Social sciences, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI&LSHTM), Uganda Research Unit, Entebbe, Uganda.
Department of Social and Behavioural Sciences, Rakai Health Sciences Program (RHSP), Kalisizo, Uganda.
Glob Public Health. 2023 Jan;18(1):2256819. doi: 10.1080/17441692.2023.2256819.
Fishing communities around Lake Victoria have among the highest burdens of HIV globally. Growing evidence suggests that high HIV prevalence is partially due to selective migration of people living with HIV to fishing communities. However, the reasons for this preferential migration are unclear. We recruited 60 men and women for qualitative in-depth interviews (30% living with HIV; 70% recent migrants of unknown HIV status) from seven Ugandan fishing communities. Interviews discussed mobility histories and the social context surrounding migration. Interviews were audio-recorded, transcribed, and translated. A version of the 'Push-Pull' theory of migration helped structure a conceptual thematic framework for data analysis. Unfavourable conditions related primarily to stigma, social discrimination, humiliation, rejection or HIV labelling, and violence, induced individuals to leave their home communities. Factors which eventually resulted in migration to fishing communities included anticipating less HIV-related stigma and a safe, friendly environment that accommodates all people. Access to healthy food (fish) and the perceived availability of community-based HIV care services were also attractions. We found that stigma is the major social phenomenon shaping preferential migration to fishing communities in Uganda.
维多利亚湖周围的渔业社区拥有全球最高的艾滋病毒负担。越来越多的证据表明，高艾滋病毒流行率部分是由于艾滋病毒感染者选择性迁移到渔业社区。然而，这种优先迁移的原因尚不清楚。我们从七个乌干达渔业社区招募了 60 名男性和女性进行定性深入访谈（30%的人携带艾滋病毒；70%的人是最近不明艾滋病毒状况的移民）。访谈讨论了流动历史和迁移的社会背景。访谈进行了录音、转录和翻译。一种“推拉”移民理论的版本帮助构建了数据分析的概念主题框架。与耻辱感、社会歧视、羞辱、拒绝或艾滋病毒标签以及暴力有关的不利条件促使个人离开自己的家乡社区。最终导致移民到渔业社区的因素包括预期的艾滋病毒相关耻辱感较少，以及安全、友好的环境可以容纳所有人。获得健康的食物（鱼）和社区为基础的艾滋病毒护理服务的可及性也是吸引人的因素。我们发现，耻辱感是乌干达优先向渔业社区迁移的主要社会现象。
