDER: S-EPMC5131684 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature