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马拉维的人口迁移与艾滋病毒感染

Migration and HIV infection in Malawi.

作者信息

Anglewicz Philip, VanLandingham Mark, Manda-Taylor Lucinda, Kohler Hans-Peter

机构信息

aDepartment of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United StatesbMalawi College of Medicine, University of Malawi, Blantyre, MalawicDepartment of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, United States.

出版信息

AIDS. 2016 Aug 24;30(13):2099-105. doi: 10.1097/QAD.0000000000001150.


DOI:10.1097/QAD.0000000000001150
PMID:27163708
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4965311/
Abstract

OBJECTIVE: To evaluate the assumption that moving heightens HIV infection by examining the time-order between migration and HIV infection and investigate differences in HIV infection by migration destination and permanence. METHODS: We employ four waves of longitudinal data (2004-2010) for 4265 men and women from a household-based study in rural Malawi and a follow-up of migrants (2013). Using these data, we examine HIV status prior to migration. Migrants are disaggregated by destination (rural, town, and urban) and duration (return and permanent); all compared with individuals who consistently resided in the rural origin ('nonmigrants'). RESULTS: HIV-positive individuals have significantly greater odds of migration than those who are HIV negative [odds ratio 2.75; 95% confidence interval (CI) 1.89-4.01]. Being HIV positive significantly increases the relative risk (RR) that respondent will be a rural-urban migrant [RR ratio (RRR) 6.28; 95% CI 1.77-22.26), rural-town migrant (RRR 3.62; 95% CI 1.24-10.54), and a rural-rural migrant (RRR 4.09; 95% CI 1.68-9.97), instead of a nonmigrant. Being HIV positive significantly increases the RR that a respondent will move and return to the village of origin (RRR 2.58; 95% CI 1.82-3.66) and become a permanent migrant (RRR 3.21; 95% CI 1.77-5.82) instead of not migrating. CONCLUSION: HIV-positive status has a profound impact on mobility: HIV infection leads to significantly higher mobility through all forms of migration captured in our study. These findings emphasize that migration is more than just an independent risk factor for HIV infection: greater prevalence of HIV among migrants is partly due to selection of HIV-positive individuals into migration.

摘要

目的:通过研究迁移与艾滋病毒感染之间的时间顺序,评估迁移会增加艾滋病毒感染这一假设,并调查不同迁移目的地和迁移持续性人群中艾滋病毒感染情况的差异。 方法:我们采用了来自马拉维农村一项基于家庭的研究中4265名男性和女性的四波纵向数据(2004 - 2010年)以及对移民的随访数据(2013年)。利用这些数据,我们考察了迁移前的艾滋病毒感染状况。移民按目的地(农村、城镇和城市)和持续时间(返回和永久)进行分类;所有这些都与一直居住在农村原籍地的个体(“非移民”)进行比较。 结果:艾滋病毒呈阳性的个体迁移的几率显著高于艾滋病毒呈阴性的个体[优势比2.75;95%置信区间(CI)1.89 - 4.01]。艾滋病毒呈阳性显著增加了受访者成为农村 - 城市移民的相对风险(RR)[相对风险比(RRR)6.28;95% CI 1.77 - 22.26]、农村 - 城镇移民(RRR 3.62;95% CI 1.24 - 10.54)以及农村 - 农村移民(RRR 4.09;95% CI 1.68 - 9.97)而非非移民的可能性。艾滋病毒呈阳性显著增加了受访者迁移并返回原籍村庄(RRR 2.58;95% CI 1.82 - 3.66)以及成为永久移民(RRR 3.21;95% CI 1.77 - 5.82)而非不迁移的RR。 结论:艾滋病毒阳性状态对流动性有深远影响:在我们的研究涵盖的所有迁移形式中,艾滋病毒感染导致显著更高的流动性。这些发现强调,迁移不仅仅是艾滋病毒感染的一个独立风险因素:移民中艾滋病毒的较高流行率部分归因于艾滋病毒阳性个体被选入迁移群体。

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本文引用的文献

[1]
Cohort profile: internal migration in sub-Saharan Africa-The Migration and Health in Malawi (MHM) study.

BMJ Open. 2017-5-17

[2]
Migration, sexual behaviour, and HIV risk: a general population cohort in rural South Africa.

Lancet HIV. 2015-6

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Brief report: Mobility and circular migration in Lesotho: implications for transmission, treatment, and control of a severe HIV epidemic.

J Acquir Immune Defic Syndr. 2015-4-15

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Science. 2014-10-2

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Migration and Health in Southern Africa: 100 years and still circulating.

Health Psychol Behav Med. 2014-1-1

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Int J Epidemiol. 2015-4

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Short-term Mobility and Increased Partnership Concurrency among Men in Zimbabwe.

PLoS One. 2013-6-18

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Short-term mobility and the risk of HIV infection among married couples in the fishing communities along Lake Victoria, Kenya.

PLoS One. 2013-1-15

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PLoS One. 2012-12-17

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Migration, marital change, and HIV infection in Malawi.

Demography. 2012-2

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